Flashcards in Behavioral/Psych Deck (58):
Do most teens who commit suicide have a history of depression?
What labs and tests should you do for PE if suicidal ideation/depression? (5)
- Free T4
- Urine tox screen
- pregnancy test
True or false: onset of BPD before age 10 is rare
repetitive, fast, unconscious movements or vocalizations
M:F ratio for Depression and suicide, childhood and young adult
of adolescents who use alcohol and drugs, __% meet criteria for dependence
___% of children and adolescents with depression/suicide have comorbid conditions
Is comorbidity of MDD and anxiety common in school age children?
Is weight usually in normal range for bulimia?
__% of kids with ADHD have additional psychiatric d/os
What is the purpose of using pro-kinetic medications in teens with anorexia nervosa?
prevents bloating after meals
screening tool for substance abuse?
the risk of ___ in BPD is higher than all other psychiatric disorders
1/3 of all BPD kids will attempt
management for PTSD (4 points)
- social support
- mental health provider
- possible beta blockers effective to treat somatic complaints
- SSRIs for depression/anxiety that's related
Depression and suicide affects __% of children, __% of adolescents
MDD must have which of the following:
3. decreased appetite
4. sleeping more
MDD in school age children often misdiagnosed as
most common time of onset for tic disorders is __ years
What SSRI is FDA approved in ages 12-adults?
__% of kids with ADHD have learning disabilities
Characteristic pattern for BPD
manic episodes before or after major depressive episodes
Key lab findings for bulimia (2)
- fluid and electrolyte imbalances (hypoK, hypoNA, hypoCL)
- metabolic acidosis
Common side effects of SSRIS (7)
Onset for anorexia associated with ?
management of OCD (3 points)
- defer if symptoms do not cause child harm or distress
causes of depression (5) - chemical changes in brain
- imbalances in serotonin, dopamine, and/or norepinephrine, excess cortisol
- environment (stressful situations)
- depressogenic cognition
- physical disorders
tic disorder is ___x more likely in boys than girls
cardiovascular/circulation PE findings associated with anorexia (2)
heart arrhythmia (sinus brady, dysrhythmia)
MMD DSM V criteria - must have how many?
- depressed or irritable mood
- anhedonia (inability to experience pleasure)
- weight loss/gain
- insomnia or hypersomnia
- psychomotor agitation or retardation
- fatigue or energy loss
- feelings of worthlessness
- diminished ability to thinker concentrate
- recurrent thoughts of death
- suicidal ideation
May consider treatment of pt with anorexia with ___ after weight gain
Most commonly diagnosed behavioral problem in childhood
Initial symptom of bipolar disorder is what in 20-40% of children?
Management of moderate to severe depression
CBT and meds (SSRI)
AVOID TCAs (tricyclic antidepressants)
Trial of an SSRI should be used for at least how many weeks? If no improvement consider what?
cross-taper and substitute another SSRI
Be careful of antidepressants and stimulants with BPD -why?
antidepressants alone may potentiate manic response
stimulants may worsen manic symptoms
Antidepressants should be used for how long after resolution of depression?
only 2 drugs FDA approved for MDD in kids
prozac (over age 7)
lexapro (over age 12)
why are the effects of psychotropic meds hard to quantify?
most don't have biomarkers that can be tested (only lithium)
Disturbed eating behavior without over concern for weight or image is known as
2nd leading cause of death in 10-24 year olds?
What 2 SSRIs are approved in adults
Sertraline (zoloft), Fluvoxamine (Luvox)
chronic tics, both motor and vocal, lasting more than 1 year
Bingeing-vomiting is in about ___% of bulimia cases
DSMV criteria for ADHD (4 main points)
- symptoms occur in 2 or more settings
- persisted for more than 6 months
- child must meet 6 of 9 criteria, adolescent only 5
- some symptoms must be present before age 12
What is the number one predictor or suicide?
degree of hopelessness
Medication management for BPD
lithium (mood stabilizer) alone or with an anticonvulsant (valproate)
lithium shown to prevent relapse
baseline labs before starting any psychiatric med (5)
- CBC, monospot
- Liver panel
- Kidney functions if med processed through kidneys
Is a definitive cause for BPD known?
mortality rate for anorexia
USPSTF (2016) recommends screening for major depressive disorder (MDD) in adolescents aged ____
Management of mild to moderate depression
CBT or skill building
If a patient is overeating without compensatory mechanism, consider what dx?
Management for anxiety (3 components)
- behavioral and family interventions
- therapy, CBT
- meds - SSRI
DSM V criteria for bulimia
must occur at least 1x/week for greater than or equal to 3 months
Cardinal 4 features of ADHD
Do pts with OCD derive pleasure from ritualistic behavior?
What SSRI is FDA approved for children > or = to 8 years?