Chapter 6

Question 1

List the axes of DSM 4

Answer 1

1. Major psych illnesses
2. Personality disorders
3. General medical conditions
4. Psychosocial and environmental problems
5. GAF score

Question 2

What is range for GAF scores qnd ehat is range for near normal and for sig. diff functioning

Answer 2

Total range 1-100.
91-100 near normal.
51-60 sig diff functioning

Question 3

List the 4 mood disorders

Answer 3

1. Depression
2. Dysthymia
3. Bipolar 1 & 2
4. Cyclothymia

Question 4

Which mood disorder has the strongest genetic component

Answer 4

Bipolar

Question 5

What diseases (not psych) Are commonly seen in association with depression

Answer 5

Heart disease, cancer, central nervous system diseases, endocrine diseases and connective tissue diseases

Question 6

What is the most common mood disorder

Answer 6

Depression

Question 7

What is the median age of onset of depression

Answer 7

34

Question 8

Are males or females more affected by depression and what is the theory why

Answer 8

Two females are affected for every male and it is felt that genetic predisposition is the main cause of the increased instance and females

Question 9

Depression is characterized by what three main symptoms

Answer 9

1. Loss of energy (anergia)
2. Loss of ability to experience pleasure (anhedonia)
3. Loss of sexual desire or libido

Question 10

According to the DSM5 criteria to diagnose depression there should be five or more of the 8 symptoms during a two week period and at least once something should be depressed mood or loss of interest or pleasure. Name the 8 symptoms

Answer 10

1. Depressed mood most of the day nearly every day
2. Markedly diminished interest or pleasure in all or almost all activities most of the day nearly every day
3. Significant weight loss when not dieting or weight gain or decrease or increase an appetite nearly every day
4. Slowing down of thought or a reduction of physical movement
5. Fatigue or loss of energy nearly every day
6. Feelings of worthlessness or excessive inappropriate guilt
7. Diminished ability to think or concentrate or indecisiveness
8. Recurrent thoughts of death recurrent suicidal ideation or a suicide attempt or specific plan

Question 11

What is dysthymia

Answer 11

The presence of chronic depressive symptoms for two years that are not severe enough to be diagnosed as major depressive disorder

Question 12

How many people with depression do not receive treatment

Answer 12

70%

Question 13

What are the three types of treatment available to treat depression

Answer 13

Psychotherapy, ECT, medication

Question 14

What does the medical adverse effects that can result from ECT

Answer 14

Cardio pulmonary events, aspiration pneumonia, dental and tongue injuries, headache

Question 15

What are the possible cognitive adverse effects from ECT

Answer 15

Acute confusion, Anterograde amnesia, retrograde amnesia

Question 16

What is the mortality rate of ECT

Answer 16

2-4 deaths for 100,000 treatments

Question 17

Mortality from ECTs mostly related to what

Answer 17

Cardio pulmonary events

Question 18

Does do use of anti-depressants mean that an individual has MDD

Answer 18

No not necessarily

Question 19

For major depressive disorder how many months of medication treatment is recommended

Answer 19

At least 6 to 9 months

Question 20

Depression and all mood disorders are associated with an increased mortality risk primarily due to ________

Answer 20

Accidents, suicides, the first affects on other illnesses.
Depression has been shown to increase the mortality risk of heart disease,cancer, stroke, diabetes, and other illnesses

Question 21

What is the name of the test used to measure the severity of depression

Answer 21

The Beck Depression inventory or BDI

Question 22

What are the characteristics of mania

Answer 22

Distractability, rapid flight of ideas, excessive involvement and pleasurable activities, also economic and social judgment, impaired social function

Question 23

What does bipolar one manifest with

Answer 23

Bipolar one manifest with episodes of major depression and mania

Question 24

Does bipolar one occur more in males or females

Answer 24

Bipolar one occurs equally in males and females

Question 25

What is the mean age of onset of bipolar one

Answer 25

19

Question 26

Bipolar 2 will have at least ___ major depression episodes and _____ episodes

Answer 26

At least two major depression episodes and at least two hypomantic episodes

Question 27

Is bipolar two more common in males or females

Answer 27

Females

Question 28

How do hypomanic episodes differ in bipolar two compared to bipolar 1

Answer 28

Symptoms of hypo manic episodes are less intense in bipolar two

Question 29

What is cyclothymia characterized by

Answer 29

Fluctuating periods of depressive and hypo manic symptoms for at least two years with the symptoms not meeting the criteria for a major depressive episode or manic episode

Question 30

What is rapid cycling

Answer 30

Four or more episodes of mania per year occurring in 10 to 15% of people with bipolar disorder

Question 31

Does rapid cycling occur more in female males or males and is the prognosis better or worse

Answer 31

It occurs more often and females in carries a worse prognosis

Question 32

Suicide risk is increased during the ______ phase of bipolar and accidents and injuries are more common during the _____ phase

Answer 32

Suicide is increased during the depression face and accidents and injuries are more common during the manic phase

Question 33

What is the treatment of choice for bipolar

Answer 33

Meds With lithium being the most commonly used

Question 34

What are the two most prevalent psychiatric disorders

Answer 34

Depression and anxiety

Question 35

As an illness anxiety is associated with what five disorders

Answer 35

1. Panic disorder 2. Phobias 3. GAD 4. OCD 5. PTSD

Question 36

Anxiety disorders occur to to three times more often in which sex

Answer 36

Females

Question 37

Are anxiety disorders curable

Answer 37

No

Question 38

mood disorders and substance abuse have an increased incidence in individuals with anxiety disorders. True or false

Answer 38

True

Question 39

is panic disorder more common in males or females

Answer 39

twice as common in females

Question 40

onset of panic disorder over age ____ is unusual

Answer 40

50

Question 41

is GAD more common in women or men?

Answer 41

equal in women and men

Question 42

what is the different between obsessions and compulsions

Answer 42

obsessions are intrusive thoughts or ideas. compulsions are repetitive behaviors performed to reduce the anxiety associated with obsessive thoughts

Question 43

is OCD more common in men or women

Answer 43

more common in males and firstborn children

Question 44

what are the three types of personality disorders

Answer 44

1. odd/eccentric group - schizoid (socially indifferent), paranoid (Suspicious), schizotypal (eccentric) patterns 2. dramatic/impulsive group - anti-social (disagreeable), borderline (unstable), histrionic (attention seeking), narcissistic (Self-centered) patterns. anti-social personality disorder (Sociopathic personality), is 4 x more common in males. 3. anxious/fearful group - dependent (Submissive), avoidant (inhibited), obsessive (perfectionistic), passive-aggressive (negativistic), and depressive (pessimistic)

Question 45

what are the main underwriting concerns with personality disorders

Answer 45

impulsive behavior, suicide attempt, and especially comorbidities

Question 46

what are the comorbidities often seen with personality disorders

Answer 46

depression, alcoholism, eating disorders, panic attacks, phobias, tobacco addiction. also criminal and aggressive behaviors with the anti-social personality.

Question 47

what are somatoform disorders

Answer 47

symptoms and complaints that cannot be explained by a known medical condition medication or mood-altering substance

Question 48

what are 4 recognized type of somatoform disorders

Answer 48

1. conversion disorder (transformation of an emotion into a physical manifestation). 2. hypochondriasis (being hypochondriac) 3. body dysmorphic disorder (when individual has a distorted view of his/her physical body) 4. factitious disorder- feigning illness and assuming the role of a sick person.

Question 49

what is the key to underwriting somatoform disorders

Answer 49

look for comorbidities, especially substance abuse and depression

Question 50

what are thought disorders

Answer 50

group of psychiatric disorders characterized by delusions

Question 51

what are the 2 main types of thought disorders

Answer 51

delusional disorders and schizophrenia

Question 52

what are delusions

Answer 52

abnormal mental state of false beliefs regarding self or individuals, or objects.

Question 53

how long would delusions last in delusional disorders

Answer 53

at least one month

Question 54

what is the most common thought disorder

Answer 54

schizophrenia

Question 55

how long should symptoms be present for schizophrenia dx

Answer 55

at least 6 months

Question 56

what are classic symptoms of schizophrenia

Answer 56

disorganized behavior with delusions, hallucinations, disorganized speech or negative symptoms.

Question 57

what are unfavorable symptoms of schizophrenia

Answer 57

loss of function, pleasure, emotional expression and concentration, decreased social engagement

Question 58

what are 4 subtypes of schizophrenia

Answer 58

1. catatonic subtype 2. paranoid 3. disorganized subtype 4. residual subtype (negative symptoms without delusions, hallucinations or decreased motor activity)

Question 59

what is the treatment of choice for schizophrenia

Answer 59

anti-psychoticsl

Question 60

is schizophrenia associated with increased mortality rate

Answer 60

yes, but to 8 times normal. high risk of suicide attempt. 10% suicide rate usually in males within one year of diagnosis.

Question 61

what is the 20 year mortality rate with anorexia

Answer 61

10-20%

Question 62

what is the key to underwriting history of eating disorder

Answer 62

look for several years of stability in body weight and symptoms and to look for comorbidities especially depression, OCD and substance abuse

Question 63

about how many suicide attempts for every committed suicide

Answer 63

12

Question 64

which gender attempts suicide more

Answer 64

females attempt suicide more but males are 4 times more successful

Question 65

do suicide rates increase or decrease with age

Answer 65

increase

Question 66

``` maladaptive behavior patterns to personal and social stress are characteristic of: A. thought disorders B. personality disorders 3. anxiety disorders 4. panic disorders ```

Answer 66

personality disorders

Question 67

``` all of the following are considered mood disorders except: A. depression B. cyclothymia C. bipolar disorder D. panic disorder ```

Answer 67

panic disorder

Question 68

which of the following can be used to diagnosis psychiatric disorders: A. subjective symptoms B. brain imaging scans C. biological markers

Answer 68

A only (subjective symptoms

Question 69

which of the following are considered anxiety disorders: A. panic disorder B. OCD C. body dysmorphic disorder

Answer 69

A and B only