MH disorders

Question 1

Neurocognitive Disorders

Answer 1

Includes delirium, dementia, and amnesia etc; clinically relavent changes in thinking and memory in contrast to previous thinking and memory abilities that may affect functioning in all areas of daily functioning

Cog domains:
1. complex attention
2. executive function
3. learning memory
4. language
5. perceptual-motor
6. social cognition

Question 2

Intervention for Neurocognitive Disorders

Answer 2

1. environmental adaptation for SAFETY
2. caregiver education
3. behavioral intervention to manage fatigue and sleep-wake cycles

Question 3

Substance-Related &
Addictive Disorders

Answer 3

1. Can affect cognitive, behavioral, and physiological symptoms that lead to addiction and compulsive actions to obtain desired substances and maintain ongoing use
2. Impact in all areas of occupational functioning, routines/roles, substance abuse heavlity in daily life

Question 4

Intervention for Subtance-Related/Addictive Disorders

Answer 4

1. psychosocial therapies, including coping, stress management, and social skills training
2. cognitive-based intervention geared toward increasing client’s motivation control of life
3. OT helps identify realistic expectations and discharge plan; reasons for why using (important to address during eval.)
4. support group refferals

Question 5

Schizophrenia

A-C

Answer 5

S&S:
Criterion A
1. delusions
2. hallucinations
3. disorganized thinking (speech)
4. grossly disorganized or abnormal motor behavior (including catatonia)
5. Negative symptoms

Criterion B: disturbence in one or more areas of function such as work, interpersonal relations, or self-care

Criterion C: ongoing signs of the illness for** 6months** includung** at least 1 symptom of criterion A**

Question 6

Schizophrenia

D-F

Answer 6

Criterion D: other related disorders, inclulding schizoaffective disorder or depressive/bipolar disorder with psychotic features, have been ruled out as diagnoses

Criterion E: the disturbances is not being caused by another medical condition or substance use

Criterion F: if an already existing neurodevelopmental or childhood communication disorder is diagnosed, schizophrenia is only diagnosed if req. symptoms plus prominent delusions/hallucinations are present for at least one month without treatment

Question 7

Psychotic DIsorders

Answer 7

Criterion A: presence of 1 or more sensory behavioral, cognitive, or psychomotor symptoms, including delusions, hallucinations, disorganization of speech or behavior, and’or catatonia

Criterion B: symptoms range from one day to one month in duration, followed by complete resolution of symptoms and return to prior level of functioning

Question 8

Schizoaffective disorder

Answer 8

uninterrupted period of illness during which, at some point, there is a** major depressive, manic, or mixed episode concurrent **with positive or negative symptoms associated with schizophrenia; symptoms of bipolar and schizophrenia; mental ill ness that can affect your thoughts, mood, and behavior.

no psychosis

Question 9

Schizophreniform disorder

Answer 9

**meets criteria for schizophrenia; however, the episode lasts for more than 1 month, but less than 6 months **required for a diagnosis of schizophrenia

Question 10

Delusional disorder

Answer 10

presence of 1 or more delusions for the duration of 1 month or longer and the criteria for schizphrenia has not been met

Question 11

Bipolar I

Answer 11

1. One or more manic episodes
2. May be combined with hypomanic or major depressive episodes

CBT, interpersonal therapy, illness management

Cyclothymic- milder form of bipolar

Question 12

Bipolar II Disorder

Answer 12

1. One or more major depressive episodes
2. Must be atleast 1 hypomanic episode
3. NO history of manic episode

Question 13

Cyclothymic Disorder

Answer 13

Characterized by several periods of hypomanic and depressive symptoms, which do not meet the criteria for a manic, hypomanic, or major depressive episode, lasting for** at least 2 years**.

Question 14

Manic Episode

Answer 14

1. at least 3 symptoms must persist for the period of at least 1 week
2. mood disturbances/psychotic features (required hospitalization to prevent harm to self/others
3. Behavoirs associated: resistence to treatment (fail to recognize illness)
4. suggestive/flamboyant dress
5. gambling, promiscuity, excessive spending, or giving things away
6. irritable, assaultive, or suicidal behavior

Question 15

Manic Symptoms

Answer 15

1. irritable, consistently moody
2. inc. targeted, goal-directed behavoir or restless, purposeless behaviors (psychomotor agitation)
3. inflated self-esteem/grandiose/impulsive behaviors
4. dec. need for sleep
5. pressured or quick speech, potentially related to feelings of rushed/racing thoughts
6. increased engagement in subjectively pleasureable activities that may be high risk painful, harmful, or have adverse consequences

Question 16

Meds for Manic Episodes

Answer 16

1. antipsychotics
2. mood-stabilizers

Question 17

OT considerations for Manic Episodes

Answer 17

1. limit-setting to set and improve boundaries, reduce the individual’s fear of losing control, increase participation in the intervention process, and promote safety
2. Engagement in activity that provide structure and the opportunity for release of excess energy in a positive and therapeutic manner
3. Periods beween episodes should be used to educate the individual,, the family, and sign. other on symptom management

Question 18

Major Depressive Episode

Answer 18

1. Five or more diagnostic symptoms must be present for at least 2 weeks.
2. Fluctuations in weight/appetite changes
3. insomnia/hypersomnia
4. slowed thinking/motor speed/restlessness, purposeless movement patterns
5. Fatigue/loss of energy
6. changes in mood/self-perception
7. dec. concentration
8. Recurrent suicidal thoughts
9. Behavior: irribility, anxiety, phobias, obessive thinking; difficulty in social relationships, self-destructive, comatic complaints, increased use of medical services

causes impairment in daily functioning

dysthymic-persistent depression (milder form)

Question 19

Meds for Major depressive episodes

Answer 19

1. antidepressants
2. tricyclics
3. SNRIs
4. Atypical antidepressants
5. Monoamine oxidase inhibitors (MAOIs

Question 20

Treatment for Major Depressive Episodes

Answer 20

1. Most effective: antidepressant with psychotherapy
2. CBT for ppl who are self-aware, intact cog skills, and ability to actively particpate in the intervention process
3. Electroconvulsive therapy (ECT) for ppl unresponsive to trails on meds/other interventions (may casue memory loss/confusion for period surrounding treatment.)
4. OT: provides safe enviroment/management of behaviors that threaten safety and well-being

Must monitor closely to prevent suicide/self-destruction

Question 21

Hypomanic Episode

Answer 21

Symptoms are the same as for a manic episode; however, not severe enough **(last 4 days rather than 1 week) **to cause marked impairment in social or occupational function or to require hospitalization

Question 22

Major Depressive Disorders

Answer 22

The presence of one or more major depressive episodes.

Depressive disorders
Problem solving training and CBT,

Question 23

Persistent Depressive Disorder
(dysthymia)

Answer 23

1. Characterized by at least two years of a depressed mood, most days, with depressive symptoms
2. Criteria for a major depressive disorder may be continuously present for 2 years.

Depressive disorders

Question 24

Disruptive mood dysregulation disorder

Answer 24

Temper:
1. severe/recurrent verbal or behavioral episodes
2. Uncharacteristic for expectations consistent with developmental level
3. The outbursts are considered an overreaction (either in intensity or duration of response) based on the stimuli

Diagnosis: around 6-18 yrs based on observation from parents/teachers/peers

Depressive disorders

Question 25

Premenstrual dysphoric disorder

Answer 25

Symptoms include marked affective lability, irritability or anger, increased interpersonal conflixts, depressive symptoms, depressed mood, and/or marked anxiety ## Footnote Depressive disorders

Question 26

Anxiety

Answer 26

Associated with fear; excessive worry that interfere with daily life

Question 27

Treatment for Anxiety Disorders

Answer 27

1. Anxiolytic medication 2. anti depressants, hypnotic medications in some cases OT: 1. Skills training and CBT to reduce anxiety/avoidant behav. 2. Relaxation, stress management- breathing/meditation/visualization, and progressive muscle relaxation 3. Graded activities/exposure therapy/expressive writing

Question 28

Treatment for OCD and related disorders

Answer 28

1. Psychotherapy: to explore psychodynamic issues 2. CBT: skill development for managing symptoms 3. Meds (anxiolytic, anti depressants, anti-obsessional meds, hypnotic meds) OT: 1. Skills trianing, CB approach: reduce intrucive thoughts and complusive behaviors 2. Relaxation, stress management to dec incidence/severity of symptoms 3. provide graded activities to promote self-efficacy (inc. confidence, motivation, and participation

Question 29

Trichotiomania

Answer 29

1. complusive, irresistable desire to pull out one's hair 2. Hair-pulling often results in bald or patchy spots, potentially impacting social and occupational functioning

Question 30

Excoriation disorder

Answer 30

Repeated picking at one's own skin, resulting in skin lesion and causing signficant disruption in daily occupations

Question 31

Reactive Attachment Disorder (RAD) of Infancy or Early Childhood

Answer 31

1. social neglect or instability/inconsistency of primary caregivers, leading to insufficient or frequently changing care that alters the nature of interactions with caregivers

Question 32

RAD (inhibited type)

Answer 32

1. persistent failure to initiate or respond in a developmentally appropriate fasion to most social interactions 2. Interactions are excessively inhibited, hypervigilant, or highly ambivalent and contradictory in nature

Question 33

RAD (disinhbited type)

Answer 33

1. indiscriminate socialibilty with insability to exhibit appropriate selective attachments 2. demo by excessive familiarity with relative strangers or lack of selectivity

Question 34

Functional impact of RAD

Answer 34

1. high need to be in control 2. freq. lying 3. affectionate and overly related with strangers 4. frequent episodes of horading or gorgin on food w/o physical need 5. denial of responsibility 6. projecting blame for their actions on others

Question 35

OT considerations for RAD

Answer 35

1. close and ongoing collaboration 2. Actively involve parents or caregivers in treatment 3. Assist children to form a more secure sense of self 4. limit child's exposure to muiltiple caregivers 5**. provide high levels of structure and consistency** 6. **goals need to be specifi, realistic, and attainable**

Question 36

Other trauma/stress disorders

Answer 36

1. PTSD- symptoms lasting over 1 month 2. Acute distress disorder- symptoms do not last more than 1 month 3. Adjustment disorders- clearly identifyable stressor causes onset of emotional and/or behavioral symptoms within 3 months of experiencing the stressor (symptoms resolve and disappear within 6 months of stressor or its cn=onsequences being removed)

Question 37

Anorexia Nervosa

Answer 37

1. fears gaining weight; altered self-perception of body weight or shape depsite being at normal weight 2. self worth is tied to physical body 3. either food restrive or binge eating/purging type 4. obsessive/compulsive behavior, depression, anxiety, ridigity, perfectionism, and poor sexual adjustment

Question 38

Bulimia Nervosa

Answer 38

1. Ongoing binge eating of much larger portions than would be expected and feeling the inability to control consumption to avoid gaining weight 2. Attempts are made to avoid gaining weight through vomiting, using laxatives, fasting, and engaging in extreme amounts of exercise 3. Personal self-concept defined by body proportions/size 4. Obsession with appearance/attractiveness to others 5. individuals maintain normal weight | Higher risk of suicide ideation/attempts with adolescents than anorexia

Question 39

Binge-Eating Disorder

Answer 39

1. inability to control recurrent periods of consuming exorbitant amount food in discrete 2. Feelings of guilt/depression after; eating when not hungry; embarrassement over behavior/eats in solitary

Question 40

Oppositional defiant disorder (ODD)

Answer 40

1. Negativistic, hostile, and **defiant behaviors** that reulst in functional impairment; **vindicitive** 2. Precursor for conduct disorder if aggression is prominent

Question 41

Conduct disorder

Answer 41

1. Assaultive behavior and parental criminality correlate highly with future incarceration