Psych in Primary Care

Question 1

what is the first thing to do treatment wise if a patient is having a bipolar manic episode?

Answer 1

put them on a mood stabilizer (therapy will then follow after)

Question 2

our mental state impacts __________ disorders, our physical state impacts __________ disorders

Answer 2

physical; mental

Question 3

“actual” leading causes of death (9)- according to hadley

Answer 3

tobacco, diet, alcohol, microbial agents, toxic agents, motor vehicles, firearms, sexual behaviors, illicit drug use

Question 4

The “BIG 5” causes of death

Answer 4

tobacco, diet, alcohol, exercise outlet

Question 5

what three things make up the “triangle”? how likely is a person to have one or more of these things?

Answer 5

depression, alcohol dependence/substance abuse, anxiety (social or simple phobia); 20% of people

Question 6

7 problems with treating mental health problems

Answer 6

1) . recognition
2) . treatment
3) . burden to system
4) . burden on relationships
5) . economic costs
6) . children
7) . suffering that occurs with chronic illness

Question 7

out of the 20% of people who have one or more of the triangle parts, its estimated that only ____% recognize these parts

Answer 7

10%

Question 8

what percent of people are given formal treatment out of the 10% who recognize their mental health concerns?

Answer 8

only 5% (only a few % have successful tx)

Question 9

what are the two components to burden to system?

Answer 9

disproportionate utilization of resources and stigma to care

Question 10

____% of American children and adolescents suffer from mental illness severe enough to cause some level of impairment; what fraction of these kids receive treatment?

Answer 10

10%; fewer than 1/3

Question 11

lifetime prevalence with depression? what fraction of those people are treated? ____% are treated on sub-therapeutic doses or inadequate duration of tx

Answer 11

1 in 5; 1/4 of those are treated; 40% on inaccurate dose

Question 12

what drug class is first line for OCD and panic attacks?

Answer 12

SSRIs

Question 13

what are the two most important screening questions for depression?

Answer 13

Over the past 2 weeks, have you felt down, depressed, or hopeless?”
“Over the past 2 weeks, have you felt little interest or pleasure in doing things?”

Question 14

____% of depressed patients have at least one comorbidity

Answer 14

68%

Question 15

half of those with depression have an ________ disorder as well

Answer 15

anxiety

Question 16

____% lifetime incidence for social phobia. ___% never access the medical system

Answer 16

13%; 75% (diagnosis is only made 1-2% of the time for people who do access the medical system)

Question 17

symptoms for social phobia?

Answer 17

blushing, trembling, SOB, sweating, tachycardia, abdominal distress, extensive embarrassment, maladaptive thoughts about social situations (onset at young age, less than 25)

Question 18

4 morbidities with social phobia

Answer 18

educational, occupational, relational, financial (limits which jobs a person can work in, usually settle for less paying jobs)

Question 19

lifetime incidence of panic attacks? what are some symptoms?

Answer 19

10-35%; disabling symptoms of SOB, sweating, feelings of doom, maybe hallucination

Question 20

how long can physical symptoms of a panic attack last?

Answer 20

10 minutes to a few days (3), attacks can progress to social isolation

Question 21

lifetime incidence of alcohol dependence?

Answer 21

15%

Question 22

stages of change

Answer 22

precontemplation- deny
contemplation- delay
preparation- declare
action- do
maintenance- keep doing
(can relapse after the action stage)

Question 23

what is the “pressure system” or push-me-pull-you model?

Answer 23

certain things are motivating and influence you to progress; certain things cause resistance and lead you to regress
always pressure on status quo

Question 24

___% of adults suffer from a diagnosable mental disorder each year

Answer 24

25%

Question 25

mental illness is the _________ leading cause of disability in the US for ages 15-44

Answer 25

first

Question 26

___% of primary care appointments have a mental health reason

Answer 26

20%

Question 27

what are the three components to deviance?

Answer 27

1) . cognitions- what the person is thinking
2) . behavior
3) . affect- facial expression of emotion and mood

Question 28

what is the psychodynamic model of mental health?

Answer 28

disorders in adults are viewed as a result of (unconscious) childhood trauma or anxiety

Question 29

what is the behavioral model of mental health?

Answer 29

maladaptive behaviors are learned (classical and operant conditioning)

Question 30

what is the cognitive model of mental health?

Answer 30

conscious thought mediates or modifies, an individual’s emotional state/behavior in response to a stimulus (ABC model of events, thoughts, feelings)

Question 31

what is the most accepted model of mental health?

Answer 31

biopsychosocial model

Question 32

what three conditions must every psych diagnosis meet?

Answer 32

1) . not caused by a drug
2) . not caused by a medical condition
3) . impairment in functioning