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CMN 552 FINAL EXAM 2| LATEST
UPDATED 100 QUESTIONS AND
ANSWERS VERIFIED 100%
CORRECT RATED A+
"What is endogenous depression? - CORRECT ANSWER=> depression with no apparent cause" "What characteristics would the clinician see if a patient presented with atypical features in a depressed patient? - CORRECT ANSWER=> Catatonic features Postpartum onset Rapid cycling Seasonal features Significant weight gain Hypersomnia Leaden paralysis" "What diagnostic criteria are required for a patient to receive a diagnosis of Major Depressive Disorder? - CORRECT ANSWER=> *Five (or more) of the following symptoms have been present during the same 2- week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Depressed most of the day, nearly every day as indicated by subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful) Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by subjective account or observation) Significant weight loss when not dieting or weight gain (e.g., change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day Insomnia or hypersomnia nearly every day Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
Fatigue or loss of energy nearly every day Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick). Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The episode is not attributable to the physiological effects of a substance or to another medical condition. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorde" "What are some common sleep disturbances experienced by patients with MDD? - CORRECT ANSWER=> Insomnia, hypersomnia." "What psychomotor changes would the clinician see when interviewing a patient with MDD? - CORRECT ANSWER=> Psychomotor retardation is the most common. Psychomotor agitation is also seen, especially in older patients. Agitation: Hair pulling, hand-wringing. Stooped posture; no spontaneous movements; and a downcast, averted gaze. Symptoms of psychomotor retardation may appear identical to patients with catatonic schizophrenia." "What is the prevalence of MDD? How do sex and age of the patient impact these rates? - CORRECT ANSWER=> Prevalence of 5-17%. Twofold greater prevalence of major depressive disorder in women than in men. The mean age of onset for major depressive disorder is about 40 years, with 50 percent of all patients having an onset between the ages of 20 and 50 years." "What is the risk of suicide for patients with MDD? - CORRECT ANSWER=> About 10 to 15 percent of all depressed patients commit suicide, and about two-thirds have suicidal ideation."
(1) they cannot tolerate the side effects, even in the face of a good clinical response; (2) an idiosyncratic adverse event may occur; (3) the clinical response is not adequate; or (4) the wrong diagnosis has been made." "25. Review discussion and study guide for Antidepressants: MAOIs, TCAs, SSRI, SNRIs, Atypical Antipsychotics, Mirtazapine, Buproprion from CMN 548. - CORRECT ANSWER=> see text" "26. What is SIGECAPS? Why is this mnemonic helpful to the clinician? - CORRECT ANSWER=> Sleep disorder (either increased or decreased sleep)* Interest deficit (anhedonia) Guilt (worthlessness,* hopelessness,* regret) Energy deficit* Concentration deficit* Appetite disorder (either decreased or increased)* Psychomotor retardation or agitation Suicidality Patient must have FOUR of these plus depressed mood or anhedonia for at least two weeks to be diagnosed with MDD." "Review interviewing a patient to assess for mood disorders... - CORRECT ANSWER=> see text" "What are the diagnostic criteria and clinical features for dysthymia? - CORRECT ANSWER=> This disorder represents a consolidation of DSM-lV-defined chronic major depressive disorder and dysthymic disorder. A. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year. B. Presence, while depressed, of two (or more) of the following: 1. Poor appetite or overeating. 2. Insomnia or hypersomnia. 3. Low energy or fatigue. 4. Low self-esteem. 5. Poor concentration or difficulty making decisions. 6. Feelings of hopelessness. C. During the 2-year period (1 year for children or adolescents) of the disturbance, the individual has never been without the symptoms in Criteria A and B for more than 2 months at a time. D. Criteria for a major depressive disorder may be continuously present for 2 years. E. There has never been a manic episode or a hypomanie episode, and criteria have never been met for cyclothymic disorder. F. The disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
G. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g. hypothyroidism). H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning." "What is the epidemiology of dysthymia? - CORRECT ANSWER=> Biological: SLEEP STUDIES: Decreased REM latency and increased REM density are markers of depression in major depressive disorder that also occur in a significant proportion of patients with dysthymia. NEUROENDOCRINE STUDIES: Patients with dysthymia are less likely to have abnormal results on a DST than are patients with major depressive disorder. Psychosocial Factors: Psychodynamic theories about the development of dysthymia posit that the disorder results from personality and ego development and culminates in difficulty adapting to adolescence and young adulthood." "What is double depression? - CORRECT ANSWER=> An estimated 40 percent of patients with major depressive disorder also meet the criteria for dysthymia. Patients with double depression have a poorer prognosis than patients with only major depressive disorder. Treatment should be directed toward both disorders because the resolution of the symptoms of major depressive episode still leaves these patients with significant psychiatric impairment." "What are the psychosocial treatments for dysthymia? - CORRECT ANSWER=> Cognitive therapy Behavioral therapy Psychoanalytic therapy Interpersonal therapy Personal/group therapy" "Which antidepressants are used most often in the treatment of dysthymia? - CORRECT ANSWER=> SSRIs, venlafaxine and bupropion. MAOIs are effective in a subgroup of patients with the disorder, a group who may also respond to the judicious use of amphetamines." "When would a patient with dysthymia require hospitalization? - CORRECT ANSWER=> Particularly severe symptoms. Marked social or professional incapacitation. Need for extensive diagnostic procedures.
D. The disturbance does not occur exclusively during the course of a delirium. E. The disturbance causes clinically significant distress" "Diagnostic criteria for Depressive Disorder Due to another Medical Condition - CORRECT ANSWER=> A. Depression/anhedonia B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the consequence of another medical condition. C. Not better explained by another mental disorder (e.g., adjustment disorder, with depressed mood, in which the stressor is a serious medical condition). D. The disturbance does not occur exclusively during the course of a delirium. E. The disturbance causes clinically significant distress." "Diagnostic criteria for other specified depressive disorder - CORRECT ANSWER=> Depression not meeting the full criteria for any of the disorders in the depressive disorders diagnostic class. Used in situations in which the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific depressive disorder. This is done by recording "other specified depressive disorder" followed by the specific reason (e.g., "short-duration depressive episode"). Examples::
- Recurrent brief depression: Concurrent presence of depressed mood and at least four other symptoms of depression for 2-13 days at least once per month (not associated with the menstrual cycle) for at least 12 consecutive months in an individual whose presentation has never met criteria for any other depressive or bipolar disorder and does not currently meet active or residual criteria for any psychotic disorder.
- Short-duration depressive episode (4-13 days): Depressed affect and at least four of the other eight symptoms of a major depressive episode associated with clinically significant distress or impairment that persists for more than 4 days, but less than 14 days, in an individual whose presentation has never met criteria for any other depressive or bipolar disorder, does not currently meet active or residual criteria for any psychotic disorder, and does not meet criteria for recurrent brief depression.
- Depressive episode with insufficient symptoms: Depressed affect and at least one of the other eight symptoms of a major depressive episode associated with clinically significant distress or impairment that persist for at least 2 weeks in an individual whose presentation has never met criteria for any other depressive or bipolar disorder, does not currently meet active or residual criteria for any psychotic disorder, and does not meet criteria for mixed anxiety and depressi" "Diagnostic criteria for Unspecified Depressive Disorder - CORRECT ANSWER=> Depression not meeting the full criteria for any of the disorders in the depressive disorders diagnostic class. Used in situations in which the clinician chooses not to specify the reason that the criteria are not met for a specific depressive disorder, and includes presentations for which there is insufficient information to make a more specific diagnosis (e.g., in emergency room settings)."
"Disorders that bridge between schizophrenia and other psychotic disorders and depressive disorder are Bipolar related disorders. This is based on what? - CORRECT ANSWER=> symptomatology, family history, and genetics." "What diagnostic criteria is required for a patient to receive a diagnosis of Bipolar I? - CORRECT ANSWER=> One manic episode not better explained by another illness." "What features/characteristics must be present for a Manic Episode? - CORRECT ANSWER=> A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary). B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
- Inflated self-esteem or grandiosity.
- Decreased need for sleep
- More talkative than usual or pressure to keep talking. 4. Flight of ideas.
- Distractibility.
- Increase in goal-directed activity or psychomotor agitation.
- Excessive involvement in activities that have a high potential for painful consequences. C. Marked functional impairment, hospitalization, or psychosis. D. Not attributable to a substance or a medical condition. Note: A full manic episode that emerges during antidepressant treatment (e.g., medication, electroconvulsive therapy) but persists at a fully syndromal level beyond the physiological effect of that treatment is sufficient evidence for a manic episode and, therefore, a bipolar I diagnosis. Note: Criteria A-D constitute a manic episode. At least one lifetime manic episode is required for the diagnosis of bipolar I disorder." "What features/characteristrics must be present for a Hypomanic Episode? - CORRECT ANSWER=> A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day. B. Three (or more) of the following symptoms (four if the mood is only irritable) have persisted and represent a noticable change.
- Inflated self-esteem or grandiosity.
- Decreased need for sleep.
- More talkative than usual or pressure to keep talking. 4. Flight of ideas/racing thoughts.
- Distractibility
- Increase in goal-directed activity or psychomotor agitation.
- Excessive involvement in activities that have a high potential for painful consequences. C. Associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic. D. The disturbance in mood and the change in functioning are observable by others.
"What are the prevalence rates in Bipolar Disorder? How do sex and age of the patient impact these rates? - CORRECT ANSWER=> Equal prevalence among men and women. Bipolar I onset is earlier than that of major depressive disorder. As early as age 5 or 6 years) to 50 years or even older in rare cases, with a mean age of 30 years. 0-8% (E-Book page 334) *The annual incidence of bipolar illness is considered generally to be less than 1 percent, but it is difficult to estimate because milder forms of bipolar disorder are often missed" "What is the usual development and course of an individual's first manic episode? - CORRECT ANSWER=> Typically tarts with depression and is recurring. Most experience both depressive and manic episodes, but 10 to 20 percent experience only manic episodes. Manic episodes typically have a rapid onset (hours or days) but may evolve over a few weeks. Untreated episode lasts about 3 months; therefore, clinicians should not discontinue giving drugs before that time. People with 1 manic episode are 90% likely to have another. Over time, the time between episodes often decreases. After about five episodes, however, the interepisode interval often stabilizes at 6 to 9 months. Four or more episodes per year and can be classified as rapid cyclers." "What are risk factors in the development of Bipolar Disorder? - CORRECT ANSWER=> " "What are some identified gender related diagnostic issues for Bipolar Disorders? - CORRECT ANSWER=> Manic episodes are more common in men, and depressive episodes are more common in women. When manic episodes occur in women, they are more likely than men to present a mixed picture (e.g., mania and depression). Women also have a higher rate of being rapid cyclers, defined as having four or more manic episodes in a 1-year period." "What is the risk of suicide for Bipolar patients? - CORRECT ANSWER=> 25% and 60% of individuals with bipolar disorder will attempt suicide at least once in their lives and between 4% and 19% will complete suicide." "What is meant by rapid cycling? - CORRECT ANSWER=> At least 4 episodes of depression/mania in 12 months."
"How does the clinician differentiate Bipolar I from Bipolar II? - CORRECT ANSWER=> Bipolar I: Full manic episode Bipolar II: Hypomanic episode" "How does the clinician differentiate Bipolar Disorder from Anxiety Disorders? - CORRECT ANSWER=> ?" "Why are children often misdiagnosed with Bipolar Disorder? - CORRECT ANSWER=> The incidence of bipolar I disorder in children and adolescents is about 1 percent, and the onset can be as early as age 8 years. Common misdiagnoses are schizophrenia and oppositional defiant disorder" "What are some common comorbid disorders for patients with Bipolar Disorder? - CORRECT ANSWER=> alcohol abuse or dependence, panic disorder, OCD, and social anxiety disorder" "Treatment of acute mania - pharmacological management. - CORRECT ANSWER=> Lithium (Sadock p. 378; p. 983) - prototypical, onset action is slow & often supplemented early by atypical antipsychotics, mood-stabilizing anticonvulsants, or high-potency benzos; therapeutic levels 0.6-1.2 mEq/L; unpredictable efficacy, problematic side effects, frequent labs. Valproate (Sadock p. 379) - only indicated for acute mania, has prophylactic effects; typical dose 750mg- 2500mg/day, therapeutic levels 50-120 ug/mL; rapid oral loading 15-20 mg/kg; number of labs required during treatment Carbamazepine & Oxcarbazepine (Sadock p. 379) - approved in US 2004; typical doses 600-1800 mg/day; blood levels 4-12 ug/mL; oxcarbazepine similar antimanic properties but require higher doses (1500 mg oxcarbazepine = 1000 mg carbamazepine) Clonazepam and Lorazepam (Sadock p. 379)- widely used for adjunct treatment (lithium, carbamazepine, or valproate) of acute manic agitation, insomnia, aggression, dysphoria, panic; safe and benign side effects Atypical and Typical Antipsychotics (Sadock p. 379) - all atypicals demonstrated antimanic efficacy and approved by FDA for indication; atypicals have lesser liability than typicals for excitatory postsynaptic potential and TD, many do NOT increase prolactin, HIGH risk for weight gain and related metabolic issues; some pts require maintenance treatment with antipsychotic Levetiracetam (Sadock p. 940) - off label for acute mania Zonisamide (Sadock p. 940) - found useful for mania in uncontrolled studies but requires further studies Phenytoin (Sadock p. 941-942) - for acute mania (in addition to seizure control); common ADR - nystagmus, ataxia, slurred speech, decreased coordination, mental confusion, may increase serum glucose in DM; therapeutic range 10-20ug/mL" "20. What are the treatment options for the maintenance of bipolar disorder? - CORRECT ANSWER=> Lithium, carbamazepine, and valproic acid, alone or in combination. Lamotrigine has superior acute & prophylactic ANTIDEPRESSANT properties compared w/antimanic properties. Many pts on lithium develop hypothyroidism and many pts w/BP d/o have idiopathic thyroid dysfunction = thyroid supplementation."
patient hx , family hx and future course can help differentiate between Bipolar and MDD. Clinical features: Hx of at least 1 lifetime manic episode is required for dx of Bipolar 1" "What is the usual course in Bipolar I? - CORRECT ANSWER=> Starts with depressive episode. Most have both mania and depression, 10-20% only mania. mania usually has rapid onset hours to days, untreated mania lasts about 3 months. when one has a manic episode they are 90% likely to have another. time between episodes decreases as it progresses until about 5 episodes it settles to every 6-9 months. Rapid cyclers have 4 + episodes per year. Lithium still #1 treatment, but still only 50-60% will gain significant control over illness." "What is DIGFAST? How is this mnemonic useful for the clinician? - CORRECT ANSWER=> Distractability Indiscretion Grandiosity Flight of ideas Activity increase Sleep deficit Talkativeness Useful to diagnose mania" "32. Review interviewing a patient to assess for mood disorders II. - CORRECT ANSWER=> See study guide" "1. What are the diagnostic criteria for Cyclothymic Disorder? - CORRECT ANSWER=> A. Numerous periods with hypomania symptoms that do not meet criteria for a hypomania episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode for TWO YEARS (adults) or ONE YEAR (kids). B. During the above 1 or 2-year period the hypomania and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time. C. Criteria for a major depressive, manic, or hypomania episode have never been met. D. The symptoms in Criterion A are not better explained by another disorder. E. Symptoms not the effect of a drug or medical condition. F. The symptoms cause clinically significant distress or impairment." "2. What are common differential diagnoses to consider when you suspect your patient has Cyclothymia? - CORRECT ANSWER=> Medical conditions Substance abuse
Personality Disorders to include: Borderline, Anti-Social, Histrionic, and Narcissistic Attention Deficit Disorder (stimulants will exacerbate symptoms of cyclothymia)" "3. What pharmacotherapies are useful in treating Cyclothymia? - CORRECT ANSWER=> Mood stabilizers and Anti mania drugs are first line agents Lithium, Carbamazepine, Valproate" "Diagnostic criteria for Substance/Medication-Induced Bipolar and Related Disorders - CORRECT ANSWER=> A. Disturbance in mood with manic/depressed symptoms. B. Symptoms from Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication.
- The involved substance/medication is capable of producing the symptoms in Criterion A. C. Not better explained by another condition. Examples: The symptoms precede the onset of the substance/medication use; the symptoms persist for a substantial period of time (e.g., about 1 month) after the cessation of acute withdrawal or severe intoxication; or there is other evidence suggesting the existence of an independent non-substance/medication-induced bipolar and related disorder (e.g., a history of recurrent non-substance/medication-related episodes). D. The disturbance does not occur exclusively during the course of a delirium. E. The disturbance causes clinically significant distress." "What medical conditions have the potential to precipitate a manic episode? - CORRECT ANSWER=> Cushing's Disease (most common) Common-Multiple Sclerosis, Stroke and Traumatic Brain Injury (TBO) May cause bipolar manic or hypomanic condition Onset usually within first weeks or months of associated condition. Worsening or later relapse can occur and precede the onset of manic or hypomanic syndromes. ADHD most common in youth; Anxiety Endocrine, nervous, respiratory, circulatory, and gastrointestinal disease more common in patients with mental illness." "Diagnostic criteria for bipolar and related disorder due to another medical condition - CORRECT ANSWER=> A prominent and persistent mood of abnormally elevated, expansive, or irritable mood and abnormally increased activity or energy that predominates in the clinical picture. Evidence from the history, physical exam or lab findings that the disturbance is the direct pathophysiological consequence of another medical condition. Disturbance is not better explained by another medical disorder. Disturbance does not occur exclusively during the course of a delirium. Disturbance causes clinically significant distress or impairment in functioning." "Diagnostic criteria for other specified bipolar and related disorder - CORRECT ANSWER=> S/S of bipolar but do not meet the full criteria for any of the disorders
between the severe temper outbursts. This irritable or angry mood must be characteristic of the child, being present most of the day, nearly every day, or noticeable by others in the child's environment" "What are some of the functional consequences for a child/adolescent with Disruptive Mood Dysregulation Disorder? - CORRECT ANSWER=> marked disruption in a child's family and peer relationships, as well as in school performance. Because of their extremely low frustration tolerance,such children generally have difficulty succeeding in school; they are unable to participate in the activities typically enjoyed by healthy children; their family life is severely disrupted by their outbursts and irritability; and they have trouble initiating or sustaining friendships. Dangerous behavior, suicidal ideation or suicide attempts, severe aggression, and psychiatric hospitalization are common." "How does a child's developmental state affect or influence the expression of depressive symptoms? - CORRECT ANSWER=> Very young children: Sad, listless, and apathetic even though they may not be able to articulate these feelings verbally. Mood congruent auditory hallucinations are not uncommon.Headaches, stomachaches, withdrawn, sad appearance, and poor self esteem are more universal symptoms. Late adolescence with severe depression: pervasive anhedonia, severe psychomotor retardation, delusions, and sense of hopelessness. Regardless of age: suicidal ideation, depressed or irritable mood, insomnia, and diminished ability to concentrate. Young children who experience recurrent suicidal ideation are rarely able to propose /carry out a plan. Social stressors such as chronic family discord ( parental mental illness, substance abuse, poverty), abuse, neglect, and academic failure can detrimentally affect children's mood. Children who develop depressive disorders in midst of severe social stressors may have remission of depressive symptoms when the stressors diminish or a more nurturing family environment is introduced." "2. What are the epidemiological statistics for children and adolescents with depressive disorders? - CORRECT ANSWER=> Preschool-0.3% in community samples/0.9 in clinic samples. School age-2-3%. Usually higher in boys. Adolescents-4-8% with 2 to 3 times higher in girls. By age 18, the incidence is increased to 20%. Children with a first degree relative are 3xs more likely to develop MDD than their pediatric counterparts without any family history. The prevalence of persistent depressive disorders in children ranges from 0.6 to 4.6% and in adolescents increased to .6-8%. Children and adolescents with persistent depressive disorders have a higher likelihood of developing MDD at some point after 1 year of the persistent depressive disorder. The rate of developing a major depressive disorder (double depression) within a 6 month period of persistent depressive disorder is estimated to be around 9.9%. In hospitalized children and adolescents, the rates of MDD are close to 20% for children and 40% in adolescents."
"3. What are the diagnostic criteria and clinical features in children with Major Depressive Disorder? - CORRECT ANSWER=> Same as adult" "5. What is the prognosis of major depression in children and adolescents? - CORRECT ANSWER=> 90% recover from a first episode within 1-2 years. Mean length of untreated MDD =8-12 months. Recurrence rate is 20-60% within 2 years. Relapse risk is greatest within first 6 months to a year after treatment is discontinued. Relapse into adulthood is 45%, increases if child is in unstable environment. 20-40% will develop bipolar disorder. Peer relationships are difficult, academic achievement compromised, and low self-esteem. Persistent depressive disorder mean episode length is 4 years. Early onset associated with comorbid MDD 70%, Bipolar 13%, future substance abuse 15%, and high suicide risk among the 12% of adolescent mortalities." "When would a child/adolescent require hospitalization? - CORRECT ANSWER=> Suicidal" "What are the psychosocial and pharmacotherapeutic recommendations in the treatment of MDD for this population? - CORRECT ANSWER=> Mild forms of depression: psychoeducation and supportive interventions. Moderate to severe depression or recurrent episodes of major depression, with significant impairment and with active suicidal thoughts or behaviors, or psychosis: Psychopharmacological and CBT. CBT or IBT may be effective alone for moderate depression when continued for 6 months or longer. CBT- aims to challenge maladaptive beliefs and enhance problem solving abilities and social competence. 70% showed improvement after intervention. CBT sometimes coupled with relaxation techniques. IPT- focuses on ways in which depression interferes with interpersonal relationships and overcoming the challenges. Four areas are loss, interpersonal disputes, role transition, and interpersonal deficits. (Read further for PCIT-ED). Fluoxetine (Prozac) and Escitalopram (Lexapro) are approved by FDA for MDD in adolescents however, Sertraline (Zoloft) has also been used." "8. What has the FDA said about treating children and adolescents with antidepressants? - CORRECT ANSWER=> Black box warning" "9. What methods of suicide attempt are most common in children/adolescents, boys vs girls? - CORRECT ANSWER=> Most common: use of firearm, which accounts for about two thirds of all suicides in boys and almost one half of suicide in girls. Second most common method of suicide in boys, occurring in about one fourth of all cases, is hanging. In girls, about one fourth commit suicide through ingestion of toxic substances.
"What cognitive distortions are commonly seen in depressed patients? - CORRECT ANSWER=> (1) views about the self —a negative self-precept, (2) about the environment—a tendency to experience the world as hostile and demanding, and (3) about the future—the expectation of suffering and failure" "What is learned helplessness? - CORRECT ANSWER=> the hopelessness and passive resignation an animal or human learns when unable to avoid repeated aversive events" "What "specifiers" are used to describe patients with various mood disorders? - CORRECT ANSWER=> Table 8.1-7" "What factors are associated with a poor prognosis for patients with mood disorders? - CORRECT ANSWER=> MDD: The percentage of patients recovering after repeated hospitalization decreases with passing time. Generally, as a patient experiences more and more depressive episodes, the time between the episodes decreases, and the severity of each episode increases. Bipolar I: Have a poorer prognosis than do patients with major depressive disorder. About 40 to 50 percent of patients with bipolar I disorder may have a second manic episode within 2 years of the first episode. poor occupational status, alcohol dependence, psychotic features, depressive features, interepisode depressive features, and male gender were all factors that contributed a poor prognosis. Short duration of manic episodes, advanced age of onset, few suicidal thoughts, and few coexisting psychiatric or medical problems predict a better outcome. Bipolar II: The course and prognosis of bipolar II disorder indicate that the diagnosis is stable because there is a high likelihood that patients with bipolar II disorder will have the same diagnosis up to 5 years later. Bipolar II disorder is a chronic disease that warrants long-term treatment strategies."
