Psychosocial/Psych Exam.

Psychosocial/Psych Exam.A 76 year-old depressed patient is started on an SSRI. When should another antidepressant be tried if there is no response? -answer 8-12 weeks Most learned authorities agree that if there is no response by 8-12 weeks at a maximal therapeutic dose, a different antidepressant should be tried. The 8-12 week period is the correct time frame because it will take this long to increase the dose and attempt to reach maximal dose for therapeutic response. 4-6 weeks is nearing the appropriate time frame, but this may be too short a period of time to reach and evaluate therapeutic dose. Which patient is most likely to exhibit depression related to his illness? A patient with: -answer Parkinson's disease Diseases associated with the central nervous system are associated with high rates of depression. These include stroke, Parkinson's disease, multiple sclerosis, and dementia. Other illnesses associated with high rates of depression are cancer and cardiovascular illnesses like myocardial infarction. Depression worsens the outcome of any physical illness. A patient with an eating disorder may concomitantly exhibit: -answer Anxiety disorders Affective disorders, anxiety disorders, and substance abuse issues are common in patients who have eating disorders. Obsessive-compulsive disorder is also commonly observed. Patients with eating disorders are more likely to have a first or second degree relative with an eating disorder, affective disorder, or alcohol abuse. There is no evidence that patients with eating disorders exhibit a higher incidence of sleep disorders or liver disease. Thyroid disease should always be assessed in patients with eating disorders, but this does not represent the reason for weight loss when eating disorder is present. Which criterion below is a criterion for Alzheimer's Disease? -answer Impairment of executive function The diagnostic criteria for Alzheimer's disease (AD) was established by DSM V and other organizations. The criteria are similar. Criteria include a gradual onset of cognitive decline. A rapid onset usually indicates another etiology, perhaps, delirium. Other criteria include impairment of recent memory, difficulty with language or finding words, the inability to execute skilled motor activities, disturbances of visual processing or disturbances in executive function that includes abstract reasoning and concentration. Focal neurologic signs are consistent with a vascular dementia. Radiologic evidence is not a criterion for diagnosis, though it may support the diagnosis of AD. There is no laboratory evidence of AD. An 80 year old adult has begun to use over the counter diphenhydramine to help him fall asleep. What common side effect can occur in older adults with use