CMN 552 Exam 1 Questions And Answers
Verified 100% Correct
What are some common sleep disturbances experienced by patients
with MDD? - ANSWER -Insomnia, hypersomnia.
What psychomotor changes would the clinician see when
interviewing a patient with MDD? - 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? - 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? - ANSWER -About
10 to 15 percent of all depressed patients commit suicide, and about
two-thirds have suicidal ideation.
,18. What are the difficulties in recognizing depression in the elderly
population? - ANSWER -Elderly people often have various co-
morbid medical disorders that may have similar symptoms to
depression.
19. What are some common Differential diagnosis when considering
MDD? - ANSWER -Table 8.8-1
20. How does the clinician differentiate MDD from Bipolar Disorder? -
ANSWER -Episodes of mania-like symptoms, indicating bipolar I
disorder (complete manic and depressive syndromes), bipolar II
disorder (recurrent major depressive episodes with hypomania),
21. What are some psychosocial therapies for the treatment of MDD? -
ANSWER -cognitive therapy, interpersonal therapy, and behavior
therapy
22. How does transcranial magnetic stimulation work? - ANSWER
Short pulses of magnetic energy stimulate nerve cells in the brain.
Used in adult patients who have failed to achieve satisfactory
improvement from antidepressants.
Produces focal secondary electrical stimulation of targeted cortical
regions.
It is nonconvulsive, requires no anesthesia, has a safe side effect
profile, and is not associated with cognitive side effects.
40-minute outpatient procedure that is prescribed by a psychiatrist
and performed in a psychiatrist office. The treatment is typically
administered daily for 4 to 6 weeks. The most common adverse event
related to treatment was scalp pain or discomfort. TMS therapy is
,contraindicated in patients with implanted metallic devices or
nonremovable metallic objects in or around the head.
23. What are the indications for Phototherapy? - ANSWER -Seasonal
disorders, sleep disorders.
24. What are the pharmacotherapeutic options in treating MDD? How
long should pharmacotherapy last? How does the clinician select
the best medication for treating MDD? What are the reasons some
patients experience treatment failure? - ANSWER -SSRIs, SNRIs,
MAOIs, Tricyclics, atypical antidepressants.
Should last at least six months, or the duration of the depressed
episode.
Selection of the initial treatment depends on the chronicity of the
condition, course of illness (a recurrent or chronic course is
associated with increased likelihood of subsequent depressive
symptoms without treatment), family history of illness and treatment
response, symptom severity, concurrent general medical or other
psychiatric conditions, prior treatment responses to other acute
phase treatments, potential drug-drug interactions, and patient
preference.
(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. - ANSWER -see text
, 26. What is SIGECAPS? Why is this mnemonic helpful to the
clinician? - 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... -
ANSWER -see text
What are the diagnostic criteria and clinical features for dysthymia? -
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.
Verified 100% Correct
What are some common sleep disturbances experienced by patients
with MDD? - ANSWER -Insomnia, hypersomnia.
What psychomotor changes would the clinician see when
interviewing a patient with MDD? - 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? - 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? - ANSWER -About
10 to 15 percent of all depressed patients commit suicide, and about
two-thirds have suicidal ideation.
,18. What are the difficulties in recognizing depression in the elderly
population? - ANSWER -Elderly people often have various co-
morbid medical disorders that may have similar symptoms to
depression.
19. What are some common Differential diagnosis when considering
MDD? - ANSWER -Table 8.8-1
20. How does the clinician differentiate MDD from Bipolar Disorder? -
ANSWER -Episodes of mania-like symptoms, indicating bipolar I
disorder (complete manic and depressive syndromes), bipolar II
disorder (recurrent major depressive episodes with hypomania),
21. What are some psychosocial therapies for the treatment of MDD? -
ANSWER -cognitive therapy, interpersonal therapy, and behavior
therapy
22. How does transcranial magnetic stimulation work? - ANSWER
Short pulses of magnetic energy stimulate nerve cells in the brain.
Used in adult patients who have failed to achieve satisfactory
improvement from antidepressants.
Produces focal secondary electrical stimulation of targeted cortical
regions.
It is nonconvulsive, requires no anesthesia, has a safe side effect
profile, and is not associated with cognitive side effects.
40-minute outpatient procedure that is prescribed by a psychiatrist
and performed in a psychiatrist office. The treatment is typically
administered daily for 4 to 6 weeks. The most common adverse event
related to treatment was scalp pain or discomfort. TMS therapy is
,contraindicated in patients with implanted metallic devices or
nonremovable metallic objects in or around the head.
23. What are the indications for Phototherapy? - ANSWER -Seasonal
disorders, sleep disorders.
24. What are the pharmacotherapeutic options in treating MDD? How
long should pharmacotherapy last? How does the clinician select
the best medication for treating MDD? What are the reasons some
patients experience treatment failure? - ANSWER -SSRIs, SNRIs,
MAOIs, Tricyclics, atypical antidepressants.
Should last at least six months, or the duration of the depressed
episode.
Selection of the initial treatment depends on the chronicity of the
condition, course of illness (a recurrent or chronic course is
associated with increased likelihood of subsequent depressive
symptoms without treatment), family history of illness and treatment
response, symptom severity, concurrent general medical or other
psychiatric conditions, prior treatment responses to other acute
phase treatments, potential drug-drug interactions, and patient
preference.
(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. - ANSWER -see text
, 26. What is SIGECAPS? Why is this mnemonic helpful to the
clinician? - 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... -
ANSWER -see text
What are the diagnostic criteria and clinical features for dysthymia? -
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.
