Mental Health exam 1

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Panic disorder: BOTH:
1.) recurrent unexpected panic attacks
2.) at least ONE has been followed by 1 month or more of one (or more) of the following:
a.) persistent concern about having another
b.) worry about implications
c.) significant change in behavior related to attacks
panic attack: FOUR of more of these develop abruptly, reach peak w/i 10 mins:
-palpitations
-sweating
-trembling
-SOB
-feeling of choking
-CP
-nausea
-dizzy
-derealization
-fear of losing control/going crazy
-fear of dying
-parestesias
-chills/hot flashes
generalized anxiety disorder: -anxiety for more days than not for at least 6 MONTHS about multiple events
-difficult to control worry
-3 or more of following (only 1 in children):
restlessness, fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance
-not confined to features of Axis I
PTSD: 1. exposed to traumatic event
-witnessed event involving death or threatened death or serious injury, or physical threat to self or others
-response = fear, horror, helplessness
2.) traumatic event persistently reexperienced
3.) persistent avoidance of stimuli
4.)persistent symptoms of increased arousal
5.)duration more than ONE MONTH
6.) clinically significant distress (criteria for all of these)
OCD: -either obsessions OR compulsions
-recognizes they are unreasonable
-marked distress, are time consuming, interfere w/ life
-obsessions/compulsions not restricted to axis I if another axis I disorder present
-not due to drugs (criteria for all of these)
obsession: 1.)recurrent persistent thoughts, impulses, images,
2.)impulses not simply excessive worries
3.)person attemps to ignore them or neutralize them w/ another thought/action
4.) recognizes thoughts are product of their own mind
compulsion: 1.) repetitive behaviors or mental acts person feels driven to perform in response to obsession
2.)acts aimed at reducing stress or preventing an event
Somatization: -before 30 y/o
-4 pain symptoms
-2 GI symptoms
-1 sexual symptom
-1 pseudoneurological symptom (not limited to pain- conversion symptoms)
-cannot be fully explained by med. condition
-if there is a medical condition, complaints are in excess of what is expected
-symptoms are NOT intentionally produced or feigned
hypochondriasis: -preocupation w/ fears of having or the idea that one has a serious disease
-persists despite reassurance
-belief is not of delusional intensity
-at least 6 MONTHS
-presents w/ fear and concern rather than dramatic symptoms
-most have comorbid disorders
major depressive episode: 5 or more (w/ one being depressed mood of loss of interest)during the same 2 week period:
-depressed mood
-loss of interest(anhedonia)
-weight loss/gain, appetite change
-insomnia/hypersomnia
-psychomotor agitation/retardation
-fatigue
-feelings of worthlessness
-diminished ability to think/concentrate
-suicidal thoughts
major depressive disorder: 2 or more major depressive episodes
Dysthymic disorder: -depressed mood for most of the day for more days than not for the past 2 years
-never w/o symptoms for more than 2 mo. at a time
2 OR MORE OF:
-poor appetite/overeating
-insomnia/hypersomnia
-fatigue, low NRG
-low self-esteem
-poor concentration/indecisive
-feeling hopeless
double depression: someone w/ dysthymic disorder who has a major depressive episode w/i the 2 year period
manic episode: 3 OR MORE:
-gradiosity
-need less sleep
-more talkative/pressured speech
-racing thoughts
-distractibility
-inc. goal-directed activity
-excessive involvement in pleasurable activities
5 Axes: I. Major mental illness
II. Personality disorder, development/intellectual disorders
III. Medical problems
IV. Stressors
VI. GAF- number b/t 0-100
ADHD: -6 or more symptoms of inattention for at least 6 months -OR-
-6 or more symptoms of hyperactivity/impulsivity for at least 6 months
-some symptoms present B4 the age of 7
-symptoms present in 2 or more settings
autism: 6 TOTAL
-at least 2 social interaction
-at least 1 communication
-at least 1 repetitive behavior
-delays in at least ONE of the following areas prior to age 3--> language, social interaction, symbolic/imaginative play
social interaction: -nonverbal behavior impairment
-no peer relationships
-lack of seeking to share enjoyment ("show and tell")
-lack of reciprocity
communication: -delayed or no spoken language
-won't sustain convo
-repetitive use of language
-lack of make-believe play
diff b/t asperger's and autism: Asp is later onset (5-6 yrs), motor impairment, NO delays in language
Asperger's: -at least 2 social interaction impairment
-at least 1 restricted pattern
-NO delay in language
-No delay in cognitive development, age-approp self help skills (except social interaction), curiosity abt environment
-can look like schizo but that presents at 18-25 not early childhood
PDD's: -autism
-rett's disorder
-childhood disintegrative disorder
-asperger's
-PDD NOS
conduct disorder: 3 or more w/i the past 12 months and at least ONE w/i the past 6 months:
-destruction of property
-deceitfulness, theft
-serious violation of rules
-aggression to people/animals** (not in ODD)
ODD: at least FOUR of the following lasting at least 6 months:
-loses temper* (don't see in conduct disorder)
-argues w/ adults
-defies/refuses to comply
-deliberately annoys people
-blames others for probs
-easily annoyed "touchy"
-angry/resentful
-spiteful/vindictive
separation anxiety: 3 or more for at least 4 weeks/ B4 age 18:
-distress when sep anticipated
-worry about losing/harm
-worry that bad event will lead to sep
-won't go to school
-reluctance to be alone
-reluc/refuse to go to sleep w/o person being there
-repeated nightmare a/b sep
-complaints of physical symp when sep occurs or is anticipated
looseness of assoc: jump w/ no connection b/t subjects
flight of ideation: jump w/ a little connection b/t 2 subjects
depressive disorders due to: serotonin and NE
-dysfunc in prefrontal cortex, limbic system, hypothalamus, brain stem
HPA overactive in which 2 conditions: anxiety and depression- elevated cortisol levels

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