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GNRS 534 Test 1

Case formulation Biopsychosocial Formulations - “a creative synthesis of a clinical case, drawing on elements from the levels of biology, psychology, and sociology and expressed chronologically.” (Ross, 2000).
4 primary tasks for the diagnostic interview: Build a therapeutic alliance * Obtain the psychiatric database Interview for diagnosis Negotiate a treatment plan with your patient. (p.2)
The 4 P’s of case formulation: Predisposing factors * Precipitating factors Perpetuating Factors Protective Factors
Serotonin (5-hydroxytryptamine or 5-HT)- serotonin regulates sleep, appetite, and libido. A dysfunction in the serotonin-circuit can result in disruptions in sleep, decrease in the ability to sleep, low sex-drive, irritability and poor impulse control.
Norepinephrine - When an individual has a deficiency of this neurotransmitter it can result in apathy, reduced responsiveness, or slowed psychomotor activity
About ___ of individuals evaluated for depression have previously undetected thyroid dysfunction 5-10%
Risk factors for depressive disorders Risk factors for depressive disorders Female gender Being unmarried Low socioeconomic class Early childhood trauma Presence of a negative life event (loss & humiliation) Family hx of depression (1st degree relatives). lives alone?
dysthymic d/o * Characterized by chronic depressive syndrome usually present for most of day, more days than not, for at least a 2-year period (APA, 2000b)
manic episode persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energylasting at least 1 week and present most of the day, nearly every day (or any duration of hospitalization is necessary).
no insight ANOSOGNOSIA
Moderate anxiety is… likely to focus exclusively on the stressful situation directly in front of you and ignore other tasks- might experience a faster heartbeat, dry mouth, sweating and stomach pain or nausea. Your speech may be rapid and high-pitched
What is the dopamine hypothesis? attributes symptoms of schizophrenia (like psychoses) to a disturbed and hyperactive dopaminergic signal transduction. The model draws evidence from the observation that a large number of antipsychotics have dopamine-receptor antagonistic effects
Schizophrenia: CHARACTERISTIC SYMPTOMS (2 or more for 1-month). Each present for a significant portion of time during a 1 month period. -Delusions -Hallucinations -Disorganized speech -Grossly disorganized or catatonic behavior -Negative symptom
Anxiety- Neurotransmitters involved in suppressing the Hypothalamus-Pituitary Axis (HPA) are SEROTONIN and GABA- for decreasing anxietyà none of the above answer
Anxiety does what? serotonin ↓ anxiety
MSE a lot of questions on this- what is the purpose of it? two purposes 1. Helps make a diagnosis 2. create a thorough picture of your patient for charting
Psychiatric interview- when to introduce HIPPA The opening Phase: Building the therapeutic alliance
Know purpose of each part of the interview A. Build therapeutic alliance B. Obtain the psychiatric data base C. Interview for diagnosis D. Negotiate a tx plan
case scenario- mass shooting PTSD
Bipolar and thyroid- what % of pts have thyroid issues ?
case scenario with heart palpitations…chest pain Panic d/o
Last part of the interview is called… Pros...The only thing I can find is Closing phase
DSM is divided into 7 chunks to help dx easier T/F F- divided- 3 Sections, using Roman numerals for Sections- also divided into: *Neurodevelopmental disorders. •Schizophrenia spectrum/psychotic d/o. •Bipolar * Depressive d/o. •Anxiety disorders. •Obsessive-compulsive •Trauma •Dissociative disorders.
2 biggest anxiety d/o- GAD and SAD
What is the purpose of the case formulation? – a. Helps us understand our patients B. Provides a foundation for treatment C.provides a written record of communication.
Question on GABA ?
Tp/TC—what is thought content include: Thought Content: SI/HI/Hallucinations, delusions, psychotic ideation (all of the above) Thought Process: Flow of thoughts- coherent vs. incoherent
TP/TC in r/t MSA ?
schizophrenia to be dx has to be present for... 6 months-- (schizophreniform is from 1 and <6 months)
MSE is done when The Body of the Interview: Interviewing for a diagnosis
Components of MSE Appearance, Behavior, Speech, Affect, Thought Process, Thought Content, Cognitive Examination
Created by: arsho453