GNRS 534 Test 1
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| 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).
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| 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)
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| The 4 P’s of case formulation: | Predisposing factors
* Precipitating factors
Perpetuating Factors
Protective Factors
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| 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.
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| Norepinephrine - | When an individual has a deficiency of this neurotransmitter it can result in apathy, reduced responsiveness, or slowed psychomotor activity
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| About ___ of individuals evaluated for depression have previously undetected thyroid dysfunction | 5-10%
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| 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?
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| 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)
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| 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).
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| no insight | ANOSOGNOSIA
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| 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
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| 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
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| 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
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| Anxiety- Neurotransmitters involved in suppressing the Hypothalamus-Pituitary Axis (HPA) are | SEROTONIN and GABA- for decreasing anxietyà none of the above answer
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| Anxiety does what? | serotonin ↓ anxiety
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| 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
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| Psychiatric interview- when to introduce HIPPA | The opening Phase: Building the therapeutic alliance
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| 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
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| case scenario- mass shooting | PTSD
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| Bipolar and thyroid- what % of pts have thyroid issues | ?
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| case scenario with heart palpitations…chest pain | Panic d/o
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| Last part of the interview is called… | Pros...The only thing I can find is Closing phase
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| 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.
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| 2 biggest anxiety d/o- | GAD and SAD
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| 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.
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| Question on GABA | ?
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| 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
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| TP/TC in r/t MSA | ?
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| schizophrenia to be dx has to be present for... | 6 months-- (schizophreniform is from 1 and <6 months)
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| MSE is done when | The Body of the Interview: Interviewing for a diagnosis
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| Components of MSE | Appearance, Behavior, Speech, Affect, Thought Process,
Thought Content, Cognitive Examination
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