Depress-y
According to the USPSTF, which patient population is recommended to be screened for depression
All adults! PHQ-2 is effective and easy to use. If either question is positive, further investigation should be done.
According to the USPSTF, which patient population is recommended to be screened for anxiety?
age<65 yo. Use either the GAD-2 or GAD-7.
Typical age of onset of Bipolar disorder
Substance causing the most common cause of preventable death in the US
tobacco
Abnormal motor function that is not explained by a medical condition or consistent with exam findings
Conversion Disorder
List at least 3 factors that increase risk for suicide
chronic suicidal ideation, major mental illness, history of prior attempts, hx of SUD, chronic pain, chronic medical condition, limited coping skills, unstable or turbulent psychosocial status, limited ability to identify reasons for living
True or false: 1 panic attack is pathognomonic for panic disorder
False. Up to 1/3 of all adults will experience a panic attack in their lifetime, but panic disorder requires >1mo of panic attacks and persistent worry about their recurrence.
Difference between type 1 and type 2 bipolar disorder
Type 1: 1+ episode of mania + episodes of MDD/hypomania
Type 2: episodes of hypomania + MDD
Two first-line medications for opioid use disorder
Methadone, buprenorphine-naloxone
Positive: delusions, hallucinations, disorganized speech
Negative: flat affect, decreased activity
3 first-line drug classes used to treat MDD
SSRIs, SNRIs, atypical antidepressants (Buproprion)
BONUS: what piece of hx is important to obtain prior to starting any of these meds?
First-line medication classes for GAD
SSRIs, SNRIs (fewer side effects than TCAs and treat comorbid psych disorders)
These classes of medications can precipitate mania
Antidepressants (SSRIs, SNRIs, atypicals)
#1 most effective treatment combination to quit smoking
Varenicline (Chantix) + nicotine replacement
Most effective treatment for binge eating disorder
CBT.
Adjunct therapies include topiramate, lisdexamfetamine, SSRIs/SNRIs
An objective way to monitor therapeutic response to antidepressant therapy once medication started
Serial PHQ9s
List at least 3 diagnoses that need to be excluded prior to diagnosis of GAD
medication effect, SUD, hyperthyroidism, symptom driven (dyspnea, arrhythmia, hypertension)
Numerous periods of hypomanic symptoms (doesn't meet hypomanic episode dx) and numerous periods of depressive symptoms (doesn't meet MDD episode dx)
Cyclothymic Disorder
An important adjunct medication for patients on combination chronic opioid and benzodiazepine therapy
Naloxone
2 labs that should be monitored in patients taking the second-generation antipsychotic olanzapine
lipid panel, A1c/BG
New adjunctive medication therapy for MDD with suicidal ideation and treatment-resistant depression
Esketamine, glutamate receptor modulator delivered via nasal inhalation
(2) first-line treatments for panic disorder and social anxiety disorder
CBT and SSRIs/SNRI
List at least 3 first-line medications for bipolar disorder
lithium, valproic acid, carbamazepine, lamotrigine
(2) first-line treatment medications for alcohol use disorder
Naltrexone, Acamprosate
Medication to use in ADHD when a patient has a history of substance use disorder
Atomoxetine OR buproprion OR TCAs