dual diagnosis test I

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dual diagnosis test I
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2013-06-03 20:21:29
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dual diagnosis bipolar mood disorders DSM IV Sroka
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Test one
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  1. Dual diagnosis definition:
    The coexistence of a substance-related diagnosis and another DSM diagnosis of mental disorder
  2. Axis I
    • Clinical syndromes
    • V-codes (conditions not attributable to mental disorder that are the focus of treatment) ie. parent child problems
  3. Axis II
    • Personality disorders
    • Mental retardation
  4. Axis III
    physical disorders and conditions (that are potentially relevant to the understanding or management of the case  ie. cancer
  5. Axis IV
    psychological stressors (type and severity) experienced within the past year or that pertain to the disorder ie. financial, job loss, divorce
  6. Axis V
    Global assessment of functioning in psychological, social and occupational aspects of life (0-100 GAF scale)
  7. What is the Self-medication hypothesis:
    user will begin to medicate themselves for a preexisting condition.  fuels delusion.
  8. Under Mood Disorders which are associated with Depressive Disorders?
    • Major depressive disorder
    • Dysthymia
    • Depressive Disorder NOS
  9. Under Mood Disorders which are associated with Bipolar Disorders?
    • Bipolar I Disorder
    • Bipolar II Disorder
    • Cyclothymic
    • Bipolar Disorder NOS(not otherwise specified)
  10. What is Major Depression?
    Five of the following symptoms, present during the same two week period, representing a change from previous functioning:

    • -Depressed mood (may be irritable mood in children and adolescents)
    • -Anhedonia: loss of interest or pleasure
    • -Unintentional weight or appetite loss or gain
    • -Insomnia or hypersomnia
    • -Psychomotor agitation or retardation
    • -Fatigue
    • -Feelings of worthlessness or guilt 
    • -Diminished ability to concentrate; Indecisiveness
    • -Recurrent thoughts of death
  11. What is Dysthymia?
    The essential feature is chronic disturbance in mood (depression in adults, depression or irritability in children) on most days for at least two years in adults (one in children)


    • In addition to depressed mood, at least two of the follwing symptoms are present:
    • -eating disturbance (poor appetite or overeating)
    • -sleep disturbance (insomnia or hypersomnia)
    • -fatigue or low energy 
    • -low self-esteem
    • -poor concentration or difficulty making decisions 
    • -hopelessness
  12. What is Mania
    • abnormally elated, expansive or irritable mood (persisting for at least one week), plus 3 or more of the following:
    • -grandiosity
    • -decreased need for sleep
    • -pressured speech
    • -flight of ideas
    • -distractibility
    • -increased physical activity and agitation
    • -increased involvement in pleasurable activities with high potential for painful consequences
  13. What is Bipolar I
    One or more manic episode
  14. Hypomania
    manic episodes but lasts few days and isn't as severe
  15. Bipolar II
    is major depressive disorder with hypomania
  16. To responsibly give a diagnosis:
    The person should come to physician and report that they are in distress and interferes with functioning
  17. What is a panic attack?
    intense apprehension of terror, dread and doom.
  18. What are the symptons of a panic attack?
    • -Disrupted percepted perceptal field with details exaggerated, scattered or distorted
    • -inability to follow directions
    • -loss of rational, logical thinking
    • -inability to solve problems, make decisions or carry out goal-directed actions
    • -intense physiological symptons
  19. What is a panic disorder
    recurrent unexpected panic attacks involving palpitations, tachycardia (rapid heart rate), sweating, trembling, shortness of breath, chest pain, nausea, lightheadedness, difficulty swallowing, derealization/depersonalization, fear of losing control, "Going crazy," or dying
  20. What is agoraphobia
    • -Anxiety about being in places from which escape might be difficult or embarrassing or in which help may be unavailable in the even of a panic attack.
    • -Agoraphobic fears usually cause individuals to confine themselves to home.
    • -Can't escape/fear of open spaces/public
  21. Specific types of phobia
    • -Animal
    • -Natural environment (heights, storms, full moon) typical childhood onset
    • -blood injection injury (something is going to invade my blood or body)
    • -situational (bridge, trains, flying)
    • -other (germs, thing)
  22. What is Social phobia
    Marked and persistent fear of one or more social/performance situations in which one is exposed to possible scrutiny by others (what people will think)
  23. What is Obsessive-Compulsive Disorder
    The occurrence of recurrent and persistent obsessive thoughts, impulses or images that are intrsive and cause distress and repetitive compulsive behaviors
  24. Posttraumatic Stress Disorder is:
    • A syndrome that results from exposre to a severely traumatic event that involved:
    • 1)Threat of death or serious injury to self or others
    • 2)intense fear, helplessness or horror
  25. In posttraumatic stress disorder causes:
    • 1)recurrent, intrusive recollections of the event
    • 2)persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness
    • 3)persistent symptons of increased arousal

    Must be greater than one month!  (high at risk for suicide and drug addiction) 
  26. Acute stress disorder is:
    Symptoms much like PTSD and also caused by exposure to traumatic event but lasting for a minimum of two days and a max of four weeks
  27. Generalized Anxiety Disorder is:
    Excessive anxiety or worry occuring more days than not for at least six months about nmeros events or activities

    • -Restlessness, feeling on edge
    • -being easily fatigued
    • -difficulty concentrating
    • -irritability
    • -muscle tension
    • -sleep disturbance
  28. What are the types of Schizophrenia
    • Paranoid type
    • Disorganized type
    • catatonic type
    • Undifferentiated type
    • Residual type
  29. What is schizophreniform disorder
    simple schizophrenia-temporary and/or episodic
  30. Shizoaffective Disorder
    delusions or hallucinogens  shorter episodes, co-occurs with mood disorders
  31. Other psychotic Disorders are:
    • Delusional Disorder
    • Brief psychotic Disorder
    • Psychotic Disorder due to (indicate the medical condition)
    • Substance-Induced Psychotic Disorder
    • Psychotic Disorder NOS (not otherwise specified)
  32. Delusions are:
    Beliefs
  33. Hallucinogens are:
    Seeing/Hearing
  34. Negative Symptoms of Schizophrenia are:
    • affect flattening (no body language/stoic) 
    • alogia(reduction in productive thought-Cant bring thoughts to organized level)
    • avolition (goal directed behavior reduction)
    • anhedonia (lack of pleasure-inability to feel pleasure)
    • Social withdrawal
  35. Positive symptoms of Schizophrenia:
    • Delusions
    • Hallucinations
    • disorganized speech
    • catatonia
  36. How/Why did the use of psychoactive drugs begin
    • to aid in religious practices
    • --ie wine and payote
  37. Single exposure addicts:
    Are usually genetics
  38. Treatment of dual diagnosed:
    • Integrated treatment approach- Minkoff
    • therapy
    • Eclectic approach (Made up of or combining elements from a variety of sources)
  39. Most successful in treating:
    • Harness therapeutic relationship (Rapport)
    • Develop empathy (mindfulness)    -understand behavior's genesis    -metamessages    -avoid pathologizing
    • Holding environment (that person feels yo actually care about them-being present <Gestalt>)
    • Understand contertransference
    • -Honor complexity of interactions
  40. Gender Identity Disorder:
    Gender identity disorder is a conflict between a person's actual physical gender and the gender that person identifies himself or herself as. For example, a person identified as a boy may actually feel and act like a girl. The person experiences significant discomfort with the biological sex they were born.

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