The document contains 5 multiple choice questions about the pharmacological treatment of anxiety, obsessive-compulsive, and trauma-related disorders. The questions assess knowledge about the appropriate treatment of conditions like generalized anxiety disorder in older adults, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Correct answers and explanations are provided after students submit their responses.
Dr Sadgun Bhandari - A PRELIMNARY REVIEW. Dr. Sadgun Bhandari is a General Psychiatrist Consultant and an expert at the management of Serious Mental Illness especially Schizophrenia and Bipolar Affective Disorder.
Health Psychology Pharmacology - Biopsychosocial Approaches to Anxiety and De...Michael Changaris
This slide series explores pharmacotherapy for anxiety and depression in integrated health approaches to managing anxiety in primary care settings. the presentation offers an overview of common health co-morbidities and tools for treatment.
Dr Sadgun Bhandari - A PRELIMNARY REVIEW. Dr. Sadgun Bhandari is a General Psychiatrist Consultant and an expert at the management of Serious Mental Illness especially Schizophrenia and Bipolar Affective Disorder.
Health Psychology Pharmacology - Biopsychosocial Approaches to Anxiety and De...Michael Changaris
This slide series explores pharmacotherapy for anxiety and depression in integrated health approaches to managing anxiety in primary care settings. the presentation offers an overview of common health co-morbidities and tools for treatment.
Please I need a response to this case study.1 pagezero plagi.docxcherry686017
Please I need a response to this case study.
1 page
zero plagiarism
three references
The Case:
The sleepy woman with anxiety
This week’s discussion presents a case study involving a 44-year old woman with a chief complaint of anxiety beginning at age 15 years old. She has a long history of mental illness and continued therapies. The purpose of this discussion is to analyze her case history to determine medication and treatment effectiveness.
Client Questions
Question 1. Are you having feelings of harming yourself or harming someone else?
Rationale: This is a possibly uncomfortable yet important set of questions to ask each client. Primary care providers may be in a unique position to prevent suicide due to their frequent interactions with suicidal patients. Reviews suggest that among patients who committed suicide, 80 percent had contact with primary care clinicians within one year of their death, whereas only 25 to 30 percent of decedents had contact with psychiatric clinicians within the year of their death (Stene-Lars & Reneflot, 2017).
Question 2. What was happening in your life as a teenager when the anxiety started and you began to self-medicate?
Rationale: Per our report, this patient began suffering signs and symptoms of anxiety at 15-years old. Asking these types of questions we may gain insight into an underlying cause or triggering event. Anxiety disorders are the most common psychiatric disorders with onset in childhood, with prevalence estimates ranging from 10 to 30 percent. Nearly 37 percent of behaviorally inhibited preschool-age children had social anxiety disorder at age 15, compared with 15 percent of non- behaviorally inhibited children
.
Children with anxiety disorders are more likely to have persistent anxiety disorders into adulthood. (Rapee, 2014).
Question 3. What was happening in your life a year ago when these symptoms returned and became debilitating? Let’s discuss what the triggering events may have been.
Rationale: Self-discovery of triggering events may help the client to come to terms with the determinants of her anxiety and depression. Studies have shown that specific types of stressors were found to differentially predict increases in specific facets of anxiety sensitivity; health-related stressors predicted increases in disease-related concerns and fear of mental incapacitation, whereas stressors related to family discord predicted increases in fear of feeling unsteady, fear of mental incapacitation, and fear of having publicly observable symptoms of anxiety (McLaughlin & Hatzenbuehler, 2009).
Support System
The support system as reported by our client is her husband. She states he is supportive and has little to no contact with the family of origin. She has a few friends and a few outside interests. As PMHNP, discussing relationships with the client is one avenue to gain insight into anxiety patterns and coping mechanisms as seen by outside support. With the client’s permissio.
Supercharge your brain and ditch anxiety and depression for good!Patients Medical
Dr. Vivian DeNise of Patients Medical and Dr. Sandlin Lowe of The Amen Clinic New York explain the causes of anxiety and depression, the cutting-edge technology that can be used to diagnose deficiencies in the brain that cause these conditions and several non-invasive holistic medical approaches that we use to treat.
This presentation contains details about generalized anxiety disorder, its symptoms and etiology along with effective treatment measure. This is for academic purpose.
Respond to at least two of your colleagues who were assigned to a di.docxpeggyd2
Respond to at least two of your colleagues who were assigned to a different case than you. Explain how you might apply knowledge gained from your colleagues’ case studies to you own practice in clinical settings.
If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained.
If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them. Include resources to support your perspective.
Case #29 The depressed man who thought he was out of options.
The patient is a 69-year-old male with unremitting chronic depression. He has suffered from depressive episodes for 40 years and has always had a good response to treatment until 5 years ago when he relapsed on venlafaxine. Two years ago, he underwent nine treatments of ECT with partial response. He has tried every known antidepressant and augmentation available in the past few years.
The patient should be asked about recent stressful life events, consumption of illicit drugs, alcohol abuse, current medical conditions and prescribed medications (Preda, 2018). If the patient was in my office, I would also want to ask questions to gain an understanding of the severity of his depression. It is important to assess the overall severity of depression symptoms because symptom severity corelates with suicide risk (Preda, 2018). The PHQ-9 screening could be used, and this screening asks about feelings of hopelessness, loss of pleasure in doing things, and feelings of being better off dead. A focused severity assessment for hopelessness, suicidal ideation, and psychotic symptoms is recommended; these symptoms independently increase the risk for suicide (Preda, 2018). This patient reports feeling severely depressed and demoralized, as well as, helplessness, hopelessness, and worthlessness. His depression is the worst it has ever been.
Family members are helpful informers, they can ensure medication compliance, and can encourage patients to change behaviors that continue depression (Halverson, 2019). Some questions I would ask family members would include whether the patient is taking their medication and I would ask the family to provide some insight as to how the patient behaves at home. The wife reports that she feels he is letting go and giving up.
There are no lab tests that will confirm depressive disorder, however, labs can be ordered to rule out illnesses that may present as depressive disorder such as endocrinological or neurological diseases. Labs tests may include TSH, B12, RPR, HIV test, electrolytes, BUN and creatinine, blood alcohol, and blood and urine toxicology screening. Neuroimaging can help clarify the nature of the neurologic illness that may produce psychiatric symptoms, but these studies are costly and may be of questionable value in patients without discrete neurologic deficits (Halvers.
Treating Insomnia in Depression Insomnia Related Factors Pred.docxturveycharlyn
Treating Insomnia in Depression: Insomnia Related Factors Predict
Long-Term Depression Trajectories
Bei Bei
Monash University and Royal Women’s Hospital, University of
Melbourne
Lauren D. Asarnow
Stanford University
Andrew Krystal
University of California, San Francisco
Jack D. Edinger
National Jewish Health, Denver, Colorado, and Duke University
Medical Center
Daniel J. Buysse
University of Pittsburgh
Rachel Manber
Stanford University
Objective: Insomnia and major depressive disorders (MDD) often co-occur, and such comorbidity has
been associated with poorer outcomes for both conditions. However, individual differences in depressive
symptom trajectories during and after treatment are poorly understood in comorbid insomnia and
depression. This study explored the heterogeneity in long-term depression change trajectories, and
examined their correlates, particularly insomnia-related characteristics. Method: Participants were 148
adults (age M � SD � 46.6 � 12.6, 73.0% female) with insomnia and MDD who received antidepressant
pharmacotherapy, and were randomized to 7-session Cognitive Behavioral Therapy for Insomnia or
control conditions over 16 weeks with 2-year follow-ups. Depression and insomnia severity were
assessed at baseline, biweekly during treatment, and every 4 months thereafter. Sleep effort and beliefs
about sleep were also assessed. Results: Growth mixture modeling revealed three trajectories: (a)
Partial-Responders (68.9%) had moderate symptom reduction during early treatment (p value � .001)
and maintained mild depression during follow-ups. (b) Initial-Responders (17.6%) had marked symptom
reduction during treatment (p values � .001) and low depression severity at posttreatment, but increased
severity over follow-up (p value � .001). (c) Optimal-Responders (13.5%) achieved most gains during
early treatment (p value � .001), continued to improve (p value � .01) and maintained minimal
depression during follow-ups. The classes did not differ significantly on baseline measures or treatment
received, but differed on insomnia-related measures after treatment began (p values � .05): Optimal-
Responders consistently endorsed the lowest insomnia severity, sleep effort, and unhelpful beliefs about
sleep. Conclusions: Three depression symptom trajectories were observed among patients with comorbid
insomnia and MDD. These trajectories were associated with insomnia-related constructs after commenc-
ing treatment. Early changes in insomnia characteristics may predict long-term depression outcomes.
What is the public health significance of this article?
This study identified three distinct depression trajectories in patients with comorbid major depression
and insomnia disorders during treatment and 2-year follow-up. Those with the largest and most
sustained improvements in depression consistently scored the lowest on postbaseline insomnia and
insomnia-related cognitions. Early changes in insomnia symptoms and insomnia-related character ...
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Please I need a response to this case study.1 pagezero plagi.docxcherry686017
Please I need a response to this case study.
1 page
zero plagiarism
three references
The Case:
The sleepy woman with anxiety
This week’s discussion presents a case study involving a 44-year old woman with a chief complaint of anxiety beginning at age 15 years old. She has a long history of mental illness and continued therapies. The purpose of this discussion is to analyze her case history to determine medication and treatment effectiveness.
Client Questions
Question 1. Are you having feelings of harming yourself or harming someone else?
Rationale: This is a possibly uncomfortable yet important set of questions to ask each client. Primary care providers may be in a unique position to prevent suicide due to their frequent interactions with suicidal patients. Reviews suggest that among patients who committed suicide, 80 percent had contact with primary care clinicians within one year of their death, whereas only 25 to 30 percent of decedents had contact with psychiatric clinicians within the year of their death (Stene-Lars & Reneflot, 2017).
Question 2. What was happening in your life as a teenager when the anxiety started and you began to self-medicate?
Rationale: Per our report, this patient began suffering signs and symptoms of anxiety at 15-years old. Asking these types of questions we may gain insight into an underlying cause or triggering event. Anxiety disorders are the most common psychiatric disorders with onset in childhood, with prevalence estimates ranging from 10 to 30 percent. Nearly 37 percent of behaviorally inhibited preschool-age children had social anxiety disorder at age 15, compared with 15 percent of non- behaviorally inhibited children
.
Children with anxiety disorders are more likely to have persistent anxiety disorders into adulthood. (Rapee, 2014).
Question 3. What was happening in your life a year ago when these symptoms returned and became debilitating? Let’s discuss what the triggering events may have been.
Rationale: Self-discovery of triggering events may help the client to come to terms with the determinants of her anxiety and depression. Studies have shown that specific types of stressors were found to differentially predict increases in specific facets of anxiety sensitivity; health-related stressors predicted increases in disease-related concerns and fear of mental incapacitation, whereas stressors related to family discord predicted increases in fear of feeling unsteady, fear of mental incapacitation, and fear of having publicly observable symptoms of anxiety (McLaughlin & Hatzenbuehler, 2009).
Support System
The support system as reported by our client is her husband. She states he is supportive and has little to no contact with the family of origin. She has a few friends and a few outside interests. As PMHNP, discussing relationships with the client is one avenue to gain insight into anxiety patterns and coping mechanisms as seen by outside support. With the client’s permissio.
Supercharge your brain and ditch anxiety and depression for good!Patients Medical
Dr. Vivian DeNise of Patients Medical and Dr. Sandlin Lowe of The Amen Clinic New York explain the causes of anxiety and depression, the cutting-edge technology that can be used to diagnose deficiencies in the brain that cause these conditions and several non-invasive holistic medical approaches that we use to treat.
This presentation contains details about generalized anxiety disorder, its symptoms and etiology along with effective treatment measure. This is for academic purpose.
Respond to at least two of your colleagues who were assigned to a di.docxpeggyd2
Respond to at least two of your colleagues who were assigned to a different case than you. Explain how you might apply knowledge gained from your colleagues’ case studies to you own practice in clinical settings.
If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained.
If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them. Include resources to support your perspective.
Case #29 The depressed man who thought he was out of options.
The patient is a 69-year-old male with unremitting chronic depression. He has suffered from depressive episodes for 40 years and has always had a good response to treatment until 5 years ago when he relapsed on venlafaxine. Two years ago, he underwent nine treatments of ECT with partial response. He has tried every known antidepressant and augmentation available in the past few years.
The patient should be asked about recent stressful life events, consumption of illicit drugs, alcohol abuse, current medical conditions and prescribed medications (Preda, 2018). If the patient was in my office, I would also want to ask questions to gain an understanding of the severity of his depression. It is important to assess the overall severity of depression symptoms because symptom severity corelates with suicide risk (Preda, 2018). The PHQ-9 screening could be used, and this screening asks about feelings of hopelessness, loss of pleasure in doing things, and feelings of being better off dead. A focused severity assessment for hopelessness, suicidal ideation, and psychotic symptoms is recommended; these symptoms independently increase the risk for suicide (Preda, 2018). This patient reports feeling severely depressed and demoralized, as well as, helplessness, hopelessness, and worthlessness. His depression is the worst it has ever been.
Family members are helpful informers, they can ensure medication compliance, and can encourage patients to change behaviors that continue depression (Halverson, 2019). Some questions I would ask family members would include whether the patient is taking their medication and I would ask the family to provide some insight as to how the patient behaves at home. The wife reports that she feels he is letting go and giving up.
There are no lab tests that will confirm depressive disorder, however, labs can be ordered to rule out illnesses that may present as depressive disorder such as endocrinological or neurological diseases. Labs tests may include TSH, B12, RPR, HIV test, electrolytes, BUN and creatinine, blood alcohol, and blood and urine toxicology screening. Neuroimaging can help clarify the nature of the neurologic illness that may produce psychiatric symptoms, but these studies are costly and may be of questionable value in patients without discrete neurologic deficits (Halvers.
Treating Insomnia in Depression Insomnia Related Factors Pred.docxturveycharlyn
Treating Insomnia in Depression: Insomnia Related Factors Predict
Long-Term Depression Trajectories
Bei Bei
Monash University and Royal Women’s Hospital, University of
Melbourne
Lauren D. Asarnow
Stanford University
Andrew Krystal
University of California, San Francisco
Jack D. Edinger
National Jewish Health, Denver, Colorado, and Duke University
Medical Center
Daniel J. Buysse
University of Pittsburgh
Rachel Manber
Stanford University
Objective: Insomnia and major depressive disorders (MDD) often co-occur, and such comorbidity has
been associated with poorer outcomes for both conditions. However, individual differences in depressive
symptom trajectories during and after treatment are poorly understood in comorbid insomnia and
depression. This study explored the heterogeneity in long-term depression change trajectories, and
examined their correlates, particularly insomnia-related characteristics. Method: Participants were 148
adults (age M � SD � 46.6 � 12.6, 73.0% female) with insomnia and MDD who received antidepressant
pharmacotherapy, and were randomized to 7-session Cognitive Behavioral Therapy for Insomnia or
control conditions over 16 weeks with 2-year follow-ups. Depression and insomnia severity were
assessed at baseline, biweekly during treatment, and every 4 months thereafter. Sleep effort and beliefs
about sleep were also assessed. Results: Growth mixture modeling revealed three trajectories: (a)
Partial-Responders (68.9%) had moderate symptom reduction during early treatment (p value � .001)
and maintained mild depression during follow-ups. (b) Initial-Responders (17.6%) had marked symptom
reduction during treatment (p values � .001) and low depression severity at posttreatment, but increased
severity over follow-up (p value � .001). (c) Optimal-Responders (13.5%) achieved most gains during
early treatment (p value � .001), continued to improve (p value � .01) and maintained minimal
depression during follow-ups. The classes did not differ significantly on baseline measures or treatment
received, but differed on insomnia-related measures after treatment began (p values � .05): Optimal-
Responders consistently endorsed the lowest insomnia severity, sleep effort, and unhelpful beliefs about
sleep. Conclusions: Three depression symptom trajectories were observed among patients with comorbid
insomnia and MDD. These trajectories were associated with insomnia-related constructs after commenc-
ing treatment. Early changes in insomnia characteristics may predict long-term depression outcomes.
What is the public health significance of this article?
This study identified three distinct depression trajectories in patients with comorbid major depression
and insomnia disorders during treatment and 2-year follow-up. Those with the largest and most
sustained improvements in depression consistently scored the lowest on postbaseline insomnia and
insomnia-related cognitions. Early changes in insomnia symptoms and insomnia-related character ...
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
2. Which of the following statements regarding pharmacological
treatment of generalized anxiety disorder (GAD) in older adults (>
65 years old) is most accurate?
A. Antidepressants are generally ineffective.
B. Antidepressants are not recommended due to their side effect
profile.
C. Antidepressants are less effective than psychotherapy.
D. Antidepressants are not recommended due to risk of drug-drug
interactions.
E. Antidepressants are a first-line treatment.
QUESTION 1
Class responses
3. QUESTION 1
Final answer?
Which of the following statements regarding pharmacological
treatment of generalized anxiety disorder (GAD) in older adults (>
65 years old) is most accurate?
A. Antidepressants are generally ineffective. (1)
B. Antidepressants are not recommended due to their side effect
profile.
C. Antidepressants are less effective than psychotherapy. (1)
D. Antidepressants are not recommended due to risk of drug-drug
interactions.
E. Antidepressants are a first-line treatment. (6)
4. ANSWER 1
Explanation
Which of the following statements regarding pharmacological
treatment of generalized anxiety disorder (GAD) in older adults (>
65 years old) is most accurate?
A. Antidepressants are generally ineffective.
B. Antidepressants are not recommended due to their side effect
profile.
C. Antidepressants are less effective than psychotherapy.
D. Antidepressants are not recommended due to risk of drug-drug
interactions.
E. Antidepressants are a first-line treatment.
5. The same treatments that are effective for anxiety in younger
persons are also effective in the elderly. Although both
pharmacotherapy and behavioral interventions are reasonably
effective, the weight of evidence suggests that there are higher
average treatment effects with pharmacological interventions.
Although side effects, drug interactions, and patient preferences
should be taken into account, in most elderly patients
pharmacotherapy is likely to be the first-line treatment
recommendation for anxiety disorders.
Pinquart M, Duberstein PR. Treatment of anxiety disorders in older adults: a
meta-analytic comparison of behavioral and pharmacological interventions. Am J
Geriatr Psychiatry. 2007; 15(8):639–651.
EXPLANATION
6. Compared with selective serotonin reuptake inhibitor (SSRI)
monotherapy, adjunctive use of benzodiazepines in combination
with an SSRI for the treatment of panic disorder is associated with:
A. worse outcomes following benzodiazepine taper.
B. more rapid stabilization.
C. higher dropout rates.
D. lower side effect burden.
QUESTION 2
Class responses
7. QUESTION 2
Final answer?
Compared with selective serotonin reuptake inhibitor (SSRI)
monotherapy, adjunctive use of benzodiazepines in combination
with an SSRI for the treatment of panic disorder is associated with:
A. worse outcomes following benzodiazepine taper. (2)
B. more rapid stabilization. (5)
C. higher dropout rates.
D. lower side effect burden. (1)
8. ANSWER 2
Explanation
Compared with selective serotonin reuptake inhibitor (SSRI)
monotherapy, adjunctive use of benzodiazepines in combination
with an SSRI for the treatment of panic disorder is associated with:
A. worse outcomes following benzodiazepine taper.
B. more rapid stabilization.
C. higher dropout rates.
D. lower side effect burden.
9. According to The APA Practice Guideline for the Treatment of
Patients with Panic Disorder benzodiazepines may be used along
with antidepressants to help control symptoms until the
antidepressant takes effect. Recent studies suggest that adjunctive
benzodiazepine use confers a short-term benefit by reducing panic
symptoms. However, the advantage of the combination does not
continue and individuals receiving SSRI alone catch up to those
receiving the combination after the first few weeks of treatment.
The benefit of quicker stabilization should be weighed against the
possibility of an increased side-effect burden. Studies of
medication and psychosocial treatment have not shown a clear and
lasting advantage for this combination.
Goddard AW, Brouette T, Almai A, Jetty P, Woods SW, Charney D. Early
coadministration of clonazepam with sertraline for panic disorder. Arch Gen
Psychiatry. 2001 Jul;58(7):681–686.
EXPLANATION 2
10. QUESTION 3
A 23 year old man is the sole survivor of a fire aboard a crowded
plane. In the immediate aftermath of exposure to the trauma,
which of the following interventions is most likely to be successful
in preventing psychological sequelae?
A. Encourage him to imagine positive emotions.
B. Have the man ventilate about how he is feeling.
C. Normalize the stress reaction.
D. Prescribe a short-acting benzodiazepine.
E. Use critical incident debriefing.
Class responses
11. QUESTION 3
Need a hint?
A 23 year old man is the sole survivor of a fire aboard a crowded
plane. In the immediate aftermath of exposure to the trauma,
which of the following interventions is most likely to be successful
in preventing psychological sequelae?
A. Encourage him to imagine positive emotions.
B. Have the man ventilate about how he is feeling.
C. Normalize the stress reaction. (4)
D. Prescribe a short-acting benzodiazepine. (1)
E. Use critical incident debriefing. (3)
12. You’ll find the answer in:
Hobfoll SE, et al. Five essential elements of immediate and mid-
term mass trauma intervention: empirical evidence. Psychiatry.
2007; 70(4):283–315.
NEED A HINT?
Final answer?
13. ANSWER 3
A 23 year old man is the sole survivor of a fire aboard a crowded
plane. In the immediate aftermath of exposure to the trauma,
which of the following interventions is most likely to be successful
in preventing psychological sequelae?
A. Encourage him to imagine positive emotions.
B. Have the man ventilate about how he is feeling.
C. Normalize the stress reaction.
D. Prescribe a short-acting benzodiazepine.
E. Use critical incident debriefing.
14. QUESTION 4
Patients with comorbid obsessive compulsive disorder (OCD) and
tic disorder most often exhibit which of the following patterns of
OCD symptoms?
A. Harm obsessions and checking compulsions
B. Cleanliness obsessions and washing compulsions
C. Symmetry obsessions and ordering compulsions
D. Unacceptability obsessions and religions compulsions
Class responses
15. QUESTION 4
Need a hint?
Patients with comorbid obsessive compulsive disorder (OCD) and
tic disorder most often exhibit which of the following patterns of
OCD symptoms?
A. Harm obsessions and checking compulsions (1)
B. Cleanliness obsessions and washing compulsions (2)
C. Symmetry obsessions and ordering compulsions (5)
D. Unacceptability obsessions and religions compulsions
16. You’ll find the answer in…
Eapen, V, et al. The role of clinical phenotypes in understanding
the genetics of obsessive-compulsive disorder. J Psychosom
Res. 2006 Sep;61(3):359-64.
NEED A HINT?
Final answer?
17. ANSWER 4
Patients with comorbid obsessive compulsive disorder (OCD) and
tic disorder most often exhibit which of the following patterns of
OCD symptoms?
A. Harm obsessions and checking compulsions
B. Cleanliness obsessions and washing compulsions
C. Symmetry obsessions and ordering compulsions
D. Unacceptability obsessions and religions compulsions
18. QUESTION 5
A 45 year old patient requests medication to treat symptoms
consistent with generalized anxiety disorder (GAD). The patient
has a history of heavy drinking. Which of the following
medications would be most appropriate to prescribe?
A. Clonazepam
B. Bupropion
C. Quetiapine
D. Gabapentin
E. Venlafaxine
Class responses
19. QUESTION 5
Final answer?
A 45 year old patient requests medication to treat symptoms
consistent with generalized anxiety disorder (GAD). The patient
has a history of heavy drinking. Which of the following
medications would be most appropriate to prescribe?
A. Clonazepam
B. Bupropion
C. Quetiapine
D. Gabapentin (2)
E. Venlafaxine (6)
20. ANSWER 5
A 45 year old patient requests medication to treat symptoms
consistent with generalized anxiety disorder (GAD). The patient
has a history of heavy drinking. Which of the following
medications would be most appropriate to prescribe?
A. Clonazepam
B. Bupropion
C. Quetiapine
D. Gabapentin
E. Venlafaxine
Explanation
21. The most appropriate option is venlafaxine, which is an efficacious
treatment for GAD. While benzodiazepines, such as clonazepam,
alprazolam, and diazepam, are effective in treating generalized
anxiety disorder (GAD), the risk of benzodiazepine abuse or
dependence among alcohol abusers limits their utility. Bupropion,
quetiapine and gabapentin are not first-line treatments for GAD.
Hoge EA, Ivkovic A, Fricchione GL. Generalized anxiety disorder: diagnosis and
treatment. BMJ. 2012;345:e7500.
EXPLANATION
22. QUESTION 6
Which of the following disorders must be considered in the
differential diagnosis of individuals with late-onset obsessive-
compulsive disorder (OCD), i.e. symptom onset after age 45?
A. Huntington’s disease
B. Major depressive disorder
C. Delusional disorder
D. Normal pressure hydrocephalus
E. Parietal lobe CVA
Class responses
23. QUESTION 6
Need a hint?
Which of the following disorders must be considered in the
differential diagnosis of individuals with late-onset obsessive-
compulsive disorder (OCD), i.e. symptom onset after age 45?
A. Huntington’s disease (3)
B. Major depressive disorder
C. Delusional disorder (1)
D. Normal pressure hydrocephalus (1)
E. Parietal lobe CVA (3)
24. You’ll find the answer in…
van Duijn E, Kingma EM, Van der mast RC. Psychopathology in
verified Huntington's disease gene carriers. J Neuropsychiatry Clin
Neurosci. 2007;19(4):441-8.
Weiss, AP and Jenike, MA. Late-onset obsessive-compulsive
disorder: a case series. J Neuropsychiatry Clin Neurosci. 2000
Spring;12(2):265-8.
NEED A HINT?
Final answer?
25. ANSWER 6
Explanation
Which of the following disorders must be considered in the
differential diagnosis of individuals with late-onset obsessive-
compulsive disorder (OCD), i.e. symptom onset after age 45?
A. Huntington’s disease
B. Major depressive disorder
C. Delusional disorder
D. Normal pressure hydrocephalus
E. Parietal lobe CVA
26. QUESTION 7
Deep brain stimulation (DBS) for treatment-refractory obsessive
compulsive disorder (OCD) typically targets which of the following
brain regions?
A. Subgenual cingulate gyrus
B. Nucleus basalis of Meynert
C. Subthalamic nucleus
D. Ventral striatum
E. Nucleus accumbens
Class responses
27. QUESTION 7
Need a hint?
Deep brain stimulation (DBS) for treatment-refractory obsessive
compulsive disorder (OCD) typically targets which of the following
brain regions?
A. Subgenual cingulate gyrus (3)
B. Nucleus basalis of Meynert
C. Subthalamic nucleus (1)
D. Ventral striatum (2)
E. Nucleus accumbens (2)
28. You’ll find the answer in…
Blomstedt P, Sjöberg RL, Hansson M, Bodlund O, Hariz MI. Deep
brain stimulation in the treatment of obsessive-compulsive
disorder. World Neurosurg. 2013;80(6):e245-53.
NEED A HINT?
Final answer?
29. ANSWER 7
Explanation
Deep brain stimulation (DBS) for treatment-refractory obsessive
compulsive disorder (OCD) typically targets which of the following
brain regions?
A. Subgenual cingulate gyrus
B. Nucleus basalis of Meynert
C. Subthalamic nucleus
D. Ventral striatum
E. Nucleus accumbens
30. QUESTION 8
A patient has been successfully treated with a selective serotonin
reuptake inhibitor (SSRI) for acute panic episodes. What is the
minimum length of time recommended for maintenance
pharmacotherapy for this patient?
A. 2–4 months
B. 6–12 months
C. 18 months
D. At least 24 months
Class responses
31. QUESTION 8
Final answer?
A patient has been successfully treated with a selective serotonin
reuptake inhibitor (SSRI) for acute panic episodes. What is the
minimum length of time recommended for maintenance
pharmacotherapy for this patient?
A. 2–4 months
B. 6–12 months (8)
C. 18 months
D. At least 24 months
32. ANSWER 8
Explanation
A patient has been successfully treated with a selective serotonin
reuptake inhibitor (SSRI) for acute panic episodes. What is the
minimum length of time recommended for maintenance
pharmacotherapy for this patient?
A. 2–4 months
B. 6–12 months
C. 18 months
D. At least 24 months
33. The APA Practice Guideline Watch for the Treatment of Patients
with Panic Disorder recommends maintenance pharmacotherapy
for at least 6–12 months following acute treatment. Studies of
fluoxetine, paroxetine, sertraline, imipramine and clomipramine
have demonstrated a benefit of continuing medication for 6–12
months. Maintenance pharmacotherapy should be considered for
most patients as a means of preventing recurrence of panic
disorder symptoms and promoting continued symptom relief and
better functioning.
American Psychiatric Association Practice Guideline for the Treatment of
Patients with Panic Disorder (2009).
Choy, Yujuan, et al. Three-year medication prophylaxis in panic disorder: to
continue or discontinue? A naturalistic study. Comprehensive Psychiatry 48
(2007) 419–425
Roy-Byrne PP, Craske MG, Stein MG. Panic disorder. Lancet 2006; 368:1023 –1032
EXPLANATION
34. QUESTION 9
A bus carrying students from a local high school is swept down the
side of the mountain following a mudslide. Despite rescue
attempts, all the youth on the bus either die or are seriously
wounded. Based on prevalence data, which of the following groups
of individuals is most likely to develop posttraumatic stress
disorder (PTSD) after the disaster?
A. Family members
B. First responders
C. Guidance counselors
D. Classmates
E. Teachers
Class responses
35. QUESTION 9
Final answer?
A bus carrying students from a local high school is swept down the
side of the mountain following a mudslide. Despite rescue
attempts, all the youth on the bus either die or are seriously
wounded. Based on prevalence data, which of the following groups
of individuals is most likely to develop posttraumatic stress
disorder (PTSD) after the disaster?
A. Family members
B. First responders (7)
C. Guidance counselors
D. Classmates (1)
E. Teachers
36. ANSWER 9
Explanation
A bus carrying students from a local high school is swept down the
side of the mountain following a mudslide. Despite rescue
attempts, all the youth on the bus either die or are seriously
wounded. Based on prevalence data, which of the following groups
of individuals is most likely to develop posttraumatic stress
disorder (PTSD) after the disaster?
A. Family members
B. First responders
C. Guidance counselors
D. Classmates
E. Teachers
37. In a systematic review of posttraumatic stress disorder following
disasters, the highest prevalence of PTSD was found among
survivors and first responders. The prevalence of PTSD among first
responders assessed following involvement in rescue, recovery and
cleaning efforts were especially high.
Neria Y, Nandi A, Galea S. Post-traumatic stress disorder following disasters: a
systematic review. Psychol Med. 2008; 38(4):467–480
EXPLANATION
38. QUESTION 10
Which of following patient characteristics most consistently
predicts poor response to behavioral therapy in obsessive
compulsive disorder (OCD)?
A. Earlier age of onset
B. Family accommodation
C. Contamination fears
D. Checking rituals
E. Comorbid depression
Class responses
39. QUESTION 10
Need a hint?
Which of following patient characteristics most consistently
predicts poor response to behavioral therapy in obsessive
compulsive disorder (OCD)?
A. Earlier age of onset
B. Family accommodation (5)
C. Contamination fears
D. Checking rituals
E. Comorbid depression (3)
40. You’ll find the answer in…
Keeley, ML, et al. Clinical predictors of response to cognitive -
behavioral therapy for obsessive-compulsive disorder. Clin Psychol
Rev. 2008 Jan;28(1):118-30.
NEED A HINT?
Final answer?
41. ANSWER 10
Which of following patient characteristics most consistently
predicts poor response to behavioral therapy in obsessive
compulsive disorder (OCD)?
A. Earlier age of onset
B. Family accommodation
C. Contamination fears
D. Checking rituals
E. Comorbid depression
42. QUESTION 11
Which of the following statements best describes the association
between posttraumatic stress disorder (PTSD) and the subsequent
emergence of a substance use disorder (SUD)?
A. Young adults with PTSD are about five times more likely to
develop an SUD compared to traumatized young adults without
PTSD.
B. Even in the absence of PTSD, a history of significant trauma is
associated with an increased risk of developing an SUD.
C. After controlling for factors such as sex, age and ethnicity, PTSD
confers no additional increased risk of developing an SUD
D. After controlling for factors such as childhood conduct problems
and risk taking, PTSD confers no additional increased risk of
developing an SUD
E. After controlling for factors such as family SES and years of
education, PTSD confers no additional increased risk of
developing an SUD Class responses
43. QUESTION 11
Need a hint?
Which of the following statements best describes the association
between posttraumatic stress disorder (PTSD) and the subsequent
emergence of a substance use disorder (SUD)?
A. Young adults with PTSD are about five times more likely to
develop an SUD compared to traumatized young adults without
PTSD. (4)
B. Even in the absence of PTSD, a history of significant trauma is
associated with an increased risk of developing an SUD. (4)
C. After controlling for factors such as sex, age and ethnicity, PTSD
confers no additional increased risk of developing an SUD
D. After controlling for factors such as childhood conduct problems
and risk taking, PTSD confers no additional increased risk of
developing an SUD
E. After controlling for factors such as family SES and years of
education, PTSD confers no additional increased risk of
developing an SUD
44. You’ll find the answer in…
Reed PL, Anthony JC, Breslau N. Incidence of drug problems in
young adults exposed to trauma and posttraumatic stress disorder:
do early life experiences and predispositions matter? Arch Gen
Psychiatry. 2007; 64(12):1435–1442.
NEED A HINT?
Final answer?
45. ANSWER 11
Which of the following statements best describes the association
between posttraumatic stress disorder (PTSD) and the subsequent
emergence of a substance use disorder (SUD)?
A. Young adults with PTSD are about five times more likely to
develop an SUD compared to traumatized young adults without
PTSD.
B. Even in the absence of PTSD, a history of significant trauma is
associated with an increased risk of developing an SUD.
C. After controlling for factors such as sex, age and ethnicity, PTSD
confers no additional increased risk of developing an SUD
D. After controlling for factors such as childhood conduct problems
and risk taking, PTSD confers no additional increased risk of
developing an SUD
E. After controlling for factors such as family SES and years of
education, PTSD confers no additional increased risk of
developing an SUD
46. QUESTION 12
According to the National Comorbidity Survey (NCS), which of the
following experiences is most frequently associated with
posttraumatic stress disorder (PTSD) in women in the U.S.?
A. Life-threatening accident
B. Combat exposure
C. Natural disaster
D. Sexual assault
E. Witnessing violence
Class responses
47. QUESTION 12
Final answer?
According to the National Comorbidity Survey (NCS), which of the
following experiences is most frequently associated with
posttraumatic stress disorder (PTSD) in women in the U.S.?
A. Life-threatening accident
B. Combat exposure
C. Natural disaster
D. Sexual assault (8)
E. Witnessing violence
48. ANSWER 12
Explanation
According to the National Comorbidity Survey (NCS), which of the
following experiences is most frequently associated with
posttraumatic stress disorder (PTSD) in women in the U.S.?
A. Life-threatening accident
B. Combat exposure
C. Natural disaster
D. Sexual assault
E. Witnessing violence
49. In the NCS, which was carried out in the early 1990s, the most
common stressor precipitants for women were sexual assault with
physical attack, being threatened with a weapon, and childhood
physical abuse, in that order. Combat exposure was the most
common stressor for men. A recent review points out that PTSD
lifetime prevalence in the NCS was twice as high in women as men
and that combat exposure accounts for a significant proportion of
PTSD in U.S. men. It also emphasizes that the main PTSD burden in
the U.S. stems not from war but from criminal victimization, motor
vehicle accidents, intimate partner violence, and childhood
maltreatment. Women are more likely to have experienced sexual
abuse, and men are more likely to have encountered physical
violence, whether in the U.S. or while at war.
Kessler RC, et al: Posttraumatic stress disorder in the National Comorbidity
Survey. Arch Gen Psychiatry 1995; 52:1048–1060
EXPLANATION
50. QUESTION 13
A patient with obsessive compulsive disorder (OCD) experienced
significant residual symptoms during adequate trials of two
different selective serotonin reuptake inhibitors (SSRIs) in
combination with psychotherapy. The patient has not tried any
other medications. Which of the following is the most appropriate
next step in treatment?
A. Switch from current SSRI to another SSRI
B. Switch from current SSRI to clomipramine
C. Augment current SSRI with clonazepam
D. Augment current SSRI with lithium
E. Augment current SSRI with buspirone
Class responses
51. QUESTION 13
Final answer?
A patient with obsessive compulsive disorder (OCD) experienced
significant residual symptoms during adequate trials of two
different selective serotonin reuptake inhibitors (SSRIs) in
combination with psychotherapy. The patient has not tried any
other medications. Which of the following is the most appropriate
next step in treatment?
A. Switch from current SSRI to another SSRI
B. Switch from current SSRI to clomipramine (8)
C. Augment current SSRI with clonazepam
D. Augment current SSRI with lithium
E. Augment current SSRI with buspirone
52. ANSWER 13
Explanation
A patient with obsessive compulsive disorder (OCD) experienced
significant residual symptoms during adequate trials of two
different selective serotonin reuptake inhibitors (SSRIs) in
combination with psychotherapy. The patient has not tried any
other medications. Which of the following is the most appropriate
next step in treatment?
A. Switch from current SSRI to another SSRI
B. Switch from current SSRI to clomipramine
C. Augment current SSRI with clonazepam
D. Augment current SSRI with lithium
E. Augment current SSRI with buspirone
53. Clomipramine is the next best medication to prescribe.
Clomipramine has substantial evidence to support its use in OCD,
but due to its side effect profile, it is not typically prescribed until
a patient has failed trials of two SSRIs (as in this case). Another
SSRI would not be a good choice given that the patient has already
failed therapeutic trials of two SSRIs. Augmentation with
benzodiazepines, lithium or buspirone has not consistently
demonstrated efficacy in OCD.
Fineberg, NA and Gale, TM. Evidence-based pharmacotherapy of obsessive-
compulsive disorder. Int J Neuropsychopharmacol. 2005 Mar;8(1):107-29.
EXPLANATION
54. QUESTION 14
Which of the diagnostic criteria for posttraumatic stress disorder
(PTSD) is rarely fully-endorsed in preschool children?
A. Disturbance of over one month
B. Re-experiencing
C. Avoidance/numbing
D. Increased arousal
E. Clinically significant impairment
Class responses
55. QUESTION 14
Need a hint?
Which of the diagnostic criteria for posttraumatic stress disorder
(PTSD) is rarely fully-endorsed in preschool children?
A. Disturbance of over one month
B. Re-experiencing (5)
C. Avoidance/numbing (2)
D. Increased arousal
E. Clinically significant impairment (1)
56. You’ll find the answer in…
Sheeringa MS, et al. New findings on alternative criteria for PTSD
in preschool children. J Am Acad Child Adolesc Psychiatry. 2003;
42(5):564–565
Friedman MJ. Finalizing PTSD in DSM-5: getting here from there
and where to go next. J Trauma Stress. 2013;26(5):548-56.
NEED A HINT?
Final answer?
57. ANSWER 14
Which of the diagnostic criteria for posttraumatic stress disorder
(PTSD) is rarely fully-endorsed in preschool children?
A. Disturbance of over one month
B. Re-experiencing
C. Avoidance/numbing
D. Increased arousal
E. Clinically significant impairment
58. QUESTION 15
Which of the following medication combinations for individuals
with obsessive-compulsive disorder (OCD) comorbid with tic
disorder is best supported by current evidence?
A. Fluoxetine plus clonazepam
B. Sertraline plus buspirone
C. Citalopram plus naltrexone
D. Fluvoxamine plus haloperidol
Class responses
59. QUESTION 15
Final answer?
Which of the following medication combinations for individuals
with obsessive-compulsive disorder (OCD) comorbid with tic
disorder is best supported by current evidence?
A. Fluoxetine plus clonazepam
B. Sertraline plus buspirone
C. Citalopram plus naltrexone (1)
D. Fluvoxamine plus haloperidol (7)
60. ANSWER 15
Explanation
Which of the following medication combinations for individuals
with obsessive-compulsive disorder (OCD) comorbid with tic
disorder is best supported by current evidence?
A. Fluoxetine plus clonazepam
B. Sertraline plus buspirone
C. Citalopram plus naltrexone
D. Fluvoxamine plus haloperidol
61. Evidence indicates that individuals with OCD and comorbid tic
disorder respond better to the combination of an SSRI and
haloperidol. While SSRI’s are typical first-line treatments for OCD,
clonazepam has not consistently demonstrated efficacy for OCD.
There is no evidence to support the use of buspirone or
naltrexone.
Grados, M, and Riddle, MA. Do all obsessive-compulsive disorder subtypes
respond to medication? Int Rev Psychiatry. 2008 Apr;20(2):189-93.
Fineberg NA, Gale TM, Sivakumaran T. A review of antipsychotics in the
treatment of obsessive compulsive disorder. J Psychopharmacology 2006; 20:97 –
103. Reprinted in FOCUS: OCD summer 2007:3.
EXPLANATION
62. QUESTION 16
Patients with acute stress disorder have been shown in controlled
trials to be least likely to subsequently develop posttraumatic
stress disorder (PTSD) when treated with:
A. cognitive restructuring therapy.
B. exposure therapy.
C. systematic debriefing.
D. couples therapy.
Class responses
63. QUESTION 16
Need a hint?
Patients with acute stress disorder have been shown in controlled
trials to be least likely to subsequently develop posttraumatic
stress disorder (PTSD) when treated with:
A. cognitive restructuring therapy. (2)
B. exposure therapy. (1)
C. systematic debriefing. (5)
D. couples therapy.
64. You’ll find the answer in…
Bryant RA, et al. Treatment of acute stress disorder: a randomized
controlled trial. Arch Gen Psychiatry. 2008; 65(6):659–667
NEED A HINT?
Final answer?
65. ANSWER 16
Patients with acute stress disorder have been shown in controlled
trials to be least likely to subsequently develop posttraumatic
stress disorder (PTSD) when treated with:
A. cognitive restructuring therapy.
B. exposure therapy.
C. systematic debriefing.
D. couples therapy.
66. QUESTION 17
Current evidence best supports which of the following statements
about the relationship between social anxiety disorder (SAD) and
body dysmorphic disorder (BDD)?
A. All patients with BDD also meet criteria for SAD.
B. BDD is the most common psychiatric comorbidity among
patients with SAD.
C. BDD is most likely a form of SAD characterized by poor insight.
D. BDD is most likely a cultural variant of SAD.
E. SAD and BDD share a similar gender distribution, age of onset
and clinical course.
Class responses
67. QUESTION 17
Final answer?
Current evidence best supports which of the following statements
about the relationship between social anxiety disorder (SAD) and
body dysmorphic disorder (BDD)?
A. All patients with BDD also meet criteria for SAD. (1)
B. BDD is the most common psychiatric comorbidity among
patients with SAD.
C. BDD is most likely a form of SAD characterized by poor insight.
D. BDD is most likely a cultural variant of SAD. (1)
E. SAD and BDD share a similar gender distribution, age of onset
and clinical course. (6)
68. ANSWER 17
Explanation
Current evidence best supports which of the following statements
about the relationship between social anxiety disorder (SAD) and
body dysmorphic disorder (BDD)?
A. All patients with BDD also meet criteria for SAD.
B. BDD is the most common psychiatric comorbidity among
patients with SAD.
C. BDD is most likely a form of SAD characterized by poor insight.
D. BDD is most likely a cultural variant of SAD.
E. SAD and BDD share a similar gender distribution, age of onset
and clinical course.
69. “Social anxiety disorder (SAD) and body dysmorphic disorder (BDD)
are two separate, but conceptually overlapping nosological
entities. […] SAD and BDD are highly comorbid, show a similar age
of onset, share a chronic trajectory, and show similar cognitive
biases for interpreting ambiguous social information in a negative
manner. Furthermore, research from treatment outcome studies
have demonstrated that improvements in SAD were significantly
correlated with improvements in BDD.” Individuals with SAD or
BDD have a range of insight; there is very little research
investigating delusionality in SAD or BDD. In some Eastern
cultures, BDD is conceived of as a subtype of SAD; however, the
relationship between culture, SAD and BDD remains poorly
understood.
Fang A, Hofmann SG. Relationship between social anxiety disorder and body
dysmorphic disorder. Clin Psychol Rev. 2010;30(8):1040-8.
EXPLANATION
70. QUESTION 18
Which of the following statements most accurately describes the
benefits of selective serotonin reuptake inhibitors (SSRIs) in the
treatment of posttraumatic stress disorder (PTSD)? SSRIs have
been shown to:
A. ameliorate core PTSD symptoms.
B. treat primarily the comorbid psychiatric disorders.
C. improve primarily hyperarousal symptoms.
D. act only to augment psychotherapy in PTSD.
Class responses
71. QUESTION 18
Final answer?
Which of the following statements most accurately describes the
benefits of selective serotonin reuptake inhibitors (SSRIs) in the
treatment of posttraumatic stress disorder (PTSD)? SSRIs have
been shown to:
A. ameliorate core PTSD symptoms. (6)
B. treat primarily the comorbid psychiatric disorders. (1)
C. improve primarily hyperarousal symptoms. (1)
D. act only to augment psychotherapy in PTSD.
72. ANSWER 18
Explanation
Which of the following statements most accurately describes the
benefits of selective serotonin reuptake inhibitors (SSRIs) in the
treatment of posttraumatic stress disorder (PTSD)? SSRIs have
been shown to:
A. ameliorate core PTSD symptoms.
B. treat primarily the comorbid psychiatric disorders.
C. improve primarily hyperarousal symptoms.
D. act only to augment psychotherapy in PTSD.
73. In randomized controlled studies, SSRIs have repeatedly
demonstrated efficacy in treating PTSD by reducing the core
symptoms of PTSD, reducing symptoms due to comorbid disorders
such as depression and memory problems, and increasing quality
of life. SSRIs are considered the first line medication treatment for
PTSD.
Davis, LL et al. Long-term pharmacotherapy for post-traumatic stress disorder.
CNS Drugs. 2006;20(6):465-76.
EXPLANATION
74. QUESTION 19
A genetic susceptibility for obsessive compulsive disorder (OCD) is
suggested by evidence that there is a familial link with:
A. panic disorder.
B. tic disorder.
C. bipolar disorder.
D. attention-deficit/hyperactivity disorder (ADHD).
E. substance use disorders.
Class responses
75. QUESTION 19
Final answer?
A genetic susceptibility for obsessive compulsive disorder (OCD) is
suggested by evidence that there is a familial link with:
A. panic disorder.
B. tic disorder. (8)
C. bipolar disorder.
D. attention-deficit/hyperactivity disorder (ADHD).
E. substance use disorders.
76. ANSWER 19
Explanation
A genetic susceptibility for obsessive compulsive disorder (OCD) is
suggested by evidence that there is a familial link with:
A. panic disorder.
B. tic disorder.
C. bipolar disorder.
D. attention-deficit/hyperactivity disorder (ADHD).
E. substance use disorders.
77. “Epidemiologically, OCD occurs more frequently than expected in
TS relatives than in the general population, even if the TS
probands do not have OCD.5 Starting from OCD probands mostly
free from tic disorders, evidence also suggests that there is an
increase in tic disorders in OCD relatives. Hence it is likely that
OCD and TS share genetic substrates.”
Grados MA. The genetics of obsessive-compulsive disorder and Tourette
syndrome: an epidemiological and pathway-based approach for gene discovery. J
Am Acad Child Adolesc Psychiatry. 2010;49(8):810-9, 819.e1-2.
EXPLANATION
78. QUESTION 20
Buspirone is thought to exert its anxiolytic effects in part through
its actions at which of the following receptor types?
A. GABA, Type A
B. Serotonin, 5HT-1A
C. Serotonin, 5HT-2A
D. Histamine, Type 1
E. Alpha-adrenergic, Type 1
Class responses
79. QUESTION 20
Need a hint?
Buspirone is thought to exert its anxiolytic effects in part through
its actions at which of the following receptor types?
A. GABA, Type A
B. Serotonin, 5HT-1A (5)
C. Serotonin, 5HT-2A (3)
D. Histamine, Type 1
E. Alpha-adrenergic, Type 1
80. You’ll find the answer in…
Loane C, Politis M. Buspirone: what is it all about?. Brain Res.
2012;1461:111-8.
Celada P, Bortolozzi A, Artigas F. Serotonin 5-HT1A receptors as
targets for agents to treat psychiatric disorders: rationale and
current status of research. CNS Drugs. 2013;27(9):703-16.
NEED A HINT?
Final answer?
81. ANSWER 20
Buspirone is thought to exert its anxiolytic effects in part through
its actions at which of the following receptor types?
A. GABA, Type A
B. Serotonin, 5HT-1A
C. Serotonin, 5HT-2A
D. Histamine, Type 1
E. Alpha-adrenergic, Type 1