Question 1

During an interview with a 22-year-old male, he begins to share that over the last 2 weeks, he has felt that he has minimal feelings of happiness in his life; he is having trouble getting out of bed and there have been some days when he can't get out of bed to go to school. He states that he is not hungry anymore and all he does is sleep, though he's always tired and becomes easily angered. Based on this clients' description of symptoms, which of the following conditions would you further your assessment on?

A) Major depression disorder
B) Generalized anxiety disorder
C) Bipolar II disorder
D) Schizophrenia

Accepted Answer

Defined by the Diagnosis and Statistical Manuel of Mental Disorders (DSM-5)m having five or more depressive symptoms during a 2-week period that represent a change in previous functioning. A depressive episode must include either depressed mood or anhedonia (loss of interest of pleasure). A depressive episode must include at least four of the following symptoms: Significant weight loss when not dieting, or weight gain (>5% total body weight in 1 month), or significant changes in appetite; Insomnia or hypersomnia every night; Psychomotor agitation or retardation (observable by others); Fatigue/loss of energy; Feelings of worthlessness or inappropriate/excessive guilt; Diminished ability to think/concentrate, or indecisiveness or Recurrent thoughts of death or suicide, suicidal ideation, or suicide attempt/planning.

Question 2

When assessing a patient who states that for the last 6 months they have difficulty controlling their feelings of worrying, are easily fatigued with difficulty concentrating, poor sleep and highly irritable. The patient states that these episodes occur during various normal activities of daily living; denies any substance abuse; taking any prescribed medications or having been diagnosed with psychiatric disorder. The health care provider should consider treating this individual for which of the following conditions?

A) Hypomania
B) Bipolar I
C) Generalized anxiety disorder
D) Substance abuse

Accepted Answer

As defined by the DMS-5, having excessive anxiety/worry on more days than not for at least 6 months, often about multiple events or activities. The patient will have difficulty controlling this worry, often about multiple events or activities, causing significant clinical distress or impairment. Symptoms present more often than not for at least 6 months and three or more must be present [restlessness/feeling on edge; being easily fatigues; difficulty concentrating or mind going blank; irritability; muscle tension or sleep disturbance.

Question 3

The DSM-5 diagnostic criteria for a manic episode can include three of any of the following symptoms, except:&#10;A) Distractibility&#10;B) Increase in goal-directed activity and/or psychomotor agitation&#10;C) Increased need for sleep&#10;D) Inflated self-esteem/grandiosity

Accepted Answer

Distractibility, increased in goal-directed activity and/or psychomotor agitation and inflated self-esteem/grandiosity are all symptoms that can present in a manic episode. Decreased, not increased, need for sleep can also present in manic episodes.

Question 4

Which of the following criteria does not apply when diagnosing a substance abuse disorder, provided the substance is being used under medical supervision?&#10;A) Tolerance for the substance&#10;B) Craving/strong desire for the substance&#10;C) Using the substance to avoid withdrawal&#10;D) A + C

Accepted Answer

When a substance is being used by a patient under medical supervision, tolerance for the substance and using the substance to avoid withdrawal cannot be used as criteria to indicate substance abuse disorder.

Question 5

All of the following genes have been found to be associated with alcohol abuse, except:&#10;A) ALDH2&#10;B) DDC&#10;C) DRD4&#10;D) MADA

Accepted Answer

DDC has not been found to be involved in alcohol abuse hereditarily.

Question 6

Although generalized anxiety disorder has the smallest overlap in terms of affected genes and substance abuse, the three implicated genes involved are associated with what kind of substance abuse:&#10;A) Opiate abuse&#10;B) Alcohol abuse&#10;C) Cocaine abuse&#10;D) Nicotine abuse

Accepted Answer

For generalized anxiety disorder, all three implicated genes for susceptibility to substance abuse are associated with opiate abuse. This may be due to the calming tendencies of opiates.

Question 7

All of these genes, all associated with major mood disorders, are only implicated in major depression, except:&#10;A) GRIK1&#10;B) NTRK2&#10;C) VMAT2&#10;D) HTR2B

Accepted Answer

VMAT2 can be implicated in either major depression or bipolar disorder.

Question 8

Because patients with major mood disorders are at high risk for developing substance abuse disorders, what steps should be taken to monitor these patients?&#10;A) Ensure proper screening for preexisting substance abuse conditions or history&#10;B) Be diligent when prescribing highly addictive substances&#10;C) Educate these patients on their risks for developing substance abuse disorders&#10;D) All of the above

Accepted Answer

All of these steps are essential for monitoring these patients, and care providers should follow them closely to make sure they do not develop a concurrent substance abuse disorder.

Question 9

Major mood disorders affect what segment of the American population?&#10;A) Between 10% and 30%&#10;B) Between 30% and 60%&#10;C) Between 40% and 70%&#10;D) Between 20% and 50%

Accepted Answer

Between 30% and 60% of all Americans are affected by major mood disorders.

Question 10

The pathways implicated in both substance abuse and major mood disorders predominantly involve the serotonin and dopamine pathways in the brain.

Accepted Answer

Both substance abuse and major mood disorders are associated with dysregulation in the serotonin and dopamine pathways, which are crucial for mood regulation and reward processing.

Deck 24: Behavioral Medicine