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Which diagnostic features distinguish a manic episode from a
hypomanic episode? -ANSWER- A manic episode involves a distinct
period of abnormally and persistently elevated, expansive, or irritable
mood and increased activity or energy, with marked functional
impairment, hospitalization, or psychotic features. Hypomania does not
cause marked impairment, require hospitalization, or include psychotic
features.
A patient reports depressed mood and loss of interest nearly every day
for three weeks, accompanied by insomnia, fatigue, guilt, and impaired
concentration. Which diagnosis should be evaluated first? -ANSWER-
Major depressive disorder. The presentation suggests a major
depressive episode, but a full assessment must establish the required
symptom count, duration, impairment, and exclusions, including any
history of mania or hypomania.
What is the defining feature of persistent depressive disorder? -
ANSWER- Depressed mood for most of the day, more days than not, for
at least two years in adults, accompanied by additional depressive
symptoms. In children and adolescents, the required duration is at least
one year.
,How does bipolar I disorder differ from bipolar II disorder? -ANSWER-
Bipolar I disorder requires at least one manic episode. Bipolar II
disorder requires at least one hypomanic episode and at least one
major depressive episode, with no history of a manic episode.
A person experiences recurrent unexpected panic attacks and spends
the next month fearing additional attacks and changing daily behavior
to avoid them. Which disorder is indicated? -ANSWER- Panic disorder.
The diagnosis involves recurrent unexpected panic attacks followed by
at least one month of persistent concern about further attacks or their
consequences, or maladaptive behavioral changes.
What is the minimum duration required for generalized anxiety
disorder in adults? -ANSWER- Six months of excessive anxiety and
worry about multiple events or activities, occurring more days than not,
with difficulty controlling the worry and associated symptoms.
A student fears scrutiny, embarrassment, and negative evaluation when
speaking in class. The fear persists and leads to avoiding presentations.
Which diagnosis best fits? -ANSWER- Social anxiety disorder. The
central feature is marked fear or anxiety about social situations
involving possible scrutiny by others.
What distinguishes a specific phobia from generalized anxiety disorder?
-ANSWER- Specific phobia involves marked fear or anxiety about a
particular object or situation. Generalized anxiety disorder involves
excessive worry across multiple areas of life.
, Following a traumatic event, an adult experiences intrusive memories,
avoidance, negative changes in mood, and heightened arousal for two
months. Which disorder should be assessed? -ANSWER- Posttraumatic
stress disorder (PTSD). Symptoms must persist for more than one
month and meet the required symptom-cluster criteria, with clinically
significant distress or impairment.
How long must symptoms persist for a diagnosis of acute stress
disorder? -ANSWER- From three days to one month after exposure to a
traumatic event. Symptoms lasting longer than one month may warrant
assessment for PTSD.
A person repeatedly checks locks because of intrusive fears that
someone will break in. The checking consumes several hours daily, and
the person recognizes that the behavior is excessive. Which disorder is
suggested? -ANSWER- Obsessive-compulsive disorder (OCD).
Obsessions, compulsions, or both are present and are time-consuming
or cause clinically significant distress or impairment.
What is the difference between an obsession and a compulsion? -
ANSWER- An obsession is a recurrent, persistent thought, urge, or
image experienced as intrusive and unwanted. A compulsion is a
repetitive behavior or mental act performed in response to an
obsession or according to rigid rules.
A patient experiences recurrent episodes of binge eating accompanied
by a sense of lack of control, followed by self-induced vomiting. Which