2025/2026
What is the GAD7?
Pa ent self rated screener for anxiety (doesn't measure tx response)
What are GAD7 cutoffs?
5= mild
10= moderate
15= severe
What is the HAM A?
Clinician rated anxiety scale
Measures tx response
What are HAM A cutoffs?
Mild: 0-17
Mod: 18-24
Severe: 25-30
Remission: 70% imp
Improved: 50% imp
Par al: 25-49%
Star ng dose of sertraline in elderly and children?
12.5-25 mg
Star ng dose of venlafaxine in children and elderly?
37.5 mg
How should BZDs be discon nued?
25% reduc on per week un l 50% of dose is reached, then reduce by 1/8 every 4-7 days
Therapy > 8 weeks: 2-3 weeks
Therapy > 6 months: 4-8 weeks
Therapy > 1 year: slow taper over 2-4 months
What is the DI between omeprazole and diazepam?
,Omeprazole increases half life and concentra on of diazepam
Which SGAs can be used as augmen ng agents in GAD?
Olanzapine, que apine, risperidone. Que apine XR can be used as early as 2nd line
What are first line treatments for panic disorder
CBT: evidence does NOT show superiority of pharm over non-pharm
SSRI
Venlafaxine
BZD
Clomipramine, imipramine
2nd line: mirtazepine
Can consider sga augmenta on or MAOI aGer failure of ssri, Snri, and tca
What are first line treatments for ptsd
Trauma focused psychotherapy: exposure based, emdr, anxiety management or cbt. Emphasized
in recent guidelines.
SSRI: paroxe ne, sertraline and fluoxe ne have strong evidence
Venlafaxine
Consider alterna ve agents or augmenta on aGer 3 failed trials: Tcas, mirtazepine, phenelzine,
AEDs
NO BZDs or SGAs
What is the YBOCS?
Yale-Brown Obsessive-Compulsive scale
Clinician rated
Used for diagnosis and to assess response
How is the YBOCS interpreted?
0-7 sub clinical
8-15 mild
16-23 moderate
24-31 severe
32-40 very severe
Response: 25%
Remission: score <8
What are first line treatments for OCD?
,CBT or SSRI. CBT + pharmacotherapy not beNer than CBT alone, but is beNer than
pharmacotherapy alone.
2nd line: venlafaxine XR, clomipramine, mirtazepine. Clomipramine may be more effec ve, but
less tolerated.
Adjunc ve: aripiprazole, risperidone *esp in pts with cs!
How should SSRIs be dosed in OCD?
Dose higher than usual
At least 12 weeks needed for response
How long to con nue pharmacotherapy in OCD?
1-2 years. Life long aGer 2-4 relapses.
How are SGAs used in OCD?
Augmenta on, hapiperidol or aripiprazole or risperidone, aGer failing 2 an depressants.
Clomipramine monitoring parameters and AES?
Cardiotoxic in overdose
Epilepsy- inc risk of seizures
Cau on in hepa c and rental impairment
Which natural product may benefit OCD?
D- cycloserine
What is the difference between interval and ra o data?
Ra o has absolute 0 (values make a true ra o when divided)
What are the 2 types of con nuous data?
Interval and ra o
How is SD calculated?
Square root of variance
SD percents?
68% lie within 1 SD
95% lie within 2 SD
99.7% lie within 3 SD
How is SEM calculated?
, SD/SQRTn
What is the difference between cohort and case-control studies?
Cohort sorts based on exposure and looks forward in me for outcomes.
Case-control classifies based on outcome and looks back in me for exposure.
Blocked random alloca on
Used to ensure that at any given point in me, the groups will be similar or equal in size. I.e.
ABBA, BAAB, ABAB
cluster randomiza on
groups of pa ents are randomized rather than the individual pa ents, I.e. en re hospitals or
clinics are randomized to an interven on
Stra fied randomiza on
individuals are grouped into strata (I.e. gender) and then randomized to one treatment group
What is the kappa sta s c and what score is sa sfactory.?
quan ta ve measure of inter-rater reliability (inter-rater concordance). -1 is perfect
disagreement, +1 is perfect disagreement.
Kappa >.7 is sa sfactory.
Alloca on bias
Occurs when subjects or inves gators can choose which treatment group they would like.
Results in groups with different characteris cs
ANri on bias
Certain par cipants are more likely to drop out of the study than others, leading to a final
sample that differs from the ini al
channeling bias
Occurs in observa onal studies. Occurs when clinicians choose treatment according to pts
diagnosis, I.e, pt at highest risk gets treatment
Classifica on bias
Bias due to a misclassifica on (ex. measurement error, errors in diagnosing AD in clinical trials
without a PET scan)
Confounding bias