Exam 100% Correct.
Dissociation - ANSWERdefense mechanism that protects a person from
overwhelming anxiety by emotionally separating
Depersonalization - ANSWERunreality or detachment from one's body, thoughts,
feeling and actions
Derealization: - ANSWERunreality or detachment from one's surroundings
Body dysmorphic disorder - ANSWERPreoccupation with one or more perceived
defects or flaws in physical appearance
Spends significant time trying to correct perceived flaw with makeup, dermatological
procedures or plastic surgery
Txt: SSRI and or CBT
Hoarding disorder - ANSWERPersistent difficulty discarding possessions regardless
of actual value
Results in accumulation of possessions that compromise living space or inability to
function
Patients who remain resistant to psychosocial interventions, or who lack access to
them, can be provided a trial of a serotonin-reuptake inhibitor, particularly if they
have a comorbid affective or anxiety disorder;
Trichotillomania - ANSWERRecurrent pulling out one's hair despite repeated
attempts to stop.
Txt: SSRI, Clomipramine; atypical antipsychotics, lithium
Excoriation Disorder - ANSWERRecurrent skin picking that results in lesions despite
attempts to stop.
Cognitive-behavioral therapies may be beneficial for patients accepting psychiatric
referral
Txt: SSRIS, antipsychotics, anxiolytics
Posttraumatic Stress Disorder (PTSD) - ANSWERRe-experiencing of an extremely
traumatic event accompanied by symptoms of increased arousal and avoidance of
stimuli associate with the trauma.
PTSD treatment - ANSWER1st line: SSRIS (Zoloft, Celexa) or SNRIS (Venlafaxine)
, FDA approved meds: Sertraline (Zoloft) and Paroxetine (Paxil)
Alpha-1 agonist (Prazosin)= targets flashbacks; nightmares and hypervigilance
Psychotherapy (CBC- exposure therapy etc.)
• PTSD - ANSWERis a potentially debilitating disorder that can occurs after a
traumatic event.
Commonly described in war veterans •
Can also present in those experiencing non- war events
PTSD - ANSWER• Clinical syndrome is characterized by 4 clusters of symptoms:
Re-experiencing the trauma (with intrusive thoughts, nightmares, or flashbacks) •
Emotional numbing •
Avoidance behaviors •
Persistent hyperarousal and mood symptoms (depression, irritability, anger)
Difference between Acute Stress Disorder and PTSD: - ANSWERWhen an individual
experiences a traumatic event and displays anxiety symptoms that lasts for only a
short duration, the condition is opposed to PTSD.
For the diagnosed as ASD as condition to be diagnosed as ASD, symptoms must
occur within one month of trauma and last for not more than one month. The
symptoms of ASD, however, are similar to those observed in PTSD.
Comorbidity Assessment: PTSD - ANSWERIt is important to look for:
Substance use disorders (avoid benzodiazepines)
Depression
Bipolar disorder
Psychosis
Nonpharmacologic Treatment in PTSD: - ANSWERСВТ
Supportive Group Therapy Relaxation therapies
Eye Movement Desensitization and Reprocessing (EMDR)
***Benzodiazepines may interfere with the psychological processes needed to
benefit from СВТ
PTSD patients experience insomnia? - ANSWERup to 90% experience insomnia