Behavioral Health & Psychiatry Flashcards

According to DSM-5, which of the following is required for a diagnosis of Major Depressive Disorder?

Answer: At least 5 symptoms present for at least 2 weeks, including depressed mood or anhedonia

DSM-5 requires ≥5 depressive symptoms for ≥2 weeks, with at least one being depressed mood or anhedonia (loss of interest).

A 25-year-old presents with disorganized speech, auditory hallucinations, and flat affect persisting for 8 months without any mood episodes. What is the most likely diagnosis?

Answer: Schizophrenia

Schizophrenia requires ≥2 characteristic symptoms for ≥6 months with active psychotic symptoms for ≥1 month and no prominent mood episodes.

A 30-year-old woman has recurrent unexpected panic attacks with persistent worry about future attacks and avoidance behaviors for 3 months. Which feature would be INCONSISTENT with a panic disorder diagnosis?

Answer: Attacks triggered exclusively by social evaluation situations

Panic disorder involves unexpected (uncued) panic attacks; attacks triggered exclusively by social situations are more consistent with social anxiety disorder.

A patient on lithium presents with coarse tremor, confusion, and vomiting. His serum lithium level is 2.5 mEq/L. Which is the most appropriate immediate intervention?

Answer: Discontinue lithium immediately and provide supportive care with IV normal saline

Lithium toxicity (level >2.0 mEq/L) with clinical symptoms requires immediate drug discontinuation; IV normal saline expands volume and promotes renal lithium clearance.

Which mechanism best explains the antidepressant effect of selective serotonin reuptake inhibitors (SSRIs)?

Answer: Blocking the serotonin transporter (SERT) at the presynaptic terminal

SSRIs block SERT, preventing serotonin reuptake into the presynaptic neuron and thereby increasing serotonin concentration in the synaptic cleft.

Which feature most clearly distinguishes Bipolar I from Bipolar II disorder?

Answer: Bipolar I requires at least one full manic episode; Bipolar II involves only hypomania

Bipolar I requires at least one full manic episode (≥7 days or requiring hospitalization), while Bipolar II involves hypomanic episodes (≥4 days, not severe enough to cause marked impairment or require hospitalization).

A combat veteran reports intrusive flashbacks, avoidance of war-related cues, negative cognitions about himself and the world, and hypervigilance persisting for 6 weeks following return from deployment. What is the minimum symptom duration required to diagnose PTSD per DSM-5?

Answer: More than 1 month

DSM-5 requires PTSD symptoms to persist for more than 1 month; symptoms lasting 3 days to 1 month following trauma meet criteria for Acute Stress Disorder instead.