Comorbidity of Medical and Psychiatric Disorders

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What is the primary goal when discontinuing antidepressant medication?

To rapidly stop the medication to avoid side effects

To prevent discontinuation symptoms from occurring

To taper the dose slowly over a period of weeks or months (correct)

To abruptly discontinue the medication once the patient feels better

Which of the following is a potential discontinuation symptom when stopping antidepressant medication?

Weight gain

Dry mouth

Diarrhea (correct)

Constipation

What is the recommended approach when discontinuation symptoms occur during tapering?

Immediately stop the medication to avoid further symptoms

Ignore the symptoms, as they are typically mild and will resolve on their own

Switch to a different antidepressant medication

Increase the dose slightly to stop the symptoms, then taper more slowly (correct)

When starting a new antidepressant while discontinuing an initial medication, what should be monitored for?

Signs and symptoms of serotonin syndrome Signup and view all the answers

What is the recommended time frame for not starting a monoamine oxidase inhibitor (MAOI) after stopping another antidepressant?

14 days Signup and view all the answers

What is the primary role of the primary care nurse practitioner in managing patients with mental health concerns?

To screen, assess, and provide overall health care, identifying comorbidities Signup and view all the answers

What is a common consequence of comorbidity between anxiety and depressive disorders with chronic medical diseases?

Decreased quality of life Signup and view all the answers

Which factor contributes to the early mortality of individuals with mental illnesses like depression and anxiety?

Nicotine and substance use Signup and view all the answers

In the treatment of depression and anxiety, what influences the choice of medication for a patient?

Severity of the patient's symptoms Signup and view all the answers

What is a recommended approach when liver or kidney function is compromised in a patient with depression or anxiety?

Slower titration and lower doses Signup and view all the answers

Why should primary care providers prioritize early assessment and treatment of mental health symptoms in patients?

To improve overall physical health Signup and view all the answers

What is the primary reason for recognizing the importance of treating depression and anxiety symptoms in patients with chronic illnesses?

To improve general health state Signup and view all the answers

What is the recommended screening tool for detecting generalized anxiety disorder and social or school phobias in children aged 8-11?

Screen for Child Anxiety-Related Disorders (SCARED) Signup and view all the answers

According to the United States Preventive Services Task Force (USPSTF), what is the recommendation for routine screening for depression in children aged 7-11?

There is insufficient evidence to support routine screening Signup and view all the answers

Which SSRI has FDA approval for the treatment of major depressive disorder (MDD) in children aged 7 and older?

Fluoxetine Signup and view all the answers

What is the recommended starting dosage of SSRIs for children and adolescents, compared to the typical starting dosage for adults?

Half of the typical adult dosage Signup and view all the answers

Which of the following statements is true regarding the use of SSRIs in children and adolescents?

Patients should be monitored for worsening depression and suicidal thoughts Signup and view all the answers

Which of the following statements is true regarding the treatment of older adults with anxiety and depression?

Medication dosages should be started low and increased slowly Signup and view all the answers

According to the American Geriatrics Society Beers Criteria, what is the caution regarding the use of benzodiazepines in older adults?

Benzodiazepines may increase the risk of delirium, cognitive impairment, and falls Signup and view all the answers

Which of the following statements is true regarding the use of antidepressants in pregnant women?

There is evidence of mild congenital abnormalities and an increased risk of low birth weight and premature delivery Signup and view all the answers

Which of the following statements is true regarding the use of clomipramine for the treatment of obsessive-compulsive disorder (OCD) in children?

Clomipramine is rarely used in children primarily due to the severity of adverse effects Signup and view all the answers

According to the Guidelines for Adolescent Depression in Primary Care (GLAD-PC), what is recommended for the management of depression in children and adolescents aged 10-21 in primary care settings?

Providing clinical guidelines, information, recommendations, education resources, and tools Signup and view all the answers

What is the most common symptom of postpartum depression (PPD) that is often referred to as the 'baby blues'?

Crying Signup and view all the answers

According to the passage, what is the recommended screening tool for assessing depression during pregnancy and the postpartum period?

Edinburgh Postnatal Depression Scale (EPDS) Signup and view all the answers

What is the key benefit of taking antidepressants during the postpartum period for a woman with a prior history of postpartum depression?

It reduces the risk of recurrence of depressive symptoms by 6.7%. Signup and view all the answers

According to the passage, what is the main risk associated with the use of the SSRI paroxetine during the first trimester of pregnancy?

Pulmonary hypertension in newborns Signup and view all the answers

Which of the following is NOT a potential negative consequence of untreated postpartum depression?

Increased risk of miscarriage Signup and view all the answers

What is the recommended approach for healthcare providers and pregnant women when making decisions about the use of antidepressants during breastfeeding?

Review the latest information on the Drugs and Lactation Database (LactMed) Signup and view all the answers

What is the primary goal of treatment for anxiety and depressive disorders?

Remission of symptoms Signup and view all the answers

What is the primary reason for conducting a thorough physical examination and laboratory tests in patients presenting with depressive and anxiety symptoms?

To rule out underlying medical conditions that can cause similar symptoms Signup and view all the answers

According to the passage, what is the main risk associated with the use of antidepressants during the first trimester of pregnancy?

Cardiac malformations Signup and view all the answers

What is the recommended approach for healthcare providers when screening for depression in pregnant and postpartum patients?

Screen routinely before, during, and after pregnancy Signup and view all the answers

What is one of the psychological symptoms that can be treated with psychotherapy?

Low self-esteem Signup and view all the answers

What is the primary care provider (PCP) recommended to do in the same appointment when treating a patient with depression and anxiety?

Prescribe medications and discuss psychotherapy Signup and view all the answers

What should the PCP do if the patient has not followed up on the referral to a mental health provider or if the therapist does not fit the needs of the patient?

Refer the patient to a different mental health provider Signup and view all the answers

Why is it important for the PCP to have a list of therapists of both genders when recommending therapy?

To accommodate the patient's preference for a therapist of a specific gender Signup and view all the answers

What information about the therapists should the PCP provide to the patient when making a referral?

The therapists' characteristics, counseling styles, and areas of focus Signup and view all the answers

What is the purpose of the PCP asking the patient to sign a release of information for the therapist?

To improve communication between the therapist and the health-care provider Signup and view all the answers

What is one of the greatest rewards for the PCP when treating a patient with depression or anxiety?

Seeing and hearing from the patient and/or caregivers about overall improvements the patient has made Signup and view all the answers

What is the purpose of the PRESCRIBING PEARL guidelines mentioned in the text?

To provide general recommendations for the treatment and monitoring of patients with anxiety and depression Signup and view all the answers

According to the PRESCRIBING PEARL guidelines, what should a PCP always do when assessing a patient for depression?

Ask about suicidal ideation Signup and view all the answers

What is the recommended approach when initiating treatment with an SNRI (serotonin-norepinephrine reuptake inhibitor) for a patient with anxiety and/or depression?

Start with a low dose and titrate up slowly Signup and view all the answers