Neupsy Key

Electroconvulsive Therapy General Considerations Uses an electrical current to depolarize the brain, inducing a generalized seizure. Mechanism of action unclear. Positive predictors include increasing age, sudden onset and short duration…

Substances of Abuse Substance Intoxication Signs and Symptoms Distinguishing Characteristics of Intoxication Urine Toxicologya Withdrawal/Chronic Use Amphetamines AKA Crank Speed Fast onset, usually within an hour. Physical: mydriasis, anorexia, insomnia,…

Psychotropic-Induced Movement Disorders Movement Disorder Mechanism Onset Clinical Features Management Akathisia An imbalance between the noradrenergic and dopaminergic systems caused by the dopamine receptor antagonists. Days to weeks Subjective feeling…

Benzodiazepine Withdrawal Guidelines for Treatment of Benzodiazepine Withdrawal1 Evaluate and treat concomitant medical and psychiatric conditions. Obtain drug history and urine and blood sample for drug and ethanol assay. Determine…

Alcohol Intoxication and Withdrawal Intoxication Blood Alcohol Level (BAL) Alcohol is metabolized at a rate of ˜30 mg/dl/h, dependent on tolerance and liver function. BAL(mg/dl) Clinical Features 30 Attention difficulties…

Capacity Capacity Assessment When to assess capacity Abrupt change in mental status Refusal of recommended treatment Not willing to discuss refusal Reasons for refusal not clear Refusal based on misinformation…

Violence Assessing Risk Factors for Violence Dynamic Static Homicidal plan Past crime/violence Weapon access Impulsivity Drug intoxication Antisocial/borderline Command auditory hallucinations Childhood abuse (e.g., violence at home) Paranoid delusions Disinhibition…

HIV/AIDS Pretest HIV Counseling1 Discussion of HIV test, including risks and benefits, sensitivity and specificity, possible need for confirmatory testing. Discuss meaning of a positive result and clarify distortions (e.g.,…

Traumatic Brain Injury Epidemiology Most common cause of death among persons under age 35 are injuries incurred during motor vehicle accidents. In the United States, between 2.5 million and 6.5…

Sleep Disorders Sleep Disorders and Psychiatric Illness Depression Insomnia: present in the majority of patients with major depression Generalized sleep disturbance: Increased time to sleep onset Increased nighttime awakenings Early…