Adjustment disorders Characterized by emotional response to stressful events like financial, medical, relationship problems Symptom complex include anxiety and depressive symptoms Need to be differentiated from depression. Diagnosis of depression takes precedence Management – Psychotherapy [Supportive psychotherapy]
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Phobias-Management Pharmacotherapy – BDZs, SSRIs Psychotherapy – Behavior therapy is the most effective Systematic Desensitization – [Exposure / Relaxation] Best Evidence in T/T of Phobias Therapeutic graded exposure [Exposure and response prevention] Flooding [Implosion]- Exposed in Most severe form Modeling [Participant modeling]- Therapist himself makes contact with phobic stimulus Social Anxiety Disorder [Social Phobia]: Fear
OCD-Management & prognosis Management: Pharmacotherapy: First Line – SSRIs and Clomipramine [adverse side effect profile] If first line fails then antipsychotics [Haloperidol, quetiapine, risperidone, olanzapine] Other Drugs [Venlafaxine, Lithium, valproate and carbamazepine] Psychotherapy: Cognitive Behavior therapy [Exposure & Response prevention] Desensitization, thought stopping, flooding and aversive conditioning Other T/T modalities – ECT, Psychosurgery [Cingulotomy,
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Generalized anxiety disorder Excessive and persistent Anxiety and not restricted to any particular symptom Also called free floating anxiety or excessive worries Management: BDZ and SSRIs Psychotherapy Cognitive Behavioral therapy Insight oriented Psychotherapy Supportive Psychotherapy
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Psychotherapy for depression Treatment using psychological techniques Cognitive Behavior Therapy Aims at correcting cognitive distortions [Faulty ways of thinking] and faulty behaviors The most effective psychotherapeutic technique in depression Interpersonal Therapy Focuses on management of patient’s current interpersonal problems Others Behavior therapy, Family Therapy and Psychoanalysis oriented therapy
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Management of depression Pharmacotherapy Tricyclic Antidepressants (TCAs) SSRIs SNRIs Monoamine Oxidase Inhibitors Atypical Antidepressants Psychotherapy Cognitive Behavior Therapy Interpersonal Therapy Behavior Therapy Somatic Therapy ECT Trans cranial magnetic stimulation Vagal Nerve stimulation Deep brain stimulation Sleep deprivation Phototherapy
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PSYCHOTHERAPY Q. 1 Patient of contamination phobia was asked by therapist to follow behind and touch everything he touches in patients house Therapist kept talking quietly & calmly all the time. And the patient was asked to repeat the procedure twice daily. The procedure is A Flooding B Modelling C Positive reinforcement D Aversion therapy
PSYCHOTHERAPY PSYCHOTHERAPY Treatment of psychiatric disorders by using psychological methods. Most important method – Behavior therapy. Behavior therapy: Psychological treatment where patient’s maladaptive behaviors changed to improve quality of life. “Behavior therapy” is generic term – Used to describe a variety of specific techniques intended to remove maladaptive behaviors. Techniques of behavior therapy: Systematic desensitization. Therapeutic
