Multiple choice questions: ANSWERS

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1 Multiple choice questions: ANSWERS Chapter 1. Diagnosis in children and adolescents 1. Which of the following statements best describes episodes of mood disorder among young people: c. Affective volatility among children seldom appears as an abrupt change, while adolescents are more likely to have a demarcated onset of affective illness 2. Disruptive mood dysregulation disorder is a new diagnostic entity that: b. Is intended to characterize early onset, persistent mood problems accompanied by intermittent behavioral loss of control to minor provocations 3. Severe irritability is: c. Common in several psychiatric disorder as well as a normative, self-limiting occurrence during adolescence 4. A typically shy 15-year-old who over a period of weeks becomes loud, socially intrusive, boastful and starts a campaign for election to the city council would raise suspicions of: a. Emerging mania or hypomania 5. During a manic episode: c. One experiences decreased need for sleep and does not feel fatigued Chapter 2. Benefits of early intervention in young people with bipolar disorder 1. Early intervention for bipolar disorder (BD) usually refers to: b. Early detection and treatment of manic or hypomanic episodes For reprint orders, please contact: reprints@futuremedicine.com 2014 Future Medicine Ltd 149

2 2. At-risk states for BD are associated with: 3. Later illness stages in BD are related to: 4. Early intervention services should ideally be: c. Holistic and recovery focused 5. The clinical stages of BD referred to in this chapter do not include: c. Recovery from the second episode Chapter 3. Medical comorbidity in youth with bipolar disorder: prevalence and implications for outcome 1. The occurrence of comorbid medical disorders in children and adolescents with bipolar disorder tend to: e. All of the above 2. Being overweight and obese among bipolar youth: 3. The most frequent cardiovascular disorders reported in the pediatric population: f. b and c 4. The predisposing factors for developing Type 2 diabetes mellitus in bipolar population are: i. b, d and e 5. The most common comorbid neurological disorder reported in children and adolescents with bipolar disorder is: c. Migraine Chapter 4. Substance use in youth with bipolar disorder 1. Bipolar disorder (BD) is reported to have an onset prior to substance use disorders (SUD) in the majority of adolescents: c. Frequently but sometimes it is simultaneous 2. Conduct disorder (CD) needs to be disentangled in order to understand the relationship of SUD in BD. Which of the following is true about conduct disorder? c. BD continues to be a risk factor for SUD even when examining non-cd samples 150

3 3. How does the developing theory of transitioning adolescents and young adults (TAY) help explain the high risk for the development of SUD in adolescents and young adults with pediatric onset BD? 4. Intervention for adolescents with BD and SUD should follow a careful evaluation of the patient including everything except for: c. Wellness evaluation 5. When treating adolescents with BD and SUD: d. Multimodal treatment of both SUD and BD are necessary 6. Which of the following is true regarding what we know about BD and SUD? a. Rates of SUD in adolescents with BD vary, with some studies findings rates up to 39% Chapter 5. Transitioning from child to adult care 1. Mark the correct statement (only one answer is correct): c. There are no studies looking specifically at pediatric bipolar disorder patients transitioning from child to adult care 2. What is known regarding the transition programs in different countries (only one answer is correct): b. In the USA, difficulties in accessing private insurance coverage during the early adult years is one of the many barriers to care for transitioning youth 3. A good transition service for youth with chronic conditions should (only one answer is correct): a. Eliminate protocols, policies and restrictions that impede timely transition to adult services for young people with special health needs 4. A transition service coordinator is (mark all that are correct): a. A healthcare professional who would take the lead of coordinating the transition of care with other professionals, family and the youth b. Considered to be a key component of transitioning services for youth with chronic conditions 151

4 c. A role inspired by the navigator model developed in cancer care d. Supposed to empower their patient s decision-making capacity, and facilitate and coordinate access to multiple levels of care, acknowledging the difficulties that patients have in navigating a fragmented healthcare system 5. About the headspace program in Australia (only one answer is correct): c. Headspace is a consortium of child and adult care providers aimed at reducing the complexity and fragmentation of the mental healthcare system, and better integrating existing resources Chapter 6. Acute treatment 1. Which mood stabilizer is still the gold standard in the treatment of bipolar disorder (only one answer is correct)? c. Lamotrigine 2. Acute presentation of mania or severe depression should be treated in the hospital if (two answers are correct): a. If medical complications such as comorbid disorders (e.g., cardiac diseases) are known. b. If the patient is at risk for suicidal behaviour 3. The first recommended pharmacological treatment strategy is (only one answers is correct): b. Monotherapy with a mood stabilizer 4. Which mood stabilizer is known to increase the risk for polycystic ovarian syndrome (only one answer is correct)? d. Valproate 5. Which other treatment strategies might be useful for the treatment of bipolar disorder (three answers are correct)? a. Electroconvulsive therapy b. Light therapy c. w3 fatty acids 152

5 Chapter 7. Maintenance treatment 1. Bipolar disorder in children and adolescents Multiple choice questions: answers a. Has been ideally treated with a combined pharmacological and psychotherapeutical strategy 2. Which mood stabilizer is known to have an antisuicidal effect? d. Lithium 3. What is the recommend time frame for the maintenance stage? d. The maintenance stage last for years 4. Which combination is especially known for an increased risk to develop a Stevens Johnson syndrome? b. Lamotrigine + valproate 5. Which atypical antipsychotic is often clinically used in treatment resistance symptoms? c. Clozapine Chapter 8. State of the art: psychotherapies for individuals at risk, or experiencing a first episode, of bipolar disorder 1. In the clinical staging model, stage 1 can represent: a. The presence of mild nonspecific symptoms or subthreshold symptoms 2. Currently how many psychological interventions that specifically target youth at risk of bipolar disorder (BD) have a therapy manual available? b. One 3. Which of the following interventions for youth who are identified as at risk for BD have been tested in a randomized controlled trial? b. Family-focused treatment with high-risk offspring of BD parents 4. Which of the following interventions for young people with BD includes a specific module for their parents to undertake on their own? b. Dialectical behavior therapy 5. Which of the following interventions is delivered exclusively in an 153

6 online format? b. HORYZONS 154