NR 509 Final Study Guide
Behavior/Mental Health Assessment and Modification for Age
1. Assessment:
a.
b. Many mental health disorders are masked by other clinical conditions;
20% of primary care outpatients have men
...
NR 509 Final Study Guide
Behavior/Mental Health Assessment and Modification for Age
1. Assessment:
a.
b. Many mental health disorders are masked by other clinical conditions;
20% of primary care outpatients have mental disorders(50-70% go
undetected and untreated)
c. Physical symptoms account for approx 50% of office visits
d. ⅓ of physical symptoms are unexplained; in 20-25% those symptoms
become chronic
e. Symptoms and Behaviors:
i. Sorting symptom is a challenge; can be unexplained symptoms
1. Patients who have unexplained symptoms depression and
anxiety exceeds 50%
ii. Physical or “somatic” symptoms account for 50% of U.S. office
visits
1. Pain, fatigue, palpitations, GI symptoms, sexual dysfunction,
dizziness or loss of balance
2. Symptoms that present as clusters are called “functional
syndromes” such as IBS, fibromyalgia, chronic fatigue, TMJ
disorder, and multiple chemical sensitivity
3. The presence of symptom overlap is high in the common
functional syndromes such as fatigue, headache, sleep
disturbance, pain, GI upset
iii. Patients with unexplained and somatic symptoms are often frequent
users of the health care system and termed “difficult patients”
iv. Patients with symptoms that last longer than 6 weeks are recognized as
chronic and should be screened for depression and anxiety.
a. A two tiered approach is recommended for screening. A brief
screening with questions that yield high sensitivity then a
more detailed investigation when indicated
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