Psychiatric symptoms associated with multiple sclerosis include each of the following, except:
Correct Answer C:
Compulsions are not particularly associated with MS. Depression is the most common psychiatric symptom associated with this population, with a lifetime prevalence of 40-50%. Suicide risk is also elevated. The coexistence of mania and MS is as high as 13 times what would be expected in a normal population. Steroid therapy may precipitate manic episodes, but there is evidence that underlying organic changes in the brain play a role. Cognitive deficits such as memory impairment, slowed information processing, and concentration problems become present in 60-70% of MS patients.
Alcohol-induced amnestic disorder is associated with each of the following, except:
At autopsy, patients with Korsakoff's syndrome show hemorrhage and sclerosis of the mammillary bodies and thalamic nuclei along with diffuse lesions of the brain stem, cerebellum and limbic system. Thiamine treatment is usually successful in treating this condition, which can be diagnosed clinically by the presence of cognitive deficits and confabulation. One-fourth of patients with this condition remain impaired chronically.
The principles of sleep hygiene management include each of the following, except:
Correct Answer A:
Good sleep hygiene includes following a regular sleep schedule, maintaining a bedtime routine and a proper sleep environment, and using the bedroom primarily as a place for sleep. Regular exercise, relaxation strategies such as a warm bath, and avoiding any substances that interfere with sleep are important as well. Daytime napping may delay the expected return to sleep later that night, disrupting many of these beneficial patterns.
Compared with younger adults, healthy older adults:
Correct Answer D:
Normal older adults require less total sleep time. This change begins by the age of 50, and gradually increases with time. By age 75, total sleep time is reduce to 6 or 7 hours per night, and by age 85, 5 to 6 hours of total sleep time is biologically and physiologically normal. Older adults take longer to fall asleep, awaken more frequently at night, spend more time awake in bed, and spend far less time in stages of deep sleep.
Which one of the following sleep disorders is in the general class of circadian sleep disorders and may respond to bright-light therapy?
Shift-work insomnia is the only circadian sleep disorder listed. It may respond to bright-light therapy. Alcoholism is a behavioral disorder that may respond to gradual discontinuance. Inadequate sleep hygiene (use of stimulants at night, sleeping other than at bedtime, etc.) may respond to habit changes. Sleep-related myoclonus is an intrinsic sleep disorder and can be treated with levodopa or clonazepam.
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