Managed Care - March 2008 - (Page M27) CONTINUING EDUCATION POST-TEST Mind Your Body: The Intersection of Physical and Behavioral Health Please tear out the combined answer sheet/evaluation form on page 28. On the answer sheet, place an X through the box of the letter corresponding with the correct response for each question. There is only one correct answer to each question. 1. According to Shore, poor clinical outcomes and overly expensive health care most likely result from: a. Failure to comply with the prescribed therapy. b. Cost of therapy. c. Lack of trust in the health care providers. d. Inconvenience of available services. 2. At IBM, the reduction in mean number of workdays missed was largely the result of: a. Behavioral change through enrollment in the Employee Assistance Plan. b. Improvement in outpatient health care services. c. Implementation of disease management programs. 3. Somatic symptoms common to women with depression and to women in menopause are: a. Sleep disorders. b. Physical pain. c. Reduced sexual responsiveness. d. Dysthymia. e. All of the above. 4. Progression through the four stages of reproductive aging in women is characterized by FSH, LH, and estradiol, and in luteal progesterone. a. Increased, decreased b. Decreased, decreased c. Increased, increased d. Decreased, increased 5. The diagnosis and treatment of depression in perimenopausal women is difficult because: a. Somatic and neurobehavioral symptoms are shared or may overlap. b. Cultural “loading” sometimes determines the diagnosis. c. Early life stress is overlooked. d. All of the above. 6. The primary barrier to effective care of depression is: a. Social stigma. b. Cost of therapy. c. Threat of suicide. d. Diffuse symptoms. 7. To make a diagnosis of minor depression in a patient, of the 9 core symptoms must be present, and one of the symptoms must be a. 1 to 3 symptoms; depressed mood or thoughts of death or suicide. b. 2 to 4 symptoms; depressed mood or anhedonia. c. 3 to 5 symptoms; depressed mood and sleep disturbances. d. 5 to 9 symptoms; anhedonia and thoughts of death or suicide. 8. The STAR*D study concluded that depression is best treated with: a. Monotherapy. b. Polypharmacy. c. Monotherapy combined with psychotherapy. d. Initial monotherapy with continuous patient monitoring to determine effective treatment. 9. Depression associated with a comorbidity such as diabetes or heart disease is best treated: a. Concurrently with an antidepressant. b. By depression counseling. c. Concurrently with psychotherapy. d. By alleviating physical distress. e. A combination of some or all of the above. 10. The mean duration of a primary care visit that involves depression or anxiety is: a. Less than 15 minutes. b. 18.8 minutes. c. 17 minutes. d. About 20 minutes. 11. Barriers to the adoption of evidence-based treatment in primary care include: a. Reimbursement policies. b. Ingrained attitudes and habits. c. Inability to expand practice. d. Inability to implement quality improvement programs and decision support tools. e. All of the above. 12. Primary care treatment of depression can be improved by: a. Implementing a care management function. b. Greater use of depressionmeasurement tools in evaluating patients. c. Restructuring carve-outs to promote evidenced-based treatment of depression. d. All of the above. SUPPLEMENT / 2007 MEDICAL DIRECTOR COLLOQUY 27
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