Question 1

Which of the following mental health conditions could lead to the development of an eating disorder?

Accepted Answer

Body dysmorphic disorder involves a normal-looking person being overly concerned about some imagined defect or slight physical anomaly that could cause the affected person to develop an eating disorder.Conduct disorders involve behavioral problems but generally are not associated with eating disorder development.Oppositional defiant disorder is another type of disruptive behavioral disorder that involves negative behaviors directed toward authority figures.Impulse control disorder involves inability to resist impulses.

Question 2

Which of the following are sources of alpha-linolenic acid?

Accepted Answer

ALA is found in the oil of seeds and some nuts.Walnuts are the best source.

Question 3

What is the most efficient way to improve the omega-6:omega-3 ratio in the diet?

Accepted Answer

To bring the omega-6:omega-3 ratio closer to the recommendation of 2:1, increasing the intake of fish and seafood will increase the intake of omega-3 fatty acids while still providing omega-6 fatty acids.Simply supplementing the diet with fish oil supplements does not bring the omega-6 fatty acid level down.Instead, it requires higher intakes of fish oil supplements to bring down the ratio.Part of the problem with the omega-6:omega-3 ratio that is consumed now is because of the decrease in saturated fat intake and increased vegetable intake.This trend in dietary intake increases the omega-6 intake while not providing omega-3 fatty acids.

Question 4

What is the recommendation of the International Society for the Study of Fatty Acids and Lipids (ISSFAL) for the daily intake of DHA and EPA?

Accepted Answer

The ISSFAL makes a general recommendation for a daily minimum intake of 500 mg combined of EPA and DHA.However, this recommendation does not clarify whether this is for populations with significant or limited fish intake.A total intake of 500 mg of alpha-linolenic acid is the AI for infants.A total intake of 1100 mg of alpha-linolenic acid is the RDA for women, and a total intake of 1600 mg is the RDA for men.

Question 5

Flavonoid-rich foods include

Accepted Answer

Evidence indicates that plant-based foods, especially foods with flavonoids, have nutritional and possibly pharmacologic effects in the brain.These foods include apples, berries, chocolate, citrus fruits, grapes, and tea.

Question 6

Which of the following disorders is likely to result in obesity?

Accepted Answer

Impulse control disorders is a group of mental disorders characterized by repeated failure to resist an impulse to perform some act harmful to oneself or others.It may affect appetite with an increase or decrease, but obesity is more likely to result.Catatonia results in decline in nutritional status because of immobilization.Rumination disorder is seen in infants and results in death from malnutrition unless treated with nutrition support.Motor skills disorder has no specific nutrition problems associated except loss of ability to shop for and prepare food.

Question 7

Which of the following is an axis I disorder?

Accepted Answer

Axis I disorders are primarily biologic in origin as opposed to axis II disorders, which are personality disorders.Depression is characterized as an axis I disorder.Narcissism, dependence, and borderline personality disorder are problems associated with personality.

Question 8

Which of the following disorders may NOT necessarily affect appetite?

Accepted Answer

Conduct disorders include a persistent pattern of childhood or adolescent disruptive behaviors.These types of disorders do not affect appetite but may result in disruption of mealtimes.Catatonic disorder involves immobilization that may promote a decrease in appetite.Conversion disorder is a mental disorder that involves a loss or alteration of voluntary motor or sensory functions.These could affect appetite through either decrease or increase.The delusions associated with delusional disorders could affect appetite by promoting increase or decrease in intake.

Question 9

What is usually a first indicator that a person has an axis I disorder?

Accepted Answer

Patients with axis I disorders may exhibit the problem through food behaviors.Difficulties in choosing foods and alterations in eating habits may be an indication that a psychiatric disorder may be at work.Registered dietitians should not attempt to treat the mental health disorder.Actual diagnosis of a psychiatric problem uses psychological testing.For most axis I disorders, there are no definitive blood tests available for diagnosis.Headaches are symptoms associated with a variety of conditions that are more neurologic as opposed to psychological in origin.

Question 10

What mental health disorder is characterized by the development of anxiety or dissociation within 1 month after a traumatic event?

Accepted Answer

Acute stress disorder, also known as posttraumatic stress disorder, develops within 1 month of a traumatic event.An adjustment disorder is characterized by a maladaptive reaction to identifiable stressful life events.An anxiety disorder, such as panic disorder or a phobia, is characterized by anxiety and avoidance behavior.Dissociative disorders are characterized by sudden, temporary alterations in identity, memory, or consciousness.

Question 11

Which of the following mental health conditions may benefit from the use of a gluten-free, casein-free diet?

Accepted Answer

To address the cause of the pervasive developmental disorder associated with autism, a variety of diets have been investigated.A gluten-free, casein-free diet has been shown to be beneficial in treating the neurologic factors that appear in autistic disorders.Childhood disintegrative disorders may impact appetite, resulting in either increase or decrease.Motor skills disorder may cause difficulty in preparing and eating foods.Rett syndrome is another type of pervasive developmental disorder that could affect intake because of problems with loss of motor skills.

Question 12

Which of the following groups is at high risk for deficiency of DHA?

Accepted Answer

Experts have recently suggested that a daily intake of 900 mg of DHA during pregnancy may be necessary to support both infant and maternal needs.Starting in 2002, DHA has been supplemented to infant formulas to ensure adequate fatty acid for brain development.The risk of deficiency of omega-3 fatty acids has not been identified in elderly or adolescent females.

Question 13

Vitamin D deficiency has been associated with

Accepted Answer

Of the various sources that provide omega-3 fatty acids, eggs and marine algae only provide DHA.EPA and DHA are available in fish, fish oils, and fish oil powders.

Question 14

The primary responsibility of the RD working with patients with mental health diagnoses is to

Accepted Answer

The registered dietitian's (RD's) primary responsibility is in relation to being a source of information and support in helping the patient make appropriate eating choices.Medications are not used in the treatment of axis II disorders.In the case of medication use in axis I disorders, the RD would be involved with educating the patient about potential food-nutrient interactions.Preventing malnutrition is always a concern of the RD; however, not every patient with a mental health condition is at risk for malnutrition.The psychotherapy team is responsible for promoting behavior changes, including those related to eating.

Question 15

When omega-3 or LCFA supplementation is used, what else should be provided with the supplement?

Accepted Answer

Because supplementation with long-chain or omega-3 fatty acids runs the risk of oxidation, provision of vitamin E along with the supplementation will prevent oxidation.Other antioxidants in foods, such as vitamin C, are protective of brain function against inflammatory processes.Fatty acid supplementation does not necessitate an increased need for fiber or fluids.Use of these other antioxidants as protective agents with fatty acid supplements has not been investigated.

Question 16

Folic acid supplementation in the methylated form is useful in some psychiatric disorders because of its role in

Accepted Answer

Clients with some genetically linked psychiatric disorders have been shown to improve when given the methylated form of folate.This is because of folate's role in production and function of dopamine and serotonin.

Question 17

Which of the following mental health conditions does NOT include depression as a characteristic?

Accepted Answer

Obsessive-compulsive disorder (OCD) is characterized by recurrent obsessions or compulsions that are severe enough to interfere with personal or social functioning.In OCD, the patient may develop tension associated with compulsive rituals or behaviors.Bipolar disorder, dysthymic disorder, and schizoaffective disorder all include depression as a characteristic of the disorder.

Question 18

Which of the following statements about Axis II disorders is FALSE?

Accepted Answer

Axis II disorders differ from Axis I disorders because, to the individual who has an Axis II disorder, it serves an important purpose.Treating an Axis II disorder may actually temporarily increase distress and acting out in response to treatment.Psychotherapy is necessary to treat Axis II disorders because these learned behaviors are nonresponsive to medications.Sometimes, Axis I and Axis II disorders occur as comorbidities.When this occurs, the Axis II disorder may develop as a means to cope with the axis I disorder.

Question 19

Which of the following may NOT be an adequate source of omega-3 fatty acids?

Accepted Answer

Flax does not provide high enough levels of DHA and EPA to be a beneficial source of these fats.Margarine supplemented with fish oil, particularly menhaden oil, provides adequate DHA and EPA.In the case of menhaden supplementation, the Food and Drug Administration considers it safe as long as it does not promote an intake of greater than 3 g/day.Feeding flax to chickens, however, does promote an elevated amount of DHA in the egg yolk.

Question 20

Which of the following conditions may be improved by supplementation of long-chain fatty acids?

Accepted Answer

Supplementation with long-chain fatty acids (LCFAs) improves depression.Other mental conditions that benefit from use of LCFA supplementation include bipolar disorder, post-partum depression, schizophrenia, dementia, alcoholism, and tardive dyskinesia.Anxiety disorder, eating disorders, and attention-deficit hyperactivity disorder benefit from the use of fish oils.

Quiz 42: Medical and Nutrition Therapy for Psychiatric Conditions