Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PSYCHIATRY > 3. Mood and Anxiety Disorders > Flashcards

3. Mood and Anxiety Disorders Flashcards

1
Q

Definition of anxiety.

A

Combination of fear, stress, and psychological and physiological symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When does panic disorder usually develop?

A

early teens through 40 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When does social phobia (social anxiety disorder) usually develop?

A

bimodal (age 5 or early adolescence)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When do simple phobias to animals, blood and situations usually develop?

A 
animals= 7
blood= 9
situations= 2-7 and early 20s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

With equal exposure to trauma, what gender is more likely to develop PTSD?

A

females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When does OCD usually develop?

A

males 6-15

females 20-29 *especially post-partum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What gender is more likely to get OCD in childhood?

A

males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When does generalized anxiety disorder usually develop?

A

mid teens to mid twenties (especially after onset of chronic illness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What gender is more likely to get general anxiety disorder and panic disorder?

A

females 2X > males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What gender is more likely to get social phobia?

A

females, but males are more likely to seek treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which phobias are more common in males?

A

blood, injury and injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Definition: discrete period of intense fear or discomfort during which at least 4 characteristic symptoms develop abruptly and reach a peak within 10 minutes.

A

panic attacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the characteristic symptoms of panic attacks?

A
  • Palpitations, pounding heart
  • Sweating
  • Trembling/shaking
  • Dyspnea
  • Choking sensation
  • Chest pain/tightness
  • Nausea
  • Dizziness, fainting
  • Paresthesias
  • Chills/hot-flashes
  • Fear of dying/going crazy
  • Depersonalization/derealizaiton
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

True or false: panic disorder, by definition is relapsing (and may remit)

A

FALSE: it is chronic or relapsing (with remissions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you treat panic attacks?

A
  • EKG (rule out heart problem)
  • Short acting benzodiazepine (alprazolam) to calm patient down
  • Long term: SSRIs and CBT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How long must someone have recurrent panic attacks to be classified as having panic disorder?

A

1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Definition: fear (sometimes panic), often with blushing, of anticipated humiliation or rejection by others in social situations

A

Social Anxiety Disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the risk factors for social anxiety disorder?

A
  • Familial modeling of social avoidance
  • Being bullied
  • Humiliation as form of discipline
  • Disfiguring lesions (ex. burns)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What diagnosis is VERY similar to social anxiety disorder and what is the major difference?

A

Schizoid personality (but these people DO NOT DESIRE RELATIONSHIPS and in SAD they desire social relationships but they dread embarrassment so they avoid them)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the treatment for social anxiety disorder?

A
  • Rehearsal
  • Improved competence (Toastmaster’s International)
  • Beta-blockers (propranolol) to reduce public speaking distress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Definition: fear responses to specific cues, encountered during a particularly frightening experience.

A

Phobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What phobia may prevent you from getting an MRI on a patient?

A

claustrophobia (fear of enclosed spases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What physiological reason may cause a person with a phobia to faint?

A

vasovagal responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When do you treat a phobia?

A

only if the phobia inhibits some necessary activity (ex. air travel or health care) or fi the phobia creates excessive distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What treatment provides symptomatic relief of phobias?

A

benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What treatment provides lasting relief for phobias?

A

Systemic desensitization (repeated, gradual exposure to a feared stimulus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Definition: marked, persistent fear or anxiety about 2 or more situations (involving leaving the home/being in public) accompanied by avoidance of the situations.

A

Agoraphobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the specific situations that are avoided by people with agoraphobia?

A
  • Being outside the home alone
  • Standing in line or being in a crowd
  • Being in shops, theaters, cinemas
  • Being in open spaces
  • Using public transportation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

True or false: agoraphobia is commonly associated with panic attacks.

A

FALSE–may or may not be accompanied by panic attacks (and if they are present, they are most likely due to an untreated or undiagnosed panic disorder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the treatment for agoraphobia?

A

Systemic desensitization

SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Definition: persistent pattern of uncontrollable worries about health, safety, access to resources, and threats to other people (with the generalized fearfulness leading to constriction of behavior, avoidance of risk and inhibition of normal curiosity)

A

Generalized anxiety disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How long must symptoms occur before someone can be diagnosed with generalized anxiety disorder?

A

> 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What type of symptoms are very common in a patient with generalized anxiety disorder?

A

somatic symptoms like HA, backaches, difficulty concentrating, muscle tension (often CC and patients cannot make the connection between anxiety and somatic symptoms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the predominant symptom of substance/medication-induced anxiety disorder?

A

panic attacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What drugs may lead to substance/medication-induced anxiety disorder?

A

Stimulants (cocaine, meth, ADHD meds, caffeine), Alcohol, OTC decongestants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is required to diagnose medical-condition induced anxiety disorder?

A
  • Condition must be proved to induce anxiety

- Condition must precede onset of anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What sorts of medical conditions induce anxiety?

A
  • Endocrinopathies (ex, pheochromocytoma, hyperthyroidism, hypoglycemia)
  • Metabolic problems
  • Neurological problems (ex. vestibular dysfunction)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Definintion: disorder with intrusive, arousal and avoidance symptoms

A

OCD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Definition: fears of contamination or danger, unjustified guild, fears of doing something violent or socially inappropriate

A

Obsessions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is interesting about the obsessions of OCD?

A

they are recurrent, persistent, and UNWANTED (person cannot suppress them but realizes they are not normal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Definition: checking, washing, counting, confessing, symmetry/precision, hoarding

A

Compulsions (also UNWANTED)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What leads tot he “cycle” of OCD?

A

relief of arousal (from obsession) after patient acts out compulsions will reinforce it and cause behaviors to proliferate until they become disabling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

True or false: onset for OCD is sudden.

A

False (gradual onset and waxes and wanes with stress)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What predisposes to worse prognosis in OCD (ex. the 15% that severely deteriorate)?

A

early onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Definition: OCD-like condition with somatic concerns predominating (imagined defects, constant plastic surgeries).

A

body dysmorphic disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What medical conditions can be caused by compulsions of OCD?

A

trichotillomania (hair pulling)

excoriation (skin picking)

47
Q

What is the treatment for OCD?

A
  • SSRIs at very high doses (TCAs have worse side effects)

- CBT or benzodiazepines for compulsions

48
Q

What is on the differential diagnosis for OCD?

A 
brain lesions
medications
substance abuse/withdrawal
anorexia
schizophrenia
PANDA (repeated strep throat in children can lead to OCD like traits)
49
Q

Definition: persistent subjective state, expressed in through, emotion, behavior, and bodily functions

A

Mood

50
Q

Definition: major depressive episodes that may be isolated or recurrent and categorized as mild (few symptoms), moderate, or severe (marked effect on social/occupational functioning).

A

Major Depressive disorder

51
Q

How long must you have a persistent, severely depressed mood to be diagnosed with major depressive disorder?

A

2 weeks

52
Q

What are the risk factors for MDD?

A
  • 1st degree relative with MDD (2X risk)

- Bereavement that extends too long

53
Q

What is the mnemonic for classic presentations of depression?

A

SIG: E CAPS

54
Q

What are the SIG: E CAPS?

A 
Sleep disturbances
Loss of interest
Guilt
Energy loss
Concentration difficulties
Appetite disturbance
Psychomotor retardation/agitation
Suicidal thoughts
55
Q

Definition: depressed mood for 2+ years (never without symptoms) causing clinically significant distress or impairment

A

persistent depressive disorder

56
Q

What is the course of Persistent Depressive Disorder?

A
  • May be lifelong quality or personality trait

- May be superimposed episodes of major depression and may occur on top of depression (causing “double depression”)

57
Q

Definition: in week before menses onset, patient suffers form combination of symptoms

A

Premenstrual Dysphoric Disorder

58
Q

What are the symptoms of premenstrual dysphoric disorder?

A
  • Marked affective liability
  • Irritability
  • Anger
  • Interpersonal conflicts
  • Feel “on edge,” anxious, depressed, out of control or overwhelmed
  • Over-eating and food cravings
  • Sleep problems
59
Q

What is the timeline for premenstrual dysphoric disorder?

A
  • Symtpoms lasted for the better part of a year
  • Must be documented PROSPECTIVELY for at least 2 menstrual cycles
  • Must disappear shortly after onset of menses
  • NOT just exacerbation of interpersonal conflicts
60
Q

Definition: rapidly alternating mood states, occurring for at least 2 years, but never meeting criteria for MDD, mania or hypomania.

A

Cyclothymic disorder

61
Q

What condition is very similar to cyclothymic disorder, and what is the major differentiating factor?

A

Borderline personality disorder (patient may have both but BPD is more commonly associated with chaotic life circumstances, self-injurious behaivor, and history of abuse)

62
Q

Definition: “manic depression” with full blown mania at least 1 time and a major depressive episode may or may not occur

A

Bipolar 1

63
Q

What is mania?

A

lose contact with reality (grandiose, quick speech, irritable), severely impaired judgement, but still logical in their own way

64
Q

What must you do before diagnosing bipolar 1?

A

rule out drugs and medical conditions that cause mania

65
Q

Definition: distinct period of abnormally and persistently elevated, expansive or irritable mood and abnormal/persistently increased activity or energy in a patient with a history of a major depressive episode.

A

Bipolar 2

66
Q

How long must the hypomania last to diagnose bipolar 2?

A

at least 4 days consecutive days

67
Q

How long must the depressive episode have lasted to diagnose bipolar 2?

A

at least 2 weeks

68
Q

Why don’t people seek attention for hypomania in bipolar 2?

A

they are energetic, creative, and more efficient than usual

69
Q

What are risk factors for bipolar?

A
  • First degree relative with BP (5-10X risk)

- BPD is bridge between psychotic disorders and depressive disorders.

70
Q

How long must you have symptoms to be diagnosed with a simple phobia?

A

> 6 months

71
Q

How long must a manic attack last in bipolar 1 for diagnosis?

A

> 1 week

72
Q

Which brain structure is responsible for short-term memory?

A

hippocampus

73
Q

Which brain structure contains nuclei that are part of 3 distinct circuits that link cortical areas with sensory cortices and subcortical structures (and regulate emotion, motivation, arousal and attention)?

A

thalamus

74
Q

Which brain structure is responsible for conscious thought and executive functions (selection among alternatives, anticipation, inhibition of impulses, sequencing)?

A

dorsolateral prefrontal cortex

75
Q

Which brain structure is used to assess risk in pursuit of reward, relate new information to context (memory and environment)?

A

orbitofrontal cortex

76
Q

Which brain structure is used for integration of emotion and cognition?

A

anterior cingulate gyrus

77
Q

Which brain structure is responsible for fear, rage, and selective attention?

A

amygdala

78
Q

Which brain structure is responsible for reward?

A

nucleus accumbens

79
Q

Which brain structure is responsible for sleep, appetite, sexual behavior, metabolic rate, adaptation to acute or chronic environmental or social stress?

A

HPA axis

80
Q

In a mood disorder, which brain structure causes: lack of pleasure (depression), decreased or increased motivation

A

nucleus accumbens

81
Q

In a mood disorder, which brain structure causes: helplessness, indecisiveness, hopelessness, distorted sense of time (slowed in depression, accelerated in mania)?

A

dorsolateral prefrontal cortex

82
Q

In a mood disorder, which brain structure causes: cognitive inefficiency and recolleciton bias (depressed people cannot access happy memory; mania makes sad memories inaccessible)?

A

hippocampus

83
Q

In a mood disorder, which brain structure causes: overestimation of risk and reduced reward in depression, underestimation of risk in mania.

A

orbitofrontal cortex

84
Q

In a mood disorder, which brain structure causes: insomnia/hypersomnia, lack of or increased sexual interest, hyperphagia or anorexia?

A

HPA axis

85
Q

In a mood disorder, which brain structure causes:

  • Erratic arousal, subjective distress, compromised attention/concentration
  • Loss of pleasurable responses to sensation in depression
  • Potential hypersensitivity to sensory input in mania
A

Thalamus

86
Q

In a mood disorder, which brain structure causes: abnormal motivation (apathy in depression) and dysregulation of arousal?

A

anterior cingulate gyrus

87
Q

In a mood disorder, which brain structure causes: anxiety, irritability, vigilance, hypersensitivity to negative environmental cues

A

amygdala

88
Q

Definition: explaining diagnosis in terms of etiology/particular symptoms while offering ways to improve coping

A

Psychoeducaiton

89
Q

Definition: identification of distortions in thinking and maladaptive behavior that contribute to depressed mood then altering the reinforcing conditions that sustain it

A

Cognitive Behavioral Therapy

90
Q

Definition: focuses on link between depression and 4 interpersonal issues (loss, conflict or detachment, life transition, and deficits in social skills) so that patients can recognize and change patterns to prevent relapses

A

interpersonal psychotherapy

91
Q

What is response latency?

A

though mood disorders can be treated with SSRIs, TCAs, and MAOIs, it may take 6-8 weeks before full therapeutic response can be differentiated from a placebo response.

92
Q

How long should a patient stay on an antidepressant to prevent relapse?

A

4-6 months

93
Q

What type of DSM defined mood features are: overeating, oversleeping while depressed, preserved reactivity to reward?

A

atypical features

94
Q

What type of DSM defined mood features are: dense anhedonia, lack of response to reward, terminal insomnia (early morning awakening), dinural variation (mornings are worse)?

A

melancholic features

95
Q

What type of DSM defined mood features are: detachment form environment while awake; negativism including immobility, mutism, refusal to eat or drink and potential threat to life?

A

catatonic features

96
Q

What type of DSM defined mood features are: delusions of poverty, guild, nihilism, illness, self-disgust and derogatory auditory hallucinations?

A

psychotic features (mood congruent in depression)

97
Q

What type of DSM defined mood features are: delusions of special powers or unlimited resources, paranoia and auditory hallucinations?

A

psychotic features (mood congruent in mania)

98
Q

List the 4 categories of core signs and symptoms of mood disorders.

A
  • Pathological moods
  • Neurovegetative dysregulation
  • Cognitive qualities
  • Motor behavior
99
Q

What does a typical depressed child look like?

A

irritable with labile sadness (more common than prolonged, persistent sadness or anhedonia)

100
Q

What does mania in a child look like?

A

VERY similar to ADHD

101
Q

What are some motor behaviors (with speech) of depression?

A
  • Slow, sparse speech
  • Leaden paralysis
  • Agitation
102
Q

What are some motor behaviors (with speech) of mania?

A
  • Restlessness
  • Hyperactivity
  • Rapid, pressured speech
  • Difficult to interupt
103
Q

What are some pathological moods of depression?

A
  • Sadness
  • Negative mood
  • Anhedonia
  • Anxiety
104
Q

What are some mixed pathological moods?

A
  • Oscillating sadness
  • Euphoria
  • Anger
  • Anxiety
105
Q

What are some manic pathological moods?

A
  • Euphoria
  • Expansiveness
  • Irritability
  • Anger
106
Q

What are some neurovegetative dysregulations seen in depression?

A
  • Difficulty fallying or staying asleep
  • Early AM awakening
  • Exhaustion
  • Loss of appetite or overeating
  • Loss of sexual interest
  • Crying spells
  • Bodily symptoms of anxiety
  • Pain sensitivity
  • Slow GI activity (constipation)
107
Q

What are some neurovegetative dysregulations seen in mania?

A
  • Lack of need for sleep
  • Increased energy
  • Increased sexual interest and activity
  • Impulsivity
  • Hyperpahgia
108
Q

What are some cognitive qualities of depression?

A
  • Guilt
  • Worthlessness
  • Hopelessness
  • Helplessness
  • Suicidal thoughts
  • Difficulty concentrating or remembering
  • Memory biased toward negative experiences
109
Q

What are some cognitive qualities of mania?

A
  • Grandiosity
  • Suspiciousness or paranoia
  • Catastrophic loss of judgement with overspending
  • Thought disorder (circumstantiality, tangentiality, flight of ideas)
110
Q

After the first episode of major depression, how many patient have recurrence?

A

50%

111
Q

AFter the third episode of major depression, how many patients have recurrence?

A

90%

112
Q

If not treated, what is the recurrence rate for bipolar after 1 year? After 3 years?

A

50%; 90%

113
Q

What is rapid cycling?

A

four or more episodes of either mood in a bipolar patient within a year

PSYCHIATRY (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions