3 - Psychiatric Disorders Flashcards
Neurologic vs psychiatric disorders
- describe neurologic
- describe psychiatric
N: involve malfunction of/damage to the nervous system
-e.g. parkinson’s, huntington’s, epilepsy, MS, Alzheimer’s
P: disturbed behavior and emotional state
Biology and dx
- heritability
- neuropathology
- diagnosis
Highly heritable, 20-90% vulnerability
All are broad heterogenous syndromes, currently lack well-defined neuropathology
Via clinical observation
Anxiety disorders
- define anxiety
- describe
Subjective sense of unease, dread, or foreboding
Most prevalent type of psychiatric illness
Anxiety disorders -panic disorder: clinical manifestations —attacks —physical symptoms —onset/duration
Recurrent and unpredictable attacks
-distinct episodes
Palpitations, sweating, trembling, shortness of breath, etc.
Sudden onset, usually resolve in an hour
Onset typically late adolescence/early adulthood
Anxiety disorders
-panic disorder: causes, dx
—etiology
Unknown
Genetic predisposition
High rate of comorbidity with other psych condns
Anxiety disorders -panic disorder: tx —goals —meds —therapy
Decr frequency, intensity
Antidepressants (SSRI’s (prozac) and benzos (valium))
Cognitive and/or exposure therapy
Mood disorders
- characterized by
- subdivisions (3)
Disturbance in regulation of mood, behavior, affect
Depressive disorders
Bipolar disorders
Despression assoc with medical illness or substance abuse
Mood disorders
-depressive disorders: clinical manifestations
—characterized by
—major depression defined as
—approx __% of the pop experiences a major depressive episode at some point
Persistently depressed mood/loss of interest in activities, causing significant impairment in daily life
Depressed mood x 2 weeks straight
15%
Mood disorders -depressive disorders: causes —negative events —factors —unipolar depressive disorders
Can preciptitate/contribute, some are more susceptible
Most cases have both biological/genetic and psychosocial factors
Usually begin in early adulthood, occur episodically
-50-60% have recurrences
Mood disorders -depressive disorders: tx —requires —meds —psychotherapy —time frame for improvement
Coordination of short-term (induce remission) and long-term (prevent recurrence) strategies
Usualy TCAs and SSRIs
Usually combined with meds
-various other tx reserved for tx-resistent cases (e.g. electroconvulsive therapy)
Response usually elevated after couple months
-75% show improvement by then, if not referral advised
Physical symptoms and psych disorders
- definition of somatic symptom disorder (SSD)
- dx of SSD
Characterized by somatic symptoms as well as excessive/disproportionate thoughts, feelings, behaviors regarding those symptoms
-i.e. an overreaction to symptoms that may/not have medical cause
Must be persistently symptomatic, typically at least 6 mo
Physical symptoms and psych disorders -somatic symptom disorder (SSD) —main feature —PCPs often deal with how —it’s important for PCPs to
Pt’s concern with physical symptoms that they attribute to a non-psychiatric disease
Treatment - unneccessary testing and procedures
Legitimize pt’s symptoms and limit diagnostic testing/referrals to subspecialists
Physical symptoms and psych disorders -somatic symptom disorder (SSD) —proven treatments/therapies (3) —effective medications (2) —when to refer
Cognitive behavior therapy, mindfulness-based therapy, pharmacotherapy
SSRIs and TCAs
When tx by PCP is ineffective
Physical symptoms and psych disorders
-conversion disorder
Unintentional production of neurological sypmptoms that can’t be explained by medical condn or another mental health disorder
-abnormal cerebral activation patterns support theory of a “psychodynamic leison” which is also reflected by new term introduced in DSM-5: “functional neurological disorder”
Physical symptoms and psych disorders
-factitious disorder
Voluntary production of symptoms for psychological reward
-considered mental illness
