Chapter 22: Mental Health Flashcards

1
Q

Mental illness

What is mental illeness and what are some interacting factors?

A

A diagnosable disorder of thought, mood, or behavior.
* Genes can predispose or protect against psychiatric illness; a single gene isn’t responsible for a disorder.
* Environment such as stress, drugs, can change how genes are expressed.

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2
Q

Mental illness

Describe Freud vs. Skinner’s view

A

Freud: Most of mental life is unconscious. Past experiences shape feelings for life.
Skinner: Pleasureable behaviors produce reinforcement. Negative behaviors produce aversion, mental illness is an inappropriate learned response and can be overcome by willpower.

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3
Q

Anxiety Disorder, OCD, PTSD

What are the 4 types of Anxiety disorders?

A
  1. Panic disorder
  2. Generalized Anxiety Disorder (GAD)
    - chronic worry accompanied by increased sympathetic arousal.
  3. Social Anxiety Disorder
    - Fear of social situations
  4. Phobias
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4
Q

Anxiety Disorder, OCD, PTSD

What is the HPA axis

A
  • Hypothalamus- In response to stress, periventricular zone secretes corticotropin releasing homorone (CRH)
  • **Pituitary **- In response to CRH, releases adrenocorticotropic hormone (ACTH)
  • **Adrenal **- In response to ACTH, releases stress hormone cortisol (a glucocorticoid)
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5
Q

Anxiety Disorder, OCD, PTSD

How are hypothalamic secretions of CRH regulated?

A

Regulated by the Hippocampus and the Amygdala
* Hippocampus
- Glucocorticoid receptors which respond to cortisol
- Suppresses CRH release in response to cortisal
- Negative feedback response

  • Amygdala
  • Dysregulation of amygdala is associated with anxitey-like bahviors
  • Sends output to BNST (Activates HPA axis)

Anxiety disorders are associated with hypoactivity of the hippocampus and hyperactivity of the amygdala

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6
Q

Anxiety Disorder, OCD, PTSD

What are Benzodiazepines?

A

Anxiety reducing drugs
* They are sedative-hypnotic class of CNS depressants that causes sedation and decrease cognitive function.
* Xanax, Valium
* They act on GABA-A receptors as positive allosteric modulators (PAMs)
- Cl- enters cell»> hyperpolarization
- Suppresses activity in brain circuits used in stress response

Xanax and alcohol can lead to overdose

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7
Q

Anxiety Disorder, OCD, PTSD

What are the downsides of Benzodiazepines

A

People will go through withdrawal and can’t function without them.

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8
Q

Anxiety Disorder, OCD, PTSD

What are SSRIs?

A

Another anxiety reducing drugs known as selective serotonin reuptake inhibitors.
* Prolongs actions of serotonin (5-HT) by blocking reuptake at SERT. (Ex. Prozac)
* Takes several weeks to become effective: do not work for acute anxiety episodes.

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9
Q

Anxiety Disorder, OCD, PTSD

What is OCD?

A
  • Obsession (thoughts): Recurring, persistent, intrusive thoughts of contamination, violence, sex or religion.
  • Compulsions (actions): Repetitive rituals to relieve anxiety generated by obsessive thoughts.
  • Some compulsions are unrelated to obessions

inappropriate or irrational and consume most of their waking hours.
Patients feel forces to do them against their will

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10
Q

Anxiety Disorder, OCD, PTSD

What is PTSD?

A

After witnessing severly traumatic events, an individual feels not only fear but also a sense of hopelessness and horror.
* Nightmares & flashbacks
* Increased physiological reactivity to reminders of the trauma, sleep disturbances, avoidance of stimuli associated with trauma, and anumbing of emotional responses for many years.
* Outbursts of irritability
* Increase in suicide
* increase in depression, substance abuse, marital problems, feelings of guilt and anger.

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11
Q

Affective Disorders and Bipolar Disorder

Give some info about major depressive disorder

A
  • Recurring episodes of dysphoria and negative thinkinh
  • World’s leading cause of disability
  • people could have different symptoms but still be treated the same so more research is needed.
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12
Q

Affective Disorders and Bipolar Disorder

What is the difference between Bipolar 1 & 2?

A
  • Bipolar 1: manic episodes with or without MDD episodes
  • Bipolar 2: Always associated with MDD and there is hypomania: increase in efficiency, accomplshment, & creativity.
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13
Q

Affective Disorders and Bipolar Disorder

Describe more about hypomanic episodes

A

May interfere to a degree with daily functioning, in patients with mania, day-to-day life is impaired. Hypomania does not include psychotic symptoms.

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14
Q

Affective Disorders and Bipolar Disorder

What are some treatments for bipolar disorders?

A
  • Lithium - Very effective treatment for mania
  • Anticonvulsants
  • Atypical Antipsychotics ( originally designated to treat Schizophrenia)
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15
Q

Schizophrenia

What is Schizophrenia?

A

It Is NOT an extreme of a normal brain state
* Loss of contact with reality
* Disruption of thought, perceptions, mood, and movement
* “Divided mind” Patients alternate between normal and abnormal states.

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16
Q

Schizophrenia

What are symptoms?

A
  1. Positive: Delusions or Hallucinations
  2. Negative: Reduced expression of emotion, withdrawal from social interactions, imporverishes thought and speech.
  3. Cognitive: Impaired working and memory and executive function (most resistant to treatment)

These are not all exhibited by a patient at one time

17
Q

Schizophrenia

Give descriptons of the genetics of Schizophrenia

A
  • Has one of the highest heritabilities of all the mental illnesses
  • 50% concordance in identical twins
  • No single gene is responsible
  • Symptoms may not appear until twenties but biological changes causing the condition begin early in development.
18
Q

Schizophrenia

What are other factors of Schizophrenia

A

Epigenetics
Environmental factors

18
Q

Schizophrenia

What is the dopamine hypothesis?

A

Schizophrenia results from too much too dopamine
* High doses of amphetamines in normal individuals produce psychotic symptoms
- Amphetamines enhance dopaminergic release
- Effective treatments for the positive symptoms of Schizophrenia block dopamine receptors

19
Q

Schizophrenia

What is the dopamine imbalance hypothesis?

A

Too much DA in mesolimbic DA pathway; to little in mesocortical DA pathway

20
Q

Schizophrenia

What is the neurodevelopmental hypothesis?

A
  • Schizophrenia is the result of neurodevelopmental alternations
  • Early life stresses and in utero problems increase the risk
  • Patients show reductions in brain volume, loss of dendrites and dentritic spines
  • Loss of gray matter in prefrontal cortex
  • Loss of gray matter in temporal lobe, amygdala, hippocampus; integration of cognition & emotion
  • Loss of gray matter counterbalanced by enlarged vetricles.
21
Q

Schizophrenia

What is the Glutamate Hypofunction Hypothesis?

A
  • Hypothesis: Schizophrenia arises from deficits in NMDA receptor function
  • Patients with Schizophrenia have reduced levels of NMDA receptors
  • PCP and ketamine are NMDA receptor antagonists (they block it) so they produce Schizophrenia like symptoms in normal individuals.
22
Q

Schizophrenia

What are treatments?

A
  • Antipsychotic (AP) drugs
  • Most effective at diminishing positive symptoms
  • Don’t really benefit the cognitive symptoms
  • 1st Generation or Typical APs
  • Chlorpromazine
  • D2 receptor antagonists
  • side effects: Extrapyramidal Symptoms (EPS)…Dystonia (continuous spasms & muscle contractions), Akathisia (motor restlessness), Parkinsonism (rigidity), Tardive dyskineasia (irregular, jerky movements)
  • 2nd generation APs
    -Clozapine
    5-HT & D2 receptor antagonists
    Bettr side effect profile
    Effective against negative and positive symptoms
  • Third Generation
  • Aripiprazole
  • Partial Agonist of D2 receptor
  • Supported by “DA imbalance hypothesis”
23
Q

Substance Use Disorders

What are the substance Use Disorders?

A
  • Alcohol
  • cannabis
  • Hallucinogens
  • inhalants
  • Opioids
  • Sedatives
  • Stimulants
  • Tobacco
24
Q

Substance Use Disorders

What are the treatments for substance use disorders?

A
  • Alcohol
  • Disulfiram (Makes drinking unpleasant)
  • Naltrexone (Block the hight that individuals get)
  • Acamprostate (Makes withdrawal easier)
  • Opioids
  • Methadone (ease withdrawal)
  • Buprenorphine ( Partial methodone receptor agonist)
  • Naltrexone (Patients have to get through the withdrawal process first then this drug prevents relapse)
  • Cigarette Smoking
  • Nicotine-replacement therapy
  • Cocaine, Amphetamines
  • None