Chapter 9: Psychiatric (DSM-5) Disorders Flashcards
What is the most common known cause of intellectual disability?
fetal alcohol syndrome
What are the most common genetic causes of intellectual disability?
Downs and Fragile X syndrome
Mild intellectual disability typical level of functioning? Also when is it typically diagnosed?
self-supporting with some guidance; usually diagnosed first year in school
Moderate intellectual disability level of functioning?
benefits from vocational training but needs supervision; sheltered workshops
Severe level of intellectual disability has what characteristic features in functioning?
vocational training not helpful, can learn to communicate and manage basic self-care habits
A profound level of intellectual disability can lead to what level of functioning for the individual?
needs highly structured environment with constant nursing care and supervision
What is the hallmark of autism spectrum disorder?
inability to connect with others
Some differential diagnosis to think of when considering autism spectrum disorder diagnosis?
- Rett syndrome
- social communication disorder
What are some features of Rett syndrome and social communication disorder that make them different from an individual with Autism Spectrum disorder?
Rett Syndrome
- girls > boys
- microcephaly
Social communication disorder
- communication disorder
- absence of RRBs
What is the major treatment for autism spectrum disorder?
behavioral techniques (shaping) and antipsychotics (for aggression only) e.g risperidone
Major characteristic of Tourette Syndrome?
- characterized by multiple motor and vocal tics that occur many times per day or intermittently for more than 1 year
What gender is seen to have tourettes more?
men
What is the mean age by which most people have tics in Tourrettes Syndrome?
age 7 ( onset must be < 8)
What conditions is Tourrette’s associated with?
ADHD and OCD
Main treatments for Tourette’s?
haloperidol, pimozide, or clonidine
What are the major characteristics of ADHD?
marked by inattention, impulsivity, and/or hyperactivity that lead to problems functioning at home, school, or work
The main gender to have ADHD
men > women 3:1
What are the requirements needed to be given the diagnosis of having ADHD?
Impairment must occur in at least 2 settings:
- Symptoms > 6 months
- Symptoms age < 12
- associated with a dopaminergic and noradrenergic imbalance
Treatment for ADHD?
- methylphenidate, dextroamphetamine, atomoxetine, or guanfacine
Compare the age of diagnosis for CD vs ODD?
Conduct disorder vs oppositional defiant disorder
CD = Until age 18
ODD = preteens - teens
Compare the gender predisposition of CD to ODD.
CD = Boys > girls
ODD = Boys > girls (pre-puberty)
Compare the symptoms of CD to ODD
CD
- 6 months of aggressive behavior
- violation of rules of society
- destruction of property
- deceitfulness or theft
ODD
- 6 months of negative, hostile, and defiant behaviors toward authority
Compare CD vs ODD etiology.
CD = genetic
ODD = N/A
Symptoms of brief psychotic disorder.
- hallucinations, delusions, disorganized behavior or thinking
Symptoms of schizophreniform.
- hallucinations, delusions, disorganized behavior or speech
Symptoms of Schizophrenia?
- hallucinations, delusions, disorganized behavior or speech, catatonic symptoms, negative symptoms, marked reduction in level of functioning
What are some symptoms of schizoaffective disorder?
- schizophrenia symptoms such as hallucinations and delusions PLUS mood disorder symptoms such as depression and mania
- must have at least 2 weeks of psychotic symptoms in the absence of mood symptoms
Duration of symptoms for brief psychotic disorder.
> 1 day but < 30 days
Duration of symptoms for schizophreniform disorder.
> 1 month but < 6 months
Duration of symptoms for schizophrenia?
> 6 months
Treatment for brief psychotic disorder?
antipsychotis
Treatment for schizophreniform disorder?
antipsychotics
Treatment for schizophrenia?
antipsychotics
Treatment for schizoaffective disorder?
antipsychotics and mood stabilizers if bipolar type of antidepressants if depressed type
Age of onset for schizophrenia for men and women?
Men = 15 - 25
Women = 25 - 35
What are some different causes of schizophrenia? Evidence?
- genetic: monzygotic greater than dizygoitc
- viral: more born in winter and early spring
- social: downward drift and social causation theories
- neurochemical/biochemical: associated with increased levels DA
What are the changes in DA levels in a person with schizophrenia and related effects?
DA is increased and this leads to the positive symptoms
What are the changes commonly seen in serotonin levels of one with schizophrenia and the related effects?
5HT is increased and these are responsible for positive and negative symptoms
What are the changes seen in glutamate levels of those with schizophrenia and drugs that produce related effects?
Glutamate will increase/decrease
PCP ( glutamate antagonist) leads to schizophrenia-like symptoms
What the changes to nicotine levels seen in those with schizophrenia and the related changes seen?
Nicotine is decreased and this affects cognition
What are the changes to GABA seen in one with schizophrenia and the related effects seen?
GABA = decreased
This leads to hyperactivity of dopaminergic neurons
What is the change seen in the ventricles in one with schizophrenia?
increase
What is the change seen to brain symmetry in one with schizophrenia?
decreased
What areas of the brain decrease when someone has schizophrenia?
limbic system, prefrontal cortex, thalamus (basal ganglia may increase or decrease
Major Depressive Disorder has a predisposition for what gender?
women > men
What are some requirements for symptoms that lead to diagnosis of MDD?
Symptoms > 2 weeks and affect level of functioning ( must include depressed mood or anhedonia, plus other symptoms such as low energy, poor concentration, sleeplessness, loss of appetite or libido, suicidal ideation
Treatment for MDD?
antidepressants
Treatment for MDD with seasonal pattern?
phototherapy
What is persistent depressive disorder and qualifications for diagnosis.
- less severe than major depressive disorder
- > 2 years; depressive symptoms experienced most days
Treatment for persistent depressive disorder?
primarily psychotherapy
