Final Exam Flashcards
Prevalence of Major Depressive Disorder?
2X as common in women
approximately 4.7% of Canadians
2-9% of depressed patients commit suicide
**Only chronic for a minority of people. Depression normally remits within 6 months for most people.
*Highest % in young people and *lowest in older people
Symptoms of Somatic Symptom Disorder
One or more bodily symptoms causing persistent (>6months) distress
*Excessive thoughts, feelings, and/or behaviours related to these bodily symptoms. (preoccupation, anxiety , excessive time and energy devoted to these symptoms)
- Chronic, but fluctuating
- EXCESSIVE medical consultation and intervention, without effect
- Can and does occur alongside real physical problems
- Inability to realize that your concern is out of proportion
- Resistant to psychological referral
Appraise their symptoms as unduly threatening, despite reassurance
High comorbidity with depression and anxiety
Physical symptoms associated with significant psychological stress or impairment
What disorders are most common in females?
Depression is 2x as common in women Phobias 2x as frequent Dissociative amnesia Anorexia-90% female (under the age of 30) Dissociative Identity Disorder Conversion Disorder 2-3x more common Social Phobia (2x as common) Generalized Anxiety (2x)
Which disorders are most common in males?
Gender dysphoria is 2-5X more common Dissociative amnesia (*Only for young men in war) Paraphilias Paranoid personality disorder Antisocial personality disorder 2X Gambling Disorder (Problem Gambling)
Symptoms of Generalized Anxiety Disorder
Worried, always nervous about everything
Nonspecific anxiety
self conscious- need excessive reassurance
Psychosomatic complaints: Upset stomach etc.
(Heightened anxiety produces more stress hormones that affect the body)
**Chronic, does not necessarily go away with time or treatment
*Highly genetic
Symptoms of Trichotillomania
Compulsive pulling out of hair, strand by strand
- Chronic
- No associated thought, which is where it differs from OCD
**Differs from OCD, because there is no associated obsessive thought
*No cognitive component, so medication is more likely to be used
In OCD behaviours are often done to counteract the obsessive thought
Treatment for Generalized Anxiety
- CHRONIC does not go away forever, even with treatment
- Does not respond to desensitization
1) Meditation:1) Here+ now focus 2) slows down mind ( no peripheral thoughts)
2) Medication : Buspirone (No withdrawl/Dependence)
3) Sometimes antihistamines
4) CBT+ Relaxation training Exercise
5) Easily aroused, sensitive limbic system. “Sensitive brain”.
Causes for Generalized Anxiety
1) Genetics
2) Easily aroused, sensitive limbic system. “Sensitive brain”.
3) Closeknit family
PTSD
Syndrome experienced by some people following a traumatic event
Includes:
1) Intrusive thoughts
2) Persistent arousal/agitation
3) Avoidance behaviours (Includes dissociative amnesia)
Common among emergency personnel
3-4% prevalence
Treatment for PTSD
NOT EFFECTIVE : Critical incident stress debriefing *However can be used to identify people who need the most help
Effective:
EMDR(Eye movement desensitzation reprocessing)
+or Desensitization
- personnel must commit
-helps to address actualy issue
-effective for nightmares especially
*Reinvoking thoughts/sounds to relive the event
Benzos: 1-2 weeks
*can cure completely in short term PTSD
Helps to prevent alcohol dependence
Medication for OCD
Clomipramine- SSRI
Cingulotomy
Surgical treatment for OCD, cuts connections between emotional parts of the brain
20-25% success for OCD
Best treatment for BDD?
CBT- challenge irrational thoughts by introducing rational beliefs surrounding bodyparty
I.e. “Nose is too big” -> “Nose is fine and no bigger than anyone elses”
SSRI- Sometimes helpful
Cosmetic surgery- Not helpful
Symptoms of MDD?
DSM criterion shown to be consistent across cultures in first, second and third world countries
1) At least two weeks of depressed mood and/or the loss of interest or pleasure in most activities.
Plus 4 additional symptoms from:
Changes in appetite or weight (Increase or decrease in weight, normally due to increase or decrease in appetite), Sleep disturbances (change in normal sleep pattern), agitation, decreased energy, feelings of worthlessness or guilt, difficulty concentrating or making decisions, recurrent thoughts of death, or suicidal ideation.
Most common additional symptoms:
Changes in appetite: Appetite may increase or decrease
Changes in weight: Increase or decrease in weight
Sleep disturbances: Normal pattern changes. May sleep more, or may sleep less. May awake frequently, ie every night at 2am
Agitation: Some people may become jittery and anxious, while others become lethargic and cant get out of bed
Treatments for Social Phobia?
Exposure:
Relaxation training:
Social skills training: Some people are socially phobic because they don’t know how to make small talk.
Yoga:
Drugs: Primarily benzodiazepines**, such as valium
SSRIs can also be effective
One-year prevalence of mental disorders
OCD-1-1.5%
What is addiction?
Difficulty controlling involvement in a pleasurable activity despite the activity causing significant problems for the person
*In OCD no pleasure is involved
How is addiction assessed?
1
What disorders are rare (With a prevelency of 1% or less?)
Schizophrenia Dissociative identity disorder, anorexia-0.4 dissociative fugue Gender Dysphoria (Less than 0.01%) Delusional disorder (0.2)
What disorders are common ( prevelency of 5% or more)
1 Any Phobias(7-9%) Social Phobia(7% in NA) Hoarding (2-6%)(could also be considered medium) Somatic Symptom Disorder (5-7%) Illness Anxiety Disorder
What disorders are middle prevalency (Between 1% and 5%)?
1 OCD(1-1.15%) Body Dysmorphic Disorder (2%-3%) Bulimia(1-2 percent) Schizoid personality disorder (3-5)% Bipolar Disorder (1.5%) PTSD (3-4%) Panic Attacks
What 2 addictions are more common among females?
Eating addiction: 70% are females
Shopping addiction: 85% are females (maybe due to evolutionary drive for women to gather)
What 4 addictions are most common among males?
Drug addictions(includes nicotine and alcohol): 25%; 60 % males
Gambling addictions: 2.4 65% males
Sex addictions: 2% overall: 70% males
Videogame addictions: 2% overall: 70% males
How prevalent is addiction?
*Most common mental disorder worldwide
Highest rates are in 18-30 year olds
episodically chronic for drug addiction and gambling; unknown for other addictions
High rates of co-occurance with other addictions (Due to reward pathways being predisposed towards over-involvement)
high rates of co-occurance with depression
Prevalence of problem gambling?
Twice as high in males
*Least common in Europe-1%
moderate in North America + Australia
*Most Common in Asia-5%
What causes addiction?
30-70% genetic
This manifests neurobiologically as dysregulation of the reward pathways and centers in the brain
Behaviourally: Impulsivity, ADHD and a propensity for risk taking
Environmental factors: 50% environmental
What are the 4 types of schizophrenia?
Brief Psychotic Disorder- break with reality, talking like crazy etc. *Lasts a month or less
Schizophreniform: *Between one and six months. *Almost always consists of positive symptoms, hallucinations etc.
*1/3 of these recover, the rest progress to schizophrenia.
Schizophrenia: *If it lasts longer than 6 months
Schizoaffective: Combination of schizophrenia symptoms + mood disorder either depression or bipolar/mania
What disorders have an equal sex ratio?
The Schizophrenias
Delusional Disorder
OCD
Bipolar
Illness Anxiety Disorder
Treatment for addiction
*On Final
is effective in the shorterm, but not as much in the longterm
Treatment for addiction
*On Final
is effective in the shorterm, but not as much in the longterm
Most addicts have periods of abuse followed by remittence, only a small minority will be unremittently chronic
What are the relapse rates for alcohol?
After 2 years of abstinence: 41% will relapse
After 4 years of abstinence: 25% will relapse
After 6 years of abstinence: 7% will relapse
Medication for alcohol addiction
Antabuse
Medication for heroin addiction
naltrexone(Reduces pleasure +Craving)
Drug substitutions for each of alcohol, tobacco, amphetamines and heroin:
Alcohol: Benzodiazepines
Tobacco: Nicotine patches, gums, inhalers etc.
Heroin: Methadone
Amphetamines: Methylphenidate, Vyvanse
Medication for tobacco addiction
Bupoprion
Medication for gambling addiction
naltrexone
What 6 factors are related to positive treatment outcome in addiction?
client motivation and premorbid functioning -empathetic and engaging therapist recieving and staying in treatment providind comprehensive services behaviourally oriented approaches ongoing support services/groups
Drug substitutions for each of alcohol, tobacco, amphetamines and heroin:
Alcohol: Benzodiazepines
Tobacco: Nicotine patches, gums, inhalers etc.
Heroin: Methadone
Amphetamines: Methylphenidate, Vyvanse (harder to get high)
What 6 factors are related to positive treatment outcome in addiction?
1) client motivation and premorbid functioning
- empathetic and engaging therapist
- receiving and staying in treatment
- providing comprehensive services
- behaviourally oriented approaches
- ongoing support services/groups * Addiction is a lifelong condition
Chronic disorders
Addictions Generalized anxiety disorder Anorexia Schizophrenia Dissociative amnesia BDD Hoarding Illness Anxiety Disorder
Difference between delusional disorder and schizophrenia?
With elusional disorder delusions, the patient will have “logical explanations”, and their delusions will not seem as “impossibly bizarre”, more comprehensive and seemingly plausible.
Schizophrenia delusions are much more bizarre, out of touch, and the patient will not have reasonable explanations
Schizophrenic symptoms with the best prognosis
Positive Symptoms = better prognosis
Negative symptoms are harder to treat = worse prognosis
Acute/early onset = good prognosis
Slow/late onset = bad prognosis
Female- good prognosis
Male-bad prognosis
Mood disturbance such as depression- better prognosis
No family history- good
Family history- bad prognosis
What are the causes of schizophrenia?
*Genetic heritability- one of the highest for this
Diagnosis of schizophrenia
2 or more of: hallucinations, delisions, disorganized or catatonic behaviour, disorganized speech, negative symptoms (avolition, poverty of speech , affective flattening)
Disorders with a good likelihood of successful treatment? (Good prognosis)
Depression
PTSD
bulimia
Intermittently chronic disorders?
Bulimia
Addiction
Histrionic Personality Disorder
Needs constant attention and can never get enough
*May be female version of antisocial personality
Antisocial personality disorder
Most reliable personality disorder
Must have been diagnosed with conduct disorder as a child
pervasive pattern of disregard for and the violation of the rights of others
childhood signs: lying, cheating, stealing, truancy
adult signs: excessive sexuality, drug use, aggressiveness ,inability to tolerate boredom, criminality, reckless disregard for others safety, impulsivity and inability to plan ahead
Borderline Personality disorder
Pervasive pattern of ubstable interpersonal relationships and mood
1-6% prevalence
Marked impulsivity
75% female
Assessment of schizophrenia
2 or more of hallucinations, delusions, disorganized or catatonic behaviour , disorganized speech, negative symptoms (ie affective symptoms, poverty of speech, avolition)
What structures of the brain are involved in the reward pathway implicated in addiction?
Ventral tegmentum
Nucleus accumbens
Prefrontal cortex
Environmental risk factors for schizophrenia
Social isolation
Living in an urban environment
Being an immigrant
Neurobiological causes of schizophrenia
Overactivity of dopamine in limbic system, underactivity of dopamine in PFC
Enlarged ventricles and decreased brain weight (especially in chronic)
Environmental causes of schizophrenia
Up to 50% of schizophrenia is environmental
Prenatal stressors (flu, stress, malnutrition)
Living in an urban ennvironment
Cultural variations (High in ireland, yugoslavia, sweden, but low in hutterites and aborigines, which cant be accounted for genetically)
Social isolation
Poor family communcation and deviant role relationships = predictor of relapse
Substance use: especially cocaine, amphetamine and marijuanna
Describe the causes and treatments for 5 disorders
1 2 3 4 5
Difficult to treat disorders
Personality disorders
Somatic Symptom Disorders
Illness Anxiety Disorder
Treatment for hobias
1) Desensitzation (Flooding)
2) Systematic desensitzation
Treatment for phobias
1) Desensitzation (Flooding)
2) Systematic desensitzation
3) Benzos
What are personality disorders?
DEFINITION: enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts and are inflexible and maladaptive.
What causes agorophobia?
Fear of fear- fear of arousal
Treatments for schizophrenia
Soteria Houses phenothiazines risperidone depot forms cbt coping strategies family education programs social skills training humming avatar training
