Mental Disorders Flashcards
Intellectual Developmental Disorder
ETIOLOGY:
1) hereditary, developmental, congenital, or traumatic factors -> cerebral hypoxia and malnutrition -> neural death
S/S:
1) Social deficits (empathy, making friends, emotional intelligence, interpersonal skills)
2) Conceptual deficits (reasoning, memory, language)
3) Practical deficits (executive function - organizing, hygiene, planning)
TREATMENT:
1) treat or manage underlying causes
2) exact therapy may vary with deficits
Learning Disorders
ETIOLOGY:
1) impaired visual, language, or memory processing -> impaired cognitive processes related to learning
S/S:
1) falling below school benchmark (based on mental age and standards)
2) low self-esteem, dropping out of school, interpersonal deficits
TREATMENT:
1) tutoring
2) stimulants if related to ADHD
Stuttering
ETIOLOGY:
1) stress and genetic factors -> stuttering (onset 2-7 years)
S/S:
1) repeated sounds, prolonged sounds, filled or unfilled spaces, broken words
TREATMENT:
1) speech therapy
BONUS FACTS:
1) spontaneous recover common into adulthood
Autism Spectrum Disorder (ASD)
ETIOLOGY:
1) RISK FACTORS include being male
2) unclear, but genetic factors involved
S/S:
1) communication impairment (absent nonverbal communication, delayed or absent verbal communication), repetitive motions, resistance to changes
TREATMENT:
1) behavioral therapy
2) risperidone (antipsychotic)
BONUS FACTS:
1) most ASD individuals manage adaptive behaviors into adulthood
2) Risperidone side effects include mammary development and secretion
Attention-Deficit Hyperactivity Disorder (ADHD)
ETIOLOGY:
1) genetic factors -> suspected abnormality in the prefrontal cortex -> impaired attention and impulse control
S/S:
1) difficulty maintaining attention, poor organization
2) squirming and fidgeting, and excessive talking
TREATMENT:
1) methylphenidate (stimulants)
2) vitamin supplements
Oppositional Defiant Disorder
ETIOLOGY:
1) poor child temperament, poor child management, and stressful life events
S/S:
1) arguing with adults, annoying others, disobeying, blaming others, irritability
TREATMENT:
1) family therapy and psychotherapy
2) possible risperidone (antipsychotic)
BONUS FACTS:
1) poor prognosis if diagnosed instead as conduct disorder
Tourette Disorder
ETIOLOGY:
1) Risk factors include family history; streptococcal infection
S/S:
1) nonrhythmic vocal (grunts, repetitive sounds, clicks) and motor (neck-jerking, blinking, grimaces) tics that changed over time
TREATMENT:
1) haloperidol (antipsychotic)
Alzheimer Disease
ETIOLOGY:
1) RISK FACTORS include chromosome 21 defects, autoimmune disorders, and neurochemical deficits
2) characterized by amyloid plaque and neurofibrillary tangles
S/S:
1) memory issues, communication issues, intellectual and physical impairment, sleep disturbances, irritability
TREATMENT:
1) donepezil (anticholinesterase)
2) haloperidol (antipsychotic)
3) paroxetine (SSRI)
Vascular Dementia
ETIOLOGY:
1) fibrous atheromatous plaque, embolism, minute aneurysms -> cerebral hypoxia and decreased nutrition -> neural death
S/S:
1) impairments in memory and judgments, changes in personality, poor executive function, apathy, depression, irritability
TREATMENT:
1) aspirin (antiplatelet)
2) carotid endarterectomy (surgical excision of tunica intima)
Dementia from Head Trauma
ETIOLOGY: any traumatic head injury that leads to cerebral edema and damaged blood vessels can cause hypoxia and decreased nutrition to brain cells
S/S: impaired intellectual and cognitive functioning
TREATMENT: treat injury to reduce further hypoxia, rehabilitative programs
PROGNOSIS: varies with extent of cerebral insult
Alcohol Abuse
ETIOLOGY:
1) PREDISPOSING FACTORS: family history, psychosocial stressors
S/S: 
1) frequent alcohol intoxication (behavioral issues, anxiety, impaired judgments, poor motor function, poor impulse control)
2) alcohol tolerance and withdrawal
3) peripheral neuropathy, cirrhosis, pancreatitis
TREATMENT:
1) rehabilitation program, group therapy, cognitive-behavioral therapy
2) disulfiram (antabuse targeting ethanol)
BONUS FACTS:
1) greatly increases risk of pancreatitis, cirrhosis, and peripheral neuropathy
Schizophrenia
ETIOLOGY: (unclear, but genetics, being male, stress, hypoxia, and infection may play a role) pathology theorized to be linked to dopamine, glutamate, and/or serotonin
S/S: positive effects (inappropriate affect, disorganized thinking, delusions, hallucinations) and/or negative effects (flat affect, poor executive function, social and occupational dysfunction, catatonia)
TREATMENT: atypical antipsychotics (risperidone), then typical antipsychotics if unresponsive (haloperidol)
PROGNOSIS: (prodromal to active to residual phase) best outcomes seen with acute rather than chronic schizophrenia, but best with compliance to treatment. Risk of extrapyramidal side effects with treatment
Bipolar Disorder
ETIOLOGY:
1) family history, stress, electrolyte imbalances, endocrine dysfunction (predisposing f.) -> suspected dopamine and/or serotonin imbalance
S/S:
1) manic episodes (grandiose or bizarre behavior, high arousal, lack of sleep, disorganized thoughts, euphoria, impaired judgment)
2) depressive episodes (flat effect, avolition, sleep disturbances)
* cycles
TREATMENT:
1) lithium carbonate (mood-stabilizer)
2) gabapentin (anticonvulsant for mood stabilizing)
3) antidepressants (during depressive episodes)
Major Depressive Disorder
ETIOLOGY:
1) (Predisposing Factors) psychosocial pressures, chronic illness, and alcohol dependency
2) Strongly linked to genetic and organic factors
S/S:
1) low-self esteem, avolition, anhedonia, inability to concentrate, social withdrawal, anxiousness
TREATMENT:
1) psychotherapy
2) fluoxetine (SSRI)
3) deep-brain stimulation (electro convulsive therapy)
4) atypical antipsychotics
Generalized Anxiety Disorder
ETIOLOGY:
1) genetic predispositions, stress, endocrine dysfunction, neurochemical imbalances
S/S:
1) free-floating anxiety, rumination, sleep disturbances
2) diarrhea, muscle tension, high blood pressure
TREATMENT:
1) psychotherapy, relaxation techniques (i.e. breathing exercises) 2) lifestyle changes
3) anxiolytic drugs
Panic Disorder
ETIOLOGY: (unclear) stress, endocrine dysfunction, neurochemical imbalances, and familial/genetic factors may play a role
S/S: episodes of unfocused anxiety (derealization or depersonalization, palpitations, high blood pressure, muscle tension, nausea)
TREATMENT: various forms of psychotherapy, relaxation techniques (breathing exercises) lifestyle changes, anxiolytic drugs
PROGNOSIS: best with compliance to treatment and strong support network
Phobic Disorders
ETIOLOGY: (unclear) severe stress, genetic predispositions, and prior conditioning may play a role
S/S: anxiety in response to phobic stimulus (situation or object usually not harmful in nature)
TREATMENT: cogntive-behavioral therapy, other forms of psychotherapy, anxiolytic drugs
PROGNOSIS: best with compliance to treatment and strong support system
Obsessive-Compulsive Disorder
ETIOLOGY: (unclear, but can be related to psychosocial stresses, endocrine dysfunction, and/or genetic predispositions) suspected abnormality in prefrontal cortex
S/S: obsessions (invasive and unwanted thoughts) and/or compulsions (behavioral urges, usual extremes of natural executive behaviors)
TREATMENT: psychotherapy, lifestyle changes, relaxation techniques, anxiolytic drugs
PROGNOSIS: best with compliance to treatment and strong support system
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptoccocal infections (PANDAS)
ETIOLOGY:
1) streptococcal infection -> autoimmune activity
S/S:
1) mood swings, separation anxiety, detachment from caregivers, sleep disturbances
2) exacerbation of pre-existing mental disorders (tics, hyperactivity)
TREATMENT:
1) antibiotics, possible steroids streptococcal infection
2) cognitive-behavioral therapy
3) SSRIs (OCD)
BONUS FACTS:
1) likely to recur with streptococcal infection
Post-Traumatic Stress Disorder (PTSD)
ETIOLOGY:
1) traumatic events (human-mediated or natural disaster) -> PTSD develops weeks, months, or years later
S/S:
1) strong physiological response to triggering stimuli, insomnia, nightmares
TREATMENT:
1) cognitive-behavioral therapy, pet therapy
2) benzodiazepines (for sleep)
3) anxiolytic drugs or SSRIs
Somatization Disorder
ETIOLOGY: (unclear) may be linked to family history and extreme periods of stress
S/S: pain in at least four body areas, GI symptoms (nausea, vomiting), sexual dysfunction (irregular menses or erectile/ejaculatry dysfunction)
TREATMENT: rule out any other medical condition, psychotherapy
PROGNOSIS: generally very poor, complete remission unlikely
Conversion Disorder
ETIOLOGY: in response to extreme stress, anxiety converted into physical symptoms as defense mechanism
S/S: disrupted voluntary motor function (tics, paralysis, tremors) impaired sensory function (paresthesia, anesthesia, analgesia, hyperesthesia), impaired speech, visceral symptoms (headaches, GI issues, difficulty swallowing)
TREATMENT: symptom-based, possible psychotherapy and hypnosis
PROGNOSIS: varies based on level of stress, but may resolve within few weeks. Recurrence is likely
Pain Disorder
ETIOLOGY: related to clinical-pathologic factors (musculoskeletal diseases, neurologic diseases, malignancies) and/or psychological factors
S/S: severe pain that may interfere with daily functioning
TREATMENT: treat underlying pathologies, possible narcotic analgesics, possible psychotherapy
PROGNOSIS: varies based on pathology
Hypochondriasis
ETIOLOGY: unclear, but different from malingering
S/S: (from a clinical perspective) preoccupation with illness, vague symptoms, generalized history
TREATMENT: treat any underlying pathologies, psychotherapy
PROGNOSIS: varies based on willingness to attend therapy
Factitous Disorder
ETIOLOGY: (unclear, behavior may be incentivized by attention)
S/S: individual may exaggerate their or someone else’s symptoms, self-imposed illnesses (i.e injecting foreign material), tampering with medical equipment
TREATMENT: believed to be untreatable (patients often find another caregiver when confronted), remove child from caregiver if caregiver-imposed
PROGNOSIS: varies based on duration of condition (worse if chronic)
Gender Dysphonia
ETIOLOGY: (uncertain)
S/S: gender identity differs from sex, discomfort with assigned gender role, adopting of behavioral habits of opposite sex, possible low-self esteem from ostracism
TREATMENT: possible hormone therapy, possible surgical intervention, psychotherapy for low self-esteem
PROGNOSIS: varies on extent of patient’s feeling and social network
Insomnia
ETIOLOGY: contributing factors include pain, stimulants (caffeine, amphetamines), anxiety, jet lag, noisy/hot/cold/bright/uncomfortable room
S/S: difficulty falling or staying asleep, nonrestorative sleep, irritability
TREATMENT: remove contributing factors if possible, psychotherapy if anxiety-induced, possible melatonin or benzodiazepine-class hypnotics
PROGNOSIS: varies on exact etiology, better if patient able to modify contributing factors
Parasomnias (Sleep Arousal Disorders)
ETIOLOGY: psychological factors, brain tumors, high fevers, certain drugs, and genetic factors may precipate disorders
S/S: parasomnias include sleepwalking (occurs during NREM S3, no recall), night terrors (NREM 3, no recall), and nightmares (REM)
TREATMENT: preventing injury, eliminate psychological factors, eliminate precipitating drugs
PROGNOSIS: varies on exact etiology, but tends to recede into adulthood
Narcolepsy
ETIOLOGY: strong genetic factors with REM stage occuring earlier in sleep
S/S: recurring compulsions to sleep (usually during monotonous activtiy)
TREATMENT: sleep-pattern changes, possible stimulants (methylphenidate or dextroamphetamine
PROGNOSIS: varies on response to therapy
Sleep Apnea
ETIOLOGY: obesity, genetic defects, or bronchitis leads to respiratory tract obstruction
S/S: breathing may stop during sleep, nonrestorative sleep
TREATMENT: encourage weight loss, continuous positive air pressure (CPAP) machines, possible uvulopalatopharyngoplasty (UPPP)
PROGNOSIS: varies on etiology
General treatment for personality disorders?
1) Psychotherapy (usually dialectal behavioral therapy, or DBT): identifying and altering thoughts and behaviors for interpersonal and emotional benefit
2) Possible drug therapy for comorbid disorders (antidepressants, anxiolytics)
Cluster A Personality Disorders
Paranoid PD: suspicious and distrustful of others
Schizoid PD: prefer isolation, detached from others
Schizotypal PD: difficulty making or maintaining relationships, cognitive distortions related to everyday relationships
Cluster B Personality Disorders
Antisocial PD: disregards social norms, can be manipulative or aggressive
Borderline PD: abrupt shifts in mood, unstable relationships, fear of rejection
Histrionic PD: desires attention, grandiose or promiscuous behavior
Narcissistic PD: extreme self-esteem, may react aggressively to criticism
Cluster C Personality Disorders
Avoidant PD: fear of being judged by others, poor self-esteem, may feel socially inept
Dependent PD: relies on others to make decisions, may be clingy, fears being alone
Obsessive-Compulsive Personality Disorder: desires control, obsessed with perfection
