Prelims Flashcards
T or F
mood can Influence a person’s behavior and perception of the world
TRUE
Pervasive and sustained
* Feeling tone that is expressed internally
Mood
Types of Mood Disorders
Major depressive disorder/unipolar depression
Bipolar disorder
Cyclothymia and dysthymia
Hypomania
both manic and depressive
episodes or patients with manic episodes alone
Bipolar disorder
episode of manic symptoms that
does not meet the criteria for manic episode
Hypomania
as disorders that
represent less severe forms of bipolar disorder
and major depression, respectively.
Cyclothymia and dysthymia
Major ___episode:
* occurs without a history of a manic, mixed, or hypomanic episode
* must last at least 2 weeks
Depression
Characteristics of?
-changes in appetite and weight
- changes in sleep and activity
- lack of energy
- feelings of guilt
- problems thinking and making decisions
- recurring thoughts of death or suicide.
Depression
is a distinct period of an abnormally and
persistently elevated, expansive, or irritable mood
lasting for at least 1 week (or less)
Mania
Characteristics of?
A hypomanic episode:
- lasts at least 4 days
- similar to a manic episode
- except that it is not sufficiently severe to cause impairment in social or occupational functioning
- no psychotic features are present.
T or F
Manic and hypomanic are both associated with:
* inflated self-esteem
* decreased need for sleep
* Distractibility
* great physical and mental activity
* overinvolvement in pleasurable behavior
TRUE
Bipolar I disorder, Mixed Episode, Bipolar II Disorder are types of what disorder?
Mania
a clinical course of one or more manic episodes and,
sometimes, major depressive episodes.
Bipolar I disorder
a period of at least 1 week – both a manic episode and a major depressive episode occur almost daily.
Mixed Episode
- A variant of bipolar disorder – episodes of major
depression and hypomania (rather than mania)
Bipolar II Disorder
at least 2 years of depressed mood
* not sufficiently severe to fit the diagnosis of major depressive episode.
Dysthymic disorder
- at least 2 years of frequently occurring
- hypomanic symptoms cannot fit the diagnosis of manic episode
- depressive symptoms that cannot fit the diagnosis of major depressive episode.
Cyclothymic disorder
T or F
* Women
* more likely than men to present a mixed picture
* higher rate of being rapid cyclers, defined as having four or more manic episodes in a 1-year period
TRUE
- Of the biogenic amines, ___-and ____are the two neurotransmitters most implicated in the pathophysiology of mood disorders.
norepinephrine and serotonin
Downregulation or decreased sensitivity of beta-adrenergic
receptors = clinical antidepressant responses
Norepinephrine
Depletion of serotonin = precipitate depression, ( suicidal impulses :
CSF - serotonin metabolites and less serotonin uptake sites on platelets)
Serotonin
▬ Reduced in depression and increased in mania.
Dopamine
Depressive disorders are associated with several immunological abnormalities, including decreased lymphocyte proliferation
- Immunological Disturbance
- CT and MRI Brain
- abnormal hyperintensities in subcortical regions
- periventricular regions
- basal ganglia
- thalamus.
- Most common in bipolar I disorder
Structural and Functional Brain Imaging
four brain regions in the regulation of normal emotions:
prefrontal cortex (PFC)
anterior cingulate:
hippocampus
amygdala
learning and memory
hippocampus
: station for processing novel stimuli
amygdala
ntegration of attentional and emotional inputs =
facilitates control of emotional arousal, particularly when goal attainment
has been thwarted or when novel problems have been encountered
anterior cingulate
representations of goals and appropriate responses to obtain these goals = multiple, conflicting behavioral responses
prefrontal cortex (PFC)
= long-lasting changes in the brain’s biology
= alter the functional states of various neurotransmitter and intraneuronal signaling systems
loss of neurons
and an excessive reduction in synaptic contacts.
Life Events and Environmental Stress
high risk of undergoing subsequent episodes even without an external stressor.
losing a parent before age 11 – Unemployment
* loss of a spouse
Ewan take note
Persons with certain personality disorders may be at greater risk for depression
What are these disorders?
OCD
* Histrionic
* Borderline
antisocial or paranoid personality disorder can use projection and
other externalizing defense mechanisms to protect themselves from
their inner rage.
Personality Factors
T or F
depression can be linked to real or imagined object loss
TRUE
T or F
* Happiness may occur as a single episode or may be recurrent.
* There’s a certain cause that triggers
FALSE
* Depression may occur as a single episode or may be recurrent.
* There’s a certain cause that triggers
- Depression may occur as a single episode or may be recurrent.
- There’s a certain cause that triggers
- Major Depressive Disorder, Single Episode
- Patients who are experiencing at least a second episode of
depression - DSM-5 requires that distinct episodes of depression be separated
by at least 2 months during which a patient has no significant
symptoms of depression.
Major Depressive Disorder, Recurrent
- The DSM-5 criteria for a bipolar I disorder requires the presence of a distinct period of abnormal mood lasting at
least 1 week
Bipolar I Disorder
characterized by depressive episodes and hypomanic episodes during the course of the disorder
Bipolar II Disorder
According to DSM-5, patients must be experiencing their first manic episode to meet the diagnostic criteria for bipolar I disorder, single manic
episode.
Bipolar I Disorder, Single Manic Episode
Manic episodes are considered distinct when they are
separated by at least 2 months without significant
symptoms of mania or hypomania.
Bipolar I Disorder, Recurrent
The two basic symptom patterns in mood disorders are
Depression and mania.
T or F
Bipolar I Disorder vs Major Depressive Disorder
* Can’t be differentiated by patient’s history, family history, and future course
FALSE
Bipolar I Disorder vs Major Depressive Disorder
* Can be differentiated by patient’s history, family history, and future
course
Clinical features of depression among Children
- School phobia
- excessive clinging to parents
Clinical features of depression among Adolescents
- Poor academic performance
- substance abuse
- antisocial behavior
- sexual promiscuity, truancy, and running away
Clinical features of depression among Older People
may be correlated with low socioeconomic status, the loss of a
spouse, a concurrent physical illness, and social isolation.
Response to questions with single words and exhibit delayed responses to questions.
Speech
During a speech examination, The examiner may literally have to wait ___ minutes
for a response to a question.
2-3 minutes
Depressed patients with delusions or hallucinations are said to have a major depressive episode with psychotic features. Even in the absence of delusions or hallucinations, some clinicians use the term psychotic depression for grossly regressed depressed patientsmute, not bathing, soiling
Perceptual Disturbances
Depressed patients customarily have negative views of the world and of themselves including nondelusional ruminations about loss, guilt, suicide, and death.
Thought
About 10 to 15 percent of all depressed patients commit suicide, and about two-thirds have suicidal ideation.
Some consider killing a person as a result of their
delusional systems
Impulse Control
T or F
* Manic patients are excited, talkative, sometimes
amusing, and frequently hyperactive.
TRUE
___ patients cannot be interrupted while they are
speaking. Their speech is often disturbed. As the mania gets more intense, speech becomes louder, more rapid, and difficult to interpret.
Manic Patients
T or F
* Delusions occur in 75% of manic patients
TRUE
Impaired judgment is a hallmark of __ patients
Manic pt.
T or F
Manic patients are very reliable in their information.
FALSE
involves the use of very short pulses of magnetic energy to stimulate nerve cells in the brain.
* It is specifically indicated for the treatment of depression in adult patients who have failed to achieve satisfactory improvement from one prior antidepressant medication at or above the minimal effective dose and duration in the current episode.
Transcranial Magnetic Stimulation
T or F
Mania tends to be characterized by a increased need for sleep, but depression can be associated with either hypersomnia or insomnia.
FALSE
Mania tends to be characterized by a decreased need for sleep, but depression can be associated with either hypersomnia or insomnia.
___deprivation may precipitate mania in patients with bipolar I disorder and temporarily relieve depression in those who have unipolar depression.
Sleep
ypically involves exposing the affected patient to bright light in the range of 1 ,500 to 1 0,000 lux or more, typically with a light box that sits on a table or desk
Phototherapy
T or F
Photography has been used to decrease the irritability and diminished functioning associated with shift work.
FASLE
* Phototherapy has been used to decrease the irritability
and diminished functioning associated with shift work.
T or F
Sleep disorders in geriatric patients have reportedly improved with exposure to bright light during the day
TRUE
- Patients with major depressive disorder with atypical features may preferentially respond to treatment with
MAOis or SSRis.
Treatment of major depressive episodes with psychotic features may require a combination of an antidepressant and an
atypical antipsychotic
Group of disorders with heterogeneous etiologies, and it includes patients whose clinical presentations, treatment response, and courses of illness vary.
Signs and symptoms are variable and include changes in perception, emotion, cognition, thinking, and behavior
Schizophrenia
Fundamental Symptoms of Schizophrenia
- Associations
- Affect
- Autism
- Ambivalence
may involve pathologic processes, caused by both genetic and environmental
factors, that begin before the brain approaches its adult anatomical state in
adolescence
Neurodevelopmental Hypothesis
· Nutrition
· Seasonality
· Infection or infectious agents
· Obstetric complications
Risk Factors
Characterized by preoccupation with one or more delusions or frequent auditory hallucinations
PARANOID
Typically tense, suspicious, guarded, reserved, and
aggressive
PARANOID
Associated features: stereotypes,
mannerisms, and waxy flexibility
● Marked disturbance in motor function Stupor, negativism, rigidity, excitement, posturing
CATATONIC
R a p i d a l t e r a t i o n b e t w e e n
extremes of excitement and
stupor
CATATONIC
Emotional blunting, social
withdrawal, eccentric behavior,
illogical thinking, and mild
loosening of associations
RESIDUAL
Delusions or hallucinations are
n e i t h e r p r o m i n e n t n o r
accompanied by strong effect
RESIDUAL
Marked regression to primitive, disinhibited, and unorganized behavior
DISORGANIZED
● Often burst into laughter without
any apparent reason
DISORGANIZED
Frequently, patients who have
schizophrenia cannot be easily fit
into 1 type or another
UNDIFFERENTIATED
Also termed borderline schizophrenia
● Occasionally shoe peculiar behaviors or thought disorders but do not consistently manifest psychotic symptoms
LATENT
SCHIZOPHRENIA
Characterized by pain anxiety, panphobia, pan ambivalence, and sometimes chaotic sexuality
● Have free-floating anxiety that rarely subsides
● Currently diagnosed as borderline personality disorder
PSEUDONEUROTIC
SCHIZOPHRENIA
Dream-like state in which patient
may be deeply perplexed and not
fully oriented in time and space
ONEIROID
SCHIZOPHRENIA
● Multiple meanings of the term
r e n d e r i t i n e f f e c t u a l i n
communicating information
● Sometimes used as a synonym
for Paranoid schizophrenia
PARAPHRENIA
Any of the five senses may be affected
● The most common: auditory, with voices that are often threatening, obscene, accusatory, or insulting.
Hallucinations
Unfounded sensations of altered states in bodily organs.
● a burning sensation in the brain, a pushing sensation in the blood vessels, and a cutting sensation in the bone marrow.
● Bodily distortions
Cenesthetic Hallucinations
Can occur in schizophrenia patients during active phases, but they can also
occur during the prodromal phases and during periods of remission
ILLUSION
T or F
Violent behavior (excluding homicide) is common among untreated
schizophrenia patients.
TRUE
Delusions of a persecutory nature, previous episodes of violence, and
neurological deficits are risk factors for violent or impulsive behavior.
TAKE NOTE
T or F
Often, suicide in schizophrenia seems to occur “out of the blue,” without
prior warnings or expressions of verbal intent.
TRUE
T or F
The inability of schizophrenia patients to perceive the prosody of speech or to inflect their own speech can be seen as a neurological symptom of a disorder in the non-dominant parietal lobe
TRUE
T or F
patients with schizophrenia have an elevated blink rate.
● The elevated blink rate is believed to reflect hyperdopaminergic activity.
TRUE
T or F
Patients with schizophrenia appear to be more underweight , with lower body mass indexes (BMis) than age- and gender-matched cohorts in the general population
FALSE
Patients with schizophrenia appear to be more obese, with higher body mass indexes (BMis) than age- and gender-matched cohorts in the
general population
Schizophrenia is associated with an increased risk of____
Schizophrenia is associated with an increased risk of type II diabetes
mellitus
TREATMENT for schizophrenia includes?
Pharmacotherapy
Social skills training
●Family-Oriented Therapies-
Personal Therapy
Dialectical Behavior Therapy
Art Therapy
Cognitive Training
In 1933, ___ introduced the term
schizoaffective disorder to refer to a disorder
with symptoms of both schizophrenia and
mood disorders
In 1933, Jacob Kasanin introduced the term
schizoaffective disorder to refer to a disorder
with symptoms of both schizophrenia and
mood disorders
refer to a disorder with symptoms of both schizophrenia and mood disorders
SCHIZOAFFECTIVE
DISORDER
Sudden onset and benign course associated with mood symptoms and clouding of consciousness
● Symptoms similar to schizophrenia
Schizophreniform Disorder
● false fixed beliefs not in keeping with the culture
● among the most interesting of psychiatric symptoms
Delusions
T or F
Delusions are difficult to treat
TRUE
The cause of delulu are ?
Unknown
Classic symptom of delusional disorder
Most frequent forms that are seen by the psychiatrist (together with jealousy type)
Persecutory
delusions of infidelity; spouse has been unfaithful
Conjugal paranoia
morbid jealousy that can arise from multiple concerns
Othello syndrome
Delusion is fixed, unarguable, and presented intensely because the patient is totally
convinced of the physical nature of the disorder.
Somatic
A clinical syndrome characterized by striking behavioral abnormalities
that may include motoric immobility or excitement, profound negativism,
or echolalia (mimicry of speech) or echopraxia (mimicry of movement).
CATATONIA
represents a core phenomenon around which considerable psychiatric theory has
been organized
ANXIETY
! played a central role in psychodynamic theory, as well as in neuroscience-focused
research and various schools of thought heavily influenced by cognitive-behavioral
principles
ANXIETY
caused by genetic and experiential factors
! abnormal genes
! traumatic life events and stress
ANXIETY
➢ a diffuse, unpleasant, vague sense of apprehension
➢ accompanied by autonomic symptoms such as headache, perspiration, palpitations, tightness in the chest, mild stomach discomfort, and restlessness
➢ indicated by an inability to sit or stand still for long
ANXIETY
an acute intense attack of anxiety accompanied by feelings of impending doom
PANIC DISORDER
characterized by discrete periods of intense fear that can vary from several
attacks during one day to only a few attacks during a year
PANIC DISORDER
a fear of or anxiety regarding places from which escape might be difficult
AGORAPHOBIA
it can be the most disabling of the phobias because it can significantly interfere
with a person’s ability to function in work and social situations outside the home
AGORAPHOBIA
an excessive fear of a specific object, circumstance, or situation
SPECIFIC PHOBIA
diagnosis of specific phobia requires the development of intense anxiety, even to
the point of panic, when exposed to the feared object
! SPECIFIC PHOBIA
T or F
persons with social anxiety disorder are fearful of embarrassing themselves in social
situations
TRUE
excessive anxiety and worry about several events or activities for most days during
at least a 6-month perio
GENERALIZED ANXIETY DISORDER
associated with somatic symptoms, such as muscle tension, irritability, difficulty
sleeping, and restlessness
GENERALIZED ANXIETY DISORDER
Two components of experiencing anxiety:
! awareness of the physiological sensations (e.g., palpitations and sweating)
! awareness of being nervous or frightened
a sudden period of intense fear or apprehension that may last
from minutes to hours
PANIC DISORDERS
it can occur in mental disorders other than panic disorder,
particularly in specific phobia, social phobia, and PTSD
PANIC DISORDERS
SIGNS and SYMPTOMS of panic disorders
Racing heartbeat or palpitations
! Shortness of breath
! Choking feeling
! Vertigo
! Light headed
! Nausea
! Sweating or chills
! Shaking or trembling
! Changes in mental state
! Numbness/tingling in hands and feet
! Chest pains or tightness
! Fear that you might die
tachycardia, palpitations, dyspnea, and sweating are physical factors of?
Panic disorders
T or F
key feature of each type of phobia is that fear symptoms occur only in the presence of a specific object
TRUE
