Psyche Flashcards
delusions
fixed, false beliefs that are completely unshakeable.
Psychosis
illogical, disorganized/nonsensical speech or writing;
often includes hallucinations (of any modality), and delusions.
Psychotic disorders
- schizophrenia, schizoaffective disorder
- delusional disorder
- depression, mania, delirium
- dementia
- anorexia nervosa (? - debated)
organic mental illness
problems in behavior related to damaged brain structure (traumatic injury, cancer, other organ problems); Dx w/ MRI.
*usually impair cognitive operations
Examples of organic mental disorders
- delirium
- dementia
- amnesic disorders
- mental retardation, learning disorders
functional mental disorders
disorders of responding to lessons learned, but coding is correct (no structural problems);
- psychosocial Tx most helpful to reverse.
ie: phobias
- psychosocial Tx most helpful to reverse.
Adjustment disorder
shift in mood (w/ anxiety or depression) that is temporary (less than 6 weeks), related to increased stress.
Borderline Personality Disorder
- will likely change to “Chronic Emotional Dysregulation” in time;
Sx: rapid mood changes and slow to return to baseline, esp. w/ interpersonal relationships; + frequent anxiety and panic attacks.
Cause: overactive amygdala & under-active frontal lobe.
Tx: psychotherapy to teach how to conceptualize interactions
Bipolar type I disorder
Full mania lasting at least 1 week, usually alternating with periods of depression (not always)
Tx: anticonvulsants, antidepressants may provoke mania
Bipolar type II disorder
aka: hypomania;
disorder of alternating mood changes, with depression and manic episodes less than full mania (less out of control, no psychosis or delusions); with at least 1 episode of major depression.
cyclothymia
disorder w/ ONLY periods of hypomanias and dysthymias (= minor reduced mood but not full depressions), more cyclic pattern.
Mixed state dysthymia
Hyperactive state with simultaneous depression/emotional pain.
** VERY high risk for suicide**
(subtype/form of manifestation of bipolar disorder)
symptoms of (full) mania
Mood & thoughts: euphoric, flight of thoughts, grandiosity, paranoia
Bx: decreased sleep need/unconcerned insomnia, pressured speech, hyperactivity, poor judgement, decreased inhibition/impulsive, inappropriate behavior (sexual or other)
conditions that may mimic mania
Drugs: amphetamines, cocaine, alcohol, corticosteroids
Metabolic: Cushing’s disease, hypERthyroidism
Neuro: stroke, brain trauma, neoplasms, epilepsy, neurodegen.
Infection: influenza, encephalitis, neurosyphilis, AIDS
Characteristics of panic attacks
- false positive rxn (abnormal rxn to normal stimulus)
- sudden onset, aversive
- lasts 10-15 minutes
- degrades performance, trigger avoidance strategies
- 4+ physical symptoms
=> circular nature (attack–> fear & hyper-vigilant –> more attacks)
obsessive-compulsive and related disorders (5)
- Obsessive-Compulsive disorder
- Body Dysmorphic disorder - ie: anorexia nervosa
- Hoarding disorder - excessive attachment of emotional value to objects
- Trichotillomania (hair pulling disorder)
- Excoriation (skin picking) disorder
Trauma & stress-related disorders (3)
- Post-Traumatic Stress Disorder
(Hx of traumatic experience, heightened arousal & re-experience trauma memories, > 6 weeks) - Acute Stress Disorder (like PTSD, but < 6 weeks)
- Adjustment Disorder (less severe, not from TRAUMATIC event, but some stressful event)
Common comorbidities w/ anxiety disorders
1. Depression
Also: Substance abuse, Borderline personality disorder, fibromyalgia or asthma, chronic pain, etc.
* if resistant to Tx, may be caused by Pheochromocytoma!*
structures of the Limbic System
- Amygdala (central structure for anxiety!),
- Thalamus, 3. hypothalamus
- hippocampus, 5. olfactory bulb
* * counteracted/controlled by frontal lobe **
Neurotransmitters involved in Anxiety (3)
NE (norepinephrine), 5-HT (serotonin), GABA
Anxiety disorders (5)
- “GAD” (Generalized Anxiety Disorder) - multiple focuses of worry
- Panic Disorder - panic attacks characterized w/ extreme avoidance Bxs.
- Agoraphobia - fear of open spaces/where vulnerable.
- Social Phobia
- Specific phobia(s)
best treatment for Anxiety disorders
1: Cognitive Behavioral Tx (“CBT”)
- Dialectical Behavior Therapy
- Pharmacological treatment:
- SSRI +/- mirtazapine or buspirone
- NOT anti-psychotics, nor benzodiazepines for long-term Tx*
prodrome of schizophrenia
= the phase preceding clinical schizophrenia, w/ changes predictive of schizophrenia;
Sx: withdrawal from relationships, drop in school performance, odd beliefs (w/ normal insight)
Epidemiology of Schizophrenia
- Age: onset usually 19-24
- Gender: M>F, but new cases after age 45 = female (estrogen may be psychoprotective)
- Heterogenous etiology
- significant genetic component (ie: monozygotic twins -> 50%), but no specific loci.
- environment/upbringing = weak factor, except for certain cases
(maternal complications/infection, early age pot abuse)
gross pathological changes in brains of schizophrenic patients
- thinner cortex (esp. frontal lobe)
2. white matter abnormalities (poor communication w/ frontal lobe)
Neurotransmitter changes in schizophrenia
- Dopamine: hyperactive
- Serotonin: increased
- Glutamate: decreased, may cause negative Sxs
Symptoms of Schizophrenia
Perception: hallucinations
Thinking: disrupted –> delusions, paranoia
Affect/Mood: blunted
* w/ treatment, SE: severely blunted affect, decreased motivation, dyskinesias, etc.
4 domains of cognition that may be affected by dementia
- Language - poor understanding & word-finding (circumlocution)
- Memory - forgetful, losing things
- Visuospatial - poor recognition of ppl, places (get lost easily)
- Executive function - impulsivity, poor judgement
Vascular Dementia
onset w/in 3 months of stroke, see multiple/bilateral stroke damage on imaging.
Dementia from infection
(rare!)
- neurosyphilis
- AIDS
- Whipple disease
- Prion disease
Potential causes of organic, trauma/toxic dementia
- head trauma –> traumatic brain injury or subdural hematoma
- Toxins: alcohol, medications (esp. anticonvulsants), heavy metal exposures
metabolic causes of dementia
- hypothyroidism
- hyperparathyroidism
- multiple episodes of hypoglycemia
- liver/kidney disease
- vitamin deficiencies (Vit B1 or B12)
Neurogenerative causes of dementia
- Alzheimer’s Disease (affects 50% of ppl 85+, slow & progressive)
- Frontotemporal (onset ~60s, esp. common w/ Down’s syndrome)
- Parkinson’s disease
- dementia w/ Lewy Bodies
Normal pressure hydrocephalus
can be a cause of dementia,
Signs: “3 Ws”
- Wet, Wild, Wobbly
