Psychiatric Disorders Flashcards by Sydney Perry

The brain is _____% fat

80%

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the fatty acid composition of neuronal cell membrane reflects ______________

dietary intake

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Nutrients effect on mental health

Support the normal development of the brain & CNS
Support ______ and sense of well-being
Maintain structure & function of ______
Provide an energy source for the brain
Serve as precursors & cofactors for _________production

mood
neurons
neurotransmitter

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what amino acids are needed for neurotransmitter productions

phenylalanine
tyrosin
tryptophan
glutamine

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Vitamins needed for neurotransmitter production

B1 B2 B3 B6 B12 and folate

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minerals needed for neurotransmitter production

zinc
copper
iron
iodine
selenium
magnesium

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Gut contains ~100 million neurons

________, ________, and __________ are major neurotransmitters in the ENS

Neural activity in the gut is triggered by receptors responding to ______, ______, and _______ stimuli

Bidirectional information continually passes between the gut & CNS

Gut ________ & byproducts influence brain function and behavior

Acetylcholine, serotonin, & norepinephrine

mechanical, osmotic, & chemical

bacteria

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Rapid & abrupt increases in BG can trigger an excessive release of insulin followed by a rapid drop in BG

The body compensates by raising levels of _______ & ________ which can trigger ________ & _______

Reducing refined CHO & sugar intake can decrease these BG fluctuations considerably

epinephrine
cortisol

emotional changes
erratic behavior

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preferred fatty acids in the brain & nervous system

Eicosapentaenoic acid (EPA)
docosahexaenoic acid (DHA)

these are omega-3 FA

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EPA & DHA may have benefit in management of what disorders?

Higher intake of ____ is associated with decreased risk of depression, especially for women

anxiety
depression
post-partum depression
bipolar disorder
schizophrenia

fish

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_______ is an essential coenzyme for neurotransmitters (e.g., serotonin) that are potential targets for antidepressant therapies

Thiamin

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_________ deficiency may be involved in the pathogenesis of depression, bipolar disorder, panic disorder, psychosis, & phobias

Vitamin B12

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______ deficiency is associated with depression & schizophrenia

_____ deficiency is associated with major & minor depression in older adults

Folate

Vit D

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MINERALS

________ deficiency can cause anxiety
______ and _______ deficiency is associated with depression
_____ may reduce depressive symptoms

Magnesium

iron and selenium

zinc

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Amino acids are precursors for what neurotransmitters?
Also the precursor for ___________

serotonin
dopamine
norepinephrine

antioxidant glutathione

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Research suggests that ____________ found in plant-based foods are important for normal brain function and mental health

ex: ______

phytochemicals

flavonoids

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__________ have antioxidant activity and protect and preserve brain cell structure & metabolism

Flavonoids

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Flavonoids Found in=>

berries, grapes & red wine, citrus fruit
onions, kale, red cabbage
tea, curcumin, dark chocolate

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Specific factors to consider in this population with mental disorders

changes in appetite

increase or decrease in activity level

decreased ability to concentrate, understand, follow directions

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factors to consider for this population if they are taking medicine

dry mouth
thirst
constipation
wt change

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ASSESSMENT

Altered nutritional needs due to use of ____ or ______

Possible decrease in ability for ______ such as adequate income, shopping, meal preparation

History of __________ that may have resulted in suboptimal nutritional intake

Use of _____________

alcohol or tobacco

self-care

comorbid conditions

nutrition supplements

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most common type of mental illness in the U.S. ?

anxiety disorders

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Common to anxiety disorders are heightened and poorly controlled ______, _____, and ______ symptoms triggered by a specific situation

Underlying etiology is not well understood
- ________ component

emotional, somatic, & neurologic

Genetic

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The stress of an adverse ____________ can constitute a significant etiologic factor for anxiety that may impact the individual into and throughout adulthood

childhood experience

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Medication types used in the Management of Anxiety

benzodiazepines SSRIs SNRIs

Benxodiazapines anxiety

alprazolam clonazepam

SSRIs for anxiety

sertraline citalopram

SNRIs for anxiety

duloxetine

FDI of benzos

avoid concurrent ingestion of alcohol limit/avoid caffiene

FDI for SSRIs

may increase appetite and wt dry mouth avoid SJW and alcohol

FDI for SNRIs

avoid SJW and alcohol

MNT for Management of Anxiety Eat ____________ meals with _______ and ___________ to promote stable BG Eliminating ________ for 3-4 wks to see if anxiety decreases Consider MVI with minerals if dietary intake does not meet the DRI for _____, _____, _____, _____, & _____ Include dietary sources of __________ Encourage __________

regularly scheduled protein low glycemic carbohydrates caffeine folate, B12, zinc, Mg, & vit D omega-3 fatty acids physical activity

Major depressive disorder (MDD) affects more _______ than ______ No definitive cause has been identified ~____ of people do not respond adequately to treatment

women than men 1/3

Contributing factors to depression

genetics environmental stressors hormonal disruption nutrition alterations in neurotransmitter biology & function

where does hormonal disruption occur especially in depressed

hypothalamic-pituitary-adrenal axis

Monoamine deficiency theory

deficiency of serotonin, dopamine, & norepinephrine, or altered receptor function, is the main pathophysiologic factor

Medications types Used in the Management of Depression

SSRIs SNRIs norepinephrine-dopamine reuptake inhibitor

SSRIs for depression

fluoxetine paroxetine sertraline

SNRIs for depression

duloxetine venlafaxine

Norepinephrine dopamine reuptake inhibitor for depression

bupropion

FDI for norepinephrine-dopamine reuptake inhibitor

may cause increase or decrease in appetite and wt dry mouth taste changes stomatitis N/V take with food to decrease GI irritation Limit/avoid alcohol avoid SJW

MNT for Depression ______________ dietary pattern may protect against the development of depressive symptoms later in life and decrease risk of MDD Encourage regular, meals and snacks that help maintain _____ Ensure adequate intake of ________________ intake Treat deficiencies of _____ or ____ _______ if possible Recommend _______

Mediterranean BG levels folate, vit B12, vit D, & omega-3 fatty acid vit B12 or folate Social eating exercise

MNT for Depression monitor for ________ assess for food drug interactions Avoid ______ for those taking antidepressant medications - increases risk for ________

wt changes St. Johns wort serotonin syndrome

Episodes of an elevated or agitated mood known as mania alternating with episodes of depression

bipolar disorder

Average age of onset for bipolar is ______

25 years

There is a genetic component, but other factors to bipolar such as _______, ___________, and _____

hormones neurotransmitter abnormalities stress

medical management of bipolar

lithium

MNT for Bipolar Disorder Address ________ of lithium A stable, moderate about of ____ is needed to stabilize lithium leve l Drink _____ L fluid/d Limit _______ Monitor for ______ Can cause _______

FDI Na 2-3 caffeine wt gain N/V/D

Severe mental disorder that presents as psychosis, often with paranoia & delusions

schizophrenia

Diagnosis of schizophrenia requires at least one of the symptoms to be _____, ______, or _____

delusions hallucinations disorganized speech

Symptoms of schizophrenia typically appear in males during their ___________ and for females during their ________

late teens to early 20s 20s to early 30s

Pathophysiology of Schizophrenia - Poorly understood - Possibly a _______ disorder generated by a combination of biochemical, genetic, structural, nutritional, and environmental factors, including _____ & ______

heterogeneous infections & toxins

Medication types Used in the Management of Schizophrenia

combination of dopamine-blocking antipsychotic medications, antidepressants, and tranquilizers

examples of dopamine-blocking antipsychotic medications

haloperidol risperidone

Side effects of antipsychotics may include __________

dry mouth constipation increased appetite and weight gain

Schizophrenia is associated with altered ______ _______ energy needs Increased _________

metabolism Reduced visceral fat

Monitor weight: a ____ weight gain should trigger assessment for _________ Refer to a ____________ program as needed

7% metabolic syndrome behavioral weight management

MNT for Schizophrenia Recommend regular meal pattern and trial of a ______________ diet Recommend sources of ________ Rx screening for _______

low glycemic, casein-free, Mediterranean EPA & DHA celiac disease

If schizophrenia patient tests positive for celiac _______ diet Assess for _____ and _____ deficiency (associated with worse symptoms)

gluten-free vit D & folate

MNT for Schizophrenia Assess for potential ______ Caution against use of _________ bc it can increase blood levels of certain _______ meds) Avoid ______

food-drug interactions grapefruit and/or grapefruit juice antipsychotic alcohol

Substance Use Disorders (SUD) and addiction Involves numerous ________ The production of dopamine (produces a sense of pleasure) is triggered by use of ________________________ ____ and ______ are also involved

neurotransmitters heroin, amphetamines, marijuana, alcohol, nicotine, & cocaine Serotonin and glutamate

Addictions may result in: ______ appetite craving for ________ _________ lack of motivation to prepare meals _________ due to: insufficient food or nutrient intake alterations in digestion, absorption, metabolism, or excretion of nutrients

poor sugar & sweets constipation malnutrition

Alcohol Use Disorder (AUD) Screening tool to identify people as risk ?

Alcohol Use Disorders Identification Test (AUDIT)

MNT for AUD Assess dietary intake, GI function, risk of malnutrition, and for potential micronutrient deficiencies - Rx biochemical assessment of _____, ____, ____, and ____ - Rx MVIM for ______ Additional supplementation: ________ ________

thiamin, folic acid, Mg, & selenium 6 months Thiamin: 50-100 mg Folic acid: 1 mg daily

MNT for AUD, continued Nutritionally adequate diet with _______% of kcal from high-quality protein Rx _________ supplement of ______ mg/day Provide nutrition education

25-30% omega-3 fatty acid 800-1000