Psychiatric Disorders Flashcards
1
Q
What is an active placebo?
A
control drugs that have no therapeutic effect but produce side effects similar to those produced by the drug under evaluation in a clinical trial
2
Q
What is agoraphobia?
A
pathological fear of public places and open spaces
3
Q
What is anhedonia?
A
a general inability to experience pleasure
4
Q
What is anxiety?
A
chronic fear that persists in the absence of any direct threat
5
Q
What is an anxiety disorder?
A
a psychiatric disorder involves anxiety that is so extreme and so pervasive that it disrupts normal functioning
6
Q
What are anxiolytic drugs?
A
antianxiety drugs
7
Q
What are atypical antidepressants?
A
a catch-all class for antidepressant drugs that do not fit into the other categories of antidepressants (e.g., monoamine oxidase inhibitors, tricyclic antidepressants). Each of the drugs in this class has its own unique mechanism of action
8
Q
What are atypical antipsychotics?
A
drugs that are effective against schizophrenia but yet do not bind strongly to D2 receptors. Also known as second-generation antipsychotics
9
Q
What are benzodiazepines?
A
a class of GABAa agonists with anxiolytic, sedative, and anticonvulsant properties; drugs such as chlordiazepoxide (Librium) and diazepam (Valium)
10
Q
What is bipolar disorder?
A
a category of psychiatric disorders that involves alternate bouts of depression and mania or hypomania
11
Q
What is bipolar disorder type I?
A
a psychiatric disorder that involves alternate bouts of depression and mania
12
Q
What is bipolar disorder type II?
A
a psychiatric disorder that involves alternate bouts of depression and hypomania
13
Q
What are butyrophenones?
A
a class of antipsychotic drugs that bind primarily to D2 receptors
14
Q
What is the cheese effect?
A
the surges in blood pressure that occur when individuals taking MAO inhibitors consume tyramine-rich foods, such as cheese
15
Q
What is chlorpromazine?
A
the first antipsychotic drug
16
Q
What is clinical depression (major depressive disorder)?
A
depression that is so severe that it is difficult for the patient to meet the essential requirements of daily life
17
Q
What are clinical trials?
A
studies conducted on human subjects to assess the therapeutic efficacy of an untested drug or other treatments
18
Q
What is clozapine?
A
an atypical antipsychotic that is used to treat schizophrenia, does not produced Parkinsonian side effects and has only a slight affinity for D2 receptors
19
Q
What does comorbid mean?
A
the tendency for two or more health conditions to occur together in the same individual
20
Q
What is the defensive-burying test?
A
an animal model of anxiety; anxious rats will bury objects that generate anxiety
21
Q
What is the DSM-5?
A
the fifth and current edition of the Diagnostic and Statistical Manual of Mental Disorders; produced by the American Psychiatric Association
22
Q
What is the elevated-plus-maze test?
A
an animal model of anxiety; anxious rats tend to stay in the enclosed arms of the maze rather than venturing onto open arms
23
Q
What is endogenous depression?
A
depression that occurs with no apparent cause
24
Q
What is fluoxetine?
A
the first selective serotonin reuptake inhibitor (SSRI) to be developed. It was initially marketed under the tradename Prozac
25
What is generalised anxiety disorder?
an anxiety disorder characterised by stress responses and extreme feeling of anxiety and worry about a large number of different activities or events
26
What is haloperidol?
a butyrophenone used as an antipsychotic drug
27
What is hypomania?
a state that is characterised by a reduced need for sleep, high energy, and positive affect. During periods of hypomania , people are talkative, energetic, impulsive, positive and very confident
28
What is imipramine?
the first tricyclic antidepressant drug
29
What is iproniazid?
the first antidepressant drug; a mono oxidase inhibitor
30
What is ketamine?
a drug that is a type of dissociative hallucinogen
31
What is lithium?
a metallic ion that is a mood stabiliser; used in the treatment of bipolar disorders
32
What is mania?
a state that has the same features as hypomania but taken to an extreme; it also has additional symptoms such as delusions of grandeur, overconfidence and distractibility. Mania usually involves psychosis
33
What are MAO inhibitors?
antidepressant drugs that increase the level of monoamine neurotransmitters by inhibiting the action of the enzyme monoamine oxidase
34
What is a mixed state?
a state that can occur in bipolar disorder type I, where the patient simultaneously display symptoms of both depression and mania
35
What are mood stabilisers?
drugs that effectively treat depression or mania without increasing the risk of mania or depression, respectively.
36
What are negative symptoms?
symptoms of schizophrenia that seem to represent a reduction or loss of typical function
37
What are orphan drugs?
drugs for which the market is too small for the necessary developmental research to be profitable
38
What are panic attacks?
rapid-onset attacks of extreme fear and severe symptoms of stress (e.g., choking, heart palpitations, shortness of breath)
39
What is panic disorder?
an anxiety disorder characterised by recurrent rapid-onset attacks of extreme fear and severe symptoms of stress
40
What is peripartum depression?
the intense, sustained depression experienced by some females during pregnancy, after they give birth, or both
41
What are phenothiazines?
a class of antipsychotic drugs that bind effectively to both D1 and D2 receptors
42
What are positive symptoms?
symptoms of schizophrenia that seem to represent an excess of typical function
43
What are psychedelic drugs?
drugs whose primary action is to alter perception, emotion and cognition
44
What are psychiatric disorders?
a disorder of psychological function sufficiently severe to require treatment by a psychiatrist or clinical psychologist
45
What is psychosis?
a loss of touch with reality
46
What is reactive depression?
depression that is triggered by a negative experience
47
What is repetitive transcranial magnetic stimulation (rTMS)?
a form of transcranial magnetic stimulation (TMS) that involves the delivery of repetitive magnetic pulses at either high frequencies (e.g., five pulses per second; high-frequency rTMS) or low frequencies (e.g., less than one pulse per second; low-frequency rTMS) to specific cortical areas
48
What is reserpine?
the first monoamine antagonist to be used n the treatment of schizophrenia; the active ingredient of the snakeroot plant
49
What is a risk-assessment test?
an animal model of anxiety. After a single brief exposure to a cat on the surface of a laboratory burrow system, rats flee to their burrows and freeze. Then they engage in a variety of risk-assessment behaviours
50
What is seasonal affective disorder (SAD)?
type of major depressive disorder in which episodes of depression typically recur during particular seasons - usually during the winter months
51
What are selective serotonin-reuptake inhibitors (SSRIs)?
class of drugs that exert agonistic effects by blocking the reuptake of serotonin from synapses; used to treat depression
52
What is a specific phobia?
an anxiety disorder that involves strong fear or anxiety about particular objects (e.g., birds, spiders) or situations (e.g., enclosed spaces, darkness)
53
What are tics?
involuntary, repetitive, stereotyped movements or vocalisations the defining feature of Tourette's syndrome
54
What is Tourette's disorder?
a disorder of tics
55
What is a translational bottleneck?
a barrier keeping promising ideas and treatments from becoming the focus of translational research; largely created by the massive cost of such research
56
What is translational research?
research designed to translate basic scientific discoveries into effective applications (e.g., into clinical treatments)
57
What is a tricyclic antidepressent?
drugs with an antidepressant action and a three-ring molecular structure
58
What are typical antipsychotics?
the first generation of antipsychotic drugs
59
What is up-regulation?
an increase in the number of receptors for a neurotransmitter in response to decreased release of that neurotransmitter
60
What are examples of positive symptoms?
```
Delusions
Hallucinations
Inappropriate affect (emotion)
Disorganised speech or thought
Odd behaviour
```
61
What are examples of negative symptoms?
Affective flattering (diminished emotions)
Avolition (reduced motivation)
Catatonia (motionless)
62
What was the first antipsychotic drug to be discovered?
Chlorpromazine
63
Why isn't Reserpine used to treat schizophrenia anymore?
It produces a dangerous decline in blood pressure at the doses needed for successful treatment
64
How long do Chlorpromazine and Reserpine take to work?
2-3 weeks
65
What are the side-effects that Chlorpromazine and Reserpine have on common?
Muscular rigidity and decrease in voluntary movement.
| Similar to symptoms of Parkinson's disease
66
What does the dopamine theory of schizophrenia state?
Schizophrenia is caused by too much dopamine and, conversely, that antipsychotic drugs exert their effects by decreasing dopamine levels
67
How do Chlorpromazine and Reserpine differ in their actions?
Reserpine works by depleting the brain of dopamine whereas Chlorpromazine works by binding to dopamine receptors
68
True or False:
| Haloperidol has a high affinity for dopamine receptors
False
| It had a relatively low affinity for dopamine receptors
69
How many classes of dopamine receptors are there?
Five
70
What class of antipsychotic drugs does chlorpromazine belong to? Which receptor(s) do they bind?
Phenothiazines
| Binds to both D1 and D2 receptors
71
What class of antipsychotic drugs does haloperidol belong to? Which receptor(s) do they bind?
Butyrophenones
| Binds to only D2 receptors
72
Which dopamine receptor is faulty in schizophrenia?
D2 receptors
73
What links have been found between schizophrenia and psychdelic drugs?
```
The effects of classical hallucinogens, such as LSD, mimic the positive symptoms of schizophrenia by acting as agonists of particular serotonin receptors.
Dissociative hallucinogens (e.g. ketamine) mimic the negative symptoms of schizophrenia by acting as antagonists of glutamate receptors
```
74
Which processes affected by genes could influence the onset of schizophrenia?
Disruption of neural proliferation and migration, synaptic pruning, myelination or transmission at glutamaterigic and GABAergic synapses
75
What structure brain changes can be seen is schizophrenia patients?
Enlarged ventricles and fissures (hence a reduced brain volume)
Smaller hippocampus, amygdala, thalamus, and nucleus accumbens
White and gray matter reduction (particularly temporal lobes)
76
True or False:
Individuals who do not have schizophrenia but have a close relative who does tend to display volume reductions in some parts of the brain
True
77
True or False:
| Areas of the brain susceptible to schizophrenia deteriorate at equal rates
False
78
What are the two categories of depression?
Reactive depression
| Endogenous depression
79
What are the two subtypes of major depressive disorder?
Seasonal affective disorder (SAD)
| Peripartum depression
80
What five classes of drugs have been used to treat depressive disorders?
```
Monoamine oxidase (MAO) inhibitors
Tricyclic antidepressants
Selective monoamine-reuptake inhibitors (SSRIs)
Atypical antidepressants
NMDA-receptor antagonists
```
81
How do MAO inhibitors work?
They inhibit the activity of monoamine oxidase, which is the enzyme that breaksdown monoamine neurotransmitters in the cytoplasm of the neuron
82
What is the main side-effect of MAO inhibitors?
The Cheese Effect - Tyramine-rich foods (such as cheese) cause a dramatic increase in blood pressure
83
Why does the cheese effect occur?
MAO is responsible for metabolising tyramine in the liver so when MAO is blocked this cannot occur
84
How do tricyclic antidepressants work?
They block the reuptake of both serotonin and norepinephrine, thus increasing their levels in the brain
85
How do SSRIs work?
SSRIs are serotonin agonists that exert their agonisitic effects by blocking the reuptake of serotonin from synapses
86
Why are SSRIs popular?
They have few side effects
| They act against a wide range of psychological disorders in addition to depression
87
What brain structures are affected by depression?
Decrease size of the prefrontal cortex, hippocampus, amygdala and cingulate cortex
88
What is the monoamine theory of depression?
Depression is associated with underactivity at serotonergic and noradernergic synapses.
89
What is the neuroplasticity theory of depression?
Depression results from a decrease of neuroplastic processes in various brain structures, which leads to neuron loss and other neural pathology
90
What concepts support the monoamine theory of depression?
Most antidepressants are serotonin and/or norepinephrine agonists
Up-regulation of norepinephrine and/or serotonin receptors in depressed individuals
91
What concepts challenge the monoamine theory of depression?
Monoamine agonists are not effective in treating most depressed patients
Other neurotransmitters have been shown to play a role in depression (i.e. GABA, glutamate and acetylcholine)
92
What concepts support the neuroplasticity theory of depression?
Research has showed that stress and depression are associated with the disruption of various neuroplastic processes
Research has shown that antidepressant treatments are associated with an enhancement of neuroplastic processes
93
What is BDNF?
Brain-derived neurotropic factor (BDNF) - a potential biomarker of depression. Treatments that improve depression also increase BDNF levels
94
What brain stimulation techniques have been used to treat depression?
Repetitive transcranial magnetic stimulation (rTMS)
| Deep brain stimulation (DBS)
95
Which parts of the brain are stimulated in DBS?
White matter of the anterior cingulate gyrus in the medial prefrontal cortex
96
How many cycles per year occur in rapid cycling bipolar disorder?
Four or more
97
What type of drugs are used to treat bipolar disorder?
Mood stabilisers
98
Which brain structures are affected by bipolar disorder and how?
Decreased size of: medial prefrontal cortex, left anterior cingulate, left superior temporal gyrus, certain prefrontal regions and hippocampus
Atypical activation of: frontal cortex, medial temporal lobe structures, and basal ganglia
99
What is the most common psychiatric disorder?
Anxiety
100
What are the four main types of anxiety disorder?
Generalised anxiety disorder
Specific phobias
Agoraphobia
Panic disorder
101
What are the three categories of drugs prescribed to treat anxiety?
Benzodiazepines
Serotonin agonists
Antidepressants
102
What are the side-effects of benzodiazepines?
Sedation, ataxia, tremor, nausea and withdrawal symptoms
103
Which animal models have been used to study anxiety?
Elevated-plus-maze test
Defensive-burying test
Risk-assessment test
104
What are the types of verbal tics common for Tourette's patients?
Coprolalia (swearing), echolalia (repeating someone) and palilalia (repeating yourself)
105
True or False:
| Symptoms of Tourette's remain consistent throughout a person's lifetime
False
| They decrease with age
106
How is the brain effected by Tourette's disorder?
Smaller striatum
| Dysfunctional dopaminergic and GABAergic signalling within the cortical-striatal-thalamic-cortical brain circuits
107
How is Tourette's treated?
Education
Treatment of ancillary emotional problems (depression and anxiety)
Antipsychotics
108
Research designed to translate basic scientific discoveries into effective clinical treatments is called what?
Translational research
109
What are the three main phases of clinical trials?
Screening for safety
Establishing the testing protocol
Final testing
110
What is the purpose of phase 1 of clinical trials?
To establish whether the drug is safe for human use, and if it is, to determine how much of the drug can be tolerated
111
What is the purpose of phase 2 of clinical trials?
To establish the protocol (the conditions) under which the final tests are likely to provide a clear result
112
What type of people usually participate in phase 1 of clinical trials?
Paid, healthy individuals
113
What type of people usually participate in phase 2 of clinical trials?
Volunteer patients suffering from the target disorder
114
What is the purpose of phase 3 of clinical trials?
To demonstrate with certainty that the drugs is effective
115
What are the five controversal aspects of clinical trials?
```
Requirement of double-blind design and placebo controls
The need for active placebos
Length of time required
Financial issues
Targets of psychopharmacology
```
116
```
A recent structural MRI study of the brains of children with Tourette syndrome revealed thinning of the:
Select one:
a. amygdala.
b. prefrontal cortex.
c. sensorimotor cortex.
d. parietal cortex.
```
c. sensorimotor cortex.
117
Benzodiazepines:
Select one:
a. are catecholamine antagonists.
b. are monoamine antagonists.
c. are monoamine agonists.
d. are GABA-A agonists.
d. are GABA-A agonists.
118
```
________ disorder is characterized by stress responses and worry that often occur in the absence of any obvious precipitating stimulus.
Select one:
a. Obsessive-compulsive
b. Panic
c. Phobic anxiety
d. Generalized anxiety
```
d. Generalized anxiety
119
```
Dopamine agonist is to dopamine antagonist as
Select one:
a. reserpine is to chlorpromazine.
b. cocaine is to reserpine.
c. reserpine is to amphetamine.
d. chlorpromazine is to reserpine.
```
b. cocaine is to reserpine.
120
```
One prominent theory of clinical depression is the ________ theory, which holds that depression is associated with underactivity at serotonergic and noradrenergic synapses.
Select one:
a. bilateral
b. synaptic
c. monoamine
d. dynamic
```
c. monoamine
121
```
Selective norepinephrine-reuptake inhibitors are used in the treatment of:
Select one:
a. schizophrenia.
b. depression.
c. tuberculosis.
d. mania.
```
b. depression.
122
The main difficulty in diagnosing psychiatric disorders is that
Select one:
a. patients suffering from the same psychiatric disorder often display different symptoms.
b. patients suffering from different psychiatric disorders often display the same symptoms.
c. dream analysis is subjective and expensive.
d. both A and B
d. both A and B
123
```
The most commonly employed physiological measure of stress is the level of circulating
Select one:
a. adrenocorticotropic hormone.
b. norepinephrine.
c. glucocorticoids.
d. epinephrine.
```
c. glucocorticoids.
124
```
The symptoms of schizophrenia are often divided into two categories:
Select one:
a. genetic and experiential.
b. active and passive.
c. positive and negative.
d. genetic and epigenetic.
```
c. positive and negative.
125
The three aspects of the bio-psycho-social approach are:
Select one:
a. not all able to be scientifically examined.
b. relevant for implementing treatment but not diagnosis.
c. relevant to psychiatric illness independent of the cause.
d. not all relevant for psychiatric disorders that have a proven genetic or biological cause.
c. relevant to psychiatric illness independent of the cause.
