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PSY2061 > Psychiatric Disorders > Flashcards

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

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2
Q

What is agoraphobia?

A

pathological fear of public places and open spaces

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3
Q

What is anhedonia?

A

a general inability to experience pleasure

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4
Q

What is anxiety?

A

chronic fear that persists in the absence of any direct threat

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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

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6
Q

What are anxiolytic drugs?

A

antianxiety drugs

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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

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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

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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)

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10
Q

What is bipolar disorder?

A

a category of psychiatric disorders that involves alternate bouts of depression and mania or hypomania

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11
Q

What is bipolar disorder type I?

A

a psychiatric disorder that involves alternate bouts of depression and mania

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12
Q

What is bipolar disorder type II?

A

a psychiatric disorder that involves alternate bouts of depression and hypomania

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13
Q

What are butyrophenones?

A

a class of antipsychotic drugs that bind primarily to D2 receptors

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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

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15
Q

What is chlorpromazine?

A

the first antipsychotic drug

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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

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17
Q

What are clinical trials?

A

studies conducted on human subjects to assess the therapeutic efficacy of an untested drug or other treatments

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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

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19
Q

What does comorbid mean?

A

the tendency for two or more health conditions to occur together in the same individual

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20
Q

What is the defensive-burying test?

A

an animal model of anxiety; anxious rats will bury objects that generate anxiety

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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

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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

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23
Q

What is endogenous depression?

A

depression that occurs with no apparent cause

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24
Q

What is fluoxetine?

A

the first selective serotonin reuptake inhibitor (SSRI) to be developed. It was initially marketed under the tradename Prozac

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25
Q

What is generalised anxiety disorder?

A

an anxiety disorder characterised by stress responses and extreme feeling of anxiety and worry about a large number of different activities or events

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26
Q

What is haloperidol?

A

a butyrophenone used as an antipsychotic drug

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27
Q

What is hypomania?

A

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

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28
Q

What is imipramine?

A

the first tricyclic antidepressant drug

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29
Q

What is iproniazid?

A

the first antidepressant drug; a mono oxidase inhibitor

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30
Q

What is ketamine?

A

a drug that is a type of dissociative hallucinogen

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31
Q

What is lithium?

A

a metallic ion that is a mood stabiliser; used in the treatment of bipolar disorders

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32
Q

What is mania?

A

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

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33
Q

What are MAO inhibitors?

A

antidepressant drugs that increase the level of monoamine neurotransmitters by inhibiting the action of the enzyme monoamine oxidase

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34
Q

What is a mixed state?

A

a state that can occur in bipolar disorder type I, where the patient simultaneously display symptoms of both depression and mania

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35
Q

What are mood stabilisers?

A

drugs that effectively treat depression or mania without increasing the risk of mania or depression, respectively.

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36
Q

What are negative symptoms?

A

symptoms of schizophrenia that seem to represent a reduction or loss of typical function

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37
Q

What are orphan drugs?

A

drugs for which the market is too small for the necessary developmental research to be profitable

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38
Q

What are panic attacks?

A

rapid-onset attacks of extreme fear and severe symptoms of stress (e.g., choking, heart palpitations, shortness of breath)

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39
Q

What is panic disorder?

A

an anxiety disorder characterised by recurrent rapid-onset attacks of extreme fear and severe symptoms of stress

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40
Q

What is peripartum depression?

A

the intense, sustained depression experienced by some females during pregnancy, after they give birth, or both

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41
Q

What are phenothiazines?

A

a class of antipsychotic drugs that bind effectively to both D1 and D2 receptors

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42
Q

What are positive symptoms?

A

symptoms of schizophrenia that seem to represent an excess of typical function

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43
Q

What are psychedelic drugs?

A

drugs whose primary action is to alter perception, emotion and cognition

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44
Q

What are psychiatric disorders?

A

a disorder of psychological function sufficiently severe to require treatment by a psychiatrist or clinical psychologist

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45
Q

What is psychosis?

A

a loss of touch with reality

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46
Q

What is reactive depression?

A

depression that is triggered by a negative experience

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47
Q

What is repetitive transcranial magnetic stimulation (rTMS)?

A

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

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48
Q

What is reserpine?

A

the first monoamine antagonist to be used n the treatment of schizophrenia; the active ingredient of the snakeroot plant

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49
Q

What is a risk-assessment test?

A

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

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50
Q

What is seasonal affective disorder (SAD)?

A

type of major depressive disorder in which episodes of depression typically recur during particular seasons - usually during the winter months

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51
Q

What are selective serotonin-reuptake inhibitors (SSRIs)?

A

class of drugs that exert agonistic effects by blocking the reuptake of serotonin from synapses; used to treat depression

52
Q

What is a specific phobia?

A

an anxiety disorder that involves strong fear or anxiety about particular objects (e.g., birds, spiders) or situations (e.g., enclosed spaces, darkness)

53
Q

What are tics?

A

involuntary, repetitive, stereotyped movements or vocalisations the defining feature of Tourette’s syndrome

54
Q

What is Tourette’s disorder?

A

a disorder of tics

55
Q

What is a translational bottleneck?

A

a barrier keeping promising ideas and treatments from becoming the focus of translational research; largely created by the massive cost of such research

56
Q

What is translational research?

A

research designed to translate basic scientific discoveries into effective applications (e.g., into clinical treatments)

57
Q

What is a tricyclic antidepressent?

A

drugs with an antidepressant action and a three-ring molecular structure

58
Q

What are typical antipsychotics?

A

the first generation of antipsychotic drugs

59
Q

What is up-regulation?

A

an increase in the number of receptors for a neurotransmitter in response to decreased release of that neurotransmitter

60
Q

What are examples of positive symptoms?

A 
Delusions
Hallucinations
Inappropriate affect (emotion)
Disorganised speech or thought
Odd behaviour
61
Q

What are examples of negative symptoms?

A

Affective flattering (diminished emotions)
Avolition (reduced motivation)
Catatonia (motionless)

62
Q

What was the first antipsychotic drug to be discovered?

A

Chlorpromazine

63
Q

Why isn’t Reserpine used to treat schizophrenia anymore?

A

It produces a dangerous decline in blood pressure at the doses needed for successful treatment

64
Q

How long do Chlorpromazine and Reserpine take to work?

A

2-3 weeks

65
Q

What are the side-effects that Chlorpromazine and Reserpine have on common?

A

Muscular rigidity and decrease in voluntary movement.

Similar to symptoms of Parkinson’s disease

66
Q

What does the dopamine theory of schizophrenia state?

A

Schizophrenia is caused by too much dopamine and, conversely, that antipsychotic drugs exert their effects by decreasing dopamine levels

67
Q

How do Chlorpromazine and Reserpine differ in their actions?

A

Reserpine works by depleting the brain of dopamine whereas Chlorpromazine works by binding to dopamine receptors

68
Q

True or False:

Haloperidol has a high affinity for dopamine receptors

A

False

It had a relatively low affinity for dopamine receptors

69
Q

How many classes of dopamine receptors are there?

A

Five

70
Q

What class of antipsychotic drugs does chlorpromazine belong to? Which receptor(s) do they bind?

A

Phenothiazines

Binds to both D1 and D2 receptors

71
Q

What class of antipsychotic drugs does haloperidol belong to? Which receptor(s) do they bind?

A

Butyrophenones

Binds to only D2 receptors

72
Q

Which dopamine receptor is faulty in schizophrenia?

A

D2 receptors

73
Q

What links have been found between schizophrenia and psychdelic drugs?

A 
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
Q

Which processes affected by genes could influence the onset of schizophrenia?

A

Disruption of neural proliferation and migration, synaptic pruning, myelination or transmission at glutamaterigic and GABAergic synapses

75
Q

What structure brain changes can be seen is schizophrenia patients?

A

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
Q

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

A

True

77
Q

True or False:

Areas of the brain susceptible to schizophrenia deteriorate at equal rates

A

False

78
Q

What are the two categories of depression?

A

Reactive depression

Endogenous depression

79
Q

What are the two subtypes of major depressive disorder?

A

Seasonal affective disorder (SAD)

Peripartum depression

80
Q

What five classes of drugs have been used to treat depressive disorders?

A 
Monoamine oxidase (MAO) inhibitors
Tricyclic antidepressants
Selective monoamine-reuptake inhibitors (SSRIs)
Atypical antidepressants
NMDA-receptor antagonists
81
Q

How do MAO inhibitors work?

A

They inhibit the activity of monoamine oxidase, which is the enzyme that breaksdown monoamine neurotransmitters in the cytoplasm of the neuron

82
Q

What is the main side-effect of MAO inhibitors?

A

The Cheese Effect - Tyramine-rich foods (such as cheese) cause a dramatic increase in blood pressure

83
Q

Why does the cheese effect occur?

A

MAO is responsible for metabolising tyramine in the liver so when MAO is blocked this cannot occur

84
Q

How do tricyclic antidepressants work?

A

They block the reuptake of both serotonin and norepinephrine, thus increasing their levels in the brain

85
Q

How do SSRIs work?

A

SSRIs are serotonin agonists that exert their agonisitic effects by blocking the reuptake of serotonin from synapses

86
Q

Why are SSRIs popular?

A

They have few side effects

They act against a wide range of psychological disorders in addition to depression

87
Q

What brain structures are affected by depression?

A

Decrease size of the prefrontal cortex, hippocampus, amygdala and cingulate cortex

88
Q

What is the monoamine theory of depression?

A

Depression is associated with underactivity at serotonergic and noradernergic synapses.

89
Q

What is the neuroplasticity theory of depression?

A

Depression results from a decrease of neuroplastic processes in various brain structures, which leads to neuron loss and other neural pathology

90
Q

What concepts support the monoamine theory of depression?

A

Most antidepressants are serotonin and/or norepinephrine agonists
Up-regulation of norepinephrine and/or serotonin receptors in depressed individuals

91
Q

What concepts challenge the monoamine theory of depression?

A

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
Q

What concepts support the neuroplasticity theory of depression?

A

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
Q

What is BDNF?

A

Brain-derived neurotropic factor (BDNF) - a potential biomarker of depression. Treatments that improve depression also increase BDNF levels

94
Q

What brain stimulation techniques have been used to treat depression?

A

Repetitive transcranial magnetic stimulation (rTMS)

Deep brain stimulation (DBS)

95
Q

Which parts of the brain are stimulated in DBS?

A

White matter of the anterior cingulate gyrus in the medial prefrontal cortex

96
Q

How many cycles per year occur in rapid cycling bipolar disorder?

A

Four or more

97
Q

What type of drugs are used to treat bipolar disorder?

A

Mood stabilisers

98
Q

Which brain structures are affected by bipolar disorder and how?

A

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
Q

What is the most common psychiatric disorder?

A

Anxiety

100
Q

What are the four main types of anxiety disorder?

A

Generalised anxiety disorder
Specific phobias
Agoraphobia
Panic disorder

101
Q

What are the three categories of drugs prescribed to treat anxiety?

A

Benzodiazepines
Serotonin agonists
Antidepressants

102
Q

What are the side-effects of benzodiazepines?

A

Sedation, ataxia, tremor, nausea and withdrawal symptoms

103
Q

Which animal models have been used to study anxiety?

A

Elevated-plus-maze test
Defensive-burying test
Risk-assessment test

104
Q

What are the types of verbal tics common for Tourette’s patients?

A

Coprolalia (swearing), echolalia (repeating someone) and palilalia (repeating yourself)

105
Q

True or False:

Symptoms of Tourette’s remain consistent throughout a person’s lifetime

A

False

They decrease with age

106
Q

How is the brain effected by Tourette’s disorder?

A

Smaller striatum

Dysfunctional dopaminergic and GABAergic signalling within the cortical-striatal-thalamic-cortical brain circuits

107
Q

How is Tourette’s treated?

A

Education
Treatment of ancillary emotional problems (depression and anxiety)
Antipsychotics

108
Q

Research designed to translate basic scientific discoveries into effective clinical treatments is called what?

A

Translational research

109
Q

What are the three main phases of clinical trials?

A

Screening for safety
Establishing the testing protocol
Final testing

110
Q

What is the purpose of phase 1 of clinical trials?

A

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
Q

What is the purpose of phase 2 of clinical trials?

A

To establish the protocol (the conditions) under which the final tests are likely to provide a clear result

112
Q

What type of people usually participate in phase 1 of clinical trials?

A

Paid, healthy individuals

113
Q

What type of people usually participate in phase 2 of clinical trials?

A

Volunteer patients suffering from the target disorder

114
Q

What is the purpose of phase 3 of clinical trials?

A

To demonstrate with certainty that the drugs is effective

115
Q

What are the five controversal aspects of clinical trials?

A 
Requirement of double-blind design and placebo controls
The need for active placebos
Length of time required
Financial issues
Targets of psychopharmacology
116
Q 
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.
A

c. sensorimotor cortex.

117
Q

Benzodiazepines:

Select one:

a. are catecholamine antagonists.
b. are monoamine antagonists.
c. are monoamine agonists.
d. are GABA-A agonists.

A

d. are GABA-A agonists.

118
Q 
\_\_\_\_\_\_\_\_ 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
A

d. Generalized anxiety

119
Q 
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.
A

b. cocaine is to reserpine.

120
Q 
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
A

c. monoamine

121
Q 
Selective norepinephrine-reuptake inhibitors are used in the treatment of:
Select one:
a. schizophrenia.
b. depression.
c. tuberculosis.
d. mania.
A

b. depression.

122
Q

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

A

d. both A and B

123
Q 
The most commonly employed physiological measure of stress is the level of circulating
Select one:
a. adrenocorticotropic hormone.
b. norepinephrine.
c. glucocorticoids.
d. epinephrine.
A

c. glucocorticoids.

124
Q 
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.
A

c. positive and negative.

125
Q

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.

A

c. relevant to psychiatric illness independent of the cause.

PSY2061 (12 decks)

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