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EPPP(B) > Psychopathology > Flashcards

Psychopathology Flashcards

1
Q

Manic episode

A
  • abnormally and persistently elevated, expensive, or irritable mood
  • increased activity or energy
  • lasts at least one week
  • 3or + sxs: inflated self-esteem or grandiosity, decrease need for sleep, flood of ideas,
  • marked impairment and functioning, a need for hospitalization to avoid harm to solve for others, and or the presence of psychotic features
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2
Q

Hypomanic

A
  • abnormally and persistently elevated, expansive, or irritable mood
  • increased activity or energy
  • three or more symptoms of mania for at least 4 consecutive days
  • symptoms are not severe enough to cause marked impairment or functioning, no psychotic features, and no need for hospitalization
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3
Q

Major depressive episode

A
  • five or more characteristic symptoms
  • at least one symptom being depressed, mood or loss of interest or pleasure in most are all activities
  • symptoms last at least 2 weeks and cause significant distress or impairment in functioning
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4
Q

Bipolar 1

A
  • at least one manic episode that may or may not have been followed by our proceeded by one or more major depressive or hypomanic episode
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5
Q

Bipolar II

A
  • at least one hypomanic episode and at least one major depressive episode
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6
Q

Cyclothymic disorder

A
  • numerous periods of depressive and hypomanic symptoms that do not meet the criteria for episodes
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7
Q

Etiology of bipolar disorder

A
  • heredity
  • neurotransmitter and brain abnormalities
  • circadian rhythm, irregularities
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8
Q

Bipolar disorder and heredity

A
  • twin, family, and adoption studies= strong genetic component
  • twin studies report concordance rates of .67 to 1.0 for monozygotic twins and .20 for dizygotic twins
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9
Q

Neurotransmitters and bipolar disorder

A

Never Give Dogs Salad

  • Norepinephrine
  • glutamate
  • dopamine
  • serotonin
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10
Q

Brain abnormalities and bipolar disorder

A
  • PHAB

-prefrontal cortex
- amygdala
- hippocampus
- basal ganglia

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11
Q

Circadian, rhythm regularities and bipolar disorder

A
  • abnormalities in the sleepwake cycle, secretion of hormones, appetite, and core body temperature
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12
Q

Bipolar disorder and ADHD similarities

A
  • distractibility
  • irritability
  • accelerated speech
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13
Q

Dxing ADHD & bipolar disorder in kids & adolescents

A
  • consider symptoms that do not overlap with ADHD, symptoms and children and adolescents
  • for youth 7 to 16, manic specific symptoms are elation, grandiosity, flight of ideas/ racing. Thoughts, decreased need for sleep, and hypersexuality
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14
Q

Hypersexuality

A
  • preoccupation with sex

-using sexually explicit language, engaging

-developmentally inappropriate sexual behaviors

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15
Q

Differential diagnosis of ADHD and bipolar disorder and adults

A
  • euphoric, elevated, or irritable mood
  • increase self-esteem or grandiosity
  • distractibility caused by thought. Acceleration
  • decreased need for sleep usually without physical discomfort
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16
Q

ADHD symptoms in adults

A
  • label, dysphoric mood
  • increased self-esteem or grandiosity
  • distractibility due to wandering of thoughts
  • fatigue
  • discomfort after loss of sleep
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17
Q

Increase sexuality and bipolar disorder and adults

A
  • confirmed by research to be common during a manic episode.
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18
Q

ADHD and increased sexuality

A
  • inconsistent findings and research
  • finding suggest ADHD is not associated with increased sexual activity but higher rates of sexual disorders and greater involvement in risky sexual behaviors
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19
Q

Treatment of bipolar disorder

A
  • combination of psychosocial interventions and pharmaco therapy
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20
Q

Evidence-based psychosocial interventions for bipolar disorder

A
  • psycho education
  • interpersonal and social rhythm therapy
  • CBT
  • family focus therapy (high expressed emotion by family members. Trigger relapses)
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21
Q

Pharmacotherapy in bipolar disorder

A
  • lithium
  • anti-convulsive drug
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22
Q

Lithium

A
  • most effective for classic bipolar disorder
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23
Q

Classic bipolar disorder

A
  • Low likelihood of mixed moon states and rapid cycling
  • long periods of recovery between episodes
  • on set between 15 and 19 years old
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24
Q

Anti-convulsant drugs

A
  • carbamazepine
  • valparic acid
  • second generation antipsychotic drugs
  • most effective for a typical bipolar disorder
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25
Q

Atypical bipolar disorder

A
  • mixed mood states
  • rapid cycling
  • lack of full recovery between episodes
  • on set between 10 to 15 years old
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26
Q

Specifiers of bipolar disorder

A
  • with a typical features
  • mood reactivity and at least two of the following: significant weight gain or increase in appetite, hypersomnia, lead in paralysis, and interpersonal rejection sensitivity
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27
Q

Major depressive disorder

A
  • 5 or more symptoms of a major depressive episode for at least 2 weeks
  • at least one symptom is depressed, mood or loss of interest or pleasure in most or all activities

Sigecaps

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28
Q

Persistent depressive disorder

A
  • depressed mood with two or more characteristics symptoms
  • loss of appetite or overeating
  • insomnia or hypersomnia
  • feelings of hopelessness
  • for at least 2 years in adults and one year and kids are adolescents
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29
Q

Disruptive mood dysregulation disorder

A
  • severe and reoccurrent temper outburst that are verbal and or behavioral
  • grossly out of proportion to situation or provocation
  • occur three or more times a week
  • persistently irritable or angry mood that is absorbable to others most of the day, nearly every day between outbursts
  • sxs present for at least a year
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30
Q

Specifiers for major depressive disorder

A
  • with peripartum onset
  • with seasonal pattern
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31
Q

With peripartum onset

A
  • symptoms begin during pregnancy or 4 weeks after delivery
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32
Q

Baby blues

A
  • up to 80%
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33
Q

Major depressive disorder with peripartum onset

A
  • 9% of pregnant people experience major depressive episode between conception and birth
  • 7% experience a major depressive episode between birth and 12 months postpartum
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34
Q

Treatment of peripartum depression

A
  • CBT
  • interpersonal therapy

Both evidence-based practice

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35
Q

Antidepressants and peripartum depression

A
  • effective especially sertraline
  • several factors must be considered: effects of developing for developing fetus & newborns who are breastfed
    & impact of untreated maternal depression on parent and child
36
Q

Exercise and peripartum depression

A
  • evidence that exercises reduces symptoms.
  • research has found inconsistent results about the magnitude of effect due to differences in methodology
  • meta analysis found that exercise alone has a non -significant beneficial effect on symptoms but exercise with co intervention with significantly more effective than co intervention alone
37
Q

With seasonal pattern

A
  • applies when there’s a temporal relationship between mood episode and time of year
  • usually occurs in the winter
  • hypersomnia, overeating, weight gain, and craving for carbohydrates
38
Q

Cause of seasonal depression

A
  • lower the normal serotonin and higher than normal levels of melatonin
39
Q

Treatment of seasonal depression

A
  • responsive to phototherapy
  • exposure to bright light suppresses the production of melatonin
40
Q

Depression in childhood

A
  • Rachel of depression similar for boys and girls
41
Q

Depression in adolescents

A
  • females increase rate for males remain stable
  • increase of hormone levels at puberty. Sense of times is females but desensitizes males to the stress of negative life events
42
Q

Depression rates in adulthood

A
  • higher rate for females persist into adulthood
  • female adolescents and adults 1.5 to 3 times higher than male adolescents or adults
43
Q

Etiology of major depressive disorder

A
  • heredity
  • neurotransmitter abnormalities
  • hormone abnormalities
  • brain abnormalities
  • cognitive & behavioral factors
44
Q

Heredity and major depressive disorder

A
  • twin and adoption studies confirm genetic component
  • concordance rate for unipolar depression.50 for monozygotic twins and .20 for dizygotic twins
    .
  • concordance rates larger for female twin pairs equal sign.50 (Mono) and .34 (dy,) female and .40 (mono) .28 (diz) male
45
Q

Neurotransmitters and major depressive disorder

A
  • low serotonin, dopamine, and norepinephrine
46
Q

Brain abnormalities and depression

A
  • abnormous in the hypothalamic- adrenal access (HPA)
  • structural and functional abnormalities in the cerebral cortex, singulate cortex, hippocampus, claudate nucleus, put them in, amygdala, thalamus, and other areas of the brain
47
Q

HPA axis and depression

A

-exposure to chronic stress, especially in early life, leads to persistent hyperactivity of the HPA access and hypersecretion of cortisol, associated with increased risk for depression

48
Q

Prefrontal, cortex and depression

A
  • abnormally high levels of activity in the ventral medial, prefrontal cortex and abnormally low levels in the door. Cilateral prefrontal cortex
  • commission of depression and response to psychotherapy or antidepressant leads to opposite pattern
49
Q

Behavioral and cognitive explanations for depression

A
  • Lewisohn’s social reinforcement theory
  • selegmans learned helplessness model
  • Beck’s cognitive theory
50
Q

Lewinsohn’s social reinforcement theory

A
  • low rate of response contingent reinforcement for social behaviors due to lack of reinforcement in the environment and or poor social skills cause depression
  • lead to social isolation, low self-esteem, pessimism, and other symptoms of depression which further decrease the likelihood of positive reinforcement in the future
51
Q

Seligman’s learned helplessness model

A

Original model: repeated exposure to uncontrollable negative events results in a sense of helplessness

  • reformulation: negative cognitive style involves attributing negative life events to stable, internal, and global factors
  • helplessness is approximal insufficient cause of depression which results in exposure to negative events and a negative cognitive style
52
Q

Beck’s cognitive theory

A
  • depression is caused by a cognitive triad that consists of negative thoughts about the self, world, and future
53
Q

Age and depression

A
  • factors are somewhat age related
  • younger adults: genetics, stressful life events, limitations and problem solving, and other cognitive abilities
  • older adults : chronic medical illness, especially likely when illness decreases physical functioning and contributes to social isolation
54
Q

Major depressive do and culture & age

A
  • older adults more likely to refer to somatic symptoms, cognitive changes, and loss of interest in usual activities
  • younger adults affective symptoms
  • non-western cultures report a larger number of somatic symptoms
  • members of Western culture report a larger number of psychological symptoms
55
Q

Comorbidity of major depressive disorder

A
  • substance use disorder (alcohol use disorder)
  • anxiety disorder
  • personality disorder
56
Q

Sleep abnormalities and major depressive disorder

A
  • prolonged sleep latency (takes longer to fall asleep)
  • reduced rem latency (shorter time from sleep on set to REM sleep
  • reduced slow wave sleep (stages 3 &4)
  • increased rem density (more rapid eye movements per unit of time)
57
Q

Medical conditions and depression

A
  • linked to coronary heart disease, stroke, diabetes, Parkinson’s disease, and other conditions
  • bidirectional
58
Q

Depression and heart attacks

A
  • independently predictive of increased risk for myocardial infraction
  • depression and anxiety most commonly developed after a myocardial infraction with depression more common
59
Q

Treatment of major depressive disorder

A
  • psychotherapy and/or pharmacotherapy
60
Q

Research on the treatment of major depressive disorder

A
  • combined treatment more effective than either psychotherapy alone or pharmacotherapy alone in terms of response and remission rates
  • no significant difference between psychotherapy alone and pharmacotherapy alone
61
Q

APA guidelines for treating children with depression

A
  • insufficient evidence to recommend any particular psychosocial or pharmacological treatment
62
Q

APA guidelines for treating adolescents with depression

A
  • CBT or interpersonal psychotherapy for adolescence
  • fluoxetine
  • there is insufficient evidence to recommend either of these treatments over the other
63
Q

APA guidelines for treating adults with depression

A
  • offer patients either psychotherapy or a second generation antidepressant (SSRI or SNRI)

-CBT, mindfulness-based cognitive therapy (MBCT), IPT, behavioral therapy, psychodynamic therapy, and supportive therapy

  • CBT or IPT + 2nd generation antidepressant as a combined treatment
64
Q

Treatment of older adults with depression

A
  • either group cognitive behavioral therapy or combination of IPT and a second generation antidepressant
  • insufficient evidence for recommended self-guided bibliotherapy or life review therapy for older adults
65
Q

St. John’s wort for depression

A
  • research has shown it has similar therapeutic effects as SSRI for mild and moderate depression
  • lower dropout rates and fewer side effects
  • has not been shown to be effective for severe depression and can interact with certain drugs
66
Q

Negative effects of St. John’s wort

A
  • If taken with an SSRI can cause serotonin syndrome
  • If taken with Xanax (alprazolam) or Wellbutrin (bupropion) or statin/immunosuppressant drugs can reduce effectiveness of those drugs
67
Q

Ketamine and the treatment of depression

A
  • effective as a fast acting treatment for treatment resistant, depression and suicidal ideations

-increases glutamate levels

  • prescribed as a nasal spray (esketamine) and using conjunction with an oral antidepressant
  • due to potential for severe side effects is self-administered under supervision of a healthcare provider and a healthcare setting
68
Q

Electroconvulsive therapy for depression

A
  • high success rate when you used to treats of your depression
  • used when other treatments have not been affective or severity of symptoms requires a quick treatment response
69
Q

Advantages of ECT

A
  • higher response rate
  • higher remission rate
  • faster remission time
70
Q

Response rate

A
  • clinically meaningful reduction in symptoms
71
Q

Remission rate

A
  • the absence or near absence of symptoms
72
Q

Reported response rate and remission rates for ECT

A

Response rate 80%

Permission rate 70%

73
Q

Response rates and remission rates for psychotherapy and pharmacotherapy

A

-Response rate 30 to 60%

  • remission rate 25 to 45%
74
Q

Remission time of ECT

A
  • one to three weeks
75
Q

Remission rates for psychotherapy and pharmacotherapy

A

IPT, CPT 6 to 10 weeks

Antidepressants 4 to 12 weeks

76
Q

Disadvantages of ECT

A
  • can cause anterograre amnesia and retrograde amnesia
  • anterograde amnesia resolves within a few weeks after last ECT session
  • retrograde amnesia affects recently acquired memories more than remote memories and resolves weeks to several months after last ECT session with older memories returning before recent ones

-

77
Q

Memory gaps and ECT

A
  • many patients experience persistent gaps and memory for events that occurred pre-ECT
78
Q

Retrograde amnesia and ECT

A
  • more severe for bilateral placement of electrodes than for right unilateral placement and for larger number of treatment sessions and less time between sessions
79
Q

Repetitive transcranial magnetic stimulation (rTMS)

A
  • non-invasive technique
  • uses magnetic fields to stimulate the left dorsolateral prefrontal cortex
  • most often used for treatment resistant depression
80
Q

Disadvantage of rTMS

A
  • lower response and remission rates then ECT
81
Q

ECT vs rTMS

A

-rTMS require sedation or memory loss

82
Q

Tell a psychology and face to face psychotherapy for depression

A
  • meta-analysis found to approaches had similar outcomes in terms of depressive symptoms. Severity, quality of life, client satisfaction, and the therapeutic alliance
83
Q

Suicide in the US

A
  • increased from 2000 to 2018
  • decreased from 2018 to 2020
  • rates consistently higher for males and females (three to four times higher for males from 2000 to 2020)
84
Q

Overall suicide rates in 2020

A

Higher for individuals. 75 years old and up and American Indians/ Alaskan natives

  • whites, Hispanics, blacks, Asian Pacific Islanders
85
Q

Suicide rates and gender 2020

A
  • highest rates for males was 75 years old and up
  • highest rates for females was 45 to 64 years old
86
Q

Suicide raids and ethnicity and age and 2020

A
  • highest rates for American Indian/ Alaska natives, Hispanics, and black were 25 to 34 years old
  • highest rates for whites was age 45 to 54
  • highest rates for Asian Pacific Islanders was 85 and older

EPPP(B) (13 decks)

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