Psychopathology Flashcards by Luis Franco

What is DSM V

Diagnostic and Statistical Manual of Mental Disorders

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What is axis 1

All psychological diagnostic categories except mental retardation and personality disorders:
Depression
Anxiety disorders
Bipolar 
Autism
Anorexia/bulimia nervosa
Drug dependency

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What is axis 2

Personality disorders and mental retardation:
Paranoid personality disorder
Schizoid personality dis
OC personality dis 
Intelectual disabilities

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What is axis 3

General medical conditions;
Acute medical conditions and
Physical disorders
Brain injuries (car accident) and other medical/physical disorders

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What is axis IV

Psychosocial and environmental factors contributing to the disorder; stress

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What is axis V

Global assessment of functioning

Children’s global assessment scale

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What is assessed in a Mental Status Examination MSE

Mood 
Affect
Thought: Process, content, perception
Appearance 
Cognitive function: define, cause ( org vs inorg)

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What is affect

How you present yourself in appearance
carry yourself
communicate

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What is thought

Process: organization, sequential
Content: relevant, insightful
Perception: understanding

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What is appearance

Relevant
Hygiene
Aware of environment
Motivation

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What are organic causes

Disease

Accident

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What are inorganic causes

Molecular level

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What are two types of Psychotic disorders

Psychosis

schizophrenia

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What is psychosis

Impaired sense of reality.

Altered cognition and emotion.

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What is the most commonly recognized psychiatric disease

schizophrenia

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Schizophrenia background

$40 billion/yr
1% of pop
mostly poor urban

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Schizo Sx

Remisions
Withdrawn
Abnormal thinking and speech
anhedonic--> suicide
Abnormal appearance --> worse in men 
Men; late 20's and more aggressive 
Wmn; late 20-30 and more aggressive 
delusional 
hallucinate 
flat or labile emotions 
difficulty filtering 
lack of prepulsive inhibition; startle reflex

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Schizophrenia requirements

sx that persist more than 6 months
deteriorating funtions
active psychosis
No drugs/trauma

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What are the subtypes of schizophrenia

Disorganized
Catatonic
Paranoid (positive)
Residual (negative)

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What is a disorganized schizophrenia

Blunted affect 
incoherent 
Not delusional 
bizarre manorisms 
grimacing

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What is catatonic schizophrenia

non responsive but aware

rigid posturing

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What is paranoid schizophrenia

POSITIVE; better response to meds
delusional 
hallucinations 
agressive 
ucoperative

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What is residual schizophrenia

NEGATIVE 
socially withdrawn
flat effect
happens in later stages of disease
most difficult to treat

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What are schizophrenia physical findings

↑ ventricular size
↓ corpus callosum 
↓ frontal cortex blood
Do not yawn 
Altered startle and accommodation

what is schizophrenia neurochemistry

DA mechanism D2 excessive activity 5HT and glutamate contribute to negative sx

What is the genetic predisposition for schizophrenia

``` Monozygotic twins = 40-50 % child of both parents = 30-40 % child of one parent = 10-15 % Dizygotic twin or sibling = 10 % General population = 1% ```

Tx for schizophrenia

All block D2 and %HT2 receptors but increase D1 activity

What are side effects of schizophrenia drugs

``` anhedonia sleepiness restlessness amenorrhea weigh gain Extrapyramidal side effects: -Tardive dyskinesias -parkinson's like tremors ```

What are two Phenothiazines and their properties

Chlorpromazine Thioridizine Least expensive More sedation and weight gain; anticholinergic actions less extrapeyramidal effects, more sedation Antiemetic action; efective against vomiting and nausea

What is a butyrophenone and its properties

Haloperidol ( Haldol) ; widely used/genetic/inexpensive High extrapyramidal side effects no anticholinergic action or side effects

What are newer/atypical schizophrenia drug and prop

``` Clozapine Serious agranulocytosis in 1-2 % Quentiapine (seroquel) Olanzepine (Zyprexa) D2 and 5HT2A antagonists little extrapyramidal side effects most effective against negative effects ```

What is psychotic disorder

Stress related delusions/halucinations fast recovery

What is Schizoaffective

Might look bipolar | Tx will help distinguish it

What is cyclothymia

Minor bipolar | No gender bias

What is depression-dysthymia

``` Greater than 2 yrs lower mood/anhedonia 6% 2:1 F/M young adults ```

What RX is used for anxiety associated with everyday stress

Bupropion

What is the Rx for Severe acute anxiety panic attack

SSRI (Paxil) | Antidepressants (Venlafaxin)

What is the Rx for Phobic disorders

SSRI (Zoloft)

What are two types of ADHD/ADD

Predominantly hyperactive-impulsive | Predominantly inattentive

What are the Rx for ADHD

Amphetamines (adderall) Methylphenidate (Ritalin) Modafinil; fewer side effects, little abuse problem, non-stimulant

Sx of anorexia

``` relentless pursuit of thinness distorted boy image restriction of eating osteoporosis Muscle wasting damage to heart infertility malnutrition laxatives and diuretic ```

Bulimia sx

``` frequent bingeing and purging normal weight damage to esophagus and teeth dehydration turmoil-shame ```

What is the Tx for bulimia

mostly behavioral | fluoxetine and other antidepressants

What are two MAOI antidepressants

Phenelzine | Selegiline

What is good about tricyclic antidepressants

long half life/ single daily dose | Blocks the uptake of NE

What are the side effects of tricyclic antidepressants

xerostomia H1 blockade orthostatic hypotension Withdrawal

What are three tricyclics antidepressants

Amytriptyline Desipramine Doxepin

What monoamine uptake blocker causes depression in adolescents

SSRI's

What are two monoamine uptake blockers (SSRI) used as antidepressants

Fluoxetine (Prozac) | Sertraline (Zoloft)

What are two NE or mixed transport blockers

Venalfaxine (effexor) | Duloxetine (cymbalta)

What medications are used as mood stabilizers for bipolar

``` Lithium Antiepileptic agents: Valproic acid Carbamazepine Latotrigine (lomotil) ```

What Bensodiazepinesdrugs are used for anxiety disorders

Bensodiazepines: allosteric modulators of GABA - sedative - -diazepam (Valium) - -Alprazolam (Xanax) - Hypnotic - -Lorazepam (Ativan) - -Triazolam (Halcion)

What barbiturates are used for anxiety, everyday stress

Bupropion (BuSpar)

What drug is used for severe acute anxiety-panic attack

SSRI's: Paxil | Antidepressant: Venlafaxin

What drug is used for phobic disorders

SSRI:Zoloft

What stimulants are used to treat ADHD/ADD

Amphetamines (adderrall) | Methylphenidate (Ritalin)

What minor stimulant is used to treat ADHD/ADD

Modafinil

What drugs can be used to treat autism

Atypical antipsychotics | SSRI

What drug can be used to treat bulimia

Fluoxetine | other antidepressants