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The Mind > Schizophrenia/anx/OCD/trauma and stress > Flashcards

Schizophrenia/anx/OCD/trauma and stress Flashcards

0
Q

Considerations in diagnostic criteria for schizophrenia

A
  • schizophrenia is last in the diagnostic algorithm

- psychotic MDD and autism/bipolar

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1
Q

Diagnostic criteria for schizophrenia

A 
- 2+ 
   ~ delusions
   ~ hallucinations 
   ~ disorganized speech 
   ~ grossly disorganized or catatonic 
   ~ negative symptoms 
AND
   ~ social occupational dysfunction 
   ~ at least 6 mo
   ~ other schozioeffective disorders and depressive disorders excluded
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2
Q

Dopamine hypothesis

A
  • mesolimbic: hyperdopaminergia-> positive symptoms

- mesocortical: hypodopaminergia-> negative symptoms

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3
Q

Nuclei involvement in schizophrenia

A

Mediodorsal nucleus
Pulvinar
- make connections to the prefrontal cortex

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4
Q

Structural abnormalities in schizophrenia

A
  • enlarged ventricles
  • decreased limb in abs hippocampus structures
  • PFC
  • MDN (thalamus)
  • normal number of pyramidal cells, decreased arborization
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5
Q

Wisconsin card sorting test

A

Illustrates hypofrontality

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6
Q

Schizophreniform criteria

A
  • normal presentation of schiz, but between 1-6 mo.
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7
Q

Brief psychotic disorder

A
  • similar presentation to schiz, but 1 day - 1 mo.
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8
Q

Schizoaffective disorder

A
  • schiz presentation but includes major depressive disorder AND a psychotic syndrome
  • may be separated by instances
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9
Q

Delusional disorder

A
  • non-bizarre delusions lasting greater/= than 1 month
  • psychotic criteria not fully met
  • other symptoms present briefly relative to delusion
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10
Q

Panic disorder

A
  • recurrent, unexpected attacks which are intense and peak in minutes and include 4 of the physical symptoms
  • at least one attack has been followed by a month of:
    ~ persistent concern about additional attacks
    ~ significant alteration of behavior to avoid
  • OFTEN associated with lines, having an appointment, feeling trapped
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11
Q

Common substance triggers of panic attacks

A 
Methylxanthines
Sympathomimetics
MSG
Stimulants
Thyroid hormones 
Antipsychotics
Withdrawal
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12
Q

Drug triggers of panic

A
  • ABCs
  • a2 blocker (yohimbine)
  • beta agonists (IsoproTERRORnol)
  • CO2 (false suffocation alarm)
  • Sodium Lactate
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13
Q

Panic disorder trt

A
  • SSRIs, SNRIs (titrate up)
  • TCAs effective but nasty (cardiotoxicity)
  • Buspirone works for GAD but NOT panic disorder
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14
Q

Agoraphobia

A
  • being in places they can’t escape, being outside or alone
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15
Q

GAD

A
  • majority of days spent in worry or anxiety for at least 6 mo
  • cant stop
  • social functional impairment
  • oft includes tension, conc lapse, sleep disturbances, restless fatigue, irritability
16
Q

GAD trt

A
  • SSRIs/SNRIs first line (TCAs effective but nasty)
  • Buspirone
  • benzos (effective but addicting)
  • antihistamines
  • psychodynamic and behavioral therapy
17
Q

Social anxiety disorder

A
  • marked by performance, potential scrutiny or humiliation
  • attacks triggered
  • duration for 6 mo +
18
Q

Social anxiety trt

A
  • therapy first line over drugs
  • cog/BH
  • social skill dev
  • systematic desensitization
  • SSRIs, SNRIs, MAOIs
19
Q

Phobias

A
  • blood runs in blood
  • flooding
  • benzo for acute attack
20
Q

Separation anxiety

A
  • in kids: 4 week duration, in adults 6 mo

- excessive worry about loosing attached persons, kidnapping et al

21
Q

OCD definitions

A
  • Compulsion: impulses/thoughts that are intrusive, causing anxiety or distress
    ~ not about actually worrying things
  • Obsession: repetitive behaviors they are driven to perform
    ~ acts are aimed at reducing stress (contamination fear: excessive hand washing)
22
Q

OCD neuroassociative conditions

A
  • head trauma
  • huntingtons
  • Sydenham’s chorea
  • epilepsy
23
Q

OCD trt

A
  • behavioral therapy
  • response prevention
  • SSRIs improve therapy efficacy
  • ECT
  • cingulotomy
24
Q

Body dysmorphic disorder

A
  • preoccupation with one or more perceived flaws
  • excessive mirror checking/grooming (causes impairment)
  • NOT eating disorder
25
Q

Hoarding (presentation, etiology)

A
  • stress associated with throwing anything away

- predominantly female, tends to be familial

26
Q

Trichotillomania/excoriation

A
  • compulsively pulling out ones hair
  • much more often in females
  • skin-picking
  • stopping -> distress. More in females
27
Q

Trauma and stress disorders (5)

A 
PTSD
Acute stress disorder
Reactive attachment disorder 
Disinhibits social engagement disorder 
Adjustment disorder
28
Q

PTSD criteria

A
  • Reexperiencing intrusive symptoms
  • efforts to avoid thoughts and feelings
  • negative alterations in cognitions or mood (selective amnesia, exaggerated negative beliefs)
  • arousal symptoms
  • duration of > 1 Mo
  • more likely in kids
29
Q

Bio abnormalities in PTSD

A
  • decreased REM
  • hypo-pit axis dysreg
  • NE and 5HT
  • reduced hyppocampal volume
30
Q

PTSD trt

A
  • trt symptoms NOT disorder
  • SSRIs for depressive assoc, benzos for panic, beta blockers may reduce incidence of development, prazosin for nightmares
  • psychotherapy and group
31
Q

Acute stress disorder criteria and trt

A
  • similar presentation to PTSD, 3 days - 1 month following trauma
  • highest rates among interpersonal events like rape
  • cog/BH -> reduces risk of PTSD development
  • benzos, beta blockers
32
Q

Reactive attachment disorder

A
  • inhibited, emotionally withdrawn, not seeking comfort from adult care givers when distressed
  • minimal social and emotional and resp to others, limited positive affect
  • between 9 mo and 5 years
33
Q

Disinhibited social engagement disorder

A
  • child has no reticence in approaching strangers
  • not limited to impulsive behavior
  • assoc with extreme insufficiency of care
34
Q

Disruptive mood disorder and premenstrual dysmorphic disorder time frame

A
  • at least 1 year with cycling symptoms
    ~ DMDD: three times a week
    ~ PMDD: at least 4 mo

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