Unit 2 - Cognition, Mood, Affect Flashcards
include disorders with a deficit in cognition or memory that causes a significant change from a previous level of functioning
Neurocognitive Disorders (NCD’s)
Mild NCD is also called…
mild cognitive impairment
Major NCD was previously described as _____ in the DSM 4-TR
Dementia
NCD due to _____ is the most common
Alzheimer’s
How does NCD differ from Delirium?
NCD: chronic & permanent
Delirium: Acute & can be treated though it can cause NCD
Characterized by a disturbance of attention and awareness and a change in cognition that develops over a short period
Delirium
Delirium can have a slower onset if underlying etiology is…
systemic illness or metabolic imbalance
_____ subsides completely upon recovery from underlying determinant
Delirium
The patient is very distractible and has to be repeatedly reminded to focus attention. Disorganized thinking prevails as evidenced by rambling, incoherent speech.
Delirium
5 S/S of Delirium
Autonomic Manifestations:
- tachycardia
- elevated BP
- dilated pupils
- sweating
- flushed face
Delirium vs Dementia:
- Onset
- Course
- Duration
- Consciousness
- Attention
- Psychomotor changes
- Revercibility
- acute, insidious
- fluctuating, progressive
- days to weeks, months to year
- altered, clear
- impaired, normal (except with severe)
- increased or decreased, normal
- usually, rarely
_____ Delirium:
- agitation
- restlessness
- attempts to remove tubes & lines
hyperactive
_____ Delirium:
- withdrawal
- flat affect
- apathy
- lethargy
- decreased responsiveness
hypoactive
_____ Delirium
- patients fluctuate between hyper and hypo
mixed
characterized by a state of generalized cognitive deficits in which there is a deterioration of previously acquired intellectual abilities.
Dementia
was created in 1990, and it was intended to be a bedside assessment tool usable by non-psychiatrists by Dr. Sharon Inouye to assess for delirium.
CAM (Confusion Assessment Method)
Delirium is defined in terms of four diagnostic features, and is deemed positive when
Feature 1 + Feature 2 + Feature 3 or 4
When to use benzodiazepines for Delirium
when etiology is substance withdrawal
Are antipsychotics recommended to treat NCD
NOOO!!! Black Box Warning for First Gen antipsychotics because there is an increase risk for death in elderly pt’s
Side effects of antipsychotics
- Extrapyramidal: jitterness & tremors
- anticholinergic: dry mouth, blurred vision, constipation, urinary retention
Contraindications for antipsychotics
- hypersensitive
- CNS depression/comatose
- blood dyscrasias
- Parkinson’s
- Narrow Angle Glaucoma
- Liver, Renal, or Cardiac Insufficiency
- In assessing NCD, CT’s of the brain will show the…
- An LP will show…
- PET scans show the…
- size and shape
- CNS infection
- metabolic activity of the brain
_____ include psychological disorders characterized by the elevation or lowering of a person’s mood
Mood DIsorders
It causes highs and lows, but isn’t as extreme as bipolar
Cyclothymeia
(or persistent depressive disorder) is in-between normal mood and mild depression.
Dysthymia
a low mood that has occurred for at least 2 years and with at least 2 other symptoms of depression.
Dysthymia
- Depressed mood or loss of interest or pleasure in usual activities
- Social and occupational functioning impaired for at least 2 weeks
- No history of manic behavior
- Cannot be attributed to use of substances or a general medical condition
- The patient must meet 5 or more of 9 symptoms
Major Depressive Disorder
_____ is similar to MDD, but milder
Dysthymia
- Characterized by mood swings from profound depression to extreme euphoria (mania), with intervening periods of normalcy
- Delusions or hallucinations may or may not be part of clinical picture
- Onset of symptoms may reflect seasonal pattern
Bipolar Disorder
age of onset for bipolar disorder
early 20’s
- 1 or more manic or mixed episodes leading to: serious problems, hospitalization, psychotic features
Bipolar 1
- 1 or more hypomanic episodes (4 days or more), and no mania
- 1 or more major depressive episodes (2 weeks or more)
Bipolar II
- altering between hypomanic symptoms and mild or moderate depressive moods like Bipolar II
- less severe, higher functioning
Cyclothymia
What does ECT treat
Mania
