Week 20: Psychopathology II Flashcards
What are mood disorders?
Extended periods of depressed, euphoric, or irritable moods that cause significant distress and interfere with daily life.
What is a major depressive episode (MDE)?
Symptoms that co-occur for at least two weeks and cause significant distress or impairment in functioning.
What are the core symptoms of a major depressive episode?
Core symptoms include:
* depressed mood
* diminished interest or pleasure in almost all activities
* significant weight loss or gain
* insomnia or hypersomnia
* psychomotor agitation or retardation
* fatigue or loss of energy
* feeling worthless or excessive guilt
* diminished ability to concentrate
* recurrent thoughts of death or suicidal ideation.
What is the duration requirement for a manic episode?
Must last one week or longer unless hospitalization is required.
What distinguishes a hypomanic episode from a manic episode?
Hypomanic episodes last at least four days and do not necessarily cause significant impairment in functioning.
What are the two major types of unipolar mood disorders?
- Major depressive disorder (MDD)
- Persistent depressive disorder (PDD; dysthymia).
What is the prevalence rate of major depressive disorder (MDD) in the U.S.?
Lifetime prevalence rate for MDD is 16.6%.
At what average age does major depressive disorder (MDD) typically onset?
The average age of onset is mid-20s.
What demographic factors influence the prevalence of MDD?
Gender, age, and socioeconomic status (SES).
How does gender affect the prevalence rates of MDD?
Women experience two to three times higher rates of MDD than men.
What is the lifetime prevalence rate of bipolar spectrum disorders in the U.S.?
Approximately 4.4%.
What are the three major types of bipolar disorders according to DSM-5?
- Bipolar I Disorder
- Bipolar II Disorder
- Cyclothymic disorder.
What is the common age of onset for bipolar disorders?
Adolescence is a significant risk period for BD.
What are common co-occurring disorders with bipolar disorder?
Anxiety disorders and substance use disorders.
What is perinatal depression?
Depression that occurs following childbirth, affecting about 5% of all mothers.
What percentage of people diagnosed with bipolar disorder (BD) will attempt suicide at least once?
Estimated 25%–50%.
What is the diagnostic criteria for persistent depressive disorder (PDD)?
Feeling depressed most of the day for more days than not for at least two years, along with at least two additional symptoms.
What is the relationship between socioeconomic status (SES) and MDD?
Higher prevalence rates of MDD are associated with lower SES.
True or False: The DSM-5 uses the term ‘mood disorders’ for classification.
False. It uses ‘Depressive Disorders’ and ‘Bipolar and Related Disorders.’
Fill in the blank: The World Health Organization ranks both major depressive disorder and ________ among the top 10 leading causes of disability worldwide.
[bipolar disorder]
What is the prevalence of Bipolar Disorder (BD) in older adults compared to younger adults?
1% in older adults vs. 4% in younger adults
(Merikangas et al., 2007)
What are some key factors implicated in the development of mood disorders?
Biological and psychosocial factors
These factors contribute to the onset and course of mood disorders.
What does MDD stand for?
Major Depressive Disorder
MDD is one of the most common mood disorders.
What role do genetic factors play in Major Depressive Disorder (MDD)?
Genetic factors are implicated in the development of MDD
Supported by family and twin studies.
What type of life events are strongly related to MDD?
Severe stressful life events
Such as divorce or unemployment.
True or False: Minor life events predict the first major depressive episode (MDE) more than subsequent episodes.
False
Minor events may play a larger role in subsequent episodes.
What is the primary focus of cognitive therapies for depression?
Helping patients identify and change distorted automatic thoughts
Based on cognitive-behavioral principles.
Which neurotransmitters are primarily targeted by antidepressant medications?
Dopamine, norepinephrine, and serotonin
These neurotransmitters are implicated in depression.
Fill in the blank: The first line treatment choice for Bipolar Disorder (BD) is _______.
lithium
What is a common side effect of lithium treatment?
Impaired cognitive function
Other side effects include nausea and weight gain.
What is Interpersonal and Social Rhythm Therapy (IPSRT) focused on?
Addressing sleep disruption
Aims to maintain a stable rhythm in patients’ lives.
What is the primary concern regarding antidepressant medications for patients with BD?
They can induce mania or hypomania
SSRIs and SNRIs are particularly noted for this risk.
What is the effect of positive life events on patients with BD?
Can adversely impact the course of BD
May lead to increased manic symptoms after achieving desired goals.
What is the mode of inheritance for Major Depressive Disorder (MDD)?
Not fully understood
No single genetic variation has been definitively linked.
What is the significance of attributional styles in the context of MDD?
Pessimistic attributional styles increase vulnerability
Internal, global, and stable attributions correlate with MDD risk.
What is a common treatment for severe depression that involves inducing a seizure?
Electroconvulsive therapy (ECT)
ECT is used for patients resistant to other treatments.
What is one of the main psychosocial treatments for depression?
Cognitive Behavioral Therapy (CBT)
Focuses on the interplay of thoughts, behaviors, and emotions.
What are some environmental factors that increase the risk for MDD?
- Early adversity (e.g., childhood abuse)
- Chronic stress (e.g., poverty)
- Interpersonal factors
These factors contribute to the onset and recurrence of depression.
What is Anhedonia?
Loss of interest or pleasure in activities one previously found enjoyable or rewarding.
Define Attributional style
The tendency by which a person infers the cause or meaning of behaviors or events.
What is Chronic stress?
Discrete or related problematic events and conditions which persist over time and result in prolonged activation of the biological and/or psychological stress response.
What is Early adversity?
Single or multiple acute or chronic stressful events occurring during childhood that result in a biological and/or psychological stress response.
Define Grandiosity
Inflated self-esteem or an exaggerated sense of self-importance and self-worth.
What is Hypersomnia?
Excessive daytime sleepiness, including difficulty staying awake or napping, or prolonged sleep episodes.
What does Psychomotor agitation refer to?
Increased motor activity associated with restlessness, including physical actions like fidgeting or pacing.
What is Psychomotor retardation?
A slowing of physical activities in which routine activities are performed in an unusually slow manner.
What are Social zeitgebers?
Environmental cues, such as meal times and interactions with other people, that entrain biological rhythms.
Define Socioeconomic status (SES)
A person’s economic and social position based on income, education, and occupation.
What is Suicidal ideation?
Recurring thoughts about suicide, including considering or planning for suicide.
True or False: Mood disorders affect people regardless of gender, age, nationality, race, religion, or sexual orientation.
True
Fill in the blank: ______ is an important step if you or someone you know is suffering from a mood disorder.
[Seek help]
What are effective treatments for mood disorders?
Available and continually improving.
How can one contribute to the understanding of mood disorders?
By engaging in research or clinical work.
What are some disorders included in the schizophrenia spectrum?
Schizophrenia, schizoaffective disorder, delusional disorder, schizotypal personality disorder, schizophreniform disorder, brief psychotic disorder, psychosis associated with substance use or medical conditions.
What are the primary clinical features of schizophrenia?
Delusions, hallucinations, disorganized speech and behavior, abnormal motor behavior, negative symptoms such as anhedonia and blunted affect.
Define delusions in the context of schizophrenia.
False beliefs that are fixed and hard to change, often culturally influenced.
What are the most common types of delusions experienced by individuals with schizophrenia?
Persecutory delusions, grandiose delusions, referential delusions, control delusions.
What are hallucinations?
Perceptual experiences occurring without an external stimulus, commonly auditory.
What characterizes disorganized speech in schizophrenia?
Speech that is difficult to follow, with answers that do not logically follow questions.
What is catatonia?
A reduction in responsiveness to the external environment, including unusual postures and lack of movement.
What are negative symptoms of schizophrenia?
Anhedonia, amotivation, flat affect, reduced speech (alogia).
Fill in the blank: The cognitive deficits in schizophrenia can include problems with _______.
episodic memory, working memory, processing speed.
True or False: Cognitive problems in schizophrenia are often a result of the illness.
False
What is social cognition in the context of schizophrenia?
The ability to recognize emotional expressions and infer intentions of others.
What brain region is associated with problems in salience detection in schizophrenia?
Ventral striatum and anterior prefrontal cortex.
What cognitive function is related to the dorsolateral prefrontal cortex (DLPFC) in schizophrenia?
Working memory and cognitive control.
List the potential risk factors for the development of schizophrenia.
Genetic factors, environmental stressors, neurobiological factors.
What are the treatment options for schizophrenia?
Antipsychotic medications, psychotherapy, psychosocial interventions.
Define the term ‘schizophreniform disorder’.
A briefer version of schizophrenia with similar symptoms.
What is the significance of the ‘clinical high risk’ approach in schizophrenia?
It identifies individuals at risk for developing schizophrenia, but is controversial.
What is anhedonia?
Lack of interest or drive to engage in social or recreational activities.
What is alogia?
Reduced amount of speech and increased pause frequency and duration.
Fill in the blank: Hallucinations can be ______, visual, olfactory, gustatory, or somatic.
auditory
True or False: The media often accurately represents schizophrenia.
False
What percentage of the general population experiences psychotic-like symptoms?
10%+
What is the prevalence of psychotic-like experiences in adolescents and young adults in Kenya?
~19%
What brain region is primarily associated with working memory and cognitive control issues in schizophrenia?
Dorsolateral prefrontal cortex (DLPFC)
Problems in DLPFC function are linked to working memory and cognitive control deficits in schizophrenia.
Which brain regions are important for working memory and cognitive control alongside the DLPFC?
- Posterior parietal cortex
- Anterior cingulate
- Temporal cortex
These regions are interconnected with the DLPFC and contribute to cognitive functions.
What is the role of the hippocampus in schizophrenia?
Creation of new memories
The hippocampus is crucial for episodic memory formation, and its deficits are linked to schizophrenia.
What structural brain changes are observed in individuals with schizophrenia?
- Changes in cellular architecture
- Altered white matter connectivity
- Reduced gray matter volume
These changes are found in various brain regions, including prefrontal and temporal cortices.
What is the relationship between antipsychotic medications and structural brain changes in schizophrenia?
Antipsychotic medications and substances like marijuana or alcohol may cause some structural changes, but they do not fully explain them.
Structural changes can also be seen in first-degree relatives of individuals with schizophrenia.
What are some genetic risk factors for developing schizophrenia?
- Family history of schizophrenia
- Older fathers
- Genetic summation of multiple genes
Schizophrenia risk is influenced by a combination of genetic factors rather than a single gene.
Which environmental factors increase the risk of developing schizophrenia?
- Complications during pregnancy/delivery
- Urban upbringing
- Cannabis use
Stressful environments and certain prenatal conditions are associated with higher schizophrenia risk.
What is the ‘Attenuated Psychotic Syndrome’ as described in the DSM-5?
A diagnosis for individuals showing milder symptoms of psychosis
This syndrome is associated with a higher risk of developing full-blown psychosis.
What are the two primary types of antipsychotic medications?
- Typical antipsychotics
- Atypical antipsychotics
Typical antipsychotics primarily block D2 dopamine receptors, while atypical ones have more varied mechanisms.
What is a major drawback of typical antipsychotic medications?
They can cause distressing motor side effects
While effective for some symptoms, typical antipsychotics do not address cognitive deficits.
What is Cognitive Enhancement Therapy (CET)?
A psychological intervention aimed at improving cognition and functional outcomes in schizophrenia
CET has shown promise in enhancing cognitive function and social cognition.
What is the definition of ‘alogia’?
A reduction in the amount of speech and/or increased pausing before the initiation of speech
Alogia is often observed in individuals with schizophrenia.
What are hallucinations?
Perceptual experiences occurring without external stimuli
Hallucinations can be auditory, visual, olfactory, gustatory, or somatic.
True or False: Schizophrenia is a highly homogeneous disorder.
False
Schizophrenia is heterogeneous, with individuals displaying a wide range of symptoms.
What is the significance of dopamine in schizophrenia?
It regulates the function of other neurotransmitters
Alterations in dopamine signaling are linked to the symptoms of schizophrenia.
Fill in the blank: The ability to learn and retrieve new information or episodes in one’s life is known as _______.
Episodic memory
Episodic memory is often affected in individuals with schizophrenia.
What does ‘flat affect’ refer to?
A reduction in the display of emotions through facial expressions, gestures, and speech intonation
Flat affect is a common symptom in schizophrenia.
What is the primary function of working memory?
To maintain information over a short period of time
Working memory is crucial for cognitive tasks and is often impaired in schizophrenia.
What are the potential benefits of including ‘Attenuated Psychotic Syndrome’ in the DSM-5?
- Higher identification of at-risk individuals
- Stimulating important research
Inclusion may lead to better understanding and treatment of early psychotic symptoms.
