Psychiatric Disorders (Chapter 13) Flashcards
(117 cards)
1
Q
what is the prevalence of schizophrenia ?
A
1% of general population
2
Q
explain the genetic predisposition towards schizophrenia
A
10% chance if parents have it.
3
Q
what is the cause of schizophrenia ?
A
genetic predisposition + environmental factors affecting development in utero
4
Q
when is the usual onset age of schizophrenia ?
A
from adolescence to age 40
5
Q
why is life expectancy reduced in schizophrenia ?
A
many commit suicide
6
Q
use of which substance is 3 times higher in schizophrenics ?
A
cigarettes
7
Q
what are the three kinds of symptoms in schizophrenia ?
A
positive, negative, cognitive
8
Q
what are positive symptoms in schizophrenia ? definition + 5 examples
A
distorted enhancement or exaggeration of normal functions
hallucinations delusions paranoia disordered speech agitation
9
Q
what is the gender most affected by schizophrenia ?
A
both
10
Q
what is the gender most affected by positive schizophrenic symptoms ?
A
women
11
Q
what are negative symptoms in schizophrenia ? definition + 5 examples
A
reduction in normal function
decrease in logical conversation, motivation, emotional expression, hygiene, social interaction
12
Q
what is the gender most affected by negative schizophrenic symptoms ?
A
male
13
Q
what are 3 cognitive symptoms in schizophrenia
A
decrease in attention, memory, task solving ability
14
Q
what are the schizophrenia symptoms caused by ?
A
altered levels of dopamine and serotonin, drugs block receptors for these NT
15
Q
what is uncomplicated depression ?
A
caused by tragic life events
16
Q
what is major depression ?
A
sustained and significant decrease in the ability of a patient to function normally
17
Q
what is the diagnostic criteria for depression ?
A
symptoms for over 2 weeks
18
Q
when is the onset of depression typically ?
A
in 20s
19
Q
which gender is more affected by depression ?
A
women twice as much
20
Q
what is a non-drug option for insomnia ?
A
sleep hygiene
use bed only for sleep
21
Q
what is another name for bipolar disorder ?
A
manic depressive disorder
22
Q
when does the first episode of bipolar disorder usually occur ?
A
20s
23
Q
what is the gender difference in bipolar disorder ?
A
affects both the same, although may be difference in symptoms (more depressive symptoms in women)
24
Q
what are the two components of bipolar ?
A
major depression (longer period) mania (requires close supervision, usually lasts a week)
25
what is hypomania ?
similar to mania, but less severe
26
what is mixed bipolar ?
when you feel mania and depression simultaneously
27
which kind of therapy is recommended for anxiety disorders ?
cognitive behavioral therapy
28
what are the diagnostic criteria for generalized anxiety disorder ?
most days for > 6 months
| anxiety about several different activities
29
what are the diagnostic criteria for social anxiety disorder ?
persistent fear of social interactions
under 18 years old: for over 6 months
30
what are the diagnostic criteria for panic disorder ?
sudden onset of intense fear, peaking within 10 minutes with 4 of the following symptoms: racing heart, sweating, shortness of breath, choking feeling, nausea, fear of losing control, chills, hot flashes, fear of dying
31
what are the diagnostic criteria for OCD ?
excessive, repetitive action
32
what are the diagnostic criteria for PTSD ?
witnessed a traumatic event, reacted with intense fear / horror
event re-experienced with flashbacks, thoughts, hallucinations, dreams, reactions to triggers
avoids reminders of events
emotional numbing
33
what NT are ADHD patients lacking ?
dopamine and norepinephrine
34
what kind of drugs treat schizophrenia ?
anti-psychotic
35
what kind of drugs treat positive schizophrenia symptoms specifically ?
first generation typical antipsychotics
36
what kind of drugs treat all three symptoms of schizophrenia ?
atypical second generation antipsychotics
37
which antipsychotics have better effects ?
atypical (second generation)
| less adverse effects and more efficacy
38
why is compliance crucial in antipsychotics ?
because they take weeks/months to have an effect
39
which receptors do first generation antipsychotics affect ?
block dopamine, ach, NE alpha, histamine H1 receptors
40
how do first generation antipsychotics affect serotonin receptors ?
they don't
41
why do first generation antipsychotics have so many adverse effects ? what are they ?
they aren't specifically for the CNS
spasms, slowness, drooling, tremors, fainting, constipation
42
what are the side effects of second generation antipsychotics ?
sedation, orthostatic hypotension
43
what health risks are more prevalent with 2nd generation antipsychotics ? why
weight gain, diabetes
appetite center in brain is affected, need to eat more
44
what is clozapine ?
a 2nd generation antipsychotic which is particularly dangerous
45
what are the two main kind of substances contraindicated with antipsychotics ?
anti-cholinergic (OTC cold remedies, sleep aids, motion sickness) and alcohol
46
how are antipsychotics administered ?
usually orally, sometimes injected
47
what is the washout period ?
you cant stop a drug and start a new one, there needs to be a period between the two
48
what 4 drugs treat depression
tricyclic antidepressants (TCA)
selective serotonin reuptake inhibitor (SSRI)
monoamine oxygenase inhibitor (MAOI)
serotonin/norepinephrine reuptake inhibitor (SNRI)
49
what is the cause of depression ?
thought to be lack of serotonin and norepinephrine
50
what is the pharmacodynamic mechanism that treats depression ?
it is dangerous to induce NT
| instead, you block clearance of NE and Ser
51
how do tricyclic antidepressants work ?
by blocking reuptake of NE and Ser
| also block histamine, ach, alpha-adrenergic receptors
52
what are the side effects of tricyclic antidepressants ?
since histamine receptors are blocked, a lot of the side effects are anti-cholinergic
dry mouth, constipation, orthostatic hypotension, sedation
53
what is the advantage of SSRI?
no anticholinergic effects
54
what are two examples of SSRI?
Prozac, Paxil
55
what is the main reason of non-compliance to SSRI ?
sexual dysfunction
56
what drug are SSRI contraindicated with ?
MAOIs
57
why arent MAOI used a lot ?
side effects
58
what is the most dangerous side effect of MAOI?
hypertensive crisis
59
how do MAOI work ?
inactivate dopamine, serotonin, norepinephrine
60
what is MAOI action on the liver ?
helps detoxify chemicals
61
how many antidepressants can you prescribe ?
only 1 !!!! even St John's Wort can't be mixed
62
what foods are problematic if you take MAOI ?
those that contain tyramine like chocolate, cheese, aged meats, yeast, soy, beans, pickles
63
what drugs are contraindicated with MAOI ?
adrenergic drugs (nasal decongestants, amphetamines, TCA, SSRI)
64
how do SNRI work ?
inhibit reuptake of serotonin and NE
65
how do SNRI block cholinergic or alpha adrenergic receptor ?
they don't
66
what are three kinds of drugs used to treat bipolar ?
mood stabilizers, antipsychotics, antidepressants
67
what are three examples of a mood stabilizing drug that also treats mania ?
valproic acid
lithium
carbamazepine
68
what is the classic antipsychotic ?
lithium
69
what is the drug of choice for anxiety disorders ?
SSRI
70
what substance should ppl with anxiety avoid ?
caffeine because it increases anxiety
71
what drug targets anxiety ?
none
72
what are the adverse effects of lithium ?
high toxicity (low TI)
73
what drugs may interact with lithium ?
those that are involved in kidney function
like thiazide diuretics, ACE-inhibitors (because they decrease lithium excretion)
NSAID (except aspirin)
74
which NSAID can be used on lithium ?
aspirin
75
what is the preferred mood stabilizing drug ?
valproic acid
76
what is the trade name for valproic acid ?
depakene
77
what is the trade name for carbamazipine
equetro
78
what is the advantage of valproic acid over lithium ?
fewer adverse effects
79
SSRIs are the drug of choice for all the anxiety disorders except ?
what is the drug of choice ?
GAD
| drug of choice is benzodiazepines
80
what are the three main drugs used for anxiety disorders ?
SSRI
benzodiazepine
buspirone
81
what are the disadvantages of benzodiazepines ?
addictive
| bad withdrawal symptoms
82
what is valium ?
a benzodiazepine
83
what particularity in the structure of benzodiazepines makes it not recommended during pregnancy
lipid soluble therefore can cross into the placenta
84
benzodiazepines interact with what receptors ?
GABA receptors
85
why are SSRI's recommended for anxiety disorders ?
because they are safer (no anticholinergic effects)
86
what is PTSD usually treated with ? for how long ?
SSRI or MAOI (alternative)
throughout life
usually CBT
87
what is buspirone ? what does it treat ?
treats generalized anxiety disorder for long term therapy more than acute symptoms
88
what treats ADHD ?
stimulants that enhance the response of the brain to NE and dopamine
89
what is the advantage of buspirone compared to benzodiazepines for GAD treatment ?
less abuse potential and adverse effects
90
what is the generic name for ritalin ?
methylphenidate
91
what is the generic name for Adderall
dextroamphetamine
92
what are the two meds mostly used for OCD ?
ritalin (methylphenidate) and adderall (dextroamphetamine)
93
why are OCD drugs addictive
because they produce euphoria
94
what are other options for OCD ?
norepinephrine reuptake inhibitor
| SSRI
95
what is the main side effect of abuse potential in OCD meds ?
cardiovascular risks
96
what are prescription drugs for insomnia called ?
hypnotics
97
what treatment is preferable for insomnia ?
non drug approaches
98
what is the preferred hypnotic drug for insomnia treatment ?
benzodiazepine
99
what is melatonin ?
sedative properties, OTC supplement
100
what is an approved drug for eating disorders ?
there is none
101
what drugs can be used in eating disorders ?
SSRI to treat underlying depression
102
what sporting events might be avoided if you're taking benzodiazepines ? why
guns, racing
| because drug causes sedation
103
can an athlete compete if they're taking medication ?
yeah, even if it's a banned substance, you can apply for an exemption
104
an athlete is feeling mentally unwell, and starts to take medication. what are the positive and negative outcomes ?
positive: might feel better
negative: performance may suffer from adverse effects, or lost training time
105
in the Hammond paper, what was the sample ?
50 elite swimmers
106
in the Hammond paper, what were the 4 outcome measures ?
Diagnosed depression was assessed using a semistructured interview, and symptoms of depression were also assessed by the Beck Depression Inventory II.
Performance was measured by changes in swimming time and athlete ranking
107
in the Hammond paper, what was the study design ?
cross-sectional
108
in the Hammond paper, what is the paradigm that was challenged?
that elite athletes are mentally tough and emotionally strong
109
in the Hammond paper, what was the main hypothesis ? what was the second hypothesis ?
do elite athletes have depression that differs from general population ?
does elite athlete performance affect depression prevalence ?
110
in the Hammond paper, what gender predominantly experienced depression ? what are the implications ?
predominantly females
expected, based on the general population
111
in the Hammond paper, in the discussion, what explanation do they give as to why athletes would have an increased risk of depression ?
juggling high expectations, school, schedules, pressure to perform, media scrutiny
112
in the Hammond paper, in the discussion, what explanation do they give as to why female athletes would have an increased risk of depression ?
females view themselves as having less social support, less encouraged to perform
113
in the Hammond paper, how did the prevalence of depressive symptoms differ in elite athletes from non elite athletes ?
almost double- 66% versus 34%
114
in the Hammond paper, how did the prevalence of depressive symptoms differ in athletes from the general population?
34% versus 17% (double)
115
in the Hammond paper, what was the main criticism ?
lack of internal control group
116
in the Hammond paper, was there a correlation between performance and prevalence of depressive episodes post-competition ?
yes !
117
What is the difference between SNRI and TCA?
SNRI only blocks the serotonin and NE receptors
TCA blocks serotonin, NE, histamine, alpha-adrenergic, and ach
