Test 5: Personality, Schizophrenia, and Neurocognitive Disorders Flashcards
(100 cards)
1
Q
What are the three personality disorder clusters? And the disorders?
A
A) Odd or eccentric: Paranoid, schizoid, schizotypal
B) Dramatic or erratic (emotional): antisocial, borderline, histrionic, narcissistic
C) Anxious or fearful: avoidant, dependent, obsessive-compulsive
2
Q
What are the statistics of personality disorders?
A
- Prevalence: ~1% general population
- Origins: thought to begin in childhood
- Course: Chronic if untreated, may transition into a different personality disorder
- Comorbidity: its the rule not the exception
3
Q
What are the statistics concerning gender for personality disorders?
A
More common traits:
- Men: aggression and detachment
- Women: submission and insecurity
More common disorders:
- Men: antisocial
- Women: histrionic
4
Q
What are the personality disorders under study?
A
- Sadistic: enjoy inflicting pain
- Passive-aggressive: defiant, undermine authority
5
Q
What are the clinical features of paranoid personality disorder?
A
- Pervasive and unjustified mistrust and suspicion
- Few meaningful relationships, sensitive to criticism
- Poor quality of life
6
Q
What are the causes of paranoid personality disorder?
A
- Not well understood, may involve early learning that people and the world are dangerous or deceptive
- More often found in people with experiences: prisoners, refugees, people with hearing impairments, older adults
7
Q
What are the treatment options for paranoid personality disorder?
A
- Few seek professional help on their own
- Focus: development of trust
- Cognitive therapy to counter negativistic thinking
- Lack of good outcome studies
8
Q
What are the clinical features of schizoid personality disorder?
A
Pervasive pattern of detachment from social relationships
- Very limited range of emotions in interpersonal situations
- Resembles autism
9
Q
What are the causes of schizoid personality disorder?
A
- Etiology unclear (scarce research)
- Childhood shyness or abuse/neglect
10
Q
What are the treatment options for schizoid personality disorder?
A
- Few seek professional help on their own
- Focus: value of interpersonal relationships
- Building empathy and social skills
- Lack of good outcome studies
11
Q
What are the clinical features of schizotypal personality disorder?
A
- Behaviors and dress is odd and unusual
- socially isolated and highly suspicious
- Magical thinking (superstitious), ideas of reference, and illusions
- Many meet criteria for major depression
- Some conceptualize this as resembling a milder form of schizophrenia
12
Q
What are the treatment options for schizotypal personality disorder?
A
- Address comorbid depression (on 30-50% pts)
- Main focus on developing social skills
- Medical treatment is similar to that used for schizophrenia
- treatment prognosis generally poor
13
Q
What are the clinical features of antisocial personality disorder?
A
- failure to comply with social norms
- violation of the rights of others
- irresponsible, impulsive, and deceitful
- lack of conscience, empathy, and remorse
- “sociopathy,” “psychopathy” typically refer to this disorder or very similar traits
- charming, interpersonally manipulative
- substance abuse common, 60% diagnosed abuse various substances
14
Q
What are potential causes of antisocial personality disorder?
A
- early histories of behavioral problems including conduct disorder
- “callous-unemotional” type of conduct disorder more likely to evolve into antisocial PD
- families with inconsistent parental discipline and support
- families often have histories of criminal and violent behavior
15
Q
What are neurobiological contributions to antisocial personality?
A
- Underarousal hypothesis: cortical arousal in too low - so seek stimulation from activities too fearful or aversive for most
- Cortical immaturity hypothesis: cerebral cortex is not fully developed
- Fearlessness hypothesis: fail to respond to danger cues
– Psychopaths less likely to give up when goal becomes unattainable - Gray’s model: inhibition signals are outweighed by rewards signals
16
Q
What might contribute to the development of antisocial personality?
A
- Genetic influences: history of antisocial behavior or criminality in parents
- Developmental influences: high-conflict childhood (in at risk children)
- Impaired fear conditioning: children not learn to fear aversive consequences of negative actions
- Biological-environmental: early antisocial behavior alienates peers who would be role models, antisocial behavior and family stress mutually increase one another
17
Q
What are potential treatment options for antisocial personality disorder?
A
- few seek treatment on their own
- antisocial behavior is predictive of poor prognosis
- emphasis is placed on prevention and rehabilitation
- often incarceration is the only viable alternative
- may need to focus on practical (selfish) consequences
18
Q
What are the clinical features of borderline personality disorder?
A
- unstable moods, behaviors, and relationships
- impulsivity, depression, fear of abandonment, very poor self-image
- self-mutilation and suicidal gestures
- comorbidity rates are high with other mental disorders, particularly mood disorders
19
Q
What are the rates of comorbid disorders with borderline personality disorder?
A
- 1 in 5: depressed (suicide attempts - 6%)
- 2 in 5: bipolar criteria
- 2 in 3: substance abuse
- eating disorders: 25% bulimia pts have borderline PD
20
Q
What are the causes of borderline personality disorder?
A
- strong genetic component: also linked to depression genetically
- high emotional reactivity may be inherited
- may have impaired functioning of limbic system
- early trauma/abuse increase risk
- high shame, low self-esteem
21
Q
What is the triple vulnerability for borderline personality disorder?
A
- generalized biological vulnerability: reactivity
- generalized psychological vulnerability: lash out when threatened
- specific psychological vulnerability: stressors that elicit borderline behavior
22
Q
What are the treatment options for borderline personality disorder?
A
- few good outcome studies
- antidepressant medications: short-term relief
- dialectical behavior therapy: most promising focusing on
– dual reality of accepting difficulties and need for change
– interpersonal effectiveness - distress tolerance to decrease reckless/self-harming behavior
23
Q
What are the causes of histrionic personality disorder?
A
- etiology unknown due to lack of research
- often co-occurs with antisocial PD feminine variant of antisocial trait?
23
Q
What are the clinical features of histrionic personality disorder?
A
- overly dramatic and sensational
- sexually provocative (may be)
- impulsive and needs to be center of attention: manipulative (often)
- thinking and emotions perceived as shallow
- more commonly diagnosed in females
24
What are the treatment options for histrionic personality disorder?
- Focus on attention seeking and long-term negative consequences
- Targets may also include problematic interpersonal behavirors
- Little evidence that treatment is effective
25
What are the clinical features of narcissistic personality disorder?
- Exaggerated and unreasonable sense of self-importance
- Preoccupation with receiving attention
- Lack sensitivity and compassion for others
- High sensitivity to criticism; envious and arrogant
26
What are the causes of narcissistic personality disorder?
- Causes largely unknown
- Failure learn empathy as child
- sociological view: product of "me" generation
27
What are the treatment options for narcissistic personality disorder?
- Focus on grandiosity, lack of empathy, unrealistic thinking
- Emphasize realistic goals and coping skills for dealing with criticism
- Little evidence efficacy
28
What are the clinical features of avoidant personality disorder?
- Extreme sensitivity to others opinions
- Highly avoidant most interpersonal relationships
- Interpersonally anxious and fearful of rejection
- Low self esteem
29
What are the causes of avoidant personality disorder?
- May be linked to schizophrenia; occurs more often in relatives of people with schizophrenia
- experiences of early rejection
30
What are the treatments of avoidant personality disorder?
- similar to social phobia
- focus: social skills, entering anxiety-provoking situations, increase social contact
31
What are the clinical features of dependent personality disorder?
- Reliance on others for major and minor life decisions
- Unreasonable fear of abandonment
- Avoidance of disagreement
- Unable make decision
- Clingy and submissive
32
Causes of dependent personality disorder?
- Not well understood/poor research
- Linked to early disruptions in learning dependence
33
What are the treatment options for dependent personality disorder?
- Efficacy treatment is lacking
- Therapy typically progresses gradually due to lack of independence
- Target skills fostering confidence and independence
34
What are the clinical features of obsessive-compulsive personality disorder?
- Excessive and rigid fixation on doing things the right way
- Highly perfectionistic, orderly emotionally shallow
- Unwilling to delegate
- Difficulty with spontaneity
- Often interpersonal problems
- Obsessions and compulsions are rare
35
What are the causes of obsessive-compulsive personality disorder?
Not well known, weak genetic contribution
36
What are the treatments of obsessive-compulsive personality disorder?
- Little data
- Address fears related to the need for orderliness
- Target rumination, procrastination, and feelings of inadequacy
37
What is psychosis and how does it relate to schizophrenia?
- Psychosis: gross departure from reality
- Schizophrenia: a pervasive type of psychosis characterized by disturbed thought, emotion, and behavior
38
What are the types of schizophrenia symptoms?
- Positive: "additional"
-- active manifestations of abnormal behavior
-- distortions or exagerations of normal behavior
- Negative: "absence" of normal behavior
- Disorganized: erratic speech, emotions, and behavior
39
What are the symptoms in the "positive" symptoms cluster?
1) Delusions: "basic feature of madness"
- gross misrepresentations of reality
- most common: of grandeur or persecution
2) Hallucinations:
- experiencing sensory events without environmental input
- Can involve all senses but most common is auditory
- SPECT: neuroimaging shows that in auditory hallucinations the Broca's area--involved in speech production (broken speech) is active
40
What are the symptoms in the "negative" symptoms cluster?
Absence or insufficiency of normal behavior
- Avolition (apathy): lack of initiation & persistence
- Alogia: relative absence of speech
- Anhedonia: lack of pleasure, indifference
- Affective flattening: little expressed emotion
41
What is more concerning avolition?
This person may experience
- no eye contact in conversation
- limited/halted speech
- stops participating in events or gatherings & no enthusiasm in special occasions/events
- avoids making or receiving phone calls
- trouble starting/completing projects
- fails to make appointments (Dr, tax preparer)
42
What are the symptoms in the "Disorganized" symptom cluster?
Confused or abnormal
1) Speech
- cognitive slippage: illogical & incoherent speech
- tangentiality: "going off on a tangent"
- loose associations: conversation in unrelated directions
2) Affect:
- inappropriate emotional behavior
3) Behavior:
- variety of unusual behaviors
- Catatonia
43
What is catatonia?
- immobility or agitated excitement
- considered its own disorder or as a symptom when comorbid
- stuporous (retarded) catatonia:
-- Stupor: immobility during which people may hold rigid poses
-- Mutism: inability to speak as well
-- Waxy flexibility: maintain positions after being placed in them by someone else
-- Mimicking: maybe partial and they may repeat meaningless phrases or speak only to repeat what someone else says
-- Stereotypy: stereotyped, repetitive movements
- Excited catatonia: bizarre, non-goal directed hyperactivity and impulsiveness
- severe and quite rare
44
What were the subtypes of schizophrenia?
- Previously divided based on content of psychosis
- No longer used
- Included: paranoid, catatonic, residual (minor symptoms persist after past episode), disorganized (many disorganized symptoms) and undifferentiated
45
What is schizophreniform disorder?
- Psychotic symptoms 1-6 months (>6 mo schizophrenia)
- Associated with relatively good functioning
- Most resume normal life
- Lifetime prevalence: ~0.2%
46
What is schizoaffective disorder?
- Symptoms of schizophrenia and major mood episode
- Psychotic symptoms occur outside mood disturbance as well
- Prognosis similar to schizophrenia
- No not tend to get better on own
47
What is delusional disorder?
Key feature: delusions contrary to reality
- lack positive and negative symptoms
- Types:
1) Erotomanic: someone higher is in love or attracted to you
2) Grandiose: they are someone other than who they are (supernatural/celebrity)
3) Jealous: sexual partner is unfaithful
4) Persecutory: they or someone close to them are being mistreated / spied on
5) Somatic: believing bones are glass
- Better prognosis than schizophrenia
- Very rare: 26-60/100,000
- Later onset: 35-55
- Somewhat more common in females (55%)
48
What is the psychotic disorders due to other causes?
- Psychosis resulting from substance use, medications, or medical conditions
- Knowing the cause is important for treatment of the underlying cause
- Includes:
1) substance/medication-induced psychotic disorder
2) psychotic disorder associated with another medical condition
49
What is the brief psychotic disorder?
- positive or disorganized symptoms
- lasting **less than 1 month**
- briefest duration of all psychotic disorders
- typically precipitated by trauma or stress
50
What is the attenuated psychosis syndrome?
- attenuate = debilitate
- a condition in need of further study
- individuals at high risk for developing schizophrenia or beginning to show signs of schizophrenia
- intention: focus attention on those benefit early intervention
- tend have good insight into own symptoms
51
What are the prevalence, onset, and life expectancy statistics of schizophrenia?
- Prevalence: 0.2- 1.5% worldwide population
- Onset: often early adulthood (but can develop at any time)
-- childhood cases extremely rare but not unheard of
-- chronic (generally): moderate-to-severe lifetime impairment
- Life expectancy: slightly less than average: increased risk suicide and accidents, self care may be poorer
52
What are the gender and cultural facture statistics of schizophrenia?
- Affects men and women equally
-- Females: better longer long-term prognosis
-- Males; slightly earlier onset
- Cultural factors: psychotic behaviors not always pathologized, found in similar rates in all cultures
53
What is the course of schizophrenia?
Prodromal phase (initial symptoms)
- 85% experience
- 1-2yrs before serious symptoms
- less severe, yet unusual symptoms:
-- ideas of reference, magical thinking, illusions, isolation, marked impairment in functioning, lack of initiative/interests/energy
54
What does the research indicate about the causes of schizophrenia?
- Can be inherited: greater risk the closer the family member with schizophrenia
- Healthy environment is a protective factor
55
What is the dopamine hypothesis of the neurobiological influences of what causes schizophrenia?
Partially caused by overactive dopamine
- Evidence: dopamine agonists (inc) result in schizophrenic-like behavior, antagonists (dec) reduces behavior (neuroleptics, L-Dopa)
- Problem: many neurotransmitters are likely involved
56
What are the neurobiological influences other than the dopamine hypothesis of what causes schizophrenia?
1) Structural and functional abnormalities in the brain:
- Enlarged ventricles, reduced tissue volume
- Hypofrontality: less active frontal lobes (major dopamine pathway)
2) Viral infections: influenza epidemics during prenatal development (inconclusive)
3) Marijuana: increase risk in at-risk
*Conclusions: reflects diffuse neurobiological dysregulation, but structural and functional brain abnormalities are not unique to schizophrenia
57
What are the psychological and social influences on schizophrenia?
- Stress: (may) activate underlying vulnerability, increase risk of relapse
- Family interactions: High expressed emotion (EE)--criticism, hostility, and emotional over-involvement/intrusiveness--associated with relapse
58
What is the medical treatment of schizophrenia?
- Historical: generally ineffective & barbaric: insulin coma induction, psychosurgery, ECT
- Antipsychotic (neuroleptic) medications: 1950s,
-- first line treatment
-- most reduce/eliminate positive symptoms,
-- primarily affect dopamine system but also serotonergic & glutamate
- Experimental: Transcranial Magnetic Stimulation (block auditory hallucinations)
59
What are the common side effects of antipsychotic medications?
DRYNESS
- blurred vision
- dry mouth
- constipation
- drowsiness
- muscle spasms/tremors
- weight gain
60
What are the development and aspects of antipsychotic medications?
1) first generation medications: acute & permanent side effects are common
- Parkinson's-like side effects
- Tardive dyskinesia: involuntary movements (face, mouth, hands, etc)
- Problematic compliance (aversion to side effects, finances, dr relationship)
- Injectable antipsychotics may improve compliance
2) Second generation/ atypical psychotics
- may help pts unresponsive to other meds
61
What was the historical precursors and current psychosocial treatment of schizophrenia?
- Historical: psychodynamic therapy - NOT effective
- Psychosocial approaches
-- Behavioral on inpatient units: reward adaptive behavior (self-care & socialization)
-- community care programs
-- social and living skills training
-- behavioral family therapy
-- vocational rehabilitation
62
What is the illness management and recovery psychosocial treatment of schizophrenia?
- Engages pt as active participant in care
- Continuous goal setting and tracking
- Modules: social skills training, stress management, substance use
- Individual social skills training and family interventions reduce schizophrenic relapses (high EE)
63
What are the cultural considerations for psychosocial treatment of schizophrenia?
- Consider cultural factors that influence individuals' understanding of own illness (supernatural beliefs)
- Involve family and community as possible
64
What is the prevention psychosocial treatment of schizophrenia?
- identify at risk children (relatives)
- foster supportive, stable environments
- offer additional treatments at prodromal stages, including social skills training
65
What are neurocognitive disorders and what are the three types?
- Affected learning, memory, and consciousness
- Most develop later in life
Types:
1) Delirium: temporary confusion and disorientation
2) Mild neurocognitive disorder: early stages of cognitive decline
3) Major neurocognitive disorder: broad cognitive deterioration affecting multiple domains
66
How has the DSM perspective changed concerning neurocognitive disorders?
- From "organic" mental disorders to "cognitive" disorders
- Broad impairments in cognitive functioning
- Cause profound changes in behavior and personality (what makes these general medical conditions often best treated by mental health professionals)
67
What is the nature of delirium?
- Central features: impaired conscientiousness and cognition
- Onset: Develops rapidly (hrs, days)
- Appear confused, disoriented and inattentive
- Marked memory and language deficits
68
What are the facts and statistics of delirium?
- Up to 20% adults in acute care facilities
- Greater prevalence: older adults, undergoing medical procedures, AIDS & Cancer patients
- Full recovery often within several weeks
69
What are the medical conditions or causes of delirium?
- Dementia (50% involve temporary delirium)
- Head injury/brain trauma
- Infections (UTI)
- Drug intolerance/withdrawal
- Poisons
- Immobility
- Excessive stress
- Sleep deprivation
70
What are treatment and prevention options for delirium?
- Treatment:
-- attention to precipitating medical problems
-- psychosocial interventions: reassurance/comfort, coping strategies, inclusion of pts in treatment decisions
- Prevention:
-- address proper medical care for illness, and proper use and adherence to therapeutic drugs
71
What is the nature of major and mild neurocognitive disorders?
- Gradual deterioration of brain functioning: judgement, memory, language, advanced cognitive processes
- Has many causes and may be irreversible
72
What is the difference between major and mild neurocognitive disorders?
- Major: new DSM-5 term for dementia
-- 1+ cognitive deficits that represent a decrease from previous functioning
-- substantiated by clinical assessment
-- interfere with daily independent activities
- Mild: New DSM-5 classification for early stages of cognitive decline: able to function independently with some accommodations
73
What is the prevalence and statistics of major neurocognitive disorders?
- New case every 7 seconds
- 65+: 5%, 85+: 20%
- Mild: 70+, 10%
74
What are the initial stages of major neurocognitive disorder?
- memory and visuospatial skills impairments
- Facial agnosia: inability to recognize familiar faces (aka prosopagnosia/facial blindness)
- Other symptoms: delusions, apathy, depression, agitation, aggression
75
What are the later stages of major neurocognitive disorder?
- Cognitive function continues to deteriorate
- Total support needed for daily activities
- Increased risk of early death because of inactivity and other illnesses
76
What are the causes of neurocognitive disorders?
- Frontotemporal
- Vascular
- With Lewy bodies
- Substance/medication induced
- Unspecified
Due to:
- TBI
- HIV infection
- Another medical condition
- Multiple etiologies
- Alzheimer's Disease
- Prion disease
- Parkinson's Disease
- Huntington's disease
77
What are the clinical features of neurocognitive disorder due to Alzheimer's disease?
- Nearly half of neurocognitive disorders
- Gradual and steady development (typically)
- Memory, orientation, judgment, and reasoning deficits
- Additional symptoms: agitation, confusion, combativeness, depression, anxiety
- Definitive diagnosis only by autopsy
78
What is the nature and progression of Alzheimer's? (Survival, onset)
- Early and later stages: slow
- During middle stages: rapid
("Nun study" - analysis of nun' journal writing over many years shows pattens of deterioration)
- Post-diagnosis survival: 8 yrs
- Onset: 60s/70s ("early onset" = 40s & 50s)
79
What is the prevalence of Alzheimer's disease?
- 5 million Americans, several million worldwide
- more common in less educated individuals
-- more educated declines more rapidly after onset
-- suggests education provides a buffer period of better initial coping
- slightly more common in women:
-- possibly estrogen is protective
80
What are the extent of deficits in Alzheimer's Disorder?
- Aphasia: difficulty with language
- Apraxia: impaired motor functioning
- Agnosia: failure to recognize objects
- Difficulties with: planning, organizing, sequencing, abstracting information
- Negative impact on social and occupational functioning
81
What are the aspects of the vascular neurocognitive disorder?
- Cause: blockage/damage to blood vessels
- 2nd leading cause of neurocognitive disorder
- Onset: sudden (ie stroke)
- Variable patterns of impairment
- Most require formal care in later stages
- Cognitive disturbances
- Obvious neurological signs brain tissue damage
- Prevalence: 70-75, 1.5% 80+, 15%
- Risk slightly higher in men
82
What are the aspects of frontotemporal neurocognitive disorder?
- Damage to frontal or temporal regions of the brain: personality, language, behavior
- 2 Types of Impairment:
1) decline in appropriate behavior
2) declines in language
ie: Pick's disease: pick bodies/cells inside nerve cells in the damaged areas of the brain
83
What are the aspects of neurocognitive disorder due to Pick's disease?
- Rare: 5% all dementia diagnoses
- Cortical dementia like Alzheimer's
- Early onset: 40s-50s
- Little known about cause
84
What are the aspects of neurocognitive disorder due to traumatic brain injury?
- Leading cause: accidents
- Symptoms at least 1 week after injury including executive functioning, learning, memory- most common
- ie athletes experiencing repeated head blows
85
What are the aspects of neurocognitive disorder due to Lewy Body Disease?
- Lewy body: microscopic protein deposits that damage brain over time
- Onset: gradual
-- impaired attention/alertness, visual hallucinations, motor impairment
86
What are the aspects of neurocognitive disorder due to Parkinson's Disease?
- Degenerative brain disorder
- Dopamine pathway damage
- 1/1,000 worldwide
- Chief difficulty: motor problems - tremors, posture, walking, speech
- Not all with PD develop dementia
- 75% survive 10+ yrs after diagnosis -
87
What are the aspects of neurocognitive disorder due to HIV infection?
HIV-1 can cause neurological impairments and dementia in some individuals
- cognitive slowness, impaired attention, & forgetfulness
- apathy & social withdrawal
- typically occurs in later disease stages
- now occurs in <10% of individuals with HIV; because HAART (highly active, antiretroviral therapies) decrease risk
88
What are the aspects of neurocognitive disorder due to Prion disease?
- Misfolded protein sin the brain that reproduce and cause damage
- No known treatment, always fatal
- Can only be acquired though cannibalism or accidental transmission (blood transfusion)
- ie: Creutzfeldt-Jakob disease
-- 1/1M
- eating nerve tissue of mad cow diseased cows
- MCD: slowly destroys brain and spinal cord of in cattle (Bovine Spongiform Encephalopathy)
89
What are the aspects of substance/medication-induced neurocognitive disorder?
- Prolonged drug use, especially in combination with poor diet
- May be caused by alcohol, sedative, hypnotic, anxiolytic, or inhalant drugs
- Brain damage may be permanent
- Symptoms similar to Alzheimer's
-- memory impairment, aphasia, apraxia, agnosia, disturbed executive functioning
90
What are the brain features of Alzheimer's disease?
- Neurofibrillary tangles (strandlike filaments)
- Amyloid plaques (gummy protein deposits between neurons)
- Atrophy
91
What are the biological processes and genetic Factors of Alzheimer's Disease?
- Many preliminary findings that need further research
- Genes: Chromosome 21,19 (late onset), 14 (early onset), and 12
- Deterministic genes: rare & inevitable (Beta-amyloid precursor gene, Presenilin-1 and -2 genes)
- Susceptibility genes: more likely but not certain to develop Alzheimer's
92
What is an example of a susceptibility gene for Alzheimer's disease?
ApoE4 gene
- chromosome 19
- late onset
- More prevalent in those with family history of Alzheimer's
- More likely to produce cognitive decline in the context of a stressful environment
93
What are the contributing psychosocial factors in Neurocognitive Disorders?
- Psychological and psychosocial factors do not cause dementia directly but they may influence onset and course
- Lifestyle factors: drug use, diet, exercise, stress
- Environmental stressors: repeated head trauma
- Cultural factors: ethnicity and lower SES
- Educational attainment, coping skills social support
94
What are the general facts about medical treatments for neurocognitive disorders?
- Few primary treatments exist
- Most attempt to slow progression of deterioration, but cannot stop it
- Most not effective because we have no way to replace extensive brain damage
95
What are specific medical treatments for neurocognitive disorders?
- Future: glial cell-derived neurotropic factors, stem cells: may slow deterioration, vaccines
- Some drugs target cognitive deficits:
-- Cholinesterase-inhibitors: Aricept, Exelon, Reminyl
-- long-term effects not well demonstrated
- Exploratory: Ginkgo biloba to improve memory (findings mixed)
- Associated symptoms: SSRIs (depression/anxiety), antipsychotics (agitation)
- All: only modestly effective, short periods
96
What are the effects of medical treatments of neurocognitive disorders?
- Any gains in a person's abilities are only temporary
- Any improvement is to 6 months prior
- Many patients discontinue medications because of expense or severe side effects
97
What are the psychosocial treatments of neurocognitive disorders?
Aim:
- enhance lives of patients and families
- teach compensatory skills
- memory enhancement devices (memory wallets with statements about ones life)
*Cognitive stimulation can delay onset of more severe symptoms
98
What are the psychosocial treatments for caregivers of neurocognitive disorders?
- Instructions on how to handle problematic behavior: wandering, socially inappropriate behaviors, aggressive or rebellious behaviors
- Treatment of mental health due to stress
99
What are prevention measures for neurocognitive disorders?
- Reduce risk in older adults:
-- use anti-inflammatory medications
-- control blood pressure
-- don't smoke, active social life
- Other targets:
-- increasing safety behaviors to reduce head trauma
-- reduce exposure to neurotoxins and use of drugs
