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QuestionAnswer
Psychiatric Disorders disorders of psychological function sufficiently severe to require treatment by a psychiatrist or clinical psychologist
DSM-IV-TR Diagnostic&Statistical Manual of Mental Disorders Guide 4 diagnosis of disorders, produced by the American Psychiatric association. Provides only general diagnostic guidelines that are often interpreted differently by different psychiatrists.
Schizophrenia splitting of psychic functions; breakdown of integration among emotion, thought, and action
Stuporous Catatonic Schizophrenia Schizophrenia characterized by long periods of immobility and waxy flexibility (
Waxy flexibility React like a mannequin, not resisting movement but holding new position until moved again
Symptoms of Schizophrenia recurrence of only 2 of these symptoms for one month is grounds for diagnosis of schizophrenia: Delusions, inappropriate affect, hallucinations, incoherent thought, odd behavior, catatonia, echolalia
Chlorpromazine 1st Anti-schizophrenic drug.1st developed as an antihystamine. Agitates schizos were calmed and emotionally unresponsive activated. Reduced symptoms enough for discharge. Typical, phenothiazine. Antagonist at dopaminergic synapses. Caused more metabolites
Reserpine Active ingredient in snakeroot plant that was once used for treatment of schizophrenia, but was then recalled because it caused dangerously low blood pressure levels. Typical, phenothiazine
Striatum depleted of dopamine in Parkinson’s patients—this finding contributed to the development of the dopamine theory of schizophrenia
Dopamine Theory of Schizophrenia theory that schizophrenia is caused by too much dopamine and that anti-schizophrenic drugs exert their effects by decreasing dopamine levels. Contradiction=schizos have same amt of dopamine in brain
Fantosnias Most uncommon symptom of schizophrenia. one of the ways ppl are IDed as faking. Hallucinations of odor.
Evidence for Dopamine theory of Schizophrenia 1reserpine known 2 deplete brain/dopamine &other monoamines by breakdown synap vesicles that store these neurotransmitters 2drugs like amphetamine & coke ^ extracell levels / dopamine &monoamines in brain & 2 cause schizophrenic breaks in normal subjects.
Metabolites molecules created when another molecule is broken down Extracell levels of metabolites are increased by chloropromazine
Receptor blocker chloropromazine=receptor blocker@dopamine synapses;binds 2dopamine receptors w/o activating them -> keeps dopamine from activating them current theory is that schizophrenia involves high levels/activity @dopamine receptors
Haloperodol 1of most potent anti-schiz drugs,only effective drug that has low affinity 4 dopamine receptors.Bind only 2 d2 receptors Type/butyrophenone
Phenothiazine ie chlorpromazine,reserpine; all bind 2 D1 + D2 receptors. Heather took it in the movie. Will cause Parkinson like symptoms by destroying dopamine receptors
Butyrophenones Only bind 2 d2 dopamine receptors ie Haloperodol & spiroperidol
Neuroleptics anti-schiz drugs more effective in treating positive schiz symptoms than negative
Spiroperidol highest affinity4d2 receptors&most potent antischiz effect. Ex of the current theory that schizophrenia caused by activity @D2 receptors specifically.butyrophenone.
Clozapine 1st atypical neuroleptic4treatment / schiz. has affinity 4 d1 receptors, D4, & serotonin receptors,slight affinity 4 D2 receptors. Often effective in treating schizophrenics who have not responded to typical neuroleptics &doesnt->Parkinsony sidefx
Atypical neuroleptics evidence that D2 receptors not sole mechanism /schiz Anti-schiz drugs not primarily D2 receptor blockers ieClozapine.
Positive Schizophrenic Symptoms More responsive2 neuroleptics=incoherence hallucinations&delusions,flight of ideas, odd behavior, motor problems Assume cause=neural activity.
Negative Schizophrenic symptoms Not as responsive 2 treatment w/neuroleptics ie lack/affect, cognitive deficits, &poverty/speech, lack of affect, inability to think clearly, lack of perceptual filtering, social withdrawl, sleep problems;assumed to be caused by brain damage
Depression Affective disorder-anhedonia, 4 no apparent reason. Often imposs 2 meet essential requirements / their daily lives. Most common mental illness.
Anhedonia loss of capacity to experience pleasure. Symptom of depression
Mania affective disorder;overconfidence, impulsivity, distractibility, high energy episodes=people r talkative, energetic, impulsive, positive, very confident
Bipolar affective disorder (manic depression) depressive patients who experience periods of mania. Antidepressants dont help. sometimes trigger periods of mania, but can be blocked with mood stabilizer.
Unipolar affective disorder Depressives who do not experience manic episodes
Mixed episode symptom of Bipolar disorder. Transitional states between mania and depression associated with particularly high suicide rates
Reactive depression Depression triggered by a negative experience
Endogenous depression depression with no apparent cause
Seasonal Affective Disorder (SAD) attacks of depression and lethargy typically occurring every winter. Often treatable through light therapy
Iproniazid first antidepressant. Monoamine agonist.increases levels /monoamines (i.e. norepinephrine,serotonin) by inhibiting activity / monoamine oxidase
Monoamine oxidase Iproniazid blocks this. Enzyme that breaks down monoamine neurotransmitters in the cytoplasm of the neuron.
MAO inhibitors include Iproniazid. Can cause the cheese effect
Cheese effect Sidefct/MAO inhibitors tyramine (in cheese, wine,pickles)metabolized by MAO in liver.MAO inhibitors prevent this-people on these meds & consume tyramine-strokes from surge in BP. blocks norepinephrine and serotonin. Dangerous
Tyramine amine in wine, cheese, pickles. Not broken down w/o MAO (prevented by MAO inhibitors)> buildup cause BP surge + strokes→ cheese effect
Tricyclic antidepressants antidepressants w/structure made of 3 atom rings ie imipramine Block serotonin+norepinephrine reuptake>^levels in brain Safer alternatives 2 MAO inhibitors
Imipramine 1st tricyclic antidepressant
Lithium metallic ion blocks mania, mood stabilizer
Mood stabilizer Drug blocks rapid transition btw depression&mania rather than treating depression. Ex- Lithium
Selective serotonin-reuptake inhibitors (SSRIS) serotonin agonists, exert agonistic fxs block reuptake /serotonin from synapses, ex- prozac and Zoloft. Much higher rate of suicide rate immediately after start taking, esp in teens. Effective 4 conditions other than depression
Fluoxetine 1st SSRI;Prozac
Prozac 1st SSRI developed,Fluoexetine
Selective norepinephrine reuptake inhibitors (SNRIS) another effective form of antidepressants
Monoamine theory Theory of depression,depression<under activity /serotinergic &noradrenergic synapses. basis=monoamine oxidase inhibitors, tricyclic antidepressants, SSRIS, &selective norepinephrine-reuptake inhibitors=all agonists of serotonin, norepinephrine, or both
Up-regulation process: when an insufficient amt/ neurotrans released @ synapse,>compensatory increases in
Diathesis-stress model theory depressed ppl inherit diathesis-If exposed 2stress early systems become permanently sensitized>overreact 2 mild stressors 4 rest/life. Th based on observation->depressed ppl release more stress hormones. Maybe cortisol? Came from epigenetics
Diathesis genetic susceptibility
Corticotropin releasing hormone Depressed individuals synthesize more of this. This is evidence for the diathesis synthesis model of depression
Adrenocoticotropic hormone depressed individuals release more of this from their anterior pituitary. This is evidence for the diathesis synthesis model of depression
Glucocorticoids depressed individuals release more of this from their adrenal cortex. This is evidence for the diathesis synthesis model of depression
Dexamethasone injections of this synthetic glucocorticoid does not reduce the release of glucocorticoids through negative feedback in many depressed patients, though they do in normal subject.->counterevidence for Diathesis stess model
Anxiety chronic fear persists in absence of direct threat
Anxiety disorder anxiety disrupt normal function, Associated w/feelings/anxiety (fear worry despondency)&w/variety/psych stress rvns: tachycardia, hypertension (high BP), nausea,breathing difficulty,sleep disturbances,^ glucocorticoid levels. Experiences shape the dsorder
Tachycardia rapid heartbeat associated w Anxiety Disorder
Hypertension high BP often associated with Anxiety disorder
Types of Anxiety Disorder Generalized anxiety disorder,phobic anxiety disorders, panic disorders,OCD, PTSD
5 Types of Anxiety Disorder Generalized Anxiety Disorder, phobic anxiety disorder,panic disorder,OCD, PTSD
Generalized anxiety disorder stress responses +extreme feelings of anxiety that occur in the absence of any obvious precipitating stimulusPhobic anxiety disorders- similar to generalized anxiety disorders except that they are triggered by exposure to particular objects or situations
Panic disorders rapid-onset attacks of extreme fear and severe symptoms of stress (e.g. choking, heart palpitations, shortness of breath); they are often components of generalized anxiety disorders and phobic disorders, but also exist as separate disorders
Obsessive Compulsive disorder characterized by frequently recurring, uncontrollable, anxiety-producing thoughts (obsessions) and impulses (compulsions)
Posttraumatic Stress Disorder a persistent pattern of psychological distress following exposure to extreme stress, such as war or being victim of sexual assault
Agoraphobia type of phobic anxiety disorder triggered by public places and open spaces
Benzodiazepines include chlordiazepoxide and diazepam. Treat anxiety disorders and also prescribed as hypnotics, anticonvulsants, and muscle relaxants. Agonistic on GABA receptors
Chlordiazeperoxide type of Benzodiazepine (Librium) used to treat anxiety
Diazepam type of Benzodiazepine (Valium) used to treat anxiety
Buspirone- serotonin agonist widely used in the treatment of anxiety disorders. Appears to have a selective agonist effect at 5-HT receptor. Produced anxiolytic effects without the common side effects of benzodiazepines.
Anxiolytic anti-anxiety. Often effective against depression because of comorbidity
Comorbidity tendency to occur in the same individual—comorbidity of anxiety disorders and depression make it hard to study both
Elevated-plus-maze test method of studying Anxiety where rats are places on a 4-armed plus-sign-shaped maze that is 50 cm above the floor. The measure of anxiety is the proportion of time the rats spend in the enclosed arms, rather than venturing onto exposed arms
Defensive-burying test rats shocked by wire-wrapped wooden dowel mounted on wall/familiar test chamber. measure/anxiety=amt/time rats spend spraying bedding material from floor of the chamber at the source of the shock with forward thrusting movements of their head and forepaws
Risk-assessment test single brief exposure to a cat on the surface of a lab burrow system, rats will flee to their burrow and freeze. The measure of anxiety are the amts of time that the rats spend in freezing and in risk assessment
Tourette syndrome a disorder of tics,Some patients also exhibit signs of ADHD, OCD, or both. Onset in childhood or early adolesce. Tics helped by neuroleptics. Current hypoth is that results from excessive dopaminergic innervation of the striatum and associated cortex
Tics involuntary, repetitive, stereotyped movements or vocalizations. Can be both complex or simple. Neuroleptics can help
Complex motor tics making lewd gestures, hitting, touching objects, squatting, hopping, and twirling
Complex verbal tics inarticulate sounds, coprolalia (uttering obscenities), echolalia, and palalia .
Coprolalia uttering obscenities
Echolalia repeating another’s words
Palilalia repeating own words
Translational Research research designed to translate basic scientific discoveries into effective clinical treatment
Clinical trials studies conducted on human subjects to assess the therapeutic efficacy of an untested drug or other treatment
Active Placebos produce the same side effects as the active drug
Orphan drugs Drugs for which the market is too small for them to be profitable
Translational bottleneck produced by the massive costs of clinical trials—only a small portion of potentially valuable ideas or treatments receive funding for translational research
Voyeurism attaining sexual gratification from spying on people. Diagnosable in the DSM(But what about watching x-rated movies?)
toryism in Revolutionary US, people would be diagnosed with this if they questioned the colonies’ fight for independence. Recog in DSM
Cultural deviance and relevancy form the basis of who has a problem and who doesn’t in DSM
Hippocrates believed mental illness =result of disruption in 4 bodily fluids>disturbance of behavior;proposed womans uterus wandered up to eyestreated her by poking her in the eyes with a sharp stick. Now called hysteria
sensorium where senses are experienced
Craniotomy Egypt 1st;3 holes drilled in cranium. saw under skull w wire+remove triangular piece.
trephine device used to do craniotomy, hole made in craniotomy
Springer monk, studied burning 4soul cleansing and wrote the book Malleus Malfricarum on how to manual on dealing with witch craft
Andersonville prison camp,Stockade. If you step over outer boundary, you’ll be shot. Line is the “deadline”
St. Mary’s of Bethlehem in London;terrible sanitation- cholera was rampant,people from town charged admission 2 watch, admission fees used 2 pay 4 food aka Bedlam
Pinel appalled by inhumanity, pays for people to be fed and clothed. Roof, fireplace. some people improved&were released;started Humanitarian Movement in Mental Healthcare
Benjamin Rush&Dorthea Dix 2 prime movers for making mental healthcare humane
George III of England used to be taken up to the tower of London and beat him until he had a seizure- improved
Metrozol cause seizures so severe -would induce seizure before syringe removed, opposing muscle contract @same time+ break bones +tear muscles from bone
Electro convulsive schock (ECS) machine increases voltage +decreases current.bike bar in mouth, elect current @ temples.now use under anesthesia w/muscle relaxants>seizure in brain, but not visible.Used most often in very severe cases of depression, especially people who attempt suicide
Trans-orbital frontal leucotomy started by Freeman,take a small hammer &push down on eye. Metal piece cracks through skull and into brain to sever brain
Moniz research on monkeys’ + frontal lobes. – Nobel prize 4 frontal lobotomies. Thought something in frontal lobe was screwing up the rest of the brain
Walter Freeman followed up on Moniz’ work & did lobotomies on people in a routine way- started doing Trans-orbital frontal leucotomies, 1stone using ice pick from home
We still use psychosurgery for… OCD,Trigeminal Noralgia
cingulate gyrus part of the limbic system associated with OCD
Trigeminal Noralgia pain on your face that’s so severe that it causes you to lose consciousness, sometimes occurs 30 times a day,Usually commit suicide,blood vessel impinges on facial nerve,doesn’t respond to pain killers,Frontal lobotomy will make them indifferent to pain
perceperation disorder those with frontal lobotomies have a hard time stopping their behavior. Problem with perserverence
frontal lobe laugh gutteral laugh, uncontrollable laugh of those with frontal lobotomies.
Iatrogenic People with lobotomies have a perceperation disorder that you get from the actual treatment by the psychiatrist
Subtypes of Schizophrenia paranoid schizophrenia, stuporous catatonic schizophrenia, hebephrenic schizophrenia, simple/undifferentiated schizophrenia,
Paranoia develop thinking that everyone is out to get them, accusatory way of thinking
Paranoid schizophrenia Most common subtype. Most important symptom for diagnosis is flight of ideas
Amphetamine psychosis Same symptoms as schizophenia resulting from acute amphetamine intoxication
Mens rea the guilty mind
The machinist Beat up daughter, had seizure, tumor in amygdala, not guilty by reason of insanity
John Silvey Killed ppl at abortion clinic, schizophrenia, found guilty
Symptoms of depression loss of interest in outcomes, change in eating habits, sleep disturbance (early waking,constant sleep, Social withdrawal
K. Redfield Jameson Psychiatrist at Johns Hopkins who wrote the Unquiet Mind on Manic Depressive or Bipolar Disorder
Chronic stress can decrease the sensitivity of the postsynaptic membrane, so it needs more serotonin. Can be treated with SSRIs, which get the serotonin stock in the synapse instead of reuptake
Electroshock Therapy Used in patients that are so depressed that they cant be left alone. Creates a window for medicine
Alzheimer's Used to be called pre-senile dementia.Amyloid Plaques and Neurofibrillary tangles.
Signs/Symptoms of Alzheimer's 1. Smell 2. Memory 3. Math deficits 4. Spatial orientation 5. Cognitive function>> neuron death until loss of cortical functioning and coma-like, reactionary (only) state
Neurofibrillary Tangles Microtubules in AD patients get tangled up so they can no longer carry neurotransmitters
Amyloid Plaques big gooey sticky proteins that form blobs (or plaques) that grow in neurons and stop the cell from functioning
Aluminum AD brains have a ton of aluminum in it--turns out bc they cant adequately get rid of it
Prion disease AD might be one. produce motor deficits first. Can catch them. include Kuru, mad cow, Crutchfeld-Jacob syndrome etc. maybe genetic
Why is loss of smell the first symptom of AD? prions are inhaled and migrate to the olfactory bulb to olfactory receptor cells, where there is not an adequate blood-brain barrier to brevent entering brain. They deteriorate olfactory pathway in exact sequence as smell travels.
Kuru prion disease found in tribe in Ornio, and other cannibalistic tribes, where males eat the brains of the elders when they die
Mad cow prion disese in England that makes your brain spongy
Crutchfeld-Jacob syndrome prion disease you get from ingesting or mingling blood with someone infected
prion self-replicating, virus-like protein without a cell membrane. cannot be killed by burning or typical forms of sterilization
Cognitive behavioral therapy substitute for anti-depressants after patient improves and goes off the drug can improve relapse
Caudate Nuclei tend to be smaller in patients with tourettes
Deep Brain Stimulation Sometimes used as treatment for tourettes
Created by: 1332090080