Ch 14 Mental Disorders

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Mental Retardation

Back 1

Developmental disability. Not a disease. Manifested during the developmental period and before the age of 18.

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Mental Retardation Signs and Symptoms

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Fails to progress intellectually and socially at a normal rate. No obvious physical defects. Certain abnormalities found at birth (downs). Delayed adaptive behavior coupled w difficulty w school.

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Mental Retardation Etiology

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Variety of causes, many unidentifiable. Some hereditary, early alterations of embryonic development, prenatal or postnatal conditions. Any condition compromising blood supply to brain, depriving of O2 and nutrients. Placental insufficiency, trauma of any type, fetal alcohol syndrome.

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Mental Retardation Treatment

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Many can function in society, if severe may be institutionalized. Has no cure. Psychotropic meds can be used to manage mood or behavioral problems.

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Stuttering

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Frequent repetition or prolongation of sounds or syllables. Speech therapy helps. No cure but good prognosis w intervention.

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Autism Spectrum Disorder Signs and Symptoms

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Social isolation, cognitive impairment (based on knowledge), language deficient, repetitive naturalistic motions.

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Autism Spectrum Disorder Etiology

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Uncertain. No singular cause. 4x more common in males over females.

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Autism Spectrum Disorder Diagnosis/Treatment

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Observation of behavior is all that is needed to diagnose. Behavioral therapy and self instructed training. Therapy more beneficial when parents also trained. Risperidone first med prescribed. Decreases tantrums.

Front 9

Asperger Syndrome

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Problems w social interaction and communication. Narrow range of interests, avg or above avg intelligence, difficulty concentrating, poor coordination, adjust better as they get older.

Front 10

Childhood Disintegrative Disorder

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Rare. Child loses many of the skills acquired such as language, social skills, bodily functions. Long period of normal development before regression starts.

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Rhett Syndrome

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Associated w pervasive development disorder, and problems w physical development. Loss of many motor or movement skills, poor coordination. Usually only affects girls. Defect on X chromosome.

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Attention Deficit/Hyperactivity Disorder

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Broken down into subtypes: ADHD: predominantly inattentive type, ADHD: predominantly hyperactive impulsive type, ADHD: combined type.

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Attention Deficit/Hyperactivity Disorder Signs and Symptoms

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Usually present before age 7. Failure to give close attention, careless mistakes, messy work, difficulty completing tasks. Avoid activities that require attention, effort, concentration, organization, unable to sit quietly. Impatient.

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Attention Deficit/Hyperactivity Disorder Etiology

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Uncertain. Genetic w definite brain malfunction.

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Attention Deficit/Hyperactivity Disorder Diagnosis

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Inattentive type: 6 or more Symptoms of inattentive, fewer than 6 Symptoms of hyperactivity for at least 6 months.

Hyperactivity: 6 or more hyperactivity Symptoms, less than 6 inattentive symptoms.

Combined: 6 or more symptoms of both for at least 6 months.

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Attention Deficit/Hyperactivity Disorder Treatment

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Stimulants Dexedrine, Ritalin, adderall. Excellent prognosis w management and meds.

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Oppositional Defiant Disorder

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Oppositional towards adults. Terrible 2s. Deliberately annoy, theft vandalism etc. put on mood stabilizers. Poor outcome.

Front 18

Tourette Disorder

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Gilles de la Tourette syndrome. Multiple motor tics coupled w one or more vocal tics appear simultaneously or at diff times.

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Tourette Disorder Signs and Symptoms

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Tics change over time. Head typically involved. Grunts, clicks, yelps, barks, snorts, utter obscenities.

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Tourette Disorder Etiology

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Uncertain associated w strep. Higher in males, may be inherited. Motor and vocal tics must occur several times per day over a year w/o a tic free period of longer than 3 months to be diagnosed.

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Tourette Disorder Treatment

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Pharmacologic Treatment only proven effective treatment for tics. Haldrol, clonidine, clonazepam, prozac. No cure but may experience lessening of symptoms as they reach maturity but lifelong and chronic condition.

Front 22

Alzheimer Disease

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Progressive degenerative disease of the brain, loss of mental and physical functioning.

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Alzheimer Disease Signs and Symptoms

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Gradual and insidious early signs include loss of short term memory, inability to concentrate, incapacity to learn new info, impaired reasoning, changes in personality. Severe: lose ability to speak, ability to walk. Emotionally detached, hostile, disoriented, bedridden.

Front 24

Alzheimer Disease Etiology

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Unknown, age related, may be genetic, abnormality on chromosome 21 (same brain changes as in downs). Higher rate if have previous head trauma.

Front 25

Alzheimer Disease Diagnosis

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Difficult to obtain direct evidence. Positive diagnosis after death. Sensory and motor deficits, brain scans show brain atrophy. Senile plaques, microscopic deposits of amyloid material, neurofibrillary tangles. One of the most overdiagnosed or misdiagnosed mental functioning disorders bc not easily distinguishable.

Front 26

Alzheimer Disease Treatment

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No cure. Drug therapy to alleviate cognitive symptoms use cholinesterase inhibitors (Aricept). Drugs for agitation and delusional symptoms. Treatment to give patients opportunities to be mobile and maintain mental abilities as long as possible.

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Drugs to avoid in patients w Dementia

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Narcotic Analgesic, Antiarrythmics, Tricyclic Antidepressants, Antiemetics, Antipsychotics, Antihistamines, Benzodiazepines, GI/Urinary Antispasmodics, Muscle Relaxants.

Front 28

Vascular Dementia

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Reduction in blood flow to the brain results from narrowed and stenosed arteries. Result in hypoxia and reduced nourishment to brain cells cause general loss of intellectual abilities.

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Vascular Dementia Signs and Symptoms

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General loss of intellectual abilities, changes in memory, judgement, abstract thinking, personality, disregard for personal hygiene, depression, anxiety, hallucinations, stupor, coma.

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Vascular Dementia Etiology

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Atherosclerotic plaque grows in carotid and cerebral arteries blood flow to brain is reduced.

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Vascular Dementia Treatment

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Increase blood supply to the brain. Low dose aspirin, surgical intervention. Guarded prognosis.

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Dementia Caused by Head Trauma

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Traumatic insult causing reduced blood flow to cerebrum may result in dementia. Can be open or closed.

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Dementia Caused by Head Trauma Signs and Symptoms

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After head injury exhibit reduced mental status unable to preform many cognitive tasks

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Dementia Caused by Head Trauma Treatment

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Correct insult to brain to prevent further damage. After necrosis damaged tissue can not be repaired. Prognosis similar to vascular Dementia.

Front 35

Alcohol Abuse

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Disorder of physical and psychological dependence on daily or regular excessive intake of alcoholic beverages. Can be accelerated by traumatic event.

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Alcohol Abuse Signs and Symptoms

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Acts as a depressant. Decrease in activity, tension, normal inhibition, slow motor skills. Prolonged use cause cirrhosis of liver, pancreatitis, peripheral neuropathy.

Front 37

Alcohol Abuse Etiology

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No single cause, genetic, biological factors, depression, social, cultural.

Front 38

Schizophrenia

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Major psychiatric disturbance. Group of disorders that may result in chronic mental dysfunction and varying degree of impairment.

Front 39

Schizophrenia Signs and Symptoms

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Either positive manifestations (excess or distortion of normal functions; delusions, hallucinations, grossly disorganized, catatonic behavior) or negative manifestations (loss of normal functions; flattening, alogia, avolition).

Front 40

Schizophrenia Etiology

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Unknown, may be genetic higher in males. Stress and environment catalysts.

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Schizophrenia Treatment

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Antipsychotic drugs minimal dose during acute phase.

Front 42

Bipolar Disorder

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Abnormal intense mood swings from hyperactive or manic to depressive syndrome. Sometimes both coexist.

Front 43

Bipolar Disorder Signs and Symptoms

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During manic patient is excited, euphoric, expansive, speak rapidly w conviction frequent change in topics, sleep little, excessive energy, judgement impaired. Then depressed.

Front 44

Bipolar Disorder Etiology

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No clear cause. Biochemical factors, alterations in neurotransmitters.

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Bipolar Disorder Treatment

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Lithium carbonate during manic phase. Antidepressants used in conjunction w anticonvulsants. Atypical antipsychotics (Latuda).

Front 46

Grief Response

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Denial, Anger, Bargaining, Depression, Acceptance.

Front 47

Postpartum Depression

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Changes in thyroid may play a role. Begin 24-48 hrs after birth

Front 48

Generalized Anxiety Disorder and Panic Disorder

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Free floating anxiety. Live in constant state of apparent cause less anxiety. Constant worry about past mistakes and future problems. Have elevated BP, diarrhea, tension, panic attacks. Have panic disorder if have 4 panic attacks in one month.

Front 49

Obsessive Compulsive Disorder

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Persistent intrusions of unwanted thoughts and uncontrollable urges to carry out certain actions.

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Obsessive Compulsive Disorder Etiology

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Some caused by severe stress. Can be related to a dysfunction in the frontal lobe. Hyperthyroidism, genetic factor. Seek therapy.

Front 51

PTSD

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Delayed response to external traumatic event produces extreme distress. Counseling and drug therapy used as treatment.

Front 52

Somatization Disorder

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Briquet Syndrome. Multi symptomatic before age 30. Complaints of pain, GI, sexual, neurotic symptoms w/o clinical basis. Continue for several yrs. intensify w stress, unknown etiology. Therapy is used poor prognosis.

Front 53

Conversion Disorder (Hysteria)

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Anxiety is changed to a physical symptom to allow a person avoid a stressful situation.

Front 54

Hypochondriasis

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Fear of having a serious disease. Patients really do feel the conditions about which they complain. Require psychotherapy

Front 55

Munchausen Syndrome and Munchausen Syndrome by Proxy

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Factitious disorder, patient simulates symptoms of illness for no apparent reason other than getting attention. Feign symptoms and can actually make themselves ill

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Malingering

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Feigning of symptoms for financial or personal gain.

Front 57

Insomnia

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Difficulty falling asleep.

Front 58

Parasomnias

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Sleepwalking, night terrors, nightmares. Often in children. Lithium and certain drugs precipitate the condition. Should not be awaken while sleep walking.

Front 59

Narcolepsy

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Chronic neurological condition. Recurring compulsion to fall asleep precipitated by sedentary monotonous activities. Are genetic. Take therapeutic naps and drug therapy.

Front 60

Sleep Apnea

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Intermittent short periods of breathing cessation during sleep. Potentially life threatening. More in men. Associated w obesity, hypertension, airway obstruction. Do not feel rested.

Front 61

Personality Disorders

Back 61

3 clusters: A- Paranoid, Schizoid, Schizotypal

B- Antisocial, Borderline, Histronic, Narcissistic

C- Avoidant, Dependent, Obsessive Compulsive

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Paranoid Personality Disorder

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Do not trust others always suspicious. Misinterpret others behavior think they are trying to exploit them.

Front 63

Schizoid Personality Disorder

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Appear to lack or show emotions of pleasure or pain. Tend to be loaners do not enjoy relationships. Indifferent, flattened, detached

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Schizotypal Personality Disorder

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Similar to SPD but have typical ideas of reference. May be superstitious, preoccupied w paranoid phenomena. Believe they have magical control over others. Seek treatment for anxiety or depression.

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Antisocial Personality Disorder

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Disregard and tend to violate the rights of others. Fail to conform to societal norms. Aggressive, manipulative, reckless. Do not show remorse or make amends for behavior.

Front 66

Borderline Personality Disorder

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Believe they are being rejected or abandoned. Unstable interpersonal relationships, self image and feelings. Impulsive and manipulative.

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Histrionic Personality Disorder

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Overly dramatic and theatrical mannerisms. Need to be center of attention. Immature and dependent, constantly seeking approval. Inappropriately seductive.

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Narcissistic Disorder

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Pathological self love and grandiose self admiration. When criticized act w rage or humiliation. Lack empathy tend to exploit others.

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Avoidant Personality Disorder

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Avoids any social situation bc of fear of criticism, disapproval, rejection. View themselves as socially inept, personally unappealing, inferior to others.

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Dependent Personality Disorder

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Excessively relying on others. Passive, have trouble disagreeing bc of fear of losing support or approval.

Front 71

Obsessive Compulsive Personality Disorder

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Extreme pattern of preoccupation w orderliness, perfection, and mental and interpersonal control. Preoccupied w lists or details to the point where they can not finish a task.