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92 Cards in this Set

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What are the five major axis of diagnosis?
Axis I: Clinical Diagnosis
Axis II: Personality disorders and Mental Retardation
Axis III: Physical Conditions and Disorders
Axis IV: Psychosocial and environmental problems
Axic V: Global assesment and functioning (GAF)
A GAF score below what number means you are a persistent danger to yourself and others.
10
what is the leading caues of mental retardation?
fetal alcohol syndrome
What is the IQ and functioning ability for each level of mental retardation.
mild
moderate
severe
profound
mild - IQ of 70-50 - these people are self-supporting with some guidance.
moderate - IQ - 49-35 - These people are trainable. These people can work but need supervision
Severe - IQ is 34-20 - These people cannont work but can communicate and learn to perform basic habits
Profound - IQ is below 20 - These people need a highly structured environment with constant nursing care supervision.
what is another name for autism?
pervasive developmental disorder
Which chromosome is autism linked to?
chrom. 15
If the mother is infected with what during the first trimester then her child has a higher chance of developing autism?
rubella
What is the mechanism for autism?
failure of apaptosis (normal pruning of neural circuits)
What is the treatment for autism?
behavioral techniques such as shaping
what percentage of people have ADHD?
10% of lower class males
5% of middle class males
What are the three treatments for ADHD?
methylphenidate, dextroamphetamine, or pemoline
What is a symptom that rules out schitzophrenia?
visual hallucinations...visual hallucinations will likely be due to organic problems
what is a schizophreniform disorder?
if you have schitzophrenia symptoms for less than 6 months.
What is a brief psychotic disorder?
when you have the symptoms of schitzophrenia for less than 30 and then return to your full level of functioning.
What is the SES of most schitzophrenics and what are are they diagnosed?
Lower SES between 15-24
What is the genetic contribution to schitzophrenia?
It is very strong. if both of your parents are schitzophrenic you have a 40% chance of being schitzophrenic
what is the formula for calculating the heritability index?
(MZ-DZ)/(100-DZ)
what is a schizophrenogenic family and what does this type of family contribute to?
these families are highly linked to the schizoid personality disorder, these families are not linked to the development of schitzophrenia
What type of family is linked to the development of schitzophrenia?
high expressed-emotion families
what are the five main subtypes of schitzophrenia?
paranoid
catatonic
disorganized
undifferentiated
residual
what is characteristic of paranoid schitzophrenia?
feelings of grandeur (you are the best) and that everyone is out to get you.
what are the subclasses of catatonic schitzophrenia and how would you distinguish each?
complete stupor - pronounced decrease in spontaneous movements

Excited catatonic - motor agitation, so much so that they are literly bouncing off of the walls
What type of schitzophrenic is just really really crazy?
disorganized schitzophrenia
what is unidfferentiated schitzophrenic?
these people are clearly schitzophrenic but do not fit neatly into one particular group.
what are the positive symptoms of schitzophrenia due to?
associate with dopamine receptors
what are the negative symptoms of schitzophrenia due to?
assisiated with muscarinic receptors
what is schizoaffective disorder
concurrent symptoms of schizophrenia and depression or mania
chemically, what is much of schitzophrenia due to?
what are the other neurotransmitters involved?
hyperactive dopeamine system

other neurotransmitters:
sertonin
glutamate
what drug targets the serotonicn receptors and makes people look and act schitzophrenic?
LSD
What drug is glutamic acid associated with?
PCP
in what neural pathway is glutamic acid a main neurotransmitter?
visual pathway
What type of neurotransmitter is glutamic acid?
one of the major amino acids in general metabolism and protein synthesis
What is the effect of glutamic acid?
stimulates neurons to fire.
what receptors do glutamate bind to?
NMDA receptors
What are the four tests that schitzophrenics have in common with people with ADHD?
-smooth pursuit eye movements
-backward masking
-enent-related potentials (ERP)
-prefrontal cortical impairment (PFC)
What are the structural and anatomic abnormalities assoc. with schitzophrenia?
-larger ventricle size and VBR
-cortical atrophy
-smaller frontal lobes
-atrophy of temporal lobes
-smaller volume of left hippocampus and amygdala
-loss of inhibitory neurons in second layer of anterior cingulate gyrus
Structurally what is a good indicator of prognosis of illness?
correlation between ventricle size, type, and prognosis of illness.
where is the site of the primary pathology assoc. with schitzophrenia?
limbic system
how long must you have had your symptoms in order ot have dysthymia?
2 years
how long must you have had symptoms in order to be diagnosed with unipolar disorder?
2 weeks
what other disease is very highly correlated with bipolar?
persons with multiple sclerosis have 13 times reate of bepolar disorder compared with general population
what percentage of people in remission will have recurences?
50-60%
What percentage of people with unipolar or bipolar do not get proper treatment?
80% with either unipolar or bipolar do not get proper treatment
Is bipolar genetic?
yes it is strongly genetic...higher even than for schitzophrenia...it is VERY HIGH
what antidepressant helps smokers quit smoking?
doxepin
what is the difference between bipolar type 1 and type 2?
type 1: mania more prominent
type 2: recurrent depressive episodes plus hypomanic episodes
What are lab tests associated with depression?
MHPG (3-methyl, 5-hydroxy, phenl-glucol)
DST (dexamethasone suppression test)
TRH (thyrotropin-releasing hormone stimulation test)
what are key classic signs of anorexia nervosa?
disappearance of menses
and
lanugo )baby-fine hair
what is hte most common psychiatric disorder for women?
men?
women - anxiety disorders
men - substance abuse
how long must you have had the generalized anxiety before being diagnosed with generalized personality disorder?
6 months
what is the number 1 phobia?
public speaking
what is agoraphobia
fear of open spaces
more accurately, fear of being open, exposed, and vulnerable to panic attacks
what is the prevalence of social phobia?
1% of population
what is discrete performance anxiety?
stage-fright...locking up when in the situation
what medicaation would you give for generalizaed social anxiety?
treat with paroxetine
(SSRI)
what medication is given for discrete performance anxiety?
Beta-Blocker such as atenolol or propranolol
or
paroxetine (SSRI)
what are the changes in brain activity associated with OCD?
-increased frontal lobe metabolism
-increased activity in the caudate nucleus
what medications are used for OCD?
-SSRIs
-clomipramine
what medications do you avoid in patient with OCD?
-neuroleptics, because they will increase frontal lobe activity
What is required to diagnose a panic disorder?
-three panic attacks in a three week period
-no clear circumstances where they occur
-there is no warning that the attack is coming.
What are the main treatments for panic disorders?
Alprazolam
Impramine
Clonazepam
Any SSRI
Carbon Dioxide (for hyperventilation)
what are the five somatiform disorders?
somatization disorder
conversion disorder
hypochondriasis
somatoform pain disorder
body dysmorphic disorder
how many symptoms and how many of each catagory of symptoms must be present in order to diagnose somatization disorder?
Set of eight or more symptoms:
Four pain
Two gantrointestingal
One sexual
One pseudoneurologic
what is the age requirement for somatization disorder?
onset must be prior to age 30
How many symptoms must be present for Conversion disorder?
One or more
What are the usulay symptoms of conversion disorder?
usually skeletal, muscular, sensory, or some peripheral nonautonomic system
What is a specific patient attitude that you should look for in someone with a conversion disorder?
La Belle Indifference - Patient seems to be indifferent to his newly acquired disability. Does not seem to be very upset.
How long must you have had the symptoms in order to be diagnosed with hypochondriasis?
6 months
how would you diagnose somatoform pain disorder?
severe, prolonged pain that disrupts everyday life with the presence of SECONDARY GAIN
what is a factitious disorder and what is the most common facticious disorder?
a factitious disorder is when a patient knows that he is doing something to create the symptoms but he is not able to stop. The syptom production is intentional but the motivatio is unconscious.

the most commonn factitious disorder is Munchauson syndrome.
How long must you have had the symptoms in order to be diagnosed with PTSD?
over 1 month
What disease is like PTSD an but can be diagnosed before 1 month?
Acute stress disorder
what are the criterion for adjustment disorder?
it is a residual catagory, diagnosed only if no other axis 1 applies

presence of identifiable stressor within three months

symptoms last less than 6 months after end of stressor

symptoms are clinically significant...significantly effect way of life

NOT a grief response
what are the different types of dissosiative disorder?
fugue
amnesia
dissociative identitiy disorder (multiple personality disorder)
Depersonalization disorder
someone wakes up in a new town but does not remember how he got there...but he has a slight memory of watching someone else traveling...what is this?
fugue subtype of dissosiative disorder
what is depersonalization disorder?
recurrent experiences of being detached from or outside of one's body
What are the characteristics of the cluster A personality disorders?
odd or eccentric
What are the three cluster A personality disorders?
paranoid
schizoid
schizotypal
What is the paranoid personality disorder like?
Long-standing suspiciousness or mistrust of others
What is the schizoid personality disorder like?
Lifelong patten of social withdrawal
what is the schizotypal personality disorder like?
very odd, strange, wierd
What are the cluster B personality disorders described as?
dramatic and emotional - these are highly associated with alcoholism and somatization disorder
What are the Cluster B personality disorders?
Historionic
narcissistic
borderline
antisocial
describe the histrionic personality disorder
colorful, dramatic, extroverted, attention seeking
describe the narcissistic personality disorder
grandiose sense of self-importance, demands constant attention, fragile self-esteem, prone to depression
desribe borderline personality disorder
very unstable affect, behavior, self-image, self-detrimental impulsivity, unstable but intense interpersonal relationships, self-mutilation, 5% commit suicide
describe antisocial personality disorder
continual criminal acts, onset before age 15, if younger than 18, diagnose as conduct disorder, comprises 75% of prison populations
how are the cluster C personality disorders described?
anxious and fearful - behaviors associated with fear and anxiety
what are the three Cluster C personality disorders?
avoidant
obsessive compulsive
dependent
describe the avoidant personality disorder
extreme sensitivity to rejection, social isolation, bu an intense desire for affection
describe obsessive compulsive disorder
orderliness, inflexible, perfectionist, loves lists, rules and order, doesn't want change, lacks sense of humor
describe dependent personality disorder
get others to assume responsibility, can't express desagreement, linked to abusive spouse