Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
208 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
Psychiatric Disorders
|
disorders of psychological function sufficiently severe to require treatment
difficult to diagnose |
|
|
|
What are the two main difficulties in diagnosing particular psychiatric disorders
|
1) patients suffering the same disorder often display different symptoms
2) patients suffering from different disorders often display many of the same symptoms |
|
|
|
What does the word "schizophrenia" mean?
|
the splitting of psychic functions
|
|
|
|
Schizophrenia is the disease most commonly associated with what?
|
madness
|
|
|
|
schizophrenia attacks about what ? % of individuals of all races and cultural groups, typically beginning when?
|
1%
adolescence or early adulthood |
|
|
|
stuporous catatonic schizophrenia
|
characterized by long periods of immobility and waxy flexibility
|
|
|
|
echolalia
|
vocalized repetition of some or all of what has just been heard
|
|
|
|
What is the major difficulty in studying and treating schizophrenia? Why?
|
defining it
symptoms are complex and diverse they overlap greatly with those of other psychiatric disorders frequently change during the progression of the disorder |
|
|
|
Positive symptoms definition
|
symptoms that seem to represent an excess of normal function
|
+
|
|
|
Negative symptoms definition
|
symptoms that seem to represent a reduction or loss of normal function
|
-
|
|
|
Positive symptoms of Schizophrenia
|
delusions
hallucinations inappropriate affect incoherent speech or thought odd behavior |
|
|
|
Negative symptoms of Schizophrenia
|
affective flattening
alogia avolition anhedonia catatonia |
|
|
|
affective flattening
|
reduction or absence of emotional expression
|
|
|
|
alogia
|
reduction or absence of speech
|
|
|
|
avolition
|
reduction or absence of motivation
|
|
|
|
anhedonia
|
inability to experience pleasure
|
|
|
|
catatonia
|
remaining motionless, often in awkward positions for long periods
|
|
|
|
what criteria must be met to be diagnosed with Schizophrenia
|
the recurrence of any two symptoms for 1 month
only one symptom is necessary if the symptom is a delusion that is particularly bizarre or a hallucination that includes voices |
|
|
|
what is the probability of schizophrenia's occurring in a close biological relative of a schizophrenic patient?
|
about 10% even if the relative was adopted shortly after birth by a healthy family
|
|
|
|
what is the concordance rate for schizophrenia in identical twins
|
45%
|
|
|
|
what is the concordance rate for schizophrenia in fraternal twins
|
10%
|
|
|
|
Adoption studies found that the risk of schizophrenia is increased by the presence of the disorder in biological parents but not by its presence in whom?
|
adoptive parents
|
|
|
|
The current view is that some people inherit a potential for Schizophrenia, which may or may not be activated by what?
|
experience
|
|
|
|
Many genes have been linked to the disorder, but no single gene can cause Schizophrenia. Instead, the genes do what to produce the disorder?
|
the genes act is combination with one another and experience
|
|
|
|
What are some of the early experiential factors that have been implicated in the development of Schizophrenia?
|
birth complications
infections autoimmune reactions toxins traumatic injury stress |
|
|
|
Early experiential factors are thought to alter what? leading to Schizophrenia in individuals who have a genetic susceptibility?
|
alter the normal course of neurodevelopment
|
|
|
|
The first major breakthrough in the study of the biochemistry of schizophrenia was the accidental discovery in the early 1950s of the first antischizophrenic drug called what?
|
Chlorpromazine
|
|
|
|
The first antischizophrenic drug was developed by a French drug company as a what? When was it commonly administered?
|
antihistamine
it was given prior to surgery to counteract swelling |
|
|
|
In 1950, a French surgeon noticed that Chlorpromazine given prior to surgery to counteract swelling had what effect? He suggested that it might this same effect on difficult-to-handle psychiatric patients. Was his suggestion correct?
|
calming effect
no |
|
|
|
The research around Chlorpromazine's calming effects on difficult-to-handle psychiatric patients lead to?
|
the discovery that the drug alleviates Schizophrenic symptoms
Agitated patients were calmed by the drug Emotionally blunted patients were activated by the drug |
|
|
|
Chlorpromazine doesnt cure Schizophrenia but it often reduces the severity of schizophrenic symptoms enough to allow what?
|
institutionalized patients to be discharged
|
|
|
|
Why is reserpine no longer used in the treatment of Schizophrenia?
|
it produces a dangerous decline in blood pressure at the doses needed for the treatment
|
|
|
|
Although the chemical structures of chlorpromazine and reserpine are dissimilar, their antischizophrenic effects are similar in what two major respects?
|
1) the antischizophrenic effects of both drugs are manifested only afyer a patient has been medicated for 2 or 3 weeks
2) the onset of this antischizophrenic effect is usually associated with motor effects similar to the symptoms of Parkinson's disease |
|
|
|
What are symptoms of Parkinson's disease
|
tremors at rest
muscular rigidity decrease in voluntary movement |
|
|
|
In 1960, it was reported that the striatums of persons dying of Parkinson's disease had been depleted of Dopamine. This finding suggested a disruption of dopaminergic transmission might produce both Parkinson's disease and what? What was created because of this suggestion?
|
the antischizophrenic effects of chlorpromazine and reserpine
the dopamine theory of schizophrenia |
|
|
|
Dopamine theory of Schizophrenia
|
schizophrenia is caused by too much dopamine and that antischizophrenia drugs exert their effects by decreasing dopamine levels
|
|
|
|
What two already established facts lended support to the dopamine theory of schizophrenia
|
1) reserpine was known to deplete the brain of dopamine & other monamines by breaking down the synaptic vesicles in which these neurotransmitters are stored
2) drugs such as amphetamine & cocaine, which can trigger schizophrenic episodes in healthy users, were known to increase the extracellular levels of dopamine and other monoamines in the brain |
|
|
|
An important step in the evolution of the dopamine theory of schizophrenia came in 1963, when Carlsson & Lindqvist assessed the effects of Chlorpromazine on extracellular levels of dopamine and its metabolites. What did they find? What did they conclude?
|
The extracellular levels of dopamine were unchanged by Chlorpromazine & the extracellular levels of its metabolites were increased.
They concluded that both chlorpromazine & reserpine antagonize transmission at dopamine synapses: reserpine depletes the brain of dopamine & chlorpromazine by binding to dopamine receptors |
|
|
|
Carlsson & Lindqvist argued that Chlorpromazine is a receptor blocker at dopamine synapses. What does this mean?
|
it binds to dopamine receptors without activating them and, in so doing, keepa dopamine from activating them
|
|
|
|
Carlsson and Lindqvist postulated that the lack of activity at postsynaptic dopamine receptors sent what ? that increased their release of dopamine, which was broken down in the synapses.
|
a feedback signal to the presynaptic cells
|
|
|
|
Rather than high dopamine levels, Carlsson and Lindqvist (dopamine theory of schizophrenia revision) suggested that the main factor in schizophrenia was presumed to be what?
|
high levels of activity at dopamine receptors
|
|
|
|
Although haloperidol was one of the most potent antischizophrenic drugs of its day, it had a what?
|
relatively low affinity for dopamine receptors
|
|
|
|
In the mid-1970s, Snyder assessed the degree to which the various antischizophrenic drugs that had been developed by that time bind to dopamine recepors. What did they do first?
|
added radioactively labeled dopamine to samples of dopamine-receptor-rich neural membrane obtained from calf striatums
|
|
|
|
In the mid-1970s, Snyder assessed the degree to which the various antischizophrenic drugs that had been developed by that time bind to dopamine receptors. What did they do second?
|
They rinsed away the unbound dopamine molecules from the samples and measured the amount of radioactivity left in them to obtain a measure of the number of dopamine receptors
|
|
|
|
In the mid-1970s, Snyder assessed the degree to which the various antischizophrenic drugs that had been developed by that time bind to dopamine receptors. What did they do third?
|
In other samples, they measured each drug's ability to block the binding of radioactive dopamine to the sample; the assumption was that the drugs with a high affinity for dopamine receptors would leave fewer sites available for the dopamine
|
|
|
|
In the mid-1970s, Snyder assessed the degree to which the various antischizophrenic drugs that had been developed by that time bind to dopamine receptors. What did they find?
|
Chlorpromazines & the other effective schizophrenic drugs had a high affinity for dopamine receptors, whereas ineffective antischizophrenic drugs had a low affinity
There were, however, several exceptions, including haloperidol. |
|
|
|
A solution to the haloperidol puzzle came with what discovery?
|
Dopamine binds to more than one Dopamine receptor subtype - actually, there are 5
|
|
|
|
What chemical class does chlorpromazine belong to?
|
phenothiazines
|
|
|
|
What do members (drugs) of the phenothiazine chemical class bind effectively to?
|
both D-1 and D-2 receptors
|
|
|
|
What chemical class does haloperidol belong to?
|
butyrophenones
|
|
|
|
What do members (drugs) of the butyrophenones all bind effectively to?
|
D-2 receptors but not to D-1 receptors
|
|
|
|
The discovery of the selective bindinf of butyrophenones to D-2 receptors led to an important revision in the dopamine theory of schizophrenia. What did this suggest?
|
It suggested that schizophrenia is caused by hyperactivity specifically at D-2 receptors, rather than at dopamine receptors in general.
|
|
|
|
Snyder confirmed that the degree to which neuroleptics bind to D-2 receptors is highly correlated with what?
|
their effectiveness in suppressing schizophrenic symptoms
|
|
|
|
What is the synonym for "neuroleptics?"
|
antischizophrenic drugs
|
|
|
|
Although the evidence implicating D-2 receptors in schizophrenia is strong, it has become apparent that the D-2 version of the dopamine theory of schizophrenia cannot explain what key findings?
|
1) Neuroleptics block activity at D-2 receptors within hours, but therapeutic effects are not manifested for several weeks.
2) Neuroleptics are of substantial benefit to only a small proportion of patients, 1 in 7 3) Neuroleptics tend to act only against Schizophrenia's positive symptoms |
|
|
|
Atypical neuroleptics
|
Often the drugs of choice for the treatment of schizophrenia
drugs that are effective against schizophrenia without binding strongly to D-2 receptors |
|
|
|
What was the first atypical neuroleptic to be licensed for clinical use?
|
Clozapine
|
|
|
|
Clozapine
|
has an affinity for D-1 receptors, D-4 receptors, & several Serotonin & histamine receptors, but only a slight affinity for D-2 receptors
|
|
|
|
It was initially claimed that atypical neuroleptics were more effective in the treatment of Schizophrenia thanthe first-generation neuroleptics and that they did this without producing Parkinsonian side effects. Is this true?
|
Unfortunately, neither of these 2 claims has been unambiguously supported by more recent research.
|
|
|
|
first-generation neuroleptics?
|
D-2 blocking
|
|
|
|
Atypical neuroleptics differ among themselves in what?
|
therapeutic efficacy
pharmacological effects production of side effects |
|
|
|
As a group, atypical neuroleptics' effects do not what?
|
seem to differ substantially from first-generation neuroleptics
|
|
|
|
Psychedelic drugs
|
a drug whose primary action is to alter perception, emotion, and cognition
|
|
|
|
The study of psychedelic drugs began when and why?
|
1950s
the discovery of LSD |
|
|
|
lysergic acid diethylamide?
|
LSD
|
|
|
|
In addition to classical hallucinogens, psychedelic drugs include a variety of other drugs including what (2)?
|
dissociative anesthetics
cannabinoids |
|
|
|
classical hallucinogens?
|
LSD
psilocybin mescaline |
|
|
|
dissociative anesthetics?
|
ketamine
phencyclidine |
|
|
|
New research in hallucinogenic drugs has led to what two important conclusions?
|
1) the effects of classical hallucinogens, such as LSD, mimic the positive symptoms of schizophrenia by acting as agonists of serotonin receptors
2) dissociative anesthetics, such as ketamine, mimic the negative symptoms of schizophrenia by acting as antagonists of glutamate receptors |
|
|
|
Recent research has identified many genes associated with the diagnosis of Schizophrenia. Each gene contributes in what degree to the likelihood of developing Schizophrenia?
|
only slightly
|
|
|
|
Various Schizophrenia-related genes have been shown to disrupt what?
|
neural proliferation & migration
myelination transmission at glutamatergic & GABAergic synapses |
|
|
|
With the development of neuroimaging techniques in the 1960s, reports of brain pathology in patients with schizophrenia accumulated rapidly. The first generation of studies reported what? what did this indicate?
|
enlarged ventricles and fissures
indicated reduced brain size |
|
|
|
Schizophrenia-related brain damage occurred where?
|
both gray and white matter
was most consistently observed in the temporal lobes |
|
|
|
Postmortem studies of schizophrenic brains have found widespread what?
|
neuron loss
abnormalities of neuron structure and circuitry in many parts of the brain |
|
|
|
Because schizophrenia is believed to be a neurodevelopmental disorder, many studies have assessed what?
|
the development of brain damage in patients with schizophrenia
|
|
|
|
Individuals who have not been diagnosed with Schizophrenia but are at risk for the disorder display what?
|
reduced volumes in several brain areas
|
|
|
|
What exists when patients first seek medical treatment and have their first brain scans?
|
extensive brain damage
|
|
|
|
Subsequent brain scans reveal that the brain damage has what in schizophrenic patients?
|
continued to develop
|
|
|
|
Damage to different areas of the brain develops how fast for schizophrenic patients?
|
different rates
|
|
|
|
What is a normal reaction to grievous loss such as the loss of a loved one, the loss of self-esteem, or the loss of health?
|
depression
|
|
|
|
symptoms of people whose tendency toward depression is out of proportion
|
repeatedly fall into the depths of despair and experience anhedonia, often for no apparent reason
depression can be so extreme that it is almost impossible for them to meet the essential requirements of their daily lives sleep disturbances thoughts of suicide |
|
|
|
when out of proportion depression lasts for more than two weeks, this individual is said to have
|
clinical depression OR major depressive disorder
|
|
|
|
affective disorder
|
any psychiatric disorder characterized by disturbances of mood or emotion
|
|
|
|
What kind of disorder is depression?
|
affective
|
|
|
|
what type of disorder is mania?
|
affective
|
|
|
|
Mania symptoms
|
overconfidence
impulsivity distractibility high energy |
|
|
|
Affective disorders are also commonly known as what?
|
mood disorders
|
|
|
|
During periods of mild mania, people are what?
|
talkative
energetic impulsive positive very confident can be very effective at certain jobs can be great fun to be with |
|
|
|
When mania becomes extreme, it is a serious clinical problem. When mania is full-blown, this person often does what?
|
awakens in a state of unbridled enthusiasm
outflow of incessant chatter that careens nonstop from topic to topic no task is too difficult no goal is unattainable |
|
|
|
Many depressive patients experience periods of mania. Those who do are said to suffer from what?
|
Bipolar Affective Disorder
|
|
|
|
Many depressive patients experience periods of mania. Those depressive patients who do not experience periods of mania are said to suffer from what?
|
Unipolar Affective Disorder
|
|
|
|
Depression triggered by a negative experience (i.e., the death of a friend) is called what?
|
Reactive Depression
|
|
|
|
What is depression with no apparent cause called?
|
Endogenous depression
|
|
|
|
In most countries, the probability of suffering from clinical depression during one's lifetime is about what %?
|
10%
|
|
|
|
Compared to men, women tend to be diagnosed with unipolar affective disorder?
|
about twice as frequently as men
|
|
|
|
Is there a sex difference in the incidence of bipolar affective disorder? if so, what is it?
|
no
|
|
|
|
What is the lifetime risk of suicide in an individual diagnosed with clinical depression?
|
5%
|
|
|
|
Affective disorders attack whom?
|
children
adolescents adults |
|
|
|
In adults, affective disorders are associated with what?
|
heart disease
|
|
|
|
In adult women, affective disorders are associated with what?
|
bone loss
|
|
|
|
Twin studies of affective disorders suggest a concordance rate of what % for identical twins?
|
60%
|
|
|
|
Twin studies of affective disorders suggest a concordance rate of what % for fraternal twins?
|
15%
|
|
|
|
Although there are many exceptions, there is a tendency for affected twins to suffer from the same type of disorder, unipolar or bipolar; and the concordance rates for bipolar disorders tend to be what in comparison to rates for unipolar disorders?
|
higher
|
|
|
|
Has any ONE gene been strongly linked to affective disorder?
|
no
|
|
|
|
Most of the research on the causal role of experience in affective disorders has focused on the role of what two things in the etiology of depression?
|
stress and trauma
|
|
|
|
Seasonal Affective Disorder (SAD)
|
attacks of depression and lethargy typically recur every winter
|
|
|
|
What two lines of evidence suggest that attacks experienced in SAD are triggered by the reduction in sunlight?
|
1) The incidence of the disorder is higher in the northern U.S. (9%) than in Florida (1.5%), where the winter days are longer and brighter
2) Light therapy is often effective in reducing the symptoms |
|
|
|
Postpartum Depression
|
intense, sustained depression experienced by some women after they give birth
|
|
|
|
To receive a diagnosis of Postpartum depression, it requires that the depression last for at least how long?
|
1 month
|
|
|
|
Although estimates vary, the disorder seems to develop following about what % of deliveries?
|
10%
|
|
|
|
What was the first antidepressant drug called?
|
Iproniazid
|
|
|
|
What was Iproniazid originally developed for the treatment of?
|
tuberculosis
|
|
|
|
Interest in the antidepressant potential of Iproniazid was kindled by what observation?
|
it left patients with TB less concerned about their disorder
|
|
|
|
When was Iproniazid marketed as an antidepressant drug?
|
1957
|
|
|
|
What class of drug does Iproniazid belong to?
|
Monoamine Agonist
|
|
|
|
What do monoamine agonists do?
|
increase the levels of monoamines by inhibiting the activity if monoamine oxidase (MAO), the enzyme that breaks down monoamine neurotransmitters in the cytoplasm of the neuron
|
|
|
|
MAO Inhibitors are known to have the "cheese effect." Explain what this is.
|
Foods such as cheese, wine, and pickles contain tyramine, which is a potent elevator of blood pressure.
People who take MAO Inhibitors and consume tyramine-rich foods run the risk of strokes caused by surges in blood pressure. |
|
|
|
Name 2 monoamines.
|
Norepinephrine
Serotonin |
|
|
|
Where did tricyclic antidepressants get their name?
|
their antidepressant action and because their chemical structures include 3 rings of atoms
|
|
|
|
What is the first tricyclic antidepressant used called?
|
Imipramine
|
|
|
|
What was Imipramine initially thought to be?
|
an antischizophrenic drug
|
|
|
|
What do tricyclic antidepressants do?
|
they block the reuptake of both Serotonin and Norepinephrine, thus increasing their levels in the brain
they are safer than MAO Inhibitors |
|
|
|
When were selective serotonin-reuptake inhibitors introduced? What were they developed to treat?
|
1980s
treating clinical depression |
|
|
|
What are SSRIs?
|
serotonin agonists that exert agonistic effects by blocking the reuptake of serotonin from synapses
|
|
|
|
What was the first SSRI developed?
|
Fluoxetine or Prozac
|
|
|
|
The remarkable popularity of Prozac and other SSRIs is attributable to what 2 things?
|
1) they have few side effects
2) they act against a wide range of psychological disorders in addition to depression |
|
|
|
What is the major drawback of antidepressant drugs?
|
They often act against depression in bipolar patients by triggering bouts of mania
|
|
|
|
Mood stabilizers
|
drugs that act against mania without increasing depression
|
|
|
|
The mechanism by which mood stabilizers work is unknown, but for some reason many of these drugs are also effective in the treatment of what?
|
epilepsy
|
|
|
|
What was the first drug found to act as a mood stabilizer?
|
Lithium
|
|
|
|
How was Lithium as a treatment for depression discovered?
|
John Cade mixed the urine of manic patients with Lithium to form a soluble salt and injected it inyo guinea pigs to see if it would induce mania.
As a control, he injected Lithium into the control group. The urine solution seemed to calm the guinea pigs & because the Lithium control injections had the same effect, Cade concluded that Lithium, not uric acid, was the calming agent. |
|
|
|
We now know that at the doses John Cade used, lithium salts produce what?
|
extreme nausea
|
|
|
|
Hollon, Thase, & Markowitz compared the efficacy of the various pharmacological treatments for depression. The results were about the same for MAO Inhibitors, tricyclic antidepressants, and selective monoamine-reuptake inhibitors. About what % of clinically depressed patients improved?
|
50%
|
|
|
|
All mood stabilizers act against bouts of mania, and some act against depression, but they do not eliminate all symptoms. Moreover, they often do not reduce the probability of subsequent attacks and produce an array of adverse effects, which encourage what?
|
high rates of nonadherence to prescribed medication
|
|
|
|
Mood stabilizers are often administered in combination with what?
|
atypical neuroleptics
|
|
|
|
what has been found in regards to the brains of bipolar patients?
|
reduction in overall brain size
reduction in tye size of several brain structures |
|
|
|
The pattern of brain atrophy tends to differ from study to study and patient to patient. This suggests what?
|
the diagnosis of bipolar affective disorder may include patients with several different disorders
|
|
|
|
Three structures have been found to be abnormal in many structural and functional brain-imaging studies of affective disorders. What are these three structures?
|
amygdala
medial prefrontal cortex hippocampus |
|
|
|
the search for the neural mechanisms of affective disorders has focused on what?
|
clinical depression
|
|
|
|
None of the prominent theories of depression deals adequately with its relation to what?
|
mania
|
|
|
|
Monoamine theory of depression
|
depression is associated with underactivity of serotonergic and noradrenergic synapses
|
|
|
|
Norepineohrine and Serotonin receptors have been found to be more numerous in the brains of deceased clinically depressed individuals who had not received pharmacological treatment. This implicates a deficit in monoamine release: EXPLAIN. What is this process called?
|
When an insufficient amount of a neurotransmitter is released at a synapse, there are usually compensatory increases in the number of receptors for that neurotransmitter
Called up-regulation |
|
|
|
What two recent lines of evidence have challenged the monoamine theory of depression?
|
1) the discovery that monoamine agonists are not effective in the treatment of most depressed patients
2) the discovery that other neurotransmitters play a role in the development of depression |
|
|
|
Nearly all antidepressant drugs rapidly increase transmission at what synapses?
|
monoaminergic
|
|
|
|
Because therapeutic effects of antidepressants are not manifested until weeks after the beginning of drug therapy, it is clear that the agonistic effects at monoamergic synapses cannot be the critical therapeutic mechanism: What does this suggest?
|
There must be some change that occurs downstream from the synaptic changes
|
|
|
|
Neuroplasticity Theory of Depression
|
depression results from a decrease of neuroplastic processes in the prefrontal cortex, hippocampus, amygdala, and other brain structures which leads to neuron loss and other forms of neural pathology
|
|
|
|
What 2 research provides support for the neuroplasticity theory of depression?
|
1) research showing that stress and depression are associated with the disruption of various neuroplastic processes
2) research showing that antidepressant treatments accelerate neuroplastic processes |
|
|
|
What is ketamine?
|
an antagonist at the NMDA glutamate receptor
|
|
|
|
A single injection of ketamine alleviates what?
|
depressive symptoms within hours
these effects are sustained for over a week |
|
|
|
What is chronic fear that persists in the absence of any direct threat called?
|
anxiety
|
|
|
|
Anxiety is a common psychological correlate of what?
|
stress
|
|
|
|
When anxiety becomes so severe that it disrupts normal functioning, it is referred to as what?
|
An anxiety disorder
|
|
|
|
All anxiety disorders are associated with what?
|
feelings of anxiety
a variety of physiological stress reactions |
|
|
|
What are the physiological stress reactions that can be associated with an anxiety disorder?
|
tachycardia
hypertension nausea breathing difficulties sleep disturbances high glucocorticoid levels |
|
|
|
What are the most prevalent disorders of all psychiatric disorders?
|
anxiety disorders
|
|
|
|
What percentage of people suffer from anxiety disorders at some point in their lives?
|
17%
|
|
|
|
The incidence of anxiety disorders is twice as great in what gender compared to the other?
|
females
|
|
|
|
Generalized anxiety disorders
|
stress responses & extreme feelings of anxiety that occur in the absence of any obvious precipitating stimulus
|
|
|
|
phobic anxiety disorders
|
triggered by exposure to particular objects
|
|
|
|
Agoraphobia
|
the pathological fear of public places and open spaces
|
|
|
|
panic disorders
|
rapid-onset attacks of extreme fear & severe symptoms of stress
|
|
|
|
Obsessive-Compulsive disorders
|
frequently recurring, uncontrollable, anxiety-producing thoughts and impulses
|
|
|
|
posttraumatic stress disorder
|
a persistent pattern of psychological distress following exposure to extreme stress, such as war
|
|
|
|
What is the heritability estimate range for anxiety disorders?
|
30-40%
|
|
|
|
Benzodiazepines are also prescribed as what three things in addition to the treatment of anxiety disorders?
|
hypnotics
anticonvulsants muscle relaxants |
|
|
|
What % of Americans currently take benzodiazepines?
|
10%
|
|
|
|
What are the adverse side effects of benzodiazepines?
|
sedation
ataxia tremor nausea a withdrawal reaction that includes rebound anxiety |
|
|
|
Because benzodiazepines are highly addictive, how should they be prescribed?
|
for only short-term use
|
|
|
|
What are two widely prescribed benzodiazepines?
|
Chlordiazepoxide (Librium)
Diazepam (Valium) |
|
|
|
Which Serotonin agonist is widely prescribed as a treatment for anxiety disorders?
|
Buspirone
|
|
|
|
What is the main advantage of Buspirone over any benzodiazepine? Explain what it does.
|
Its specificity
It produces anxiolytic effects w/o producing ataxia, muscle relaxation, and sedation, the common side effects of benzodiazepines |
|
|
|
What are the main side effects of Buspirone?
|
dizziness
nausea headache insomnia |
|
|
|
One of the complications in studying both anxiety disorders and depression is their tendency to occur together in the same individual. What is this called?
|
Comorbidity
|
|
|
|
Anxiolytic drugs
|
anti-anxiety drugs
|
|
|
|
Elevated-plus-maze test
|
rats placed on 4 armed plus-sign shaped maze 50 cm above the floor
2 arms have sides & 2 arms do not the measure of anxiety is the proportion of tine the rats spend in the enclosed arms, rather than venturing into the exposed arms |
|
|
|
Defensive-burying test
|
rats are shocked by a wire-wrapped wooden dowel mounted on the wall of a familiar test chamber
the measure of anxiety is the amount of time the rats spend spraying bedding material from the floor of the chamber at the source of the shock with forward thrusting movements of their head & forepaws |
|
|
|
Risk-assessment test
|
after a single brief exposure to a cat on the surface of a laboratory burrow system, rats flee to their burrows and freeze
then, they engage in a variety of risk-assessment behaviors before their behavior returns to normal the measures of anxiety are the amounts of time that the rats spend in freezing and in risk assessment |
|
|
|
Existing animal models of anxiety may be models od what rather than anxiety in general, and thus the models may not be sensitive to anxiolytic drugs that act by a different mechanism.
|
benzodiazepine-sensitive anxiety
|
|
|
|
Current theories of the neural bases of anxiety disorders rest heavily on the analysis of what?
|
therapeutic drug effects
|
|
|
|
Tics
|
involuntary, repetitive, stereotyped movements or vocalizations
|
|
|
|
Involuntary cursing is a common symptom of what disorder?
|
Tourette Syndrome
|
|
|
|
When does Tourette syndrome typically begin?
|
usually in childhood or early adolescence
|
|
|
|
Tourette syndrome typically begins early in life with what symptoms?
|
simple motor tics i.e., eye blinking or head movements
|
|
|
|
Common complex motor tics include what
|
hitting
touching objects squatting hopping twirling making lewd gestures |
|
|
|
Common verbal tics
|
inarticulate sounds (barking)
coprolalia echolalia palilalia |
|
|
|
Coprolalia
|
uttering obscenities
|
|
|
|
palilalia
|
repetition of one's own words
|
|
|
|
Tourette syndrome develops in approximately what % of the population
|
0.7%
|
|
|
|
Tourette Syndrome is three times more frequent in what gender compared to the other
|
males
|
|
|
|
What is the concordance rate for Tourette Syndrome in identical twins?
|
55%
|
|
|
|
What is the concordance rate for Tourette Syndrome in fraternal twins?
|
8%
|
|
|
|
Although the tics of Tourette Syndrome are involuntary, they can be temporarily suppressed with what?
|
concentration and effort by the patient
|
|
|
|
What is the greatest difficulty in studying Tourette Syndrome?
|
the fact that symptoms usually subside as people age
|
|
|
|
Most research on the cerebral pathology associated with Tourette syndrome has focused on what?
|
the caudate
|
|
|
|
Patients with Tourette Syndrome typically have smaller what
|
caudate nuclei
|
|
|
|
The neuropathology of Tourette Syndrome appears to be more widespread. An MRI study of children with this disorder documented thinning in what?
|
sensorimotor cortex that was particularly prominent in the areas that controlled the face, mouth, & larynx
|
|
|
|
The tics of Tourette Syndrome are usually treated with what type of drug?
|
neuroleptics
|
|
|
|
Neuroleptics can reduce tics by about what %?
|
70%
|
|
|
|
Research designed to translate basic scientific discoveries into effective clinical treatments
|
translational research
|
|
|
|
studies conducted on human volunteers to assess the therapeutic efficacy of an unexpected drug or other treatment
|
clinical trials
|
|
|
|
What are the three phases to clinical trials?
|
1) screening for safety
2) establishing the testing protocol 3) final testing |
|
|
|
What is the purpose of the "screening for safety" phase of clinical trials?
|
to determine whether the drug is safe for human use and, if it is, to determine how much of the drug can be tolerated
|
|
|
|
What is the purpose of the "establishing the testing protocol" phase of clinical trials?
|
to establish the protocol under which the final tests are likely to provide a clear result
|
|
|
|
placebo-control groups
|
groups of patients who receive a control substance rather than the drug
|
|
|
|
At therapeutic doses, many drugs have side effects that are obvious to people taking them, and thus the participants in double-blind, placebo-control studies who receive the drug can be certain that they are not in the placebo group.
This knowledge may greatly contribute to what? |
the positive effects of the drug, independent of any real therapeutic effect
|
|
|
|
active placebos
|
control drugs that have no therapeutic effect but produce side effects similar to those produced by the drug under evaluation
|
|
|
|
drugs for which the market is too small for them to be profitable are called what?
|
orphan drugs
|
|
|
|
The massive costs of clinical trials have contributed to a translational bottle-neck. What is this?
|
only a small proportion of potentially valuable ideas or treatments receive funding for translational research
|
|
