Exam 2
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Psychosis | show 🗑
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| Schizophrenia | show 🗑
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| show | -does NOT mean split personality
-are NOT unusually prone to violence
-NOT caused by family dysfunction
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| DSM-IV Diagnostic Criteria: Schizophrenia | show 🗑
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| show | -Paranoid:Delusions of persecution/grandeur
-Disorganized:Regressed,silly,inappropriate behav
-Catatonic:motor immobility, stupor,excessive purposeless motor activity
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| show | -Undifferentiated:indicate schizophrenia but fail to meet criteria
-Residual:no active symptoms, continues neg. symptoms
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| Other Psychotic Disorders | show 🗑
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| Schizophrenia Etiology | show 🗑
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| Schizophrenia: Genetics | show 🗑
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| Schizophrenia: Nongenetic Risk Factors | show 🗑
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| show | -Decreased cerebral and cranial size
-Lowered numbers of cortical neurons
-Decreased volume of brain-reduced brain activity in the frontal lobe.
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| show | -Increase in dopamine receptors in the brain's basal ganglia
-Typical antipsychotics reduced or eliminated positive symptoms by dopamine receptor blockage
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| Comorbidity | show 🗑
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| show | -Withdrawn from others
-Depressed
-Anxious
-Phobias
-Obsessions and Compulsions
-Difficulty concentrating
-Preoccupation with self
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| show | -Positive: reflects an excess or distortion of normal function, add something to personality
-Negative: Reflects a lessening or loss of normal function, take something away
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| Positive Symptoms | show 🗑
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| Positive Symptoms: Alterations in Behavior | show 🗑
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| show | -Poverty of speech - limited
-Affective blunting
-Anhedonia
-Social withdraw
-Apathy
-Avolition - no goals
-Poor grooming
-Attentional Impairment
-Anergia
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| Outcome Criteria | show 🗑
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| show | -Auditory hallucinations most common
-Assess if suicidal/homicidal
-Avoid arguing about delusions
-Don't pretend to understand associative looseness1
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| show | -Chlorpromazine HCL, Thoridazine, Fluphenazine, Thiothixene, Haloperidol
-Block dopamine
-Tx of pos symptoms, not neg
-Higher incidence of EPS
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| show | -Sedation
-Orthostatic Hypotension
-Alt. in sex
-Increase appetite
-Decrease tolerance to alcohol/sedatives
-Seizures
-Galactorrhea/Amennorhea
-Gynecomastia
-Jaundice, Agranulocytosis
-NMS
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| show | -Hyperthermia
-Muscular rigidity (stiffness)
-Altered Consciousness
-Autonomic dysfunction: HTN, tachycardia, diaphoresis, incontinence
-Stop drug and treat symptoms
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| show | -Withdraw med
-Cooling blankets, antipyretics
-Dantrolene - muscle relaxer
-Bromocriptine - dopamine receptor agonist
-Benzodiazepines - relieve anxiety and reduce bp, tachycardia
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| EPS: Acute | show 🗑
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| EPS: Late | show 🗑
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| show | -Benztropine, Trihexphenidyl, Diphenhydramine
-Side effects: dry mouth,blurred vision, decrease lacrimation,mydrasis,photphobia, constipation, urinary hesitancy/retention
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| show | -Blocks D2 receptors(low) and serotonin blockage (high)
-Less incidence of EPS
-Effective in treating both of the pos and neg symptoms
-Risperidone,Olanzapine,Quetiapine,Siprasidone,Apriprazole,Clozapine, Paliperidone
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| Atypical Antipsychotics: Side Effects | show 🗑
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| show | -Housing
-Social network and supports
-Finances and benefits
-Education
-Employment
-Transportation
-Stigma/Discrimination
-Nonadherence to Medication Regimen
-Comorbid medical conditions
-Coexisting substance abuses
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| Why don't clients take their medications? | show 🗑
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| Beautiful Minds Can Be Reclaimed | show 🗑
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| show | -Maintenance - hopelessness - Entitlements, Staying out of hosp
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| show | -Rehabilitation - Recovery - Self-sufficiency - Employment - Community reintegration
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| Recovery and Rehabilitation | show 🗑
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| show | -A personal process of overcoming the negative impact of a psychiatric disability despite its continued presence
-Recovery from consequences of the illness can be more difficult than recovery from the illness itself
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| show | -Stigma
-Institutionalization
-Effects of poor/wrong tx
-Lack of opportunities for self-determination
-Neg. side effects of unemployment
-Crushed dreams
-No and/or miseducation about illness
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| Community Resources | show 🗑
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| show | -Daily structure to promote socialization and vocational skills
-May be consumer-driver and involve a "clubhouse" atomostphere
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| show | -Coordinates services
-Provides psychosocial services
-Acts as advocates for clients
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| Community Resources: Community Outreach Programs | show 🗑
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| Topics for Education | show 🗑
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| show | -50% of people with SMI have substance use disorder
-Suicide risk is 3 to 4 times higher in substance abusers
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| show | -Major depression disorder
-Alcohol with panic disorder/depression
-Alcoholism and polydrugism with schizophrenia
-Substance abuse with personality disorder
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| show | -Wernike's encephalopathy
-Korsakoff's psychosis
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| show | -Esophagitis
-Pancreatitis
-Gastritis
-Hepatitis
-Cirrhosis of liver
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| Alcohol and Pregnancy | show 🗑
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| show | -MI
-CVA
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| Alcohol and Infections | show 🗑
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| Alcohol and Respiratory | show 🗑
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| Alcohol and Long term use | show 🗑
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| show | -IV - infections, sclerosed veins, AIDS, hepatitis, endocarditis, cardiac arrest, coma, seizures, PE
-Intranasal - sinusitis, perforated septum
-Smoking - Resp. problems
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| What is Addiction? | show 🗑
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| Biological Theory | show 🗑
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| Psychological Theory | show 🗑
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| show | -Women diagnosed with less substance abuse
-NO SINGLE CAUSE OF SUBSTANCE ABUSE
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| show | One or more in 12 mo
-Inability to fulfill major work, home, school
-Hazardous situations while impaired
-Recurrent legal issues
-Continued use despite recurrent social and interpersonal problems
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| Substance Dependence | show 🗑
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| Synergistic Effect | show 🗑
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| show | -Refers to the weakening or inhibiting the effect of one drug by using another
-Heroin OD and get narcan to block receptors
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| Tolerance and Withdrawal | show 🗑
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| show | -Periods of amnesia during which the person appears to function normally but later does not recall the events that transpired
-Frequent blackouts can be sign of alcohol dependence/addiction
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| show | -Alcohol
-Barbiturates
-Benzo
-Sedatives
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| CNS Depressants: Intoxification | show 🗑
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| CNS Depressants: OD | show 🗑
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| CNS Depressants: Treatment of OD | show 🗑
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| show | -N/V
-Tachycardia
-Diaphoresis
-Anxiety
-Tremors
-Insomnia
-Grand mal sz
-Delerium
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| CNS Depressants: Withdrawal Tx | show 🗑
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| Alcohol Withdrawal | show 🗑
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| show | -Anxiety
-Anorexia
-Insomnia
-Hand Tremor
-"Shaking Inside"
-N/V
-Vivid nightmares
-Illusions
-Sweating
-I HR/BP
-Psychomotor agitation
-Grand mal seizures
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| show | -Medical Emergency - 10% mortality
-Peak 48-72h
-lasts 2-3d
-Altered consciousness
-Changes in cognition - memory/ language impairment,disorientation
-Perceptual Disturbances - hallucinations, illusions
-Fever
-I pulse, BP, diaphoresis
-Seizur
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| CNS Stimulants | show 🗑
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| show | -Pupil dilation
-Dryness oronasal
-Excessive motor activity
-Tachycardia
-I BP
-Twitching
-Insomnia
-Anorexia
-Grandiosity
-Impaired judgment
-Paranoid thinking
-Hallucinations
-Hyperpyrexia
-Convulsions
-Death
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| show | -Dilated pupils
-Dryness of oronasal cavity
-Excessive motor activity
-N/V
-Insomnia
-Grandiosity
-Impaired judgment
-Euphoria
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| Amphetamine Intoxication | show 🗑
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| show | -Resp. Distress
-Ataxia
-Fever
-Convulsions
-Coma
-Stroke
-MI
-Death
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| CNS: Tx of Overdose | show 🗑
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| CNS: Withdrawal | show 🗑
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| CNS: Tx of Withdrawal | show 🗑
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| show | -From Indian hemp plant
-THC active ingredient
-Depressant/Hallucinogenic
-Usually smoked
-Desired effects euphoria, detachment,relaxation
-Long term:lethargy,anhedonia, trouble concentrating,loss of memory,D motivation
-OD&w/drawal rare
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| Opiates | show 🗑
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| Opiates: Intoxication | show 🗑
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| show | -Possible dilation of pupils
-Resp. Depression/arrest
-Coma
-Shock
-Convulsions
-Death
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| show | -Narc antagonist (Narcan)
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| Opiates: Withdrawal | show 🗑
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| show | -Methadone: synthetic opiate
-Clonodine
-Buprenophine: Treat symptoms
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| show | -Trip: slowing of time, lightheadedness, images in intense colors, visions in sound
-BAD trip: severe anxiety, paranoia, terror, distortions in time and distance
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| show | -PCP, angel dust, horse tranquilizer, peace pill
-Route significant: Oral(1h);IV, sniffing,smoking (5 min)
-Symptoms:blank stare, ataxia, musc. rigidity, violence
-High dose:hyperthermia,chronic jerk of extrem. HTN, renal fail
-Suicidal Ideation
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| show | -Result in dulled thinking, lethargy, loss of impulse control, poor memory, and depression
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| show | -Transitory recurrence of perceptual disturbance caused by a person's earlier hallucinogenic drug when he or she is in a drug free state
-Examples: Club drugs - ecstasy, GHB, Rohypnol, LSD
-Can happen with any drug but more common w/ hallucinogen
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| show | -Dilated pupils
-Tachycardia
-Sweating
-Palpitations
-Tremors
-Uncoordinated
-I temp, resp, pulse
-Paranoid
-Anxiety
-Depression/SI
-Synesthesia
-Depersonalization
-Hallucinations
-Bizarre behavior
-Labile
-Violent
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| show | -Minimal Stimuli
-Manage symptoms
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| Inhalants | show 🗑
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| show | -Excitation followed by drowsiness
-Disinhibition
-Lightheaded
-Agitation
-Enhancement of sexual pleasure
-Giggling, laughter
-Damage to nervous system
-Death
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| Inhalants: Tx | show 🗑
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| Club Drugs | show 🗑
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| Club Drug: Effects | show 🗑
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| show | -Flunitrasepam (Rohypno) or Roofies
-GHB-y-Hydroxybutyric acid
-Rapidly produce: disinhibition, relaxation of voluntary muscles, retrograde amnesia
-Alcohol synergistic drug
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| show | -Most important Question: When did you last drink/use?
-In last year have you ever drunk or used drugs more than you meant to?
-Have you felt you wanted or needed to cut down on your drinking or drug use in the last year?
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| show | -Denial (Hallmark sign)
-Depression
-Anxiety
-Dependency
-Hopelessness
-Low self esteem
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| Quick Screening Tools (CAGE) | show 🗑
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| show | -Blood Alcohol Level
-Legal limit in OH = .08
-How many drinks? 1 or 2
-Lethal BAL = .5
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| Defense Mechanisms | show 🗑
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| Planning | show 🗑
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| Codependency | show 🗑
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| Enabling Behaviors | show 🗑
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| Dual Diagnosis | show 🗑
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| Relapse Cycle | show 🗑
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| show | -Overall chance of a substance disorder in a patient seeking psychiatric treatment is 1 in 2
-Highest occurrence: Antisocial Personality Disorder, Bipolar, Schizophrenia, Mood
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| Effects of drugs on mental illness | show 🗑
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| show | -Mask or cause psychiatric symptoms or may mimic:substance use,w/drawal
-Substance can initiate/exacerbate psychiatric disorder
-Psychiatric&subsatnce use disorders can exist independently
-Psychiatric behaviors can mimic alcohol/other drug problems
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| show | -Primary mental illness w/subsequent substance abuse
-Primary substance abuse disorder w/ psychopathologic sequelae
-Dual primary diagnosis (both @ same time)
-Common Etiology
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| Barriers to Treatment | show 🗑
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| Mood | show 🗑
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| Affect | show 🗑
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| Major Depressive Disorder Characteristics | show 🗑
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| MDD - DSM-IV-TR Criteria -Change in previous functions -Symptoms cause clinically significant distress or impair social, occupational or other important areas of functioning | show 🗑
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| show | -Psychotic (voices, delusions)
-Catatonic
-Melancholic
-Postpartum onset (4wks after birth)
-SAD
-Atypical: hypersomnia,overeating -seen in young ppl
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| show | -Premenstral dysphoric disorder
-Mixed anxiety-depression
-Recurrent brief depression
-Minor depression
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| show | -Chronic depressive syndrome
-Present for most of the day
-More days than not
-At least 2 years
-Hosp. rare
-Early age of onset, still able to function
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| Depression Epidemiology | show 🗑
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| show | -Schizophrenia - go on schizo drugs and relieve symptoms but realize they'll have to be on them for the rest of their life and become depressed
-Substance abuse
-Eating disorders
-Anxiety disorders
-Personality disorders
-Medical disorders - fibromya
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| show | -Biological:genetic,biochemical(serotonin, NE), Alt. in hormonal regulation, Diathesis-stress model
-Psychological:Beck's Triad (neg.view of self, world, future), learned helplessness
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| Depression Recovery Model | show 🗑
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| show | -The acute phase (6-12wks): psychiatric mngt and initial tx
-The continuation phase (4-9mos): tx continues to prevent relapse
-The maintenance phase (1+yrs):continuation of antidepressants to prevent relapse;edu=relapse prevention
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| Basic Level Interventions: Depression | show 🗑
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| show | Psychotherapy
-Cognitive Behavioral Therapy (most common)
-Interpersonal Therapy
-Time-Limited focused psychotherapy
-Behavior Therapy (coping and social skills)
Group Therapy:important in maintenance phase
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| Antidepressants: SSRIs | show 🗑
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| New Atypical Antidepressants | show 🗑
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| show | -Neurotransmitter: NE and Serotonin
-Indications: Depressive Disorders
-Adverse Effects: anticholinergic effects, orthostatic hypotension
-Contraindications: MAOIs, MI, pregnancy, seizures, glaucoma
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| show | -Neurotransmitter: block MAO, I serotonin and NE
-Indications: depression, anxiety
-Adverse Effects: I BP, could result in sz or stroke
-Interactions: Food (tyramine)
-Contraindications: stroke, sz, other drugs
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| show | -Electroconvulsive Therapy (ECT)
-Indications
-Transcranial magnetic stimulation
-Vagus Nerve Stimulation
-Light therapy
-St. John's wort
-Exercise
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| show | -Use of electrically induced sz for the tx of severe depression
-Indications:Elderly,non responsive to drug therapy
-80% effective
-Contraindications:severe cardiac disease,HTN,lesions of brain/spinal cord
-Side Effects:memory loss transient,confusion
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| show | -6-12txs over 3-4wks
-Admin. anticholinergic
-Prebreathe O2
-Anesthetic
-Air way w/ventilator assist
-bilaterlly,unilaterally
-Musc contraction
-Tonic/Clonic phase(barely noticeable)
-Spontaneous breathing w/in 60-120 sec
-Regain consciousnes
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| Complementary Therapies | show 🗑
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| show | -Release energy
-Increase feelings of well being
-Increase feelings of control and accomplishment
-Walking, jogging, swimming, aerobics, weight lifting
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| show | -Exposure to bright artificial broad spectrum light for a prescribed period each day
-Usually in the morning before sun comes up
-Usually for 30 minutes
-Client must face the light
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| Bipolar Disorder | show 🗑
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| Epidemiology | show 🗑
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| Etiology | show 🗑
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| Self-Assessment | show 🗑
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| Bipolar: Assessment | show 🗑
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| show | -Acute Phase:Stabilization, prevent injury
-Continuation Phase:relapse prevention,education
-Maintenance Phase: goal limit relapse occurrence and limit periods out of normal
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| Bipolar: Planning | show 🗑
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| Bipolar: Lithium Carbonate | show 🗑
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| Bipolar: Anticonvulsant | show 🗑
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| show | -Antianxiety: Clonazepam, Lorazepam
-Atypical Antipsychotics: Olanzapine, Risperidone
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| show | -Electroconvulsive Therapy: can be used for mania or depression
-Milieu management
-Support groups
-Health teaching and health promotion
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| Sleep Disorders | show 🗑
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| show | -Excessive sleepiness
-Serious enough to: impact social, vocational functioning, increase risk for accident/injury
-Comorbidity: sleep apnea - HTN, HF - fewer antibodies can't fight infection, obesity, diabetes; addiction
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| show | -Varies from individual to individual; most adults require 7-8h each night
-Long sleepers: require more than 10h each night
-Short sleepers: can function effectively on few than 5h per night
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| Normal Sleep Cycle | show 🗑
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| show | -Complex interaction b/w 2 processes: homeostatic process or sleep drive promotes sleep; Circadian process or circadian drive promotes wakefulness
-Influenced by endogenous factors (neurotransmitters, hormones) or exogenous factors (light and dark)
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| Sleep Disorders | show 🗑
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| Dyssomnias | show 🗑
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| Primary Insomnia | show 🗑
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| Dx of Primary Insomnia | show 🗑
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| show | -Conditions and practices that promote continuous and effective sleep
-Bed used only for sleep
-Sleep ritual
-Reduce stimuli
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| Pharmacological Interventions:Primary Insomnia | show 🗑
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| Herbals: Pharmacological Interventions | show 🗑
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| Parasomnias | show 🗑
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| Sleep Disorders related to other mental disorders | show 🗑
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| show | -Sleep disorders due to a general medical condition
-Substance-induced sleep disorders
-In both sleep disorders, sleep disturbances maybe: insomnia, hypersomnia, parasomnia, combination
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| Relaxation Therapies | show 🗑
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| show | -Stimulus control: decrease neg. associations b/w the bed and bedroom
-Sleep restriction: limiting sleep creates a mild sleep deprivation
-Sleep hygiene
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