Term
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Definition
| Wellness Recovery Action Plan |
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Term
Mental Status Exam
"A Sane Man Thinks Pretty Clearly" |
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Definition
A: Appearance, Attitude, Activation
S: Speech
M: Mood/Affect
T: Thought Content & Process
P: Perceptions - Hallucinations or Illusions
C: Cognition (MMSE)
Full mental status exam - do on anyone on psych drug or high risk of psych disorder. |
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Term
| Major Depressive Episode Diagnosis |
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Definition
During a 2 wk period, 5 or more of the following:
-Depressed Mood
-Loss of interest/pleasure
-Weight loss/gain
-Change in sleep
-Change in activity
-Fatigue
-Worthlessness or guilt
-Decreased ability to think, concentrate, make decisions
-Recurrent thoughts of death
Symptoms cause impairment in daily functioning
Must have either one of the first two |
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Term
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Definition
A distinct period greater than 1 week of persistent increase, expansive or irritable mood with greater than or equal to 3 of these:
-inflated self-esteem, grandiosity
-decreased need for sleep
-more talkative/pressured speech
-flight of ideas
-distractibility
-psychomotor agitation/over-activity
-excessive involvement in pleasure activities
Symptoms result in marked impairment in social functioning |
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Term
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Definition
| Manic episode criterion met without marked impairment of social or occupational functioning |
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Term
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Definition
Manic: at least 1 episode
Depressed: at least 1 manic episode, currently depressed
Mixed: history of manic and depressive episodes |
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Term
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Definition
Presence or hx of greater than or equal to 1 major depressive episode
Presence or hx of greater than or equal 1 hypomanic episode
No hx of a manic episode
Sx's cause significant stress or impairment |
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Term
| Cyclothymic Disorder (Bipolar III) |
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Definition
For at least 2 years, numerous hypomania and depressive symptoms (not major depression)
15-20% risk of developing bipolar disorder |
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Term
Bipolar
-onset?
-which phase more prolonged?
-% attempt suicide
-family hx? |
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Definition
onset: mid-teens to 30's; 90% recurrence depressed phase more prolonged
25% attempt suicide-15% suicide rate!
family hx: 5-10x more common (25%) |
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Term
| Neurotransmitters for mania & depression |
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Definition
Mania: excess norepinephrine & epinephrine; excess dopamine
Depression: depleted serotonin |
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Term
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Definition
Lithium - 80% effective
Anticonvulsants
Anti-psychotics
Depression without mania: Lamictal, Lithium, Seroquel, Zyprexa, SSRI's |
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Term
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Definition
Gross impairment in a person's ability to
-think
-communicate
-interpret reality
-behave appropriately to a situation
Interferes with the ability to meet ordinary demands of life |
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Term
Schizophrenia
-definition?
-characteristic symptoms?
-prevalence?
-onset? |
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Definition
Definition: syndrome or group of disorders
Char sx's: 2 or more of these for at least 1 month:
-delusions
-hallucinations
-disorganized speech
-grossly disorganized behavior
-negative symptoms
Prevalence: 1% worlwide
Onset: late adolescence or early adulthood with men diagnosed earlier than women |
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Term
Schizophrenia
1st 4 characteristics (positive symptoms) |
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Definition
1. Hallucinations: usually visual and auditory
2. Delusions: 75% (persecutory, grandiose, somatic, ideas of reference)
3. Disorganized speech: disorganized thought
4. Grossly disorganized or bizarre behavior |
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Term
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Definition
| Symptoms added to your regular personality |
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Term
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Definition
| taking away from your personality |
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Term
| Schizophrenia 5th characteristic |
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Definition
Affective flattening
Alogia: poverty of speech, thought blocking
Avolition: anhedonia, apathy, anergia, attention deficit |
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Term
| Neurotransmitters with Schizophrenia |
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Definition
Dopamine excess
Serotonin
Norepinephrine
Glutamate
Amino Acids (GABA) |
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Term
| Schizophrenia Prodromal Phase |
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Definition
Social W/D
Odd behavior or speech
Ideas of reference
Odd perceptual experience/illusions
Changes in hygiene and role functioning
Decreases in motivation, energy, or initiative |
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Term
| Schizophrenia - Active Phase |
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Definition
| prominent psychotic symptoms |
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Term
| Schizophrenia - residual phase |
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Definition
Persistence of symptoms of the prodromal phase
No return to previous level of functioning |
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Term
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Definition
| prominent delusions or hallucinations |
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Term
| Disorganized Schizophrenia |
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Definition
| prominent abnormalities in speech and behavior with inappropriate or flat affect |
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Term
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Definition
| prominent bizarre behaviors |
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Term
| Undifferentiated Schizophrenia |
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Definition
| Does not meet criteria for other subtypes |
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Term
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Definition
| prominent negative symptoms (absence of positive symptoms) |
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Term
| Poor prognosis for Schizophrenia if? |
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Definition
-early, insidious onset
-no precipitators
-frequent relapses
-poor premorbid hx
-autism
-not married, less support
-family hx of schizo.
-prominent negative symptoms
-hx of perinatal trauma |
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Term
| Schizophrenia Comorbities |
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Definition
-20% decrease in life expectancy
-80% substance abuse
-75% nicotine abuse
-Chronic medical conditions: Hypothyroidism, COPD, Hep C, fluid/electrolyte imbalances, increased XOL/DM, HTN, Metabolic Syndrome |
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Term
|
Definition
Symptoms:
-Delusions
-Hallucinations
-Disorganized Speech
-Grossly disorganized behavior
-Negative symptoms
During the same period of time, there is a major depressive episode, manic episode, or mixed episode. |
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Term
| First Line meds for schizophrenia |
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Definition
2nd generation (atypical) anti-psych: increase negative and positive symptoms
-Geodon
-Risperdal
-Seroquel
3rd generation anti-psych: dopamine system stabilizers
-Abilify |
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Term
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Definition
1st generation anti-psych: used less secondary to SE's
-Haldol
-Prolixin
-Thorazine
-Mellaril
Other 2nd generation anti-psych: special prescribing license required
-Clozaril |
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Term
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Definition
| inability to identify and respond to bodily sensations such as hunger & fullness. |
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Term
| Etiology of Eating Disorders |
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Definition
Neuro: brain abnormalities, altered serotonin, pathway
Genetic: monozygotic twins, 12x likely if female relatives have it
Psych: fear of sexual maturity, hx sexual abuse, low self-esteem and over-valued social ideas, controlling, perfectionist, chaotic, and emotionally expressive
Cultural: western women higher risk- ? social roles
Bio-psychosocial: anxiety d/o, personality d/o, mood d/o, substance abuse |
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Term
Anorexia Nervosa
-onset?
-prevalence?
-course?
-prognosis?
-mortality? |
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Definition
onset: early adolescence
prevalence: females - 1%, males - 0.3%
course: less than 2 yrs (shorter than bulimia)
prognosis: 50% develop bulimia
30-40% recover
25-30% improve
15-20% do not improve
mortality: 2-18% usually from cardiac arrest |
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Term
| Diagnostic Criteria of Anorexia Nervosa |
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Definition
A: refusal to maintain weight greater than 85% ideal
B: intense fear of gaining weight or becoming fat, even though underweight
C:Body image distortion, unrealistic self-eval. based on body weight or denial of the seriousness of low body weight
D: Absence of at least 3 consecutive menstrual cycles |
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Term
| 2 types of anorexia nervosa |
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Definition
1: Restricting- No regular binge-eating or purging behavior
-starvation with food preoccupation
-forced metabolism (exercise, caffeine, other stimulants)
2: Binge-Eating/Purging:
-self-induced vomiting
-diuretics
-laxatives
-enemas |
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Term
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Definition
-A & O but c/o difficulty thinking, impaired memory, "brain fog": metabolic encephalopathy
-preoccupied with thoughts of food and fear of gaining, weight
-peculiar handling of food
-cold extremities, acrocyanosis, pitting edema
-lanugo: dull, thinning scalp hair
-hypothermia, bradycardia, hypotension
-sunken cheeks, sallow skin |
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Term
| Criteria or Anorexia Nervosa Hospitalization |
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Definition
-weight loss greater than 30% over 6 months
-not gaining weight with outpt tx
-hypothermia or dehydration
-HR less than 40bpm
-systolic BP less than 70
-hypokalemia/electrolyte imbalance
-ECG changes
-suicidal ideation, psychosis and/or inability to comply with outpt tx |
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Term
| Treatment for Anorexia Nervosa |
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Definition
Medically stable and refer!
Interdisc. team approach
Tx goals:
-resolve body image disturbance
-develop healthy effective coping skills
-develop healthy gender and role image
-develop healthy family communication |
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Term
Bulimia Nervosa
-onset?
-prevalence?
-course?
-weight? |
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Definition
onset: late adolescence, early adulthood
prevalence: women 1.5%, men 0.5%
course: usually symptomatic greater 8 years
weight: usually at or just slightly above/below ideal weight |
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Term
| Diagnostic criteria of bulimia nervosa |
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Definition
A: Recurrent episodes of binge eating, eating large amounts of food within a 2 hr period of time, sense of lack of control over eating during episode
B: recurrent inappropriate compensatory behavior to prevent weight gain
C: binge eating and compulsive behavior at 2x/week
D: self-evaluation based on body shape and weight |
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Term
| Complications of bulimia nervosa |
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Definition
-cardiac and skeletal myopathies
-menstrual irregularities
-altered bowel elimination patterns
-esophageal tears
-gastric rupture
-fluid & electrolyte abnormalities
-peripheral edema
-metabolic alkalosis or acidosis |
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Term
| Treatment off bulimia nervosa |
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Definition
-usually outpt tx
-cognitive-behavior tx
-meds: SSRI's, esp. Prozac
-nutrition counseling
-therapeutic relationships |
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Term
Binge Eating D/O
-s/s?
-tx? |
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Definition
-currently proposed dx
-impaired control of eating with recurrent
episodes of binging
-NO fasting or purging
-associated with obesity
-more common in women
Tx: cognitive-behavioral therapy, meds: SSRI's esp. Zoloft |
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