Psychopathology Midterm Study Guide
Psychopathology Midterm Study Guide
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Date Created: 05/12/14
History and Concepts 4192009 94700 PM Asylums Institutions whose primary purpose was to care for people with mental illness o Once they started to overflow they became virtual prisons where patients were held in filthy conditions and treated cruelly Comorbidity The presence of two or more disorders in a single person Course of Illness How a disorder or illness progresses from the time of diagnosis to the time of death Deinstitutionalization Process of replacing long stay asylums with community mental health services Based on the views of moral treatment Institutions had become isolated untherapeutic and overcrowded Demonological View Regarded abnormal behavior as the work of evil spirits Battle of good and evil where abnormal behavior was the resultant of evil winning Treatments included trephination and exorcism Diagnosis After hearing their symptoms figure out what kind of suffering is going on attempt to label a nosology category to the patient 0 A determination that a person39s problems reflect a particular disorder Etiology o Study of causation of pathologies General Paresis and Malarial Cure General paresis is caused by syphilis a disorder affecting the brain and central nervous system Malarial cure discovery that use of penicillin to treat syphilis lead to full recovery Humoral Theory Hippocrates abnormal behavior as a disease from internal physical problems 0 Each of the four humors bodily chemicals were thought to have a different effect on the body and personality o The humors were yellow bile choleric black bile melancholic blood sanguine and phlegm phlegmatic 0 ie yellow bile drives a husband to beat his wife Hysteria Used to describe conversion disorder somatization disorder and pain disorder associated with psychological factors Incidence The number of new cases of a disorder occurring over a specific period of time IQ tests Results represent the person39s mental age to his or her chronological age o Measure a person39s intellectual ability Mesmerism Friedrich Mesmer Had his patients who suffered from hysterical disorders sit in a darkened room filled with music then he appeared dressed in a costume and touched the troubled area of each person39s body with a special rod Moral Treatment Emphasized moral guidance and humane and respectful treatment when treating those with a mental illness o Philippe Pinel and William Tuke 19 century Neuropsychological tests A test that detects brain impairment by measuring a person39s cognitive perceptual and motor performances Bender Visual Motor Gestalt Test patients look at simple designs and copy them onto a piece of paper Nosology The science of classification how human suffering is categorized into different types how they are distinguished from one another scheme of classification Pharmacogenomics Concerned with developing drug therapies for patients with disordersillnesses Phrenology Bumps on the skull were considered areas of personality traits Premenstrual dysphonic disorder PMDD basically sever PMS o 5 to 11 symptoms during the week before the menses sad or hopeless feelings tense or anxious feelings marked mood changes frequent irritability or anger and increased interpersonal conflicts decreased interest in usual activities lack of concentration lack of energy changes in appetite insomnia or sleepiness feeling overwhelmed out of control physical symptoms such as swollen breasts headaches muscle pain bloated weight gain Prevalence o The total number of cases of a disorder occurring in a population over a specific period of time Prognosis The prediction of the probable course of an illness Projective assessment Require that subjects interpret vague stimuli such as inkblots or ambiguous pictures or follow openended instructions such as draw a person Psycho physiological tests amp polygraph Measure physiological responses as possible indicators of psychological problems 0 States of anxiety are accompanied by the physiological changes increases in heart rate body temperature blood pressure sweat muscle contraction Psychogenic view of mental illness The chief causes of abnormal functioning are psychological Selfreport inventories Aka personality inventory a test designed to measure broad personality characteristics consisting of statements about behaviors beliefs and feelings that people evaluation as either characteristic or uncharacteristic or them MMPI 50O true false cannot say The statements describe physical concerns mood morale attitudes toward religion sex and social activities psychological symptoms ie hallucinations Assessment and Diagnosis 4192009 947 00 PM Alternative ways of defining psychopathology Deviance from culture norms they violate a society39s ideas about proper functioning o Distress behaviors ideas or emotions cause distress and proceed abnormal behavior Dysfunction behavior that interferes with daily functions Danger behavior that is dangerous to one s self and others Clinical interview Signs Noted in Clinical Interview 0 O O Attire amp grooming Posture Physical characteristics Skin tone complexion Weight stature Symmetry atrophy bodily anomalies Mannerisms spasms or tics Speech Articulation Prosody tone of voice is it normal abnormally flat or abnormally pitchy Consciousness Level of alertness fogginess hyper alert Emotional state General attitude Defiant compliant guarded defensive sincere plaintive resistant apathetic etc Thought content Solicited by free inquiry delusions false beliefs Thought processes Thought broadcasting your thoughts have become available to everyone removal insertion hallucinations false experiences auditory hallucinations hearing voices General knowledge General facts pop culture Abstract thinking O O 0 Social judgment Insight Cognitive functioning Usually current mental status via MMSE Mini Mental Status Exam Neuropsychological screens like clock drawing Mini Mental Status Exam MMSE O Orientation up to x3 Time year season date day month Place state county city facility Person name age Registration Slowly say the names of 3 common objects apple table penny and ask patient to repeat them Attention amp calculation Serial 739s or WOR LD backwards Recall Ask for names of 3 objects above Language Name a pencil and a watch when pointed to Repeat No ifs ands or buts Follow a 3 stage command Take a paper in your right hand fold it in half and put it on the floor Read and obey the following CLOSE YOUR EYES Write a sentence Copy the following design Clock Drawing as a Neurological Screen have them draw a clock where and how they lay it out can suggest a diagnosis Epidemiological studies Reveals the incidence and prevalence of a disorder in a particular population without trying to predict or explain when or why it occurs a They interview people on large scales Prevalence the total number of cases during a given period of time Incidence the number of new cases that emerge during a given period of time Signs and Symptoms Signs objective evidence or a manifestation of the illness 0 Can be seen or measured ie rash 0 Observable markers Symptoms things that only the patient can seefeel 0 Hallucinations are a symptom 0 Patient reports Somatogenic view of Mental Illness Abnormal psychological functioning has physical causes Structured types of assessment Clinical interview face to face interview where clinician asks questions of client weigh responses and reactions and learn about them and their psychological problems Syndrome A cluster of symptoms that usually occur together Trephination A trephine a stone instrument was used to cut a circular section of the skull as treatment for severe abnormal behavior involving hallucinations or melancholia depression Purpose to release the evil spirits that were causing the problem Types of brain imaging some problems in personality or behavior are caused primarily by damage to the brain or changes in brain activity 0 EEG electroencephalogram records brain waves which is the electrical activity taking place as a result of neurons firing 0 CATCT scan computerized axial tomography X rays of the brain are taken at different angles 0 PET scan positron emission tomography a computer produced motion picture of chemical activity throughout the brain o MRI magnetic resonance imaging uses magnetic property of certain atoms in the brain to create a detailed picture of the brains structure and activity AdvantagesDisadvantages of external validity the degree to which the results of the study may be generalized beyond the study a internal validity the accuracy with which a study can pinpoint one of various possible factors as the cause of a phenomenon Clinical case study case history 0 source of new ideas about behavior may offer tentative support for a theory may challenge a theory s assumptions may inspire new therapeutic techniques present opportunities to study unusual problems that do not occur often enough to permit a large number of observations 0 therapists who have a personal stake in seeing their treatments succeed become biased observers these studies rely on subjective evidence internal validity generalization bias does this cause apply to everyone external validity Experimental methods 0 blind design random assignment experimental group control group 0 mostly still in a lab not real life situations Correlation methods o possesses high external validity 0 does the sample accurately reflect a real correlation in the general pop lack internal validity they show a relationship but don39t explain it do not mean causation Experimental Studies Experiment groups the subjects exposed to the independent variable Control groups subjects who are not exposed to the IV Blind designs an experiment in which the subjects do not know whether they are in the experimental or the control condition o So that participants do not bias an experimenter s results Experimenter bias bias towards a result by the experimenter the inability for a human to remain completely objective Natural experiment nature itself manipulates the IV while the experimenter observes the effects o Used to study the psychological effects of unusual and unpredictable effects such as floods earthquakes plane crashes and fires a Analogue experiment induce lab subjects to behave in ways that seem to resemble reallife abnormal behavior and then conduct experiments on the subjects in the hope of shredding light on the real life abnormality o Sometimes use animals but mostly humans Singlesubject experiment a single subject is observed and measured both before and after the manipulation of an independent variable 0 Rely on baseline data info gather prior to manipulation Rosenhan experiment 8 normal people faked symptoms of schizophrenia and were hospitalized 0 reverted to normal behavior following admission 0 none were un diagnosed after weeks of in hospital 0 after their stays discharged as schizophrenia in remission Rosenhan s Conclusions mental disorder is a matter of social labeling and the mental health profession is a matter of social control Criticisms o Most psychiatric patients get better quickly under confines of the hospital so they couldn39t tell they were faking it 0 Hospital admissions don39t expect people to lie about being mentally ill MMPI 2 personality inventory 567 items objectively scored includes selfstatements that are true false or cannot say The statements describe physical concerns mood morale Attitudes toward religion sex and social activities Includes psychological symptoms like fears and hallucinations Interpretation value overview of TAT thematic apperception test pictorial projective test viewers shown 30 black and white picture of people in vague situations and asked to make up a dramatic story about each card Rorschach administration patients interpreted inkblots images the viewer saw seemed to correlate with their psychological condition Psychodiagnosis o Advantages and disadvantages 0 A valid and consistent definition of mental disorder will produce no false positives and no false negatives 0 People with mental dosprdersgt social stigma 0 Excuse abuse by criminals Type of information that go into it o Phenotypic Signs symptoms course outcome response to treatment 0 Genotypic cause laboratory tests Diagnosis or assessment Semantic vs prototype conceptions of diagnosis o Definition vs prototype Phenotypic vs genotypic diagnosis 0 Phenotypic Signs symptoms course outcome response to treatment In mental health most diagnosis are phenotypic o Genotypic Cause and laboratory tests Physical medicine consists of moving from a phenotypic to genotypic diagnosis DSM IV TR conception of mental disorder 0 a clinically significant behavior or psychological syndrome or pattern that occurs in an individual associated with present distress disability significant risk of suffering death pain disability or loss of freedom 0 Axis I an extensive list of clinical syndromes that typically cause significant impairment o Axis II includes long standing problems that are frequently over looked in the presence of disorders on Axis I o AXIS III general medical conditions that the person may be suffereing o Axis IV special psychological or environmental problems o Axis V GAF GAF Scale global assessment of Functioning rate a person39s psychological social and occupational functioning overall Depression 4192009 94700 PM CognitiveMotivational vs Neurovegetative SignsSymptoms of Major Cognitive 0 Pervasive sadness guilt or feelings of worthlessness o Recurrent thoughts of death or suicide Motivational 0 Pervasive anhedonia losing all sense of pleasure in life a Neurovegetative o Significant change in weight Sleep disturbance Psychomotor agitation or retardation Pervasive fatigue or loss of energy Difficulty concentrating Depression and cultural specificity Nonwestern depressed people tend to have fewer cognitive symptoms negative views of themselves and more physical symptoms such as fatigue weakness and sleep disturbances Anaclitic and Post partum depression possible etiologies of post partum depression Postpartum may last up to a year extreme sadness intrusive thoughts compulsions feeling of inability to cope suicidal thoughts o Hormonal changes accompanying childbirth may trigger postpartum depression all women experience a hormonal withdraw after delivery 0 May be a genetic predisposition to postpartum depression 0 Babies may suffer from their mother39s depression anaclitic depression a pattern of depressed behavior found among small children that is caused by separation from one s mother Atypical depression Atypical Depression hysteroid dysphoria reversed neurovegetative signssymptoms o Weight gain carbohydrate binging 0 Hypersomnia o Leaden paralysis o Interpersonal rejection sensitivity Often 0 Histrionic traits very dramatic OOOO o Selfmedication with caffeine or chocolate Sometimes uniquely responsive to MAO Inhibitors Sex ratios in prevalence of Major Depression possible explanations and implication of Amish findings Why Are Women Diagnosed with Depression Twice as Much as Men Some Possibilities 0 X inked depression genes Premenstrual symptoms Quality of female vs male life Female masochism Freud Cognitive style Females dwell on problems Males ignore or escape them Male depression masked by alcohol drug abuse Amish study Genetic evidence on incidence of depression Family pedigree twin adoption and molecular biology gene studies all reveal that a person is at elevated risk of depression if they have a family history of depression as compared to the general population Kinding and depression risk Each Depression Increases the Risk of Later Depression Regardless of Life Stress Psychotic features in severe Major Depression Learned helplessness model of depression and limitations Based on past experiences one learned to have no control over one s rewards and punishments one is responsible for this helpless state Limited to laboratory and mostly animal subjects anxiety not always a factor in depression Types of psychotherapy for Major Depression rationales evidence for effectiveness OOOOOOO Brain changes including BDNF neocortical and neurotransmitter disturbances in depression and possible mechanisms of action of major classes of antidepressant drugs Brain derived neurotrophic factor BDNF the activity of key neurotransmitters or hormones ultimately leads to deficiencies of important proteins and other chemicals particularly in the chemical BDNF The endocrine system may play a role in depression release hormones people with depression seem to have abnormal levels of cortisol which is released in times of stress Depression may be caused by abnormal levels of the neurotransmitters serotonin dopamine norepinephrine and acetylcholine Medical disorders that can mask as major depression Hyperthyroidism Low Testosterone or Estrogen levels Undiagnosed illness eg infectious mononucleosis Anemia Chronic Fatigue Syndrome Types of antidepressant medications uses in depression and other disorders side effects precautions and general drug classes you will not need to recall any specific drug names The drugs do not cure depression they treat the symptoms and only work as long as they are taken 0 Monoamine Oxidase Inhibitors MAO Inhibitors Introduced in the late 195039s Had severe dietary restrictions and very unpleasant side effects and are no longer in common use Get suicidal eat peanut butter or something else on restricted diet list 0 Tricyclics Introduced in the early 196039s very unpleasant side effects eg weight gain dry mouth constipation dizziness blurred vision and are no longer in common use Hypotension get out of bed too fast faint Cardiotoxic poison for the heart Suicidal could down their pills 0 Selective Serotonin Reuptake Inhibitors SSRI s Introduced in the late 198039s and revolutionized medication treatment for depression ie Prozac very hard to OD just bodily side effects o Atypical Antidepressants Introduced beginning in the 196039s and through the 200039s Various kinds with various modes of action Together the most prescribed class of current antidepressants Relationship between antidepressant medication and suicidality ECT nature of treatment effectiveness and side effects Works fastest of any therapy for depression o Mechanism of action unknown Has fewest side effects of any therapy for depression very high satisfaction ratings Sometimes causes spotty memory losses episodic gtgt semantic Usually applied only to right hemisphere to minimize speech disturbance Abused in past and now used only as a last resort and for most severe cases Comparative effectiveness of medications vs psychotherapy for Major Depression o ECT works fastest for most people and with fewest side effects 0 Medication and psychotherapy esp cognitive or interpersonal therapy work equally well for most people but medication works faster o For adults a combination of therapy and medication seems no more beneficial than either one alone for adolescents a combination is preferred For adolescent depression current recommendation is an SSRI by 2009 two were FDAapproved for adolescents Prozac and Lexapro plus cognitive behavior therapy Overview of SADs seasonal affective disorder and phototherapy Melatonin is released in the pineal gland melatonin secretions increases during winter season calls for less energy and more rest Phototherapy increased exposure to artificial light or talking long walks outside seem to be effective Suicide Highrisk groups major triggers warning signs biological contributors sociocultural aspects Those with a serious illness abusive environment and occupational stress Sudden change in mood 0 Sense of hopelessness and dichotomous thinking everything is eitheror Modelinggenetics suicide in the family Older white males Findings of TADS study and implications for childhood and teenage depression treatments Compared the effectiveness of cognitive therapy alone antidepressant therapy alone cognitive and antidepressant therapy together and placebo therapy for teenage depression Findings Cognitive therapy antidepressant therapy is best cognitive therapy is useless alone and antidepressant therapy alone is better than no therapy at all Case Descriptions and Anxiety 4192009 947 00 PM Depression Post partum vs Baby blues 0 Baby blues disappear within days or weeks has to do with coping with wakeful nights rattled emotions of having a new baby and can cause crying spells fatigue anxiety insomnia and sadness 0 Postpartum may last up to a year extreme sadness intrusive thoughts compulsions feeling of inability to cope suicidal thoughts Anxiety Disorders Brain areas neurotransmitters and ANS involvement in anxiety Physical conditions that can masquerade as anxiety disorders Hyperthyroidism Pheochromocytomas adrenal tumors that over secrete adrenalin Inner ear disease Angina pectoris Hypoglycemia Mitral valve prolapse Cardiac arrhythmias Drug effects caffeinism nicotine addiction nasal decongestants asthma inhalers or other stimulants Types of symptomatic treatments for anxiety including types of anxiolytic medications differences precautions side effects and general classes of drugs 0 Psychotherapy relaxation and meditation techniques Stress management training Biofeedback Exercise Support groups Anxiolytic antianxiety medications o For acute use Benzodiazepines eg Xanax At van Konopin Valium Rarely Beta bockers eg Tenormin Inderal O For chronic use Most often SSRI s Prozac Lexapro etc or atypical antidepressants eg Cymbata Effexor Occasionally Atypical anxiolytics eg Buspar buspirone Know major features of and treatments for Generalized anxiety disorder 0 O O Debilitating worry fretfulness Worry is hard to control Varied anxiety symptoms incl restlessness fatigue difficulty concentrating or mind going blank irritability muscle tension insomnia Often arises with or just before or after major depression Treatments ssri disorder with and without agoraphobia Occurrence of panic attacks without warning Pattern of avoidance and disability as a result Ritualized avoidance becomes panic disorder with agoraphobia home or room within the home becomes safety zone reluctance to venture outside safety zone without escape route treatments Dietary medication control eg caffeine nicotine marijuana Anxiolytic medications benzodiazepines mainly Xanax for acute use only Antidepressant medication mainly SSRI s chronically as preventative Psychotherapy cognitive therapy normalization de catastrophization paced metronomic breathing D supportive therapy n In vivo desensitization if agoraphobia is present Social anxiety disorder 0 Most common anxiety disorder More common in females ratio of 15 to 1 Develops in late adolescence or young adulthood Grossly under diagnosed in managed care population 0 Occurs when people become disabled by Intense persistent and chronic fears of being watched and judged by others and of doing things that will be humiliating or embarrassing Can be generalized or occur in specific situations non generalized One third are sufferers are very disabled and are more likely to be depressed divorced unemployed or under employed 0 Awareness that fears are excessive o Common performance situations Public speaking Toastmasters Public restroom use Going to parties Eating in front of others Bedroom some erectile dysfunction some orgasmic dysfunctions o Most commonly treated with medications benzodiazepines and or SSRI s plus supportive and proactive psychotherapy o Specific phobias types 0 Types of Specific Phobias Animal type Natural environment type ie storms heights water Situation type ie claustrophobia tunnels bridges flying driving Bodily reactions vomiting headache fever Bloodinjuryinjection type vasovagal reaction Nature of phobic stimuli undercuts a straightforward conditioning view of specific phobia o Treatments for Specific Phobias All treatments are complicated by avoidance behavior Anxiolytic or antidepressant medication preferably an SSRI Systematic desensitization In vivo desensitization effective but low treatment acceptance and high therapy dropout rates Applied tension for bloodinjection phobias Experimental VR therapy for flying and height phobias Self help groups 0 Behavioral account of etiology of phobias and its validity idea of phobia preparedness Classical conditioning Model learning see someone else afraid from it OCD Obsessive compulsive Disorder diagnosed when obsessions or compulsions feel excessive or unreasonable cause great distress consume considerable time least 1 hour per day or interfere with daily functions A person has recurrent and unwanted thoughts a need to perform repetitive and rigid actions or both 0 Risk factors signssymptoms course prognosis treatments o Brain Drugs and antidepressant treatments that increase serotonin activity seem to help some OCD cases Antidepressant therapy with serotoninboosting medications u SSRIs eg Prozac Luvox Celexa Lexapro U Tricyclics esp clomipramine Anafranil Behavior Therapy D Thought stopping a Response prevention Psychosurgery cingulotomy for otherwise intractable cases areas involved in OCD The frontal cortex and the caudate nuclei in basal ganglia gt these convert sensory info into thoughts and actions These regions may be over active in OCD patients o OCD spectrum disorders Body Integrity Identity Disorder BIID D A belief usually from early childhood that one or more limbs usually the legs do not belong to one s body and that amputation of the limbs will achieve quotwholenessquot Gilles de la Tourette Syndrome 0 Anxiety n Tics people can control them but it puts them in a heightened state of tension 0 Coproaia making noises loudly suddenly PANDAS n Streptococcus and OCD PANDAS Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections Seen in schoolage children who develop strep throat or strep rash usually with fever and urinary incontinence U Sudden onset of tic disorder or OCD signssymptoms most commonly hand washing and preoccupation with germs D Rapid remission of symptoms usually occurs with antibiotic therapy a PANDAS accounts for only a small 00 of childhood OCD but may point to possible mechanisms involved in OCD autoimmunity neurotoxicity Reactions to Extreme Trauma o Intrusive recollections daytime flashbacks nightmares illusions and acute distress upon cues suggestive of the trauma Dissociative symptoms psychic numbing O OOOOOO emotional detachment being in a daze dropping out of usual activities avoidance of topics related to trauma forgetting or fogginess re key aspects of trauma feeling that the current setting is not real dereaization feeling detached from one s body depersonaization Chronic hyperarousal exaggerated startle hypervigilance motor restlessness Irritability and aggressiveness esp males Survival guilt insomnia Acute Stress Disorder and PTSD risk factors treatment Acute stress disorder Disability gt 2 days and lt 1 month Posttraumatic stress disorder PTSD Disability gt 1 month Men and women show similar signsymptom patterns in PTSD exceptthat o women are likelier to show numbing and anxious avoidance 0 men are likelier to show irritability and ETOH abuse Risk factors o Family history of depression anxiety disorders or PTSD perhaps these reflect common inheritance Depression or anxiety disorder at the time of the trauma Early prenatal traumatic conditioning Meaney Effect Severity and chronicity of trauma o Poor social support Treatment o Anxiolytics for anxiety panic attacks o Antidepressants mainly SSRI s for depression irritability 0 Antipsychotics eg Abilify Risperdal for any paranoia social estrangement etc 0 Sleep medications eg Lunesta Ambien Trazodone for insomnia 0 Experimental and unproven propanolol Indera an anti hypertensive drug that blocks adrenalin may block memory consolidation after stress and reduce chances of developing PTSD 0 Psychotherapy acute stress Critical Incident Stress Debriefing Fact phase Ask victims to tell their story Reaction phase Ask victims to report their thoughts and feelings about the incident Symptom phase Solicit symptomatology and suggest coping strategies OOO Teaching phase Educate victim regarding traumas and typical reactions to trauma Reentry phase Wrapup answer Q39s provide referrals develop plan of action 0 Psychotherapy PTSD Guided re exposure and abreaction controversial due to risk of re traumatization EMDR Eye movement desensitization reprocessing no evidence for special effectiveness Cognitive skills training thought neutralization Group therapy self help rap groups for estrangement abreaction and support Stress management training Finding meaning in tragedy sublimation BiDolarI and II Disorders Hypotheses about etiology including neurochemistry Brain mechanism is unknown but most anti manic appear to operate on ProteinKinase C PKC an enzyme involved in the calcium metabolism of neurons Mania may be related to high norepinephrine activity along with a low level of serotonin activity Genetic evidence Family history of Bipolar Disorder in 30 of BD patients 65 concordance rate in identical twins 14 in fraternal twins Signssymptoms Crying Irritability anger Suicidal ideation Euphona Hypersexuality Racing thoughts Severe insomnia Auditory hallucinations Differences between major depression and bipolar depression 1 1 sex ratio of diagnosis instead of 21 Types of antimanic medications side effects precautions and general classes of medications you will not need to recall any specific drug names Lithium carbonate strong antimanic and antisuicide but weak antidepressant actions Anticonvulsants moderate antimanic and antidepressant actions Antipsychotic agents moderate antimanic and antidepressant actions Antidepressants strong antidepressant actions but increase risk of switching into mania or mixed states Non medication treatments Psychotherapy 0 usually requires prior medication response to be valuable o builds compliance to medication o helps patient and family understanding impact of disorder 0 no effect on disorder itself ECT rarely used but effective Induced Sleep very rarely used General features of pediatric bipolar disorder Occurs in about 1 of children sometimes as early as infancy Manifested by mood instability eg rages despondency hyper sexuality pressured speech racing thoughts impaired judgment delusions and hallucinations Up to 2 of severe childhood depressions become adult bipolar disorder About 2 of children treated for depression with SSRI s develop manic or hypomanic episodes Typically a 10year lag between occurrence of first signssx and onset of treatment Often confused with Attention Deficit Hyperactivity Disorder ADHD due to shared sx of distractibility and hyperactivity Relationship of bipolar disorder andor depression to creativity Depression only Major Unipolar Depression Depression Mania Bipolar Disorder Hypomania often produce sharpened and creative thinking and greater creativity o Mild psych disturbances more creative enabling Other disorders associated with bipolar disorder o Bipolar I full manic and major depressive episodes a Bipolar II hypomania episodes alternate major depressive episodes Cyclothymic disorder hypomanic and mild depression lease severe than bipolar disorders I and II Additional Info 4192009 94700 PM Medications used to augment SSRI s and which side effects each medication helps o Abilify and other anti psychotics help with mania o Could get agranulocytosis life threatening drop in white blood cells Vagus nerve stimulation VNS o Nature of the procedure surgery apparatus 0 an adjunctive treatment for certain types of intractable epilepsy and major depression VNS uses an implanted stimulator that sends electric impulses to the left vagus nerve in the neck via a lead wire implanted under the skin Rationale for use in depression seems to be effective in about 50 cases o Side effects o Decrease in respiratory flow o Increase in AHI levels Efficacy in treatment resistant depression Transcranial magnetic stimulation TMS Nature of the stimulator and how it is used 0 noninvasive method to excite neurons in the brain weak electric currents are induced in the tissue by rapidly changing magnetic fields electromagnetic induction This way brain activity can be triggered with minimal discomfort and the functionality of the circuitry and connectivity of the brain can be studied 0 Basic evidence on efficacy 0 Not much better than placebo effect 0 White coat syndrome
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