Med Sci: Mental Health

• Behavior Changes During a Manic Episode?

  Increased energy and high risk activities (sex, drugs), decreased need for sleep, racing thoughts, impulsivity, grandiosity, irritability, poor judgment, and restlessness.
• How many Americans have a mental health issue? Who is more likely to have one?

  26.2%. White people more likely than black people
• ICD-10 vs. ICF 


  billing vs. classification
• Intellectual Developmental Disorders Criteria for Diagnosis


  impairment in general mental abilities, impairment in adaptive functioning that leads to significant activity limitations, and participation restrictions in daily life, occurs prior to age 18
• IQ levels for each category of Intellectual Developmental Disorders

  severe: 20-34

  moderate: 35-49

  mild: 50-69

  borderline: 70-84
• Characterizations of Down Syndrone

  muscle hypotonia, cognitive delay, and abnormal facial features
• Down Syndrome is also called?

  Trisomy 21 (3 copies of chromosome 21)
• Affects of Downs on the brain?

  reduced brain weight affecting brainstem and cerebellum

  smaller convolutions

  decreased pyramidal neurons in hippocampus (increased incidence of Alzheimer’s?)

  less cortical area for higher brain function
• Manifestations of Downs

  flat face, nasal bridges, short limbs, hypotonia, inc. susceptibility to infections of the middle ear, hep B, inc. thyroid dysfunction, constipation, leukemia, cardiac abnormalities, feeding difficulties, delayed acquisition of motor skills
• Goal of treatment of downs?

  for child to reach their full potential
• Autism Spectrum Disorder (ASD) Impairment Domains?

  Social communication and interaction, and restricted, repetitive behaviors, interests or activities.
• Prevalence of ASD 


  inc from ‘02-08 from 6.6 to 11.3 in 1000 children
• Cause of ASD?

  unknown: genetic? environment?
• Prognosis of ASD?

  Better for mild forms
• Echolalic


  repeating words back (all they can do)
• Schizophrenia/Psychotic Disorders cause…

  abnormal thinking and perceptions and psychoses causes to lose touch w reality
• Schizophrenia Characterization

  at least 2: hallucination, disorganized speech, delusions, extreme motor behaviors, flat affect in a 12-month period
• Schizophrenia Prevalence? Onset?

  1.1% of US adults

  onset of late teens, early 20s

  women diagnosed at older age less often than men
• Cause of Schizophrenia

  unknown (genetic? stressors?)
• Schizophrenia Treatment 


  psychotropic drugs (side effects: tardive dyskinesia)
• Schizophrenia Prognosis 


  33-50% have good outcomes

  20% attempt suicide more than once

  6% succeed
• Behavior Changes during a depressive episode? 


  decreased energy, fatigue, feelings of guilt, worthlessness, helplessness, difficulty concentrating, remembering, making decisions, doing activities, insomnia/hypersomnia, unintentional weight gain/loss, lethargy, restlessness, chronic pain, suicidal thoughts
• Bipolar 1 vs 2

  1: most severe, swings between mania and major depressive disorder (MDD)

  2: less disruptive, swings between hypomania and MDD
• Cyclothymic Disorder

  least severe form of bipolar, mood swings not severe
• Bipolar Prevalence

  1: 1%

  2: 1.1%

  Cyclothymic: 2.4%
• Etiology of Bipolar

  genetic based suspected
• Which mood lasts longer in Bipolar II?

  depression longer than hypomania
• Bipolar Treatment

  mood stabilizing drugs (lithium)

  antipsychotics

  antidepressants

  psychotherapy

  behavior modification

  education
• How many w Bipolar deny any problems?

  55%
• Symptoms Associated with Major Depressive Disorder

  fatigue, weakness, depressed mood, muscle pain, dizziness, palpitations, concentration/memory problems, dry skin, flushing, tinnitus, digestive problems, amenorrhea, sleep problems, loss of interest
• Seasonal Affective Disorder (SAD)

  depressive symptoms when colder out and less daylight

  more common at higher altitudes

  more common in F than M
• MDD

  mood changes AND behavioral changes

  most common disorder seen in therapy

  seen in 14-25 yo

  more common in F than M
• Postpardum depression

  20% of pregnancies
• Predisposing Factors of MDD

  genetic, familial, biologic, psychosocial, surgical
• What medications can lead to MDD?

  sedatives, hypnotics, cardiac drugs, antihypertensives, steroids, alcohol/drug use

  exposure to heavy metals/toxins
• Psychoneuroimmunology links to depression

  neural, endocrine, altered immune responses

  altered neurotransmitter function unclear
• SAD factors

  possibly changes in melatonin hormone release (shorter days)
• Mental health problems that can co-occur with depression

  substance abuse, panic disorder, OCD, GAD, PTSD, eating disorders, BPD
• Depression Misdiagnoses

  15% false positives

  10% false negatives
• MDD Treatments

  selective serotonin reuptake inhibitors (SSRIs)

  serotonin and norepinephrine reuptake inhibitors (SNRIs)

  tricyclate antidepressants (TCAs)

  monoamine oxidase inhibitors (MAOIs)

  ketamine

  CBT

  electroconvulsive treatment (ECT)