Lecture Notes: Mood Disorders through Substance-Related & Addictive Disorders (Ch 9-17)

A comprehensive set of practice flashcards covering mood disorders, schizophrenia spectrum, anxiety disorders, neurocognitive disorders, OCD/BDD and related disorders, trauma, somatic symptom disorders, feeding/eating disorders, and substance-related/addictive disorders as presented in the notes.

Which brain regions are part of the limbic system associated with mood disorders (as listed in the notes)?

Amygdala; hippocampus; insula; regions of the anterior cingulate cortex; dorsolateral prefrontal cortex.

Mania is defined as what kind of mood?

Extremely elevated mood or irritable mood.

Hypomania differs from mania in that it is which of the following?

Less intense than full mania.

First-generation antidepressants include which classes?

Tricyclics (TCAs) and Monoamine Oxidase Inhibitors (MAOIs).

Second-generation antidepressants are characterized by what in comparison to first-generation?

Less side effects.

Name three categories listed as antidepressants used for mood disorders.

Tricyclics, MAOIs, SSRIs.

List three manic symptoms from the notes.

Act impulsively; Talking faster than usual; Racing thoughts.

List three depressive symptoms from the notes.

Feeling very sad or hopeless; Isolating from others; Difficulty concentrating; Suicidal thoughts.

What is cyclothymia?

A chronic mood disturbance with hypomanic behaviors and depressive symptoms for at least 2 years, not meeting full criteria for mania or major depressive episodes.

Affect is defined as what?

The display of emotion, particularly facial expression.

Anhedonia is defined as what?

Lack of interest in previously pleasurable activities.

Avolition is defined as what?

Lack of drive or ambition to complete goal-directed tasks or activities.

Flight of ideas refers to what?

Rapidly changing, disconnected thoughts.

Grandiosity refers to what symptom?

Inflated sense of self-esteem or importance.

What does ECT stand for?

Electroconvulsive therapy.

What does rTMS stand for?

Repetitive transcranial magnetic stimulation.

Name two common suicide risk warning signs listed in the notes.

Feeling hopeless or helpless; Statements about not wanting to live; Creating a plan for suicide.

What are the defining characteristics of schizophrenia?

Chronic & lifelong condition with abnormal interpretation of reality, often with delusions, hallucinations, and disorganized thinking.

List the stages of schizophrenia in order.

Premorbid; Prodromal; Syndromal/Progressive; Chronic or residual.

How long must delusions be present for a schizophrenia-related diagnosis in absence of mood disorder?

Delusions for >1 month.

Give two examples of positive symptoms of schizophrenia.

Delusions; Hallucinations.

Give two examples of negative symptoms of schizophrenia.

Diminished emotional expression; Avolition (lack of initiative) or Alogia (poverty of speech) or Anhedonia.

What is the typical age of onset for schizophrenia?

Late adolescence or early adulthood (16-30 years old).

What is the purpose of typical (1st generation) antipsychotics?

Decrease delusions and hallucinations by targeting dopamine levels.

Where can the catatonia specifier be added to a diagnosis?

To diagnoses such as major depressive disorder, schizophrenia, or neurodevelopmental disorders.

Which side effects are associated with acute extrapyramidal symptoms (EPS) from typical antipsychotics?

Akathisia (restlessness), drug-induced parkinsonism (tremor, rigidity, dystonia), drug-induced dystonia (involuntary contractions).

Tardive dyskinesia is most commonly a side effect of which drug class?

1st generation (typical) antipsychotics.

What distinguishes schizoaffective disorder from schizophrenia alone?

Presence of major mood episodes (depression, mania, or mixed) with delusions/hallucinations; mood symptoms occur for a major portion of the illness.

What criterion must be met for delusions or hallucinations in the context of a mood episode (in schizoaffective-type presentations)?

Delusions and hallucinations must be present for at least 2 weeks in the absence of a major mood episode.

What is the role of cholinesterase inhibitors in neurocognitive disorders?

Used for mild or major NCD due to Alzheimer's disease to improve cognitive and behavioral symptoms.

Memantine targets which neurotransmitter receptor system?

Glutamate receptors (NMDA receptor antagonism) to regulate calcium influx.

Define agnosia.

Difficulty recognizing objects and familiar people.

Define anomia.

Difficulty finding words or naming objects.

What is sundowning?

Worsening of cognitive and behavioral symptoms in the evening or at night.

What protein is associated with Alzheimer's disease progression?

Tau protein; it forms neurofibrillary tangles.

What is OCD?

Obsessive-Compulsive Disorder: repetitive, unwanted thoughts with excessive urges to perform certain behaviors.

What is Body Dysmorphic Disorder (BDD)?

Severe preoccupation with perceived physical defect causing distress and impairment.

Name two related disorders to OCD discussed in the notes.

Hoarding Disorder; Trichotillomania (Hair-Pulling Disorder); Excoriation (Skin Picking Disorder); Body Dysmorphic Disorder.

What is Hoarding Disorder?

Persistent difficulty discarding possessions, resulting in clutter and distress or impairment.

What is Trichotillomania?

Hair-pulling disorder; recurrent pulling out of one's hair leading to hair loss.

What is Excoriation (Skin Picking Disorder)?

Recurrent skin picking resulting in skin lesions and impairment.

What is the difference between collecting and hoarding as described in the notes?

Collecting is organized and purposeful; Hoarding involves lack of awareness of items and disorganized gathering.

What is complex trauma?

Chronic exposure to multiple traumatic incidents within a relational system, often starting in childhood.

Define alexithymia.

Impaired capacity to describe emotions or bodily states.

What is parentification?

One child takes on the role of a parent within the family system.

What is polyvictimization?

Exposure to multiple types of maltreatment.

What does transgenerational trauma refer to?

Trauma transmitted across generations due to caregivers' past experiences.

What is conversion disorder?

Functional neurological symptom disorder; one or more motor or sensory symptoms with normal medical testing.

What is Munchausen syndrome?

Factitious disorder where a person fakes or induces illness in themselves for sympathy.

What is Munchausen syndrome by proxy?

Factitious disorder where a caregiver fabricates or induces illness in someone else (often a child) for attention/sympathy.

What is somatic symptom disorder (DSM-5 criteria) characterized by?

Persistent somatic symptoms for more than 6 months with excessive thoughts, feelings, and behaviors related to the symptoms; substantial impairment.

Name two components of managing somatic symptom disorder.

CBT; recognizing illness; relaxation and stress management; patient education.

What is the DSM-5 criterion for anorexia nervosa?

Restrictive energy intake resulting in significantly low body weight; intense fear of gaining weight; body image disturbance.

What are the DSM-5 criteria for bulimia nervosa?

Recurrent episodes of binge eating with compensatory behaviors (purging, misuse of laxatives, etc.); at least once per week for 3 months; excessive influence of body shape on self-evaluation.

What defines binge eating disorder?

Recurrent episodes of eating an objectively large amount of food with a sense of loss of control; no regular compensatory behaviors; occurs at least once a week for 3 months.

What is Pica?

Persistent eating of nonnutritive substances for at least 1 month and not developmentally appropriate.

What is Rumination Disorder?

Repeated regurgitation of recently ingested food, which may be rechewed, swallowed, or spit out.

What is Avoidant/Restrictive Food Intake Disorder (ARFID)?

Persistent failure to meet appropriate nutritional or energy needs, with significant distress or impairment; not due to lack of food or cultural practice.

What are the common mental disorders of eating disorders that tend to co-occur with ASD (as listed)?

ASD features may accompany ARFID and other feeding/eating issues.

What is addiction defined as in the notes?

Chronic brain disease characterized by recovery and relapse; cravings and compulsive use.

What brain areas are implicated in the Binge/Intoxication, Withdrawal/Negative Affect, and Preoccupation/Anticipation stages of addiction?

Binge/Intoxication: basal ganglia (nucleus accumbens; ventral pallidum); Withdrawal/Negative Affect: amygdala; Preoccupation/Anticipation: prefrontal cortex.

What is gambling disorder characterized by according to the notes?

Gambling use disorder develops gradually; often begins earlier in males; co-occurs with depressive, bipolar, and anxiety disorders; compulsive betting with chronic money involvement.

Define cravings in substance use disorders.

Desire for the drug predisposing thinking toward use, often triggered by environmental cues.

What is tolerance in substance use disorders?

Need for larger amounts of the substance to achieve the same effect, or reduced effect with the same amount.

What is withdrawal in substance use disorders?

Syndrome that occurs when blood/tissue concentrations decline after heavy use.

What is dual diagnosis?

Co-occurrence of a substance-use disorder with one or more other psychiatric conditions.

What is the main purpose of family-based therapy in eating disorders for children/adolescents?

A common psychological intervention to involve family in treatment and support recovery.

What is the DSM-5 criterion for separation anxiety disorder in adults?

Excessive fear/anxiety about losing attachment figures, lasting at least 6 months in adults; in children, at least 4 months.

What is the primary characteristic of generalized anxiety disorder (GAD) in DSM-5?

Excessive worry and anxiety for 6+ months with at least 3+ associated symptoms (on edge, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance).