SAS 14,15,16 (Anxiety-Related Disorders, Schizophrenia, Personality Disorders)

decreased GABA, increased norepinephrine

what neurotransmitters are related to anxiety?

panic disorder

occurs when a patient experiences unexpected periods lasting 15-30 minutes of high anxiety and feelings of doom, resulting in the patient being unable to perform ADLs

6 weeks

how long are benzodiazepines limited to reduce the likelihood of dependency?

primary gain

relief of anxiety by performing anxiety-relieving activities such as staying in the house if going to a place is causing the client anxiety

secondary gain

the attention received from others as a result of these behaviors

phobias

an illogical, intense, and persistent fear of a specific object or social situation

agoraphobia, specific phobia, social phobia

3 categories of phobias

agoraphobia

fear or anxiety of places from which escape is difficult

specific phobia

fear or anxiety caused by an object

social phobia

fear or anxiety caused by social or performance situations which leads the person to panic and become incapacitated

acrophobia

fear of heights

astraphobia

fear of lightning and thunder

autophobia

fear of being alone

ophidophobia

fear of snakes

behavior therapy

helps identify anxiety responses and relaxation techniques when phobia occurs

systematic desensitization

progressive exposure to phobia-inducing object or situation, done gradually and progressively

flooding

rapid desensitization; direct confrontation with a phobia-inducing object or situation

generalized anxiety disorder

involves persistent and excessive worry that interferes with daily activities

social anxiety disorder

has significant anxiety and discomfort about being embarrassed, humiliated, rejected, or looked down on in social interactions

separation anxiety disorder

is excessively fearful or anxious about separation from those with whom he or she is attached

antidepressants (SSRIs, SNRIs) -ine

benzodiazepines -pam

medications for most anxiety disorders?

cognitive behavioral therapy (CBT)

teaches clients how to turn negative or panic-causing thoughts and behaviors into positive ones

schizophrenia

develop beliefs or behaviors that do not align with reality

Delusions

Hallucinations

Disorganized speech

Grossly disorganized or catatonic behavior

Negative symptoms

DSM-5 criteria for schizophrenia

requires only 1 symptom if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary, or two or more voices conversing with each other

how to diagnose criteria A of schizophrenia?

schizophreniform disorder

experiences the symptoms of schizophrenia for at least 1 month and either recover from it before 6 months

schizoaffective disorder

characterized by the presence of a generally continuous psychotic illness plus intermittent mood episodes

delusional disorder

characterized by the presence of either bizarre or non-bizarre delusions which have persisted for at least one month

brief psychotic disorder

can be though of as a time-limited schizophrenia that is resolved within one month’s time

Folie a deux / Falret syndrome

shared psychosis is also known as?

shared psychosis disorder

usually occurs only in long-term relationships in which one person is dominant and the other is passive

antipsychotics:

chlorpromazine, haloperidol, risperidone

medications for schizophrenia?

Cluster A includes people whose behavior appears odd or eccentric and includes paranoid, schizoid, and schizotypal personality disorders.

Cluster B includes people who appear dramatic, emotional, or erratic and includes antisocial, borderline, histrionic, and narcissistic personality disorders.

Cluster C includes people who appear anxious or fearful and includes avoidant, dependent, passive - aggressive and obsessive-compulsive personality disorders.

categories of personality disorders?

personality disorders

characterized by extreme and rigid personality traits that impair a person’s ability to function normally in society

antisocial personality disorder

characterized by impulsivity, aggression, lack of remorse, and disregard for societal rules

psychotherapy

treatment for ASPD?

avoidant personality disorder

exaggerates negativity to avoid new situations. marked by low self-esteem, social withdrawal, and extreme sensitivity to judgment.

fear of rejection and embarrassment leads to severe social anxiety

MAOI - phenelzine (Nardil)

medication for AVPD?

borderline personality disorder (BPD)

characterized by emotional instability, impulsivity, and self-destructive behaviors

intense fear of abandonment

splitting; BPD

sees other as either all good or all bad; what disorder?

dialectical behavior therapy (DBT)

mood stabilizers - valproate, lithium

treatment and medications for BPD?

dependent personality disorder

characterized by excessive neediness, reliance on others for decision-making, and fear of being alone

lack confidence, fear criticism, and seek validation from others

psychotherapy on independent decision-making

treatment for DPD?

histrionic personality disorder

characterized by excessive emotionality, dramatization, and a constant need for attention

emotions are shallow and can shift rapidly to extremes

often dress or act provocatively to be the center of attention

psychotherapy on problem-solving

treatment for HPD?

narcissistic personality disorder

characterized by self-absorption, grandiosity, and a need for admiration

crave superiority, seek perfection, and fear failure

psychotherapy

treatment for NPD?

obsessive-compulsive personality disorder

characterized by rigid thinking, perfectionism, and an excessive focus on rules and order

inflexible, self-righteous, and easily angered when challenged

psychotherapy

treatment for OCPD?

paranoid personality disorder

characterized by unreasonable mistrust and suspicion of others

psychotherapy

therapy for PPD?

schizoid personality disorder (SPD)

characterized by social withdrawal, emotional detachment, and a strong preference for solitude

lack interest in relationships, avoid social events, and are indifferent to praise or criticism

psychotherapy

treatment for SPD?

schizotypal personality disorder

characterized by eccentric behavior, severe social anxiety, and unusual beliefs

psychotherapy

clozapine to reduce paranoia

treatment and medication for STPD?