PSYC 350: ADHD, Addiction, Eating Disorders, and Schizophrenia

diagnostic criteria for inattention in children with ADHD?

Six or more symptoms of inattention for children up to age 16, or five or more for adolescents 17 and older and adults, present for at least six months and inappropriate for developmental level.

Symptoms of ADHD

Fidgety or squirmy, leaving seat when required to remain seated, running or climbing in inappropriate situations, unable to play quietly, talking excessively, blurting out answers, trouble waiting for turn, and interrupting others.

What are the diagnostic criteria for ADHD?

Requires either Attention Deficit (AD) or Hyperactivity Disorder (HD) symptoms present before age 12, with functional impairments socially, academically, or occupationally.

Prevalence of ADHD

Approximately 10% in school-age children and about 5% in adults.

Sex ratio for ADHD

Approximately 3:1 (male to female).

Causes of ADHD

Involvement of the frontal cortex, reward circuits, heritability (~50%), and neurotransmitters like dopamine and norepinephrine.

Treatments for ADHD

Stimulants (e.g., Ritalin, Adderall), non-stimulants (e.g., Strattera), cognitive-behavioral therapy (CBT), omega-3 supplements, exercise, light therapy, restricted diet, and meditation.

Non-stimulants for ADHD

Strattera, Qelbree, Wellbutrin (non-epinephrine target)

Stimulants for ADHD

Ritalin, Adderall, Concerta, Vyvanse

Substance dependence

Physiological dependence with withdrawal symptoms, frequent use that interferes with functions, and inability to stop using.

Substance Abuse

Less severe than dependence; use is typically sporadic but causes functional impairment

How does substance abuse differ from substance dependence?

Substance abuse is less severe, typically sporadic use that causes functional impairment, while dependence involves more severe symptoms.

What are the categories of Substance Use Disorder as per DSM-5?

Alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics/anxiolytics, stimulants, and tobacco.

What is the estimated prevalence of alcohol use in the past year and lifetime?

14% in the past year and 29% lifetime.

Addiction cycle

Intoxication → withdrawal → craving → intoxication.

Narcan (Naloxone)

Used to reverse opioid overdoses

What brain pathways are involved in addiction?

Dopamine circuits, Mesolimbic dopamine pathway, nucleus accumbens, amygdala, and hippocampus.

mesolimbic dopamine pathway

Transports dopamine from the VTA to the nucleus accumbens

What are the effects of alcohol on neurotransmitters?

Alcohol affects glutamate, GABA, and dopamine, reducing neural firing in certain brain areas and increasing dopamine activity.

What is Korsakoff's syndrome?

A neuropsychiatric condition caused by vitamin B1 deficiency, leading to cognitive impairment and amnesia.

What are the effects of varying blood alcohol concentrations?

0.05%: slight buzz; 0.10%: moderate motor incoordination; 0.20%: severe intoxication; 0.35%: surgical anesthesia; 0.40%: coma; 0.50%: death.

Treatments for substance use problems

Pharmacological interventions (e.g., Naltrexone, Antabuse), Alcoholics Anonymous (AA), and cognitive-behavioral therapy.

What are the diagnostic criteria for Anorexia Nervosa?

Persistent restriction of energy intake leading to low body weight, intense fear of weight gain, disturbance in body shape perception, and lack of recognition of low body weight severity.

What are the two subtypes of Anorexia Nervosa

Restricting and binge eating/purging.

Prevalence of Anorexia Nervosa

Lifetime prevalence is 2-4% in females and 0.2-0.4% in males.

What are some medical complications associated with Anorexia Nervosa?

Malnutrition, dry yellow skin, cold sensitivity, slow heartbeat, dehydration, and loss of potassium.

Bulimia Nervosa

Recurrent episodes of binge eating followed by compensatory behaviors to prevent weight gain, occurring at least once a week for three months.

What are the medical complications of Bulimia Nervosa?

Electrolyte imbalance, gastric ulcers, tooth decay, and swollen salivary glands.

Risk factors for developing eating disorders

Sexual abuse, personality traits (perfectionism, self-criticism), and family factors such as parental neglect.

Treatments for Anorexia Nervosa

Hospitalization to restore weight, individual therapy, family therapy, and limited pharmacotherapy.

What is Orthorexia?

An excessive preoccupation with eating healthy food.

What is OSFED?

Other Specified Feeding/Eating Disorders; individuals do not meet all criteria for an eating disorder but exhibit symptoms of multiple eating disorders.

What is a key characteristic of schizophrenia?

The hallmark of schizophrenia is psychosis, which includes delusions and hallucinations.

Who coined the term 'schizophrenia' and when?

Bleuler, a Swiss psychiatrist in 1911.

What are the two main types of symptoms in schizophrenia?

Positive symptoms (such as hallucinations and delusions) and negative symptoms (such as flat affect and lack of motivation).

Delusions

Beliefs that do not conform with reality, such as delusions of grandeur or persecution.

Hallucinations

Perceptions that do not conform with reality, affecting all five primary sensory modalities, with auditory hallucinations being the hallmark.

What is the diagnostic criteria for schizophrenia?

Two or more of the following for at least one month: delusions, hallucinations, disorganized speech, grossly disorganized behavior, stupor/flat affect, and impaired functioning.

Prevalence of schizophrenia?

Approximately 1%, with a slightly higher prevalence in males.

Median age of onset for schizophrenia

18 years for males and 25 years for females.

What genetic evidence supports the medical model of schizophrenia?

Heritability is 60-80%, with a monozygotic twin concordance rate of 40-60% and dizygotic twin concordance of about 10%.

Environmental factors and schizophrenia

Maternal influenza during the second trimester, maternal malnutrition, low birth weight, and subtle neurological deficits.

Dopamine hypothesis

Increased cerebral dopamine activity is linked to schizophrenia; antipsychotic drugs block dopamine transmission.

Side effects of antipsychotic drugs

Weight gain, sedation, motor spasms, and brain shrinkage.

Neuroleptic drugs for schizophrenia

Haldol, Thoraxine, Melloril,

Novel antipsychotic drugs for schizophrenia

Clozaril, Seroquel, Zyprexa, Geodom, Saphris, Latuda, Abilify

Dissociative Identity Disorder (DID)

Formerly known as multiple personality disorder, characterized by two or more distinct personalities and amnesia for important personal information.

What is the trauma model of DID?

It suggests that DID arises from chronic childhood trauma, such as sexual or physical abuse.

What is the socio-cognitive model of DID?

It posits that DID is a result of social and cognitive factors rather than solely trauma.

Dementia Praecox

It refers to the early description of schizophrenia, emphasizing the psychotic features of the disorder.

Language Disturbances

Disorganized speech and neologisms, which reflect impaired thought processes.

Socioeconomic status and schizophrenia?

Low socioeconomic status is a significant risk factor for developing schizophrenia.

omega-3 acids in schizophrenia treatment

EPA, a form of omega-3, helps correct disordered lipid metabolism in the brain.

What is the recovery rate for schizophrenia over two years?

Recovery rates are low, with only 13% achieving significant improvement in a landmark meta-analysis.

What is the distinction between schizophreniform disorder and schizophrenia?

Schizophreniform disorder lasts less than six months, while schizophrenia requires continuous signs for at least six months.

What are the common treatments for schizophrenia?

Neuroleptic drugs (like Haldol and Thorazine) and novel antipsychotic drugs (like Clozaril and Seroquel) are commonly used.