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Chapter 18: Biopsychology of Psychiatric Disorders: The Brain Unhinged
Multiple Choice Questions
General Concepts
- Psychiatric Disorder Definition: A disorder of psychological function sufficiently severe to require treatment by a psychiatrist is called a psychiatric disorder.
- Answer: B) psychiatric
Diagnostic Challenges in Psychiatry
- Difficulty in Diagnosing Psychiatric Disorders:
- Patients suffering from the same psychiatric disorder often display different symptoms.
- Patients suffering from different psychiatric disorders often display the same symptoms.
- Answer: D) both A and B
Schizophrenia Statistics
- Prevalence of Schizophrenia: Approximately 1% of the adult population suffers from schizophrenia.
- Answer: C) 1%
- Onset of Schizophrenia: Schizophrenia typically begins in adolescence or early adulthood.
- Answer: C) adolescence or early adulthood
Symptoms and Types of Schizophrenia
- Unique Symptoms in Catatonic Schizophrenia: Catatonic schizophrenic patients often experience waxy flexibility when moved.
- Answer: B) waxy flexibility
- Positive Symptoms of Schizophrenia: Symptoms that are added (positive) include:
- Hallucinations
- Inappropriate affect
- Delusions
- Incoherent speech or thought
- Answer: E) all of the above
Hallucinations
- Common Forms of Hallucinations in Schizophrenia: Often take the form of imaginary voices making critical comments or telling the patient what to do.
- Answer: D) imaginary voices making critical comments or telling the patient what to do.
Symptom Classification
- Categories of Schizophrenia Symptoms: Symptoms of schizophrenia are divided into positive and negative categories.
- Answer: A) positive and negative
Genetic Factors in Schizophrenia
- Hereditary Probability: The probability that a close biological relative of a patient suffering from schizophrenia will also be diagnosed with schizophrenia is about 10%.
- Answer: C) 10%
- Monozygotic vs. Dizygotic Twin Studies: Studies suggest schizophrenia is greatly influenced by genetic factors.
- Answer: C) is greatly influenced by genetic factors
Concordance Rates in Twins
- Concordance Rate in Monozygotic Twins: About 45% concordance rate for schizophrenia in monozygotic twins.
- Answer: E) about 45%
Environmental Factors in Schizophrenia
- Concordance Rate Comparisons: The concordance rate for identical twins is much less than 100% but much more than 50%.
- Answer: B) much less than 100%
- Early Experiential Factors in Schizophrenia: All of the above factors such as stress, faulty autoimmune reactions, infections, and exposure to toxins have been implicated.
- Answer: E) all of the above
Antipsychotic Medications
- Chlorpromazine:
- Originally developed as an antihistamine, effective in treating schizophrenia.
- Answer: C) was originally developed as an antihistamine.
- First Antipsychotic Drugs: The first two antipsychotic drugs were chlorpromazine and reserpine.
- Answer: B) chlorpromazine and reserpine.
- Precaution about Reserpine: Reserpine is not commonly used due to its potential to produce dangerous decreases in blood pressure.
- Answer: C) can produce a dangerous decrease in blood pressure.
- Psychotropic Drugs Triggering Schizophrenia: Amphetamines and cocaine can trigger episodes at high doses.
- Answer: E) both A and B
Antipsychotic Mechanisms
- Dopamine Antagonists: Chlorpromazine acts as a dopamine antagonist, preventing dopamine from binding to receptors without activating them.
- Answer: C) dopamine antagonist
- Haloperidol: Known as a potent neuroleptic medication and D2 receptor ligand.
- Answer: D) all of the above
Neuroleptics Effectiveness
- Classical Neuroleptics: Generally, conventional neuroleptics are more effective against positive symptoms of schizophrenia.
- Answer: B) positive schizophrenic symptoms.
- Atypical Neuroleptics: Clozapine is the first atypical neuroleptic affecting serotonin and dopamine receptors.
- Answer: B) the first atypical neuroleptic.
Psychoactive Substances
- Psychedelic Drugs Classification: Disassociative anesthetics like ketamine act as dopamine antagonists and can mimic symptoms of schizophrenia.
- Answer: E) both B and D
Treatment Efficacy Studies
- Treatment Differences: Studies indicate that overall antidepressants benefitted 25% more patients than placebos.
- Answer: D) all of the above
Depression and Affective Disorders
- Clinical Depression Duration: To qualify for clinical depression (major depressive disorder), symptoms must last more than 2 weeks.
- Answer: A) last more than 2 weeks
- Types of Depression: Divided into reactive and endogenous (no clear cause).
- Answer 1: B) endogenous
Co-morbidity and Treatments
- Comorbidity of Disorders: Clinical depression substantially increases the likelihood of anxiety disorders, which can be treated with benzodiazepines.
- Answer: D) tend to occur together in the same individuals.
Research and Clinical Trials
- Clinical Trial Phases: Human clinical trials are typically conducted in 3 phases.
- Answer: B) 3
- Importance of Placebos: An ideal placebo must produce the same psychological effects as the drug under investigation.
- Answer: C) psychological
Conclusions from Research Studies
- Clinical Challenges: Many individuals struggle with psychiatric disorders that impact their daily functioning and require a comprehensive treatment approach, including both pharmacological and psychotherapy interventions.