Treatments for the Neuropsychiatric disorders associated with AIDS:
Mild Neuro-cognitive disorder
No confabulation
Difficulty concentrating, unusual fatigue, subjectively slowed down, difficulty in remembering, learning and recalling new info
Difficulty problem solving, abstract reasoning, and slowin of simple motor performances (finger tapping)
Be sure to distinguish from delirium and dementia (these have confabulation)
Psychopharmacology - in addition to [...]
Substance use - use of a substance in a socially acceptable manner (ie glass of wine at dinner)
Drug misuse - doc using drugs not for medical use (prescribing [...]
Characteristics:
- Recurrent multiple complaints that are not fully explained by the physical factors and that result in medical attention or physical impairment
- Chronic (↑ history)
- Before age 30
- Associated with significant psychological stress
- Aka “Briquets syndrome”
Epidemiology:
- Women > Men
- Pts of the family doctor
- Begins before age 30 and most often in their [...]
The School-Aged Child - middle childhood (elementary school-age, 6-7 yrs); child is:
Educable- high focus on education; easy to teach
Pliable- easily influenced by the external environment
Well-behaved
Learns roles & roles of society- right/wrong and appropriate/inappropriate behavior
- Freud - latency stage; a time of relative stability, tranquility in development
o Child not very self-reflective- [...]
Essential ingredient in a good patient therapist relationship is built on genuine trust & interest
Hundreds of types of psychotherapy; all have different theories to how changes in pt occur
I. Psychoanalysis
The classical long-term insight oriented therapy
Goal = identifying major personality changes by identifying and “working through” unconscious conflicts by free association, analysis [...]
Psychosis, NOS
(Atypical psychotic disorders)
Schizophreniform disorder episodee less than 6 months; often a tentative diagnosis; identical to schizophrenia in Tx and Sx; duration 1-6 mo
- Good Prognosis - short prodrome, confusion is predominent during the active phase, good morbid functioning, intact affect
Schizoaffective disorder Mood d/o + Schizophrenia; must have 2 wks of symptoms of [...]
Definitions
Hallucinations
Delusions
Thought disorder
Impaired reality testing
Prevalence- not common among kids (1%); most present in young adulthood
Symptoms
1. Hallucinations- no sensory input
Organic, psychiatric, and medical conditions
Most common + Sx on schizophrenia (80% of childhood schizophrenia; AUDITORY is most common)
RARE/poorly formed before age 7
Different from and illusion because in an illusion there is sensory [...]
Terms
Personality- enduring pattern of perceiving, relating to , & thinking about environment & self. Exhibited in social and personal function. Reflects personality traits.
Character- person’s distinctive nature
Temperament- biologically [...]
General considerations about suicide
- Contagious effect
Myths about suicide
- People who talk of suicide don’t commit suicide
- Suicide happens w/o warning
- Suicidal persons are fully intent on dying
- Once a person is suicidal, s/he is suicidal forever
- Improvement following suicide crisis means risk of suicide is over
- Suicide is inherited
- Asking someone about suicide, suggests [...]
Criteria for depression
Mood d/os occur in infants, children & adolescents; ds made by same criteria use to ds mood d/os in adults, w/ minor modifications that take into account different developmental levels observed in kids
- Major depressive episode - represent a change from functioning; at least one of the symptoms is either 1) depressed [...]
Introduction:
In the resting state: intracellular = negative; during the action potential = positive
Inhibitory NT’s make interior more negative (hyperpolarize)
Excitatory depolarize
Act on ligand-gated or votage-gated channels
3 types of ligand-gated channels: direct coupled, G PRO coupled, and 2nd messenger coupled
G PRO neurotransmitter acts on it receptor protein, which then [...]
Natural narcotics come from opium
Opium comes from Papver somniform
Meaning of opium: poppy juice
Induce sleep and eliminate pain
Only two natural narcotics that come from opium: morphine and codeine
Semisynthetic narcotics come from manipulation of morphine and codeine
Synthetic narcotics are not derived from natural opiates at all
- Methadone
- Phentanyl
- Darbone
Opiod/Narcotic [...]
I. Mental Retardation
- IQ < 70
- deficit of adaptive behavior - (can you button pants, make ice w/out recipe, and other activites required for daily life functioning)
- Onset before age 18
Intelligence Testing
- Welchsler is gold standard
WISC (Wechsler Intelligence Scale for Children)
WAIS (Wechsler Adult Intelligence Scale)
- 100 is average
- Produces a full scale composite [...]
• Affect: Observed expression of emotion ( happy you smile, etc.) response to an emotion
• Mood: A pervasive and sustained emotion, subjectively experienced and/or reported by the patient and/or reported by others; PROLONGED
* Anxiety is a mood
• The mood disorders ….
1. Include disorders that have a disturbance in mood as the predominent features
2. Are characterized [...]
Names given to Cannibus:
Grass
Pot
Mary jane
Tea
Weed
Cannibus Indica
Cannibus Indica - marijuana christmas tree
Cannibus Americana
The following Indian names were given to different preparations from cannibus:
Bhang comes from cut tops and low resin content
Ganja obtained from flowering tops and leaves and has higher quality and quantity or [...]
Neonatal Period (0-1 m)
- APGAR score - assessment of newborn based on Appearance, Pulse, Grimace, Activity & Respiration (0-10); taken at 1, 5 & 10 min
If summary score is…
0-2 NICU; Serious problems
3-6 Fair; needs help to maintain life
7-9 Good health
10 Excellent health
Apgar newborn scoring system
Score
0
1
2
Appearance
Color
Pale
Blue extremities
Pink
Pulse
Heart rate
Not detectable
Below 100
Above 100
Grimace
Reflex irritability
No response
Grimace
Vigorous cry
Activity
Muscle tone
Flaccid [...]
Produce visual illusions and visual hallucinations (usually)
Some of them (LSD), psilocybin and dimethyltryptamine (DMT) - have structural resemblance to serotonin
Another group is chemically related to Dopamine & NE, such as mescaline, methylenedioxy metamphetamine (MDMA or ecstasy) and Dimmethoxy and metamphetamine (DOM or STP)
Usually PO
Other Hallucinogens
Methylenedioxy amphetamine (MDA)
Bufotenine
[...]
Compenents of Mental Function
Level of Consciousness= alertness, awareness of environment
Attention = ability to focus or concentrate on task
Recent (Short-term) Memory = memory in minutes, hours, days
Remote (Long-term) Memory = memory in years
Orientation = awareness of who person is in relation to time, place, other people
Depends on memory + attention
Sensory perception = awareness of [...]
The dissociative disorders involve a disturbance in the integrated organization of identity, memory, perception, or consciousness
Men = Women
Symptoms decrease w/ age
There may be an association between traumatic events (childhood physical or sexual abuse) and dissociative sx
May arise as a defense against trauma
BIRTH
A. APGAR score @ 1, 5, 10 mins (1-10 w/ 10 = best)
B. SOCIAL INTERACTION
a. Alertness:
1. regular sleep - > irregular sleep - > periodic sleep - > drowsiness - > alert inactivity - > waking inactivity - > crying
b. eye contact imp. as well as non-verbal communication for bonding
c. irritability/innate temperament is [...]
ADHD Definition
Persistent pattern of inattention and/or hyperactivity-impulsivity that’s more frequent & severe than is typically observed in individuals at a comparable level of development
Symptoms
- Inattention
o Difficulty w/sustained attention in tasks or play
o Poor follow through on instructions & fails to finish schoolwork, chores or duties
- Hyperactivity
o Fidgets or squirms in seat
o Inappropriately runs about [...]
Definition - repetitive persistent pattern of behavior in which the basic rights of others or societal norms or rules are violated; behavior is more serious than transient mischief of kids & teens.
Oppositional defiant d/o (ODD) - kids won’t do what their told; minor incidents
Attention deficit hyperactivity d/o (ADHD) - kids are impulsive & [...]
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