Final Exam Abnormal CLP4143 April 30 Thursday 7 30 9 30 a m Don t be late Room PDA D0201 Eating disorders Schizophrenia Plus You tube Ted Talk of a woman who has schizophrenia Personality disorders just from power point not book Childhood disorder Chapter 14 late life Plus Extra Power point on geriatric psychiatry Substance Eating Disorders Substance Related Disorders DSM 5 has one category Substance use disorder List some of the DSM 5 symptoms o Examples Problematic pattern of use that impairs functioning Failure to meet obligations Repeated use in situations where it is physically dangerous Repeated relationship problems Continued use despite problems caused by the substance Tolerance Withdrawal Substance taken for a long time or in greater amounts than intended Efforts to reduce control do not work Much time spent trying to obtain the substance Social hobbies or work activities given up or reduced Craving to use the substance is strong Describe some of the more serious symptoms associated with withdrawal symptoms from alcohol and other substances Negative physical and psychological effects from stopping usage o Withdrawal o Muscle soreness and twitching tearfulness yawning o Become more severe and also include cramps chills sweating increase in HR and BP insomnia and vomiting o Withdrawal lasts about 72 hours o Negative symptoms o More severe symptoms Delirium Tremens Can occur when blood alcohol levels drop suddenly deliriousness Tremulousness Hallucinations primarily visual but may be tactile i e bugs crawling all over the body Briefly describe each drug o Example marijuana Drug derived from dried and ground leaves and stems of the female hemp plant Major active ingredient THC Psychological effects are Feelings of relaxation and sociability Rapid shifts of emotion Hashish Interferes with attention memory and thinking Stronger than marijuana Produced by drying the resin exudate of the tops of plants Most frequently used illicit drug in the US 17 000 reported using it in 2010 Greater use by men than women Use more common in European and Hispanic Americans than in African and Asian Americans and Hispanics Heavier use in the US than in Europe Africa or Canada Major active ingredient THC Effects Feelings of relaxation and sociability Rapid shifts of emotion Interferes with attention memory and thinking o Decline in IQ over time Heavy doses can induce hallucinations and panic Difficult to regulate dosage o Effects take 30 minutes to appear o Smoke more than intended waiting for effects Interfere with cognitive functioning o Impairs memory complex motor skills Physiological o Bloodshot and itchy eyes o Dry mouth and throat o Increased appetite o Reduced pressure within the eye o Increased BP o Damage to lung structure and function in long term users Marijuana and the brain Two cannabinoid brain receptors o CB1 and CB2 o High concentration in hippocampus Increased blood flow to emotion regions o Amygdala and anterior cingulate Habitual use leads to tolerance o Withdrawal symptoms also observed Therapeutic effects of marijuana Reduces nausea and loss of appetite caused by chemotherapy Relieves discomfort of AIDS chronic pain Supreme Court rulings o Federal law prohibits dispensing marijuana for medicinal purposes o Medical use can be prohibited by federal government even if states approve Describe briefly o Alcohol Alcohol use disorder More severe symptoms delirium tremens Can occur when blood alcohol level drops suddenly Deliriousness Tremulousness Hallucinations o Primarily visual may be tactile ex bugs crawling all over body Abuse 85 of alcohol abusers are smokers Lifetime prevalence DSM IV Abuse 17 Dependence 12 Binge drinking Heavy use drinking 5 drinks 5 or more times in a 30 day period 16 prevalence among college students 5 drinks in short period e g within an hour 43 5 prevalence among college students White and Hispanic adolescents and adults more likely to binge drink than African Americans Binge and heavy use drinking lowest among Asian Americans Alcohol dependence highest among Native Americans and Hispanics 21 3 of those with alcohol abuse or dependence also have at least 1 mental disorder o hallucinogens i e LSD LSD d lysergic acid diethylamide Hallucinogen effects include o Colorful visual hallucinations o Psychedelic trip expansion of consciousness Only 1 2 regular users o African Americans less likely to use than others Flashbacks o Hallucinogen persisting perception disorder HPPD o Most common during stress active ingredient of peyote Extracted from mushroom psilocybe Mexicana Mescaline Psilocybin Ecstasy Methylenedioxymethamphetamine MDMA Increase feelings of intimacy enhances mood Chemically similar to mescaline and amphetamines Acts on serotonin May be rising again Improves interpersonal relations Its use peaked in 2001 with 1 8 million users PCP phencyclidine Angel dust Animal tranquilizer Causes severe paranoia and violence o Barbiturates Drugs that act as central nervous system depressants and can therefore produce a wide spectrum of effects from mild sedation to total anesthesia They are also effective as anxiolytics hypnotics and anticonvulsants Induce sleep Dulled slow thinking Emotional instability swing from laughter to tears easily Slurring stumbled speech Lack of motor control Confusion Irritation antagonism o amphetamines Stimulants Increase alertness and motor activity reduce fatigue Produce high levels of energy sleeplessness Reduce appetite increase HR constrict blood vessels Synthetic stimulants o Benzedrine Dexedrine Methedrine Trigger release of and block reuptake of norepinephrine and dopamine High doses can lead to o Nervousness agitation irritability confusion paranoia and hostility Tolerance can develop after only 6 days use is an amphetamine derivative which can be taken orally Methamphetamine intravenously or intranasal snort Cocaine Crack o Form of cocaine that quickly become popular in the 80s o Rock crystal that is heated melted and smoked o Cheaper than cocaine o Alkaloid obtained from coca leaves o Reduces pain o Produces euphoria o Heightens sexual desire o Increases self confidence Blocks reuptake of dopamine in mesolimbic areas of brain Overdose o Chills nausea insomnia paranoia hallucinations possibly heart attack and death Not all users develop tolerance o Some become more sensitive o May increase risk of over dose o Cocaine use declined between 2002 and 2009 dropping to 1 4 from 2 Crack use is also declining Group of addictive
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