Patho I, Ch.19 - Neurobiology of Schizophrenia, Mood Disorders, and Anxiety Disorders

Which statement is true of anxiety disorders? A. Anxiety disorders are the most prevalent psychiatric illness. B. More than 20 distinct anxiety disorders have been recognized. C. Anxiety disorders are normal and will correct themselves. D. Benzodiazepines are first-line, single treatment for panic disorder.

A. Anxiety disorders are the most prevalent psychiatric illness. Anxiety disorders are the most prevalent psychiatric illness, occurring in approximately 10% to 30% of the general population. The Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DMS-IV-TR) lists eight recognized anxiety disorders: panic disorder (PD), agoraphobia, generalized anxiety disorder (GAD), social phobia, specific phobia, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and acute stress disorder. When normal fear and anxiety mental states persist and become uncontrollable, an individual may develop an anxiety disorder. PD, GAD, PTSD, and OCD are examples of uncontrollable fear and anxiety states that require medical attention. Panic disorders are generally treatable with cognitive behavioral therapy (CBT) and antidepressants such as TCAs and SSRIs. Benzodiazepines (BZs) are used as an adjunct or augmentation therapy for individuals who are nonresponsive to SSRIs or TCAs.

Which drugs may produce psychosis at high doses? (Select all that apply.) A. Levodopa B. Fluphenazine C. Haloperidol D. Cocaine

A. Levodopa D. Cocaine Drugs that increase dopamine transmission such as levodopa or cocaine may produce psychosis at high doses. Traditional antipsychotic drugs, such as fluphenazine and haloperidol, have a high affinity for dopamine receptors and reduce psychotic states.

Which statement is true regarding a mood disorder? A. Mood disorder is a sustained emotional state. B. It is a disruption of thought. C. Lifetime prevalence rate for depression is 1%. D. Of those with depression, 95% respond to medication.

A. Mood disorder is a sustained emotional state. A mood disorder is a sustained emotional state. The condition is unipolar or a major depressive disorder, or it is bipolar (manic-depressive) illness. A disruption of thought is consistent with schizophrenia, not a mood disorder. Lifetime prevalence for depression is 16.2% for the general population. The prevalence of the bipolar disorder ranges from 3% to 5% in the general population. Approximately 80% of depressed persons will respond to antidepressant drugs such as monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), and selective serotonin reuptake inhibitors (SSRIs).

A woman with a history of schizophrenic asks the nurse, "Now that I'm pregnant, how will my mental illness affect my baby?" Which response from the nurse is true regarding her child? A. Schizophrenia may result from neurodevelopmental defects. B. Research does not indicate any environmental involvement in schizophrenia. C. An early brain defect immediately reveals itself. D. No alterations are suspected in the brain structure.

A. Schizophrenia may result from neurodevelopmental defects. Alterations are suspected in the brain structure that may be the result of neurodevelopmental defects. Researchers believe that environmental factors may alter brain development; these factors include prenatal infection, prenatal nutritional deficiencies, perinatal complications, hypoxia, and upbringing in an urban environment. Researchers also hypothesize that an early brain defect may remain silent until that part of the brain is used.

Which statement is true regarding mood disorders? A. The hypothalamic-pituitary-adrenal (HPA) system hormones are decreased in a large percentage of individuals with major depression. B. Depression occurs with deficits in brain norepinephrine. C. Environmental factors play no role in depression. D. No genetic role exists in depression.

B. Depression occurs with deficits in brain norepinephrine. The monoamine hypothesis of depression suggests that a deficit in brain norepinephrine, dopamine, and/or serotonin is the underlying cause of depression. HPA system activity is increased in a large percentage of individuals with major depression (30% to 70% of those with major depression have chronic activation of the HPA system and elevated glucocorticoid secretion). Environmental and genetic factors play large roles in the development of depression.

Which term describes the inability to experience emotions, especially pleasure? A. Alogia B. Avolition C. Anhedonia D. Aphasia

C. Anhedonia Anhedonia is the inability to experience emotions, and individuals often report a sense of detachment from the environment. Alogia is the absence of spontaneous speech production for the purpose of answering or expressing oneself. Avolition is a deficit in spontaneous or goal-directed behavior. Aphasia is the lack of speech.

Which of the following best describes schizophrenia? A. Positive personality B. Negative personality C. Disruption of thoughts D. Constant hallucinations

C. Disruption of thoughts Schizophrenia is a collection of illnesses characterized by thought disorders that reflect a break in reality or a splitting of the cognitive from the emotional side of a person's personality. It is characterized by positive and negative symptoms. Hallucinations, delusions, and cognitive defects are components of schizophrenia.

Which statement is true regarding the epidemiologic effects of schizophrenia? A. If one twin has schizophrenia, then a 70% chance exists that the remaining twin will develop the disease. B. Ten percent of the general population will have schizophrenia. C. Schizophrenia is a simple genetic transmission. D. Concordance between siblings is 12%.

D. Concordance between siblings is 12%. Monozygotic twins have a concordance rate of 30% to 50%. Siblings and dizygotic twins have a 12% concordance rate. Schizophrenia can occur in a child with parents who do not have the disease. Schizophrenia occurs in approximately 1% of the population. The genetic penetrance is not simple.

When an individual reports that, "Voices are telling me to steal money from the church," the nurse determines that the person is experiencing: A. Delusions B. Disorganized speech C. Disorganized behavior D. Hallucinations

D. Hallucinations A hallucination is a perception experienced without external stimulation of the sense organs. Sensory hallucinations may involve auditory, tactile, visual, gustatory, and olfactory features. A delusion is a persistent belief contrary to the educational and cultural background of the individual. Disorganized speech and behavior (bizarre behavior) are also positive symptoms of schizophrenia. Incongruity of affect is another dimension of disorganized behavior.