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29 Cards in this Set
- Front
- Back
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A bachelor's degree alone is utterly ________
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insufficient
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When did mental hospitals lose favor?
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1960s
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How was the care in mental hospitals?
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inhumane and expensive
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In the 1980s, what did massive budget cuts to social welfare programs lead to?
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Many mental hospitals closed. Patients released to outpatient care programs
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Mental hospitals still exist but only care for...how long?
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2-4 weeks
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Where do most mental-health related inpaitents stay now?
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general hospitals with psychiatric wards
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As psychiatric patients age, they are placed in _______ ______ but these places have few ___________ _________ _________
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- nursing homes
- specialized treatment personnel |
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Halfways houses provide assisted living for an extended period of time. What do they do and why?
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Halfway housing provide help acquiring living skills and help finding outside employment and living arrangements for patients to guide them to be able to be aprt of mainstream society.
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Community health centers
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- provide free or low-cost mental health services
- inpatient, outpatient, day hospital, night hospital, emergency, aftercare, rehab, public education, consultation, evaluation services |
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clinician's private practice offices
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for those that can afford them
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psychiatrist
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- top of heirarchy
- MD with specialized psych training - any treatment setting, usually hospital or private practice - the ONLY ones who can prescribe drugs |
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clinical psychologists
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- non-medical doctorate degrees (PhD or PsyD)
- research and private practice - work in universities |
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PhD
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- higher research requirement
- suited for teachers |
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PsyD
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emphasizes clinical practice
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counseling psychologists
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- PhD or PsyD
- don't see super psycho patients - talking therapy - Humanistic/Phenomenological approach of Carl Rogers and Abraham Maslow - counsel clients on experiences from normal development through life experiences - do NOT work in hospitals |
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counselors
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- master's degree, state certification, teaching certificate
- work in schools, halfways houses, community mental health centers, private practice - help with school or job problems, substance abuse, behavioral, mental health, or family and relationship problems |
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psychiatric social workers
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- master's degree in social work
- work for govt agencies, hospitals in management of outpatient cases (substance abuse to strokes to mood disorders, etc.) - maybe private practice - visit clients or patients in home settingsp |
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psychiatric nurse
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- minimum bachelor's or master's degree in nursing
- work in hospitals or community care centers - conduct psychotherapy sessions, DISPENSE meds (but NOT prescribe) under supervision of an MD |
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3 categories of disorders treated with psychoactive drugs
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- anxiety disorders
- schizophrenia - depression |
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benzodiazepines (BZDs)
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- most common anti-anxiety drugs (anxiolytics)
- Librium, Valium, Xanax - fast-acting, cross blood-brain barrier to relieve axiety wtihin 20-30 min - enhance activity of inhibitory transmitter GABA by bind to some GABA receptors - limbic system (emotion/motivation) has high numbers of BZD sensitive GABA receptors, especially amygdala (memory/emotion) - BZDs have potential for abuse/dependence-- enhance action of alcohol which also enhances GABA activity --> unintentional overdose, lower baseline GABA activity - sudden stopping = rebound anxiety therefore administration must gradually taper off |
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antipsychotic meds
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- block excessive dopamine transmission at receptor => direct antagonists
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phenothiazines
- 1st antipsychotic drug was chlorpromazine (Thorazine) |
- 1950s sedative to schiz
- blocks dopamine D2 dopamine receptors which are plentiful in basal ganglia (voluntary movements) - after long time of meds, schiz report loss of hallucinations and delusions = adoption of chloropromazine and phenothiazines as antipsychotic meds |
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phenothiazines/chloropromazines...curiousity
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drugs chemically do direct antagonist job at receptor level immediately but minimum of 10 days to 2 weeks required for symptomatic relief to weeks or months for max relief
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tardive dyskinesia
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- side effect to phenothiazines
- disorder with spontaneous uncontrollable writhing movements - because motor system's D2 receptors become overly sensitive to dopamine due to their constant blockade - newer antipsychotic meds called novel antipsychotic avoid TD by blocking D4 receptors (in cortex but not in motor system). They also block %HT3 receptors and since hallucinogens are serotonin agonists, it is unclear how much blocking 5HT3 receptors have on reduction of hallucinogens and delusions |
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antidepressants
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- also biochemically active immediately but may take 10 days to 2 weeks for relief and max relief after weeks or months
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MAOIs
(monoamine oxidase inhibitors) |
- 1st antidepressants
- MAO enzyme that breaks down dopamine, norepinephrine and serotonin - used on depressed patients 1950s |
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TCAs
(tricyclic antidepressants) |
- 2nd generation after MAOIs
- less toxic - prevent reuptake of norepinephrine --> increase levels in synapse |
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SSRIs
(selective serotonin reuptake inhibitors) |
- 1980s
- Prozac, Paxil, Zoloft - low toxicity but may facilitate aggressiion and suicide |
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ECT
(electroconvulsive therapy) |
- "shock therapy"
- for drug-resistant cases - electric current pass through the brain to induce a seizure - patient is anesthetized and unconscious - treatments 2-3 times/wk, total of 6-12 treatments - side effects include memory loss and confusion |
