Psychology Summaries
Solomon, Caren G., Murray B. Stein, and Jitender Sareen. "Generalized Anxiety Disorder." The New England journal of medicine 373.21 (2015): 2059-68. ProQuest. 7 Apr. 2016 .Retrieved fromhttp://search.proquest.com.contentproxy.phoenix.edu/docview/1735349848?pq-origsite=summon
Generalized Anxiety Disorder (GAD) is a condition that creates excessive worry and concern in a debilitating manner for those afflicted with the condition. “According to representative epidemiologic surveys, the estimated prevalence of generalized anxiety disorder in the general population of the United States is 3.1% in the previous year and 5.7% over a patient’s lifetime; the prevalence is approximately twice as high among women as among men” (Solomon, Stein, and Sareen 2015, p.2059). One of the common problems seen in individuals with GAD are also symptoms of depression and higher likelihood for addiction. Many turn to alcohol and drugs to help ease the anxiety in hopes to get relief or to help them fall asleep.
For the population who suffers with anxiety disorder, their life can be disrupted as persistent fear and worry consume their thoughts making it difficult to concentrate. Other symptoms of GAD present themselves in gastrointestinal problems, headaches, muscle tension, back pain, and insomnia (Solomon, Stein, and Sareen 2015, p.2061). Despite the fact that too many patients suffering from GAD go years without informing their doctors, it is important to also work with a psychiatrist who can provide specialized treatment to help ease the problems that anxiety has created in their lives.
Treatment plans for anxiety have included cognitive behavior therapy in conjunction with pharmacological treatment. “Studies provide support for the efficacy of most (but not all) antidepressants, several benzodiazepines, buspirone, and pregabalin in the treatment of generalized anxiety disorder, in addition to newer drug treatments that include vilazodone, bupropion, vortioxetine, and imipramine” (Solomon, Stein, and Sareen 2015, p.2063).
Conclusive evidence has yet to confirm which pharmacologic treatments work best with psychotherapy for those struggling with GAD despite the current treatment plans and available options that most doctors turn to for treatment of generalized anxiety disorder. However, the current options have been helpful for many suffering with these exaggerated sense of worry and concern that can develop into more complicated ailments associated with anxiety.
"Borderline Personality Disorder"
Bhome, Rohan, and Pavel Fridrich. "Borderline Personality Disorder." British Journal Of Hospital Medicine (London, England: 2005) 76.1 (2015): C14-C16. MEDLINE Complete. Web. 2 Apr. 2016. Retrieved from- http://goo.gl/Q0t4JJ
“Borderline personality disorder (BPD) is marked by difficulties in interpersonal relationships, impulsiveness, mood instability and a high rate of suicidal behavior” (Bhome, and Fridrich 2005, p. C14). Individuals with BPD are highly volatile in their relationships and have difficulty maintaining and managing interpersonal exchanges in both personal and professional affairs. Reduced productivity and increased health care costs are associated with the portion of the population who are diagnosed with BPD.
American psychoanalyst Adolf Stern was the first to come up with the term “borderline” in 1938 (Bhome, and Fridrich 2005, p. C14). This condition was one that was difficult to define as it was difficult to fit the group of suffers into the neurotic or psychotic mental illness disorders. “It wasn’t until the 1960’s and 1970’s that Otto Kernberg recommended that mental disorders be broadly based on three separate groups of personalities: psychotic, neurotic or ‘borderline personality’” (Bhome, and Fridrich 2005, p. C14).
Despite the fact that BPD most likely exists globally, it is only in the U.S. and UK that it has been recognized as a condition requiring treatment (Bhome, and Fridrich 2005, p. C14). There have been no indication to support that there is a prevalence of BPD that is gender specific; however young single people living in a city were much more likely to complain of symptoms of BPD than any other group (Bhome, and Fridrich 2005, p. C14). “There is growing evidence that borderline personality disorder is linked to genetic abnormalities affecting neurotransmitter pathways in the brain which govern behavioral responses such as impulsiveness, emotion processing and controlling destructive urges,” and these symptoms can become worse based on environmental stressors (Bhome, and Fridrich 2005, p. C14). “Imaging studies have shown deficits in prefrontal cortex connectivity which correlate with the clinical observation that borderline personality disorder patients have difficulty with interpersonal skills owing to a limited ability to think ahead, empathize with others and problem solve using learnt behaviors (Nelson and Schulz, 2012; Bhome, and Fridrich 2005, p. C14).
“Schizophrenia”
Owen, Michael J., Akira Sawa, and Preben B. Mortenson. “Schizophrenia.” The Lancet. (2016). Retrieved from- http://ac.els-cdn.com/S0140673615011216/1-s2.0 S0140673615011216-main.pdf? tid=5babf09a-fd1a-11e5-9b4b-
Schizophrenia is a mental illness that is extremely debilitating for those who are afflicted. Although not all individuals diagnosed with the disease display severe symptoms, as many as 50% diagnosed have tremendous difficulty in their ability to function in society (Owen, Sawa, Mortenson 2016). The characteristics of symptoms involve delusions and hallucinations creating disconnect from reality. Other symptoms affecting those diagnosed with schizophrenia are cognitive impairment, problems integrating in society, inability to work, problems with relationships, problems with motivation, spontaneous speech and social withdrawal (Owen et al. 2016).
Treatment options with schizophrenia include psychotherapy and anti-psychotic medications. Symptoms of schizophrenia often present themselves in adolescents and often show signs of other mental illness symptoms, “such as bipolar disorder, depression, schizo affective disorder, schizophreniform disorder, delusional disorder, brief psychotic disorder, and psychotic disorder not otherwise specified” (Owen et al. 2016, 1). Schizophrenia commonly varies widely in symptoms and treatment results are just as diverse; “however, attempts to resolve this heterogeneity into valid subtypes have been unsuccessful” (Owen et al. 2016, 1).
Researches find that the auditory and visual hallucinations are a symptom that is displayed in 5-8 percent of the population who are not diagnosed with schizophrenia making it difficult to pin down. Schizophrenia is likely to be a genetically inherent disease, but it is not always an underlying cause (Owen et al. 2016). The information obtained from the genomic studies done on the disease over the past eight years has resulted in three important finding- 1) the disease is highly polygenic, 2) genetic risk seems highly pleiotropic, and 3) although genetic connection has not been discovered in the specifics of the DNA, there is clearly indication of a biological process (Owen et al. 2016).
In terms of pathophysiology there is evidence of change in the structure or function of the brain in schizophrenics. Changes in the prefrontal cortex suggest a possible reason for cognitive issues; and a reduction in grey matter and abnormalities of white matter are seen in various parts of the brain (Owen et al. 2016). It appears there’s evidence of “dysfunction in the dopaminergic neurotransmission in the genesis of psychotic symptoms such as delusions and hallucinations” (Owen et al. 2016, 5).
Treatment option with medication can involve anti-psychotics to help minimize symptoms, but clozapine is most effective as it binds and affects the DRD2, and other neurotransmitter receptors, such as serotonin receptors 2 (5HT-2R) (Owen et al. 2016, 6). Aside from pharmacotherapy, it is helpful for schizophrenics to have appropriate support via therapy, social support, educational and vocational support to manage life in society.
Diagnosis and treatment of schizophrenia still remains a mystery in some aspects and further research continue to better understand the disease. Fortunately what is known about the disease allows for treatment option like those mentioned. Additional studies are needed to fully understand the disease.
“Mechanisms underlying the benefits of anticonvulsants over lithium in the treatment of bipolar disorder.”
Corrado, A.D., Walsh, J.P. “Mechanisms underlying the benefits of anticonvulsants over lithium in the treatment of bipolar disorder.” Neuro Report 27, 131-135 (2016) Retrieved from- http://goo.gl/jbcVmt
Bipolar disorder is a complex and costly disorder that is split in two categories- Bipolar I, which involves manic episodes of hypomania and then depression, while Bipolar II is linked with less severe involving only one major bout of mania and one severe depressive episode. Treatment of bipolar has generally involved the use of lithium, but there is evidence of anticonvulsants being extremely helpful in mood stabilization.
Lithium has been used in the treatment of Bipolar Disorder since 1970 has been the most common form of pharmacological therapy. Lithium “inhibits brain glycogen synthase kinase (GSK-3β), a serine-threonine kinase GSK-3β activates growth factor cascades through phosphorylation, including those triggered by nuclear factor κ-light-chain-enhancer of activated B cells, heat shock factor protein-1,cAMP response element-binding protein, activator protein-1, and β-catenin” (Corrado and Walsh 2016, 131). This activation process affects metabolism and growth, stabilizing the cell’s cytoskeleton, and the process of apoptosis (Corrado and Walsh 2016). An increase in GSK-3β has been shown to be associated with manic and other behavioral episodes common in bipolar patients. By the use of lithium, the GSK-3β is downregulated resulting in a reduction of neural apoptosis, which decreases the onset of manic episodes (Corrado and Walsh 2016).
“Pharmacological treatment of adult ADHD”
Bitter, I., Angyalosi, A. & Czobar, P. “Pharmacological treatment of adult ADHD.”
Current Opinion in Psychiatry 25 (6), 529-534 (2012). Retrieved from-
http://goo.gl/Q2U51i
The article reviews the results in treatment of adult attention deficit hyperactivity disorder (ADHD) using various pharmacological treatments over the past 18 months (Bitter, Angyalosi, and Czobar, 2012). ADHD is a condition that often presents itself in childhood, but can clearly affect adults as well. Treatment options have been limited to stimulant and non-stimulants. Stimulants have shown more effective.
The stimulant group includes methylphenidate (MPH) and amphetamines (AMP) such as dextroamphetamine, lisdexamphetamine dimesylate and mixed amphetamine salts. Lisdexamphetamine dimesylate (LXD) is a prodrug, which is converted to L-lysine and dexamphetamine, which increases dopamine in the brain helping with symptoms of ADHD (Bitter et al, 2012). There are two type, immediate-release and extended-release. Extended-release is recommended of immediate-release for the effectiveness throughout the day and with less chances of abuse.
Seven studies were collected from PUBMED and MEDLINE for the literature review on the ADHD and stimulant medication use. Stimulants show to be the most effective course when compared to the non-stimulant or placebo in the various studies, in addition to the Cohen-d indicating medium to high effects of pharmacotherapy in adult ADHD treatment (Bitter et al, 2012).
Works Cited
Bhome, Rohan, and Pavel Fridrich. "Borderline Personality Disorder." British Journal Of
Hospital Medicine (London, England: 2005) 76.1 (2015): C14-C16. MEDLINE
Complete. Web. 2 Apr. 2016. Retrieved from- http://goo.gl/Q0t4JJ
Bitter, I., Angyalosi, A. & Czobar, P. “Pharmacological treatment of adult ADHD.”
Current Opinion in Psychiatry 25 (6), 529-534 (2012). Retrieved from-
http://goo.gl/Q2U51i
Corrado, A.D., Walsh, J.P. “Mechanisms underlying the benefits of anticonvulsants over
lithium in the treatment of bipolar disorder.” Neuro Report 27, 131-135 (2016)
Retrieved from- http://goo.gl/jbcVmt
Owen, Michael J., Akira Sawa, and Preben B. Mortenson. “Schizophrenia.” The Lancet.
(2016).
Retrieved from- http://ac.els-cdn.com/S0140673615011216/1-s2.0-
S0140673615011216-
main.pdf? tid=5babf09a-fd1a-11e5-9b4b-
00000aacb35e&acdnat=1460072715_aa0977c4573cc82436a8b46e540c35d6
Solomon, Caren G., Murray B. Stein, and Jitender Sareen. "Generalized Anxiety
Disorder." The New England journal of medicine 373.21 (2015): 2059-68.
ProQuest. 7 Apr. 2016 .Retrieved from
http://search.proquest.com.contentproxy.phoenix.edu/docview/1735349848?pq-
origsite=summon
