NURS 6501 Knowledge Check Concepts of Psychological Disorders
Walden University NURS 6501 Knowledge Check Concepts Of Psychological Disorders-Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NURS 6501 Knowledge Check Concepts Of Psychological Disorders assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NURS 6501 Knowledge Check Concepts Of Psychological Disorders
Whether one passes or fails an academic assignment such as the Walden University NURS 6501 Knowledge Check Concepts Of Psychological Disorders depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NURS 6501 Knowledge Check Concepts Of Psychological Disorders
The introduction for the Walden University NURS 6501 Knowledge Check Concepts Of Psychological Disorders is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NURS 6501 Knowledge Check Concepts Of Psychological Disorders
After the introduction, move into the main part of the NURS 6501 Knowledge Check Concepts Of Psychological Disorders assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NURS 6501 Knowledge Check Concepts Of Psychological Disorders
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NURS 6501 Knowledge Check Concepts Of Psychological Disorders
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NURS 6501 Knowledge Check Concepts Of Psychological Disorders
Scenario 1: Schizophrenia
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What are the known characteristics of schizophrenia and relate those to this patient?
Schizophrenia is a chronic mental disorder displayed in patients who interpreted reality abnormally just like the 22-year-old patient in the provided case study. It can lead to a combination of delusion. Hallucination and extremely disordered behaviour and thinking impair the patient normal functioning (Correll et al., 2019). The patient in the provided case study reported signs of auditory and visual hallucination, unexpected rage and crying, and delusion. Additional symptoms include disorganized speech and thinking as demonstrated by the results of the mental status examination. The patient also displayed negative symptoms such as inability to make eye contact and being socially withdrawn which are significant indications of schizophrenia disorder.
Musculoskeletal, metabolic, and multisystem health dysfunctions represent one of the most challenging health conditions that may have a complex challenge to the affected patient (Beefcroft & Hough, 2016). Symptoms of these conditions may range in severity. Musculoskeletal complications can affect the muscle, bone, tendons and joints. A major symptom that patients encounter is pain. Conditions may range from the ones that are sudden and short-lived to the ones that are lifelong and are associated with disability as well as ongoing pain. Among the notable changes that a patient with this condition may experience include persistent pain as well as mobility limitations. In this, the patients who may suffer from the long-term condition may experience severe pain that may be related to the wearing out of the tendons. For some patients with complex conditions, they may experience joint deformity that may be a long term condition, and it may be relatively challenging to treat it. When these abnormal changes occur, the involved patient may find it hard to handle some of the changes in weight, thus affecting some parts of the body (Black, 2016). Although musculoskeletal conditions may arise in many forms as well as a result of different factors, there are many ways that the situation may represent itself. The identification
of specific symptoms of the disorder plays an essential role in the development of an approach to assist in the management of the stated condition.
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Genetics are sometimes attached to schizophrenia explains this.
Pre-molecular and molecular genetic studies have reported that genetics play a significant role in the development of schizophrenia. Consequently, the inheritance pattern of the disease demonstrates increased risk among first relatives. At the molecular level, several positional and functional genes associated with the development of schizophrenia have been identified, such as neuregulin (NRG-1, 8p12–21), proline dehydrogenase (PRODH-2, 22q11.21), dysbindin, (DTNBP1,6p22.3), catechol-O-methyltransferase (COMT, 22q11.21), G72 (13q34) / D-amino acid oxidase (DAAO,12q24),5HT2A and dopamine D3 receptor (DRD3) and regulator of G protein signaling (RGS-4) (Cleynen et al., 2021). Recent studies support schizophrenia candidate regions on chromosomes 1q, 2q, 5q, 6p, 8p, 10p, 13q,15q and 22q. Additional studies are however required to provide a precise association with the above-mentioned genetic factors concerning how they lead to the development of schizophrenia.
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What roles do neurotransmitters play in the development of schizophrenia?
Neurotransmitters are chemicals responsible for conveying messages between brain cells. Studies illustrate an association between changes in the levels of neurotransmitters in the brain to the development of schizophrenia. This is evident by the mechanism of antipsychotics in relieving symptoms of schizophrenia through altering the levels of certain neurotransmitters in the brain. Recent studies have reported several biochemical alterations in schizophrenia, concerningneurotransmitter dysfunction in different systems, with the most prominent being γ-aminobutyric acid (GABA), serotonin, glutamate, and dopamine (Müller, 2018). For instance, alterations in the signaling of dopamine and hyperactivity of the D2 receptor in the limbic and subcortical region of the brain have been associated with some of the schizophrenia symptoms including delusion and hallucination. Consequently, hypodopaminergic activity in the mesocortical system is also associated with negative symptoms of schizophrenia such as flattening, lack of pleasure, withdrawal, and inability to follow through.
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Explain what structural abnormalities are seen in people with schizophrenia.
Through imaging studies, several complex patterns of structural abnormalities have been reported among patients diagnosed with schizophrenia, in addition to those who are at high risk of the disorder (Zhao et al., 2018). For example, MRI studies have reported a reduced volume of grey matter in the prefrontal, superior temporal, and medial temporal areas of the brain. These regions of the brain are involved in several functions such as short-term memory/decision making, processing of auditory information, and episodic memory respectively. Postmortem studies on the other hand report that a reduction in the cortical grey matter does not indicate loss of cell bodies but instead, reflects a reduction in synaptic density and dendritic complexity which may impair intraneuronal integration and communication leading to cognitive changes among other associated symptoms. Disruptions in the integrity of the white matter have also been implicated in schizophrenia, given that it forms the structural connections between different regions of the brain.
Scenario 2: Bipolar Disorder
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How does genetics play in the development of bipolar 2 disorders?
Bipolar disorder (BD) is characterized by extreme shifts in the patient’s mood, behaviour, and energy levels. The patient in the provided case study is however diagnosed with bipolar 2 disorder, which is characterized by hypomanic and depressive episodes. The inheritance pattern of bipolar 2 disorder is quite unclear. Studies however report greater risks among first-degree relatives, with genetic factors accounting for approximately 80% of the causes of this mental disorder (Gordovez& McMahon, 2020). Genome-wide association studies (GWASs) have associated increased risk of bipolar 2 disorder with several genetic factors such as alpha-1 subunit of the L-type voltage-gated calcium channel (CACNA1C), teneurin transmembrane protein 4 (ODZ4), ankyrin G node of Ranvier (ANK3), nesprin-1 (SYNE1) and diacylglycerol kinase eta (DGKH).For instance, the DGKH is involved in diacylglycerol (DAG) phosphorylation in the phosphoinositol pathway sensitive to lithium, which contributes to the development of the bipolar disorder.
References
Cleynen, I., Engchuan, W., Hestand, M. S., Heung, T., Holleman, A. M., Johnston, H. R., … & Bassett, A. S. (2021). Genetic contributors to the risk of schizophrenia in the presence of a 22q11. 2 deletion. Molecular psychiatry, 26(8), 4496-4510. https://doi.org/10.1038/s41380-020-0654-3
Correll, C. U., Brevig, T., & Brain, C. (2019). Patient characteristics, burden, and pharmacotherapy of treatment-resistant schizophrenia: results from a survey of 204 US psychiatrists. BMC psychiatry, 19(1), 1-12. https://doi.org/10.1186/s12888-019-2318-x
Gordovez, F. J. A., & McMahon, F. J. (2020). The genetics of bipolar disorder. Molecular psychiatry, 25(3), 544-559.https://doi.org/10.1038/s41380-019-0634-7
Müller, N. (2018). Inflammation in schizophrenia: pathogenetic aspects and therapeutic considerations. Schizophrenia bulletin, 44(5), 973-982. https://doi.org/10.1093/schbul/sby024
Zhao, C., Zhu, J., Liu, X., Pu, C., Lai, Y., Chen, L., … & Hong, N. (2018). Structural and functional brain abnormalities in schizophrenia: a cross-sectional study at different stages of the disease. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 83, 27-32. https://doi.org/10.1016/j.pnpbp.2017.12.017.
Sample Answer 2 for NURS 6501 Knowledge Check Concepts Of Psychological Disorders
Scenario 2: Bipolar Disorder
A 44-year-old female came to the clinic today brought in by her husband. He notes that she has been with various states of depression and irritability over the past 3 months with extreme fatigue, has lost 20 pounds and has insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity.
DIAGNOSIS: bipolar type 2 disorder.
Question
1. How does genetics play in the development of bipolar 2 disorders?
Selected Answer: The pathophysiology of bipolar disorder, or manic-depressive illness (MDI), has not been fully identified, and there are no objective biologic markers that correspond definitively with the disease state. Twin, family, and adoption studies indicate that bipolar disorder has a significant genetic component. First-degree relatives of a person with bipolar disorder are approximately seven times more likely to develop bipolar disorder than the rest. The heritability of bipolar I disorder (BPI) has recently been estimated at 0.73. Bipolar individuals, who may exhibit psychotic behavior, have deficits in reelin expression linked to genetic loci located on chromosome 22, which confers susceptibility to schizophrenia. Given that, large variations in clinical symptoms still suggest that developmental and environmental factors are as important as genetic factors in contributing to the etiology of mood disorders.
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Correct Answer:
The pathophysiology of bipolar disorder, also known as manic-depressive illness (MDI), is not fully understood, and there are no objective biologic markers that definitively correspond with the disease state. Twin, family, and adoption studies have all found a significant genetic component to bipolar disorder. First degree relatives of people with bipolar disorder are approximately 7 times more likely than the general population to develop bipolar disorder, and the heritability of bipolar I disorder (BPI) has recently been estimated at 0.73. Bipolar people, who may exhibit psychotic behavior, have reelin expression deficits linked to genetic loci on chromosome 22, which confers susceptibility to schizophrenia. Given this, the fact that clinical symptoms vary widely suggests that developmental and environmental factors are involved.
Response Feedback: [None Given]
https://nursingassignmentgurus.com/nurs-6501-knowledge-check-concepts-of-psychological-disorders/
In this exercise, you will complete a 10- to 20-essay type question Knowledge Check to gauge your understanding of this module’s content.
Possible topics covered in this Knowledge Check include:
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- Generalized anxiety disorder
- Depression
- Bipolar disorders
- Schizophrenia
- Delirium and dementia
- Obsessive compulsive disease
Photo Credit: agsandrew – stock.adobe.com
Complete the Knowledge Check By Day 7 of Week 9
To complete this Knowledge Check:
Module 6 Knowledge Check
What’s Coming Up in Module 7?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In Module 7, you will analyze processes related to women’s and men’s health, infections, and hematologic disorders through case study analysis. To do this, you will analyze alterations in the relevant systems and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, which may impact physiological functioning and altered physiology.
Week 10 Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders
In the Week 10 Knowledge Check, you will demonstrate your understanding of the topics covered during Module 7. This Knowledge
Check will be composed of a series of questions related to specific scenarios provided. It is highly recommended that you review the Learning Resources in their entirety prior to taking the Knowledge Check, since the resources cover the topics addressed. Plan your time accordingly.
Also Read:
NURS 6501 Knowledge Check Women’s and Men’s Health, Infections, and Hematologic Disorders
NURS 6501 Module 7 Assignment: Case Study Analysis
NURS 6501 Knowledge Check Concepts Of Pediatrics
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NURS 6501 Musculoskeletal, metabolic, and multisystem health dysfunctions
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Next Module
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Week 9: Concepts of Psychological Disorders
Among the many risk factors for mental disorders are genetics and other pathophysiological factors. While other factors, such as environmental factors or substance abuse, can also have an impact, it is important to recognize the connections between biological factors and psychological disorders.
Ranging from anxiety to schizophrenia, psychological disorders offer unique challenges in diagnosis and treatment. Clearly, the presence of these disorders can be life-altering for patients, but they can also significantly impact families and other loved ones.
This week, you examine fundamental concepts of psychological disorders. You explore common psychological disorders, and you apply the key terms and concepts that help communicate the pathophysiological nature of these issues to patients.
Learning Objectives
Students will:
- Analyze concepts and principles of pathophysiology across the lifespan
Learning Resources
Required Readings (click to expand/reduce)
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
- Chapter 19: Neurobiology of Schizophrenia, Mood Disorders, Anxiety Disorders, and Obsessive-Compulsive Disorder, including Summary Review
Required Media (click to expand/reduce)
Module 6 Overview with Dr. Tara Harris
Dr. Tara Harris reviews the structure of Module 6 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check. (1m)
Concepts of Psychological Disorders – Week 9 (12m)
Generalized Anxiety Syndrome
Note: The approximate length of the media program is 5 minutes.
Sample Answer 3 for NURS 6501 Knowledge Check Concepts Of Psychological Disorders
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Question 1
Scenario 1: Schizophrenia
A 22-year-old female student was brought to her college student health department by her boyfriend. He was concerned about the changes in her behavior. The boyfriend noted that she has been hearing voices, and seeing things that are not there. She also thinks that there are people that want to harm her. She told her family that she cannot finish college as the voices told her to quit because she is “dumb”. The boyfriend relates episodes of unexpected rage and crying.
PMH: noncontributory
FH: positive for a first cousin who “had mental problems”.
SH: Denies current drug abuse but states he smoked marijuana every day during junior and senior years of high school. Admits to drinking heavily on weekends at various fraternity houses.
PE: thin, anxious disheveled female who, during conversations, stops talking, tilts her head and appears to be listening to something. There is poor eye contact and conversation is disjointed.
DIAGOSIS: schizophrenia.
Questions
1. What are known characteristics of schizophrenia and relate those to this patient.
Selected Answer: Schizophrenia is a serious mental disorder in which people interpret reality abnormally. Schizophrenia may result in hallucinations, delusions, and extremely disordered thinking and behavior that impair daily functioning and can be disabling. Schizophrenia involves a range of problems with thinking (cognition), behavior, and emotions. Signs and symptoms of schizophrenia may vary but usually involve delusions, hallucinations, or disorganized speech and reflect an impaired ability to function.
1- Delusions: These are false beliefs not based on reality. For example, you think that you are being harmed or harassed; certain gestures or comments are directed at you; you have exceptional ability or fame; another person is in love with you, or a major catastrophe is about to occur. Delusions occur in most people with schizophrenia.
2- Hallucinations: These usually involve seeing or hearing things that do not exist. Nevertheless, the person with schizophrenia has the full force and impact of a normal experience. Hallucinations can be in any sense, but hearing voices is the most common hallucination.
3- Disorganized thinking (speech): Disorganized thinking is inferred from disorganized speech. Effective communication can be impaired, and answers to questions may be partially or completely unrelated. Rarely, speech may include putting together meaningless words that cannot be understood, sometimes known as word salad.
4- Extremely disorganized or abnormal motor behavior: This may show in several ways, from childlike silliness to unpredictable agitation. Behavior is not focused on a goal, so it is hard to do tasks. Behavior can include resistance to instructions, inappropriate or bizarre posture, a complete lack of response, or useless and excessive movement.
5- Negative symptoms: This refers to reduced or lack of ability to function normally. For example, the person may neglect personal hygiene or appear to lack emotion (does not make eye contact, does not change facial expressions, or speaks in a monotone). Also, the person may lose interest in everyday activities, socially withdraw or lack the ability to experience a pleasure.
Certain factors seem to increase the risk of developing or triggering schizophrenia, including having a family history of schizophrenia; some pregnancy and birth complications, such as malnutrition or exposure to toxins or viruses that may impact brain development; taking mind-altering (psychoactive or psychotropic) drugs during teen years and young adulthood.
In summary, Positive symptoms of schizophrenia include hallucinations that may be auditory, olfactory, somatic-tactile, visual, voices commenting, and voices conversing. Delusions are also positive symptoms and include delusion of being controlled, mind-reading, the delusion of reference, grandiosity, guilt, persecution, somatic thought broadcasting, thought insertion, and thought withdrawal. Thought disorder symptoms include distractible speech, incoherence, illogicality, circumstantiality, and derailment. Bizarre behaviors are other positive symptoms of schizophrenia. Those behaviors include aggressiveness and agitated states, clothing appearance, repetitive stereotyping, and social and sexual behavior. This patient exhibited signs of auditory hallucinations, disheveled appearance, and persecution.
Correct Answer: Positive symptoms of schizophrenia include hallucinations that may be auditory, olfactory, somatic-tactile, visual, voices commenting, and voices conversing. Delusions are also positive symptoms and include delusion of being controlled, delusion of mind reading, delusion of reference, delusion of grandiosity, guilt, persecution, somatic thought broadcasting, thought insertion and thought withdrawal. Thought disorder symptoms include distractible speech, incoherence, illogicality, circumstantially, and derailment. Bizarre behaviors are other positive symptoms of schizophrenia. Those behaviors include aggressiveness and agitated states, clothing appearance, repetitive stereotyped, and social and sexual behavior. This patient exhibited signs of auditory hallucinations, disheveled appearance, and persecution.
Response Feedback: [None Given] -
Question 2
Scenario 1: Schizophrenia
A 22-year-old female student was brought to her college student health department by her boyfriend. He was concerned about the changes in her behavior. The boyfriend noted that she has been hearing voices, and seeing things that are not there. She also thinks that there are people that want to harm her. She told her family that she cannot finish college as the voices told her to quit because she is “dumb”. The boyfriend relates episodes of unexpected rage and crying.
PMH: noncontributory
FH: positive for a first cousin who “had mental problems”.
SH: Denies current drug abuse but states he smoked marijuana every day during junior and senior years of high school. Admits to drinking heavily on weekends at various fraternity houses.
PE: thin, anxious disheveled female who, during conversations, stops talking, tilts her head and appears to be listening to something. There is poor eye contact and conversation is disjointed.
DIAGOSIS: schizophrenia.
Question:
1. Genetics are sometimes attached to schizophrenia explain this.
Selected Answer: The causes of schizophrenia are not known. There are probably at least two sets of risk factors, genetic and perinatal. In addition, undefined socioenvironmental factors may increase the risk of schizophrenia in international migrants or urban populations of ethnic minorities. Increased paternal age is associated with a greater risk of schizophrenia. The risk of schizophrenia is elevated in biological relatives of persons with schizophrenia but not in adopted relatives. The risk of schizophrenia in first-degree relatives of persons with schizophrenia is 10%. If both parents have schizophrenia, the risk of schizophrenia in their child is 40%. Concordance for schizophrenia is about 10% for dizygotic twins and 40-50% for monozygotic twins. Genome-wide association studies have identified many candidate genes. However, the individual gene variants that have been implicated so far account for only a small fraction of schizophrenia cases, and these findings have not always been replicated in different studies. The genes that have been found mostly change a gene’s expression or a protein’s function in a small way.
Correct Answer: The causes of schizophrenia are not known. There are probably at least 2 sets of risk factors, genetic and perinatal. In addition, undefined socioenvironmental factors may increase the risk of schizophrenia in international migrants or urban populations of ethnic minorities. Increased paternal age is associated with a greater risk of schizophrenia. The risk of schizophrenia is elevated in biologic relatives of persons with schizophrenia but not in adopted relatives. The risk of schizophrenia in first-degree relatives of persons with schizophrenia is 10%. If both parents have schizophrenia, the risk of schizophrenia in their child is 40%. Concordance for schizophrenia is about 10% for dizygotic twins and 40-50% for monozygotic twins. Genome-wide association studies have identified many candidate genes, but the individual gene variants that have been implicated so far account for only a small fraction of schizophrenia cases, and these findings have not always been replicated in different studies. The genes that have been found mostly change a gene’s expression or a protein’s function in a small way.
Response Feedback: [None Given] -
Question 3
Scenario 1: Schizophrenia
A 22-year-old female student was brought to her college student health department by her boyfriend. He was concerned about the changes in her behavior. The boyfriend noted that she has been hearing voices, and seeing things that are not there. She also thinks that there are people that want to harm her. She told her family that she cannot finish college as the voices told her to quit because she is “dumb”. The boyfriend relates episodes of unexpected rage and crying.
PMH: noncontributory
FH: positive for a first cousin who “had mental problems”.
SH: Denies current drug abuse but states he smoked marijuana every day during junior and senior years of high school. Admits to drinking heavily on weekends at various fraternity houses.
PE: thin, anxious disheveled female who, during conversations, stops talking, tilts her head and appears to be listening to something. There is poor eye contact and conversation is disjointed.
DIAGOSIS: schizophrenia.
Question:
What roles do neurotransmitters play in the development of schizophrenia?
Selected Answer: Abnormalities of the dopaminergic system are thought to exist in schizophrenia. The first observable effective antipsychotic drugs, chlorpromazine, and reserpine, were structurally different, but they shared antidopaminergic properties. Drugs that diminish the firing rates of mesolimbic dopamine. D2 neurons are antipsychotic, and drugs that stimulate these neurons (e.g., amphetamines) exacerbate psychotic symptoms. Hypodopaminergic activity in the mesocortical system, leading to negative symptoms, and hyperdopaminergic activity in the mesolimbic system, leading to positive symptoms, may coexist. The newer antipsychotic drugs block dopamine D2 and serotonin (5- hydroxytryptamine [5-HT]) receptors. Clozapine, probably the most effective antipsychotic agent, is a particularly weak dopamine D2 antagonist. Thus, other neurotransmitter systems, such as norepinephrine, serotonin, and gamma-aminobutyric acid (GABA), are undoubtedly involved.
Correct Answer: Abnormalities of the dopaminergic system are thought to exist in schizophrenia. The first observable effective antipsychotic drugs, chlorpromazine and reserpine, were structurally different from each other, but they shared antidopaminergic properties. Drugs that diminish the firing rates of mesolimbic dopamine D2 neurons are antipsychotic, and drugs that stimulate these neurons (eg, amphetamines) exacerbate psychotic symptoms. Hypodopaminergic activity in the mesocortical system, leading to negative symptoms, and hyperdopaminergic activity in the mesolimbic system, leading to positive symptoms, may coexist. The newer antipsychotic drugs block both dopamine D2 and serotonin (5- hydroxytryptamine [5-HT]) receptors. Clozapine, probably the most effective antipsychotic agent, is a particularly weak dopamine D2 antagonist. Thus, other neurotransmitter systems, such as norepinephrine, serotonin, and gamma-aminobutyric acid (GABA), are undoubtedly involved.
Response Feedback: [None Given] -
Question 4
Scenario 1: Schizophrenia
A 22-year-old female student was brought to her college student health department by her boyfriend. He was concerned about the changes in her behavior. The boyfriend noted that she has been hearing voices, and seeing things that are not there. She also thinks that there are people that want to harm her. She told her family that she cannot finish college as the voices told her to quit because she is “dumb”. The boyfriend relates episodes of unexpected rage and crying.
PMH: noncontributory
FH: positive for a first cousin who “had mental problems”.
SH: Denies current drug abuse but states he smoked marijuana every day during junior and senior years of high school. Admits to drinking heavily on weekends at various fraternity houses.
PE: thin, anxious disheveled female who, during conversations, stops talking, tilts her head and appears to be listening to something. There is poor eye contact and conversation is disjointed.
DIAGOSIS: schizophrenia.
Questions:
Explain what structural abnormalities are seen in people with schizophrenia.
Selected Answer: Advances in neuroimaging studies show differences between the brains of those with schizophrenia and those without this disorder. In people with schizophrenia, the ventricles are somewhat larger, and there is decreased brain volume in medial temporal areas and changes in the hippocampus. Magnetic resonance imaging (MRI) studies show anatomic abnormalities in a network of neocortical and limbic regions and interconnecting white-matter tracts. Some studies using diffusion tensor imaging (DTI) to examine white matter found that two networks of white-matter tracts are reduced in schizophrenia. Brain imaging showed reductions in whole-brain volume and left and right prefrontal and temporal lobe volumes in many people at high genetic risk for schizophrenia. The changes in the prefrontal lobes are associated with the increasing severity of psychotic symptoms. MRI studies of schizophrenic patients show that structural brain abnormalities may progress over time. The abnormalities identified included whole-brain volume loss in both gray and white matter and increases in lateral ventricular volume.
Correct Answer: Advances in neuroimaging studies show differences between the brains of those with schizophrenia and those without this disorder. In people with schizophrenia, the ventricles are somewhat larger, there is decreased brain volume in medial temporal areas, and changes are seen in the hippocampus. Magnetic resonance imaging (MRI) studies show anatomic abnormalities in a network of neocortical and limbic regions and interconnecting white-matter tracts. Some studies using diffusion tensor imaging (DTI) to examine white matter found that 2 networks of white-matter tracts are reduced in schizophrenia. Brain imaging showed reductions in whole-brain volume and in left and right prefrontal and temporal lobe volumes in many people who are at high genetic risk for schizophrenia. The changes in prefrontal lobes are associated with increasing severity of psychotic symptoms. MRI studies of schizophrenic patients show that structural brain abnormalities may progress over time. The abnormalities identified included loss of whole-brain volume in both gray and white matter and increases in lateral ventricular volume.
Response Feedback: [None Given]
Question 5
Scenario 2: Bipolar DisorderA 44-year-old female came to the clinic today brought in by her husband. He notes that she has been with various states of depression and irritability over the past 3 months with extreme fatigue, has lost 20 pounds and has insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. DIAGNOSIS: bipolar type 2 disorder. Question 1. How does genetics play in the development of bipolar 2 disorders? |
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Scenario 2: Bipolar DisorderA 44-year-old female came to the clinic today brought in by her husband. He notes that she has been with various states of depression and irritability over the past 3 months with extreme fatigue, has lost 20 pounds and has insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. DIAGNOSIS: bipolar type 2 disorder. Question 1. How does genetics play in the development of bipolar 2 disorders? |
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Sample Answer 4 for NURS 6501 Knowledge Check Concepts Of Psychological Disorders
Primary Diagnosis: Depression
- Describe the pathophysiology of the primary diagnosis in your own words. What are the patient’s risk factors for this diagnosis?
Pathophysiology of Primary Diagnosis | |
· Depression has been primarily being associated with low brain 5‐hydroxytryptophan (5-HT) levels and altered 5‐HT receptors, such as upregulated 5‐HT2 and downregulated 5‐HT1A receptors causing mood alterations (Tian et al., 2022).
· Alterations in dopamine, glutamate, noradrenaline and GABA neurotransmitters and their receptors have been associated with synaptic plasticity and altered neurogenesis resulting in symptoms of major depression. · In addition, stress has been associated with high cortisol levels that inhibit 5‐HT1 neurotransmission increasing risk of depression. · High cortisol levels have also been associated with inflammatory cytokines such as interleukins that alter synaptic connections resulting in depression-like-behavior. |
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Causes | Risk Factors (genetic/ethnic/physical) |
· Neurodegenerative diseases such as dementia.
· Genetic alterations in serotonin 5-HT receptors (Remes et al., 2021). · Poor nutrition resulting in anemia · Thyroid diseases · Cushing disease · Pregnancy and post-partum state. |
· Family history of depression especially in a first degree relative.
· Medical conditions such as cancer and diabetes (Remes et al., 2021). · Female gender. · Psychological stress · Grief and loss · Alcohol and substance use. |
- What are the patient’s signs and symptoms for this diagnosis? How does the diagnosis impact other body systems and what are the possible complications?
Signs and Symptoms – Common presentation | How does the diagnosis impact each body system? Complications? |
· Depressed mood
· Insomnia or hypersomnia · Anhedonia · Loss of concentration · Increased or reduced appetite (Christensen et al., 2020) · Weight gain or loss · Fatigue and lack of energy. · Feeling guilty or worthless · Suicidal ideations |
· The diagnosis has been associated with an increased risk of comorbid alcohol and substance use.
· Depression has higher risks of relapse thus increasing morbidity rates (Fernandes et al., 2023). · The diagnosis has been associated with an increased rate of suicide hence increasing their morbidity and mortality. · Depression has an impact in a patient’s social life leading to failed friendships and marriage further worsening the prognosis. · Obesity can co-occur increasing the patient’s risk for cardiovascular diseases. |
- What are other potential diagnosis that present in a similar way to this diagnosis (differentials)?
· Central nervous system diseases such as Parkinson’s and dementia.
· Endocrine diseases such as hyperthyroidism, hypothyroidism, and Cushing’s disease (Menezes et al., 2022). · Schizophrenia and schizoaffective disorders. · Medical conditions such as syphilis and HIV. · Alcohol and substance use intoxication. · Anxiety disorders |
- What diagnostic tests or labs would you order to rule out the differentials for this patient or confirm the primary diagnosis?
· Thyroid function tests.
· Complete blood count. · Rapid plasma reagin (RPR). · HIV test. · Dexamethasone suppression tests (Menezes et al., 2022). · Blood alcohol level and toxicology screen. · Urea, electrolytes, and creatinine (UECs). · Brain magnetic resonant imaging (MRI). |
- What treatment options would you consider? Include possible referrals and medications.
a) Pharmacotherapy using antidepressants such as:
· Selective serotonin receptor inhibitors such as fluoxetine. · Serotonin-Noradrenaline receptor inhibitors such as venlafaxine (Karrouri et al., 2021). · Tricyclic antidepressants such as amitriptyline. · Monoamine oxidase inhibitors such as phenelzine. b) Psychotherapy methods such as: · Cognitive-behavioral therapy (Karrouri et al., 2021) · Interpersonal therapy · Problem-solving therapy · Behavioral activation c) Electroconvulsive therapy in patients who: · Have failed drug response. · Have high risk of suicide (Karrouri et al., 2021). · Need high antidepressant response. |
References
Christensen, M. C., Wong, C. M. J., &Baune, B. T. (2020). Symptoms of major depressive disorder and their impact on psychosocial functioning in the different phases of the disease: Do the perspectives of patients and healthcare providers differ? Frontiers In Psychiatry, 11, 280. https://doi.org/10.3389/fpsyt.2020.00280
Fernandes, M. D. S. V., Mendonça, C. R., da Silva, T. M. V., Noll, P. R. E. S., de Abreu, L. C., & Noll, M. (2023). Relationship between depression and quality of life among students: a systematic review and meta-analysis. Scientific Reports, 13(1), 6715. https://doi.org/10.1038/s41598-023-33584-3
Karrouri, R., Hammani, Z., Benjelloun, R., &Otheman, Y. (2021). Major depressive disorder: Validated treatments and future challenges. World Journal of Clinical Cases, 9(31), 9350–9367. https://doi.org/10.12998/wjcc.v9.i31.9350
Menezes, I. C., von Werne Baes, C., Fígaro-Drumond, F. V., Dias Macedo, B. B., Bueno, A. C., Lacchini, R., Feijó de Mello, M., de Castro, M., &Juruena, M. F. (2022). Differential diagnosis of major depressive disorder and bipolar disorder: Genetic and hormonal assessment and the influence of early-life stress. Brain Sciences, 12(11), 1476. https://doi.org/10.3390/brainsci12111476
Remes, O., Mendes, J. F., & Templeton, P. (2021). Biological, psychological, and social determinants of depression: a review of recent literature. Brain Sciences, 11(12), 1633. https://doi.org/10.3390/brainsci11121633
Tian, H., Hu, Z., Xu, J., & Wang, C. (2022). The molecular pathophysiology of depression and the new therapeutics. MedComm, 3(3), e156. https://doi.org/10.1002/mco2.15