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dumb brain > 9 - Psychiatric Disorders > Flashcards

9 - Psychiatric Disorders Flashcards

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1
Q

define schizophrenia

A

severe mental disorder characterised by emotional dysregulation and cognitive deficits

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2
Q

difference between males and females

A

males have more severe forms, pronounced abnormalities and more resistant to treatment

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3
Q

male and female onset

A

15-25 in males

30 in females

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4
Q

what are the 4 courses of conditions

A

one episode
several with no impairment
impairment after first episode
exacerbated impairment

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5
Q

define alogia

A

reduced speech

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6
Q

define anhedonia

A

decreased ability to find pleasure in things one used to

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7
Q

define avolition

A

hard to initiate and pursue goal-directed behaviour

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8
Q

define affective flattening

A

lack of emotional and facial expressoin

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9
Q

define cognitive symptoms

A

difficulties with aspects of cognition which makes it harder to live a normal life and work

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10
Q

what are the wider areas of impact of schizophrenia

A 
more family stress
comorbidity
abuse
reduced employability and income
shame
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11
Q

define affective disorders

A

mood disorders where disordered feelings arise

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12
Q

some key things about the prevalence, incidence, onset, gender divide, etc. about depression are

A

15% p, 1% in, early adulthood, females get it more than males after 13 years old, can be continuous or episodes

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13
Q

some key things about the prevalence, incidence, onset, gender divide, etc. about bipolar are

A

1% p, 4% in, late adolescence, 50:50 males:females, manic and depressive episodes

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14
Q

how much longer are depressive episodes in bipolar than manic

A

three times longer

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15
Q

examples of manic mood and behaviour in bipolar

A

impulsivity, recklessness, euphoria

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16
Q

examples of psychotic symptoms in bipolar

A

delusions, hallucinations

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17
Q

examples of cognitive symptoms in bipoalr

A

distracted a lot, disorganised, inattentive

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18
Q

examples of dysphoric mood and behaviour symptoms in bipolar

A

depressopn, anxiety, suicide

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19
Q

in terms of genetics, schizophrenia is what and what other aspect causes it

A

polygenic

environment

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20
Q

define common variant

A

caused by a large number of genetic changes each of which has a small effect, involving single nucleotide polymorphism

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21
Q

with common variants in sz, what genes are responsible

A

MHC gene, DA system, Ca2+ channel functioning, glutamatergic system

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22
Q

define rare variant

A

rare but highly penetrant genetic changes where DNA has been deleted or duplicated

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23
Q

key gene with rare variants in sz

A

DISC1 - assoc w scaffolding protein for development, neurogenesis, synaptic/mitochondrial functioning

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24
Q

how does dopamine cause schizophrenia

A

DA synaptic overactivity in mesolimbic pathway causing +ive but underactivity in the mesocortical causing cognit/-ive

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25
Q

how do low levels of glutamate in the cerbrospinal fluid cause sz

A

genes influencing glutamate transmission changes, reducing NMDA binding which is linked to neurodevelopment e.g. pruning

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26
Q

how do serotonin changes affect sz

A

linked to -ive symptoms and moderates dopamine

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27
Q

what’s the neurodevelopmental approach towards sz

A

end of adolescence shows more marked difference in neurobiological processes

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28
Q

where is there less grey matter in those with sz

A

frontal and temporal cortex, as rapid loss in young adulthood

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29
Q

what do enlarged ventricles filled with water due to brain tissue loss correlate with

A

correlates with -ive symptoms, drug responsiveness, and cognitive symptoms

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30
Q

during hallucinations in schizphrenics, where is there activity and why

A

in auditory and visual cortices as brain can’t distinguish between real and imagined sounds and images

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31
Q

define hypofrontality

A

less activity in the pre-frontal cortex, associated with cognit/ive symptoms

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32
Q

what causes less PFC activity in sz

A

PCP/ket and indirect NMDA receptor antagonists suppressing the dorsal-lateral PFC

33
Q

when do MZ twins have a higher concordance rate

A

shared placenta

34
Q

where the split of the zygote occurs affects what with MZ twins

A

how identical the prenatal environment is

35
Q

6 schizophrenia risk factors

A 
urban area
pregnancy fever
winter birth
childhood cat
maternal substance abuse
birth comps
36
Q

why does a winter birth increase risk of sz

A

can contract a virus, meaning toxins and antibodies affecting brain development and attacking foetal cells may be produced

37
Q

how do early behavioural changes in individuals predict developing schizphrenia

A

sz triggered when neurons degenerate via pruning when the NS is developing connections

38
Q

in the diathesis-stress model, how is the nervous system involved

A

genetic and env risks trigger expression of genes altering NS function, causing SZ behaviour

39
Q

in depression, which gene is predisposed and ends with 8

A

GRM8 - metabolic glutamate production

40
Q

what gene is predisposed which ends with A in depression

A

RORA - circadian rhythm control

41
Q

name the 6 other genes which can predispose depression

A 
APOE
PCLO
TOMM40
GNB3
MTHFER
SLC6A4
42
Q

5 environmental factors risking depression

A 
ethnic minority
childhood maltreatment
trauma
prior trauma
natural brain changes
43
Q

3 materal environmental risk factors of depression

A

maternal stress
in utero infections
lack of nutrients

44
Q

how do environmental stressors and serotonin transporter gene polymorphisms combine to cause depression

A

short allele assoc w poor serotonin functioning more likely to have it when experienced higher # of stressful life events and homozy rec

45
Q

what things moderate depressive symptom severity experienced by those who have had child abuse

A

environmental stressors

single nucleotide polymorphisms in the brain-derived neurotrophic factor

46
Q

what have twin studies shown about heritability of bipolar

A

MZ/DZ show higher heritability than combined data from twin studies

47
Q

which gene, responsible for Wolfram syndrome, is associated with bipolar

A

WFS1 as comorbid with psychiatric disorders

48
Q

what gene is associated with the rapid cycling of bipolar

A

RORB

49
Q

what gene responsible for cortisol actions is associated with bipolar

A

CRH

50
Q

what gene related to stress is associated with bipolar

A

encodes binding protein aiding glucocorticoid receptor heterocomplex which regulates cortisol effects of stress

51
Q

3 other biological causes of bipolar

A

neurochemical changes
brain damage
hippocampus neurogenesis suppression

52
Q

how can increasing prefrontal cortex activity treat bipolar symptoms

A

by decreasing subgenual anterior cingulate cortex activity

53
Q

what does the prefrontal cortex do to cause negative emotional responses

A

inhibit the amygdala

54
Q

environmental risk factors of bipolar

A

IBS
head injury
perinatal infection

55
Q

in GxE, how does COMT relate to bipolar

A

responsible for breaking down dopamine, serotonin, and noradrenaline and risk depends on alleles and # stressful live events

56
Q

in GxE, how does BDNF relate to bipolar

A

MET carriers of BDNF had more severe, earlier onset of bipolar when experienced child abuse

57
Q

psych explanations of bipolar

A

negative explanatory style, learnt helplessness, gender differences

58
Q

socio-cultural explanations of bipolar

A

traumatic life events, cultural expectations, and depress-evoked responses

59
Q

how does the neurochemistry of bipolar and depression relate to stress hormones

A

higher cortisol/CSF
lower hippocampus and PFC volume in depressed
injecting CRH in rats causes depressive symptoms

60
Q

how do monoamines relate to depression and serotonin

A

post-morterms after suicide show high # 5HT receptors

depleting tryptophan reduced 5HT causing lowered moods since it’s a precursor protein

61
Q

which drug treatments working on serotonin have a positive effect on depression

A

MAOA inhibitors, tricyclics which block reuptake, SSRIs which are more selective than tricyclics

62
Q

in what season are most depressed people who commit suicide born in

A

summer

63
Q

how does BDNF relate to depression and bipolar

A

stress reduces levels but SSRIs increase levels through neural plasticity so don’t work straightaway

64
Q

why are some atypical antipsychotics partial agonists

A

have a high affinity for particular receptors but activate it less than norma;

65
Q

in what pathways are D2 receptors blocked by typical APs

A

all

66
Q

what receptors do atypical APs act on

A

D2 and serotonin receptors on DA neurons to counterbalance D2 blockage

67
Q

how do MAO inhibitors work to treat depression

A

inhibit MSO enzymes so DA, 5HT, NA broken down less but can cause hypertensive reactions

68
Q

how do tricyclics work to treat depression

A

inhibits NA, 5HT reuptake and prolongs PSPs but affects cholinergic system and linked to dementia

69
Q

how do SSRIs work to treat depression

A

inhibits 5HT or 5HT and NA reuptake with fewer non-specific effects but fewer side effects

70
Q

another example of a drug treatment for depression

A

serotonin noradrenaline reuptake inhibitors

71
Q

how does electroconclusive therapy for depression work

A

electrodes induce seizure activity which helps suicidal patients as relieves thoughts quickly by increasing seizure threshold and decreasing brain activity

72
Q

transcranial magnetic stimulation works as a treatment how

A

localised magnetic field induces electrical current when applied to the prefrontal cortex without causing cognitive deficits

73
Q

how does direct brain stimulation work as a depression treatment

A

electrodes implanted in subgenual anterior cingulate cortex and directed towards the nucleus accumbens to increase dopamine release

74
Q

how does REM sleep deprivation work

A

wake up when patient is in REM

75
Q

how does slow-wave sleep deprivation work

A

suppressing slow waves without waking person up to reduce time spent in REM

76
Q

how does total sleep deprivation work

A

helps facilitate medication effects as brain produces depressogenic chemical when asleep but not awake

77
Q

3 examples of bipolar drug treatments of which lithium is an example of one

A

mood stabilisers
anticonvulsants
antipsychotics

78
Q

how does lithium treat bipolar

A

treats manic phase so depression doesn’t occur and allows joy/sadness to be felt without any LT effects for intellect and emotion

79
Q

what are lithium’s biological effects

A

serotonin stabilised, increases neuroprotective proteins to reduce cell death, and grey matter increased

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