Ch.16 Psychopathology Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

Epidemiology

A

study patterns of disease in a population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Depression is more prevalent in what gender?

A

Females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Drug dependency is more prevalent in what gender?

A

Males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Alcoholism is more prevalent in what gender?

A

Males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Peaks for depression occurs at what age?

A

25 to 44 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Peaks for antisocial behavior occurs at what age?

A

25 to 44 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cognitive impairment occurs especially in people of what age group?

A

Older than 65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What percent of the U.S. population report symptoms that match the defining features of a major psychiatric disorder.

A

33.33% or 1/3rd of the population.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What percent of people with Schizophrenia recover?

A

30-40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is schizophrenia considered a “public” disorder?

A

B/c many who have it become homeless on our streets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the prevalence of Schizophrenia?

A

1% which is ~3 million people in the United States.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dissociative thinking

A

The key symptom of schizophrenia

major impairment in logical structure and thought.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Key symptom of schizophrenia?

A

Dissociative thinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Are Schizophrenia hallucinations usually visual and auditory?

A

No usually just auditory if some one has a visual hallucination it is usually associated with a drug such as LSP and not a schizophrenic episode.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the clinical features common to the varied forms of schizophrenia according to German Psychiatrist Emil Kraepelin?

A
Paranoia 
grandiose delusions 
abnormal emotional regulation (changes in emotion/affect)
bizarre disturbances of thought 
auditory hallucinations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the associative symptoms of schizophrenia identified by Eugen Bleuler in his book “The Group of Schizophrenias”?

A

loosened associations
emotional disturbance
delusions (false thought)
hallucinations (auditory)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the clinical features common to the varied forms of schizophrenia according to German Psychiatrist Emil Kraepelin?

A
Paranoia 
grandiose delusions 
abnormal emotional regulation 
bizarre disturbances of thought 
auditory hallucinations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are considered today’s symptoms of schizophrenia?

A

1) auditory hallucinations
2) Highly personalized delusions (false belief)
3) changes in affect (emotion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Some investigators proposed major division of schizophrenic symptoms into what two groups?

A

1) Positive

2) Negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Examples of positive symptoms in reference to schizophrenia?

A

hallucinations
delusions
excited motor behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

The term negative symptoms refers to what

A

Behavioral functions that have been lost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The term positive symptoms refers to what

A

abnormal behavioral states that have been gained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What suggest that positive and negative symptoms arise from different neural abnormalities?

A

Positive and negative symptoms respond differently to drug treatments.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

There are several kinds of schizophrenia that vary in related degree of what?

A

Paranoia, blunted effect, or cognitive impairment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Role of genes in schizophrenia? All or nothing?

A

No instead they can simply affect the probability that an individual will develop the disorder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Examples of negative symptoms in reference to schizophrenia?

A
slow and impoverished thought 
slow and impoverished speech 
emotional withdrawal 
social withdrawal 
blunted affect of emotional expression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is Alogia?

A

reduced speech output, a negative symptom of schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the Flat affect?

A

blunted emotional response, a negative symptom of schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is Anhedonia?

A

loss of pleasurable feeling, a negative symptom of schizophrenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is Catatonia?

A

Reduced movement, a negative symptom of schizophrenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Is Schizophrenia an inheritable disorder?

A

it is partially heritable but environmental influences and developmental difficulties also play a role in the development of schizophrenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

who has a higher risk of schizophrenia than general population?

A

parents and siblings of people with schizophrenia. Which supports the theory of it being partly genetic since the closer relatives share a greater number of genes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What do they mean when they say the mode of inheritance of Schizophrenia is not simple?

A

It means it does not involve a single recessive or dominant gene. Rather multiple genes can play a role in the emergence of schizophrenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Monozygotic twins

A

identical; share an identical set of genes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what type of monozygotic twins are more likely to be concordant for schizophrenia?

A

Monozygotic twins that share the same placenta are more likely to be concordant for schizophrenia than monozygotic twins with their own placenta.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Why can one twin with the same genetics have schizophrenia and not the other if schizophrenia partly has to do with genetics?

A

Genes can be expressed in different ways.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

dizogotic twins

A

fraternal; have 1/2 their genes in common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Concordant for schizophrenia means what?

A

Concordant refers to when both twins in a pair express/suffer from the trait, in this case the trait being schizophrenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Discordant for schizophrenia refers to?

A

Discordant refers to when only one of a pair of twins suffers from/expresses a trait, in this case the trait being schizophrenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what is the percent of monozygotic twins of people with schizophrenia are concordant for the disorder?

A

~1/2 or 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What percent of dizogotic twins of people with schizophrenia are concordant for the trait?

A

17%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is strong evidence of the genetic factor of schizophrenia?

A

The percent of concordant of schizophrenia for monzygotic twins of people with the disorder is significantly higher than the percent concordant for dizogotic twin. Monozygotic zwins are twice as closely related by genetics than dizogotic twins. Also the environmental and variables like family structure and socioeconomic stress factor would be presumably comparable for twins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What typically tended to be the characteristics of the twin that developed schizophrenia, in twins that were discordant for the trait?

A

tended to be more abnormal throughout life
frequently weighed less at birth
Early developmental history including more instances of physiological distress.
during development more submissive. tearful, sensitive than the other twin and seen by the parents as more vulnerable.
In childhood impairments of motor control and other neurological signs
behavioral developmental difficulty during childhood
Cognitive development difficulty during childhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

How can an eye tracking measurements (neuropsychological test) show if you may have schizophrenia?

A

In an eye tracking measurement the eye movements are recorded while the eyes follow a moving target on a computer screen. These measurements are abnormal in schizophrenic patients. Schizophrenic patients tend to be unable to use normal smooth muscle movements of the eyes to follow the moving target and instead show an intrusion of rapid, jerky eye movements.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

endophenotype

A

Behavioral or physical characteristics accompany susceptibility to a particular disorder, which may be used to identify those risks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Genetic analyzing suggest genes influencing the development of schizophrenia are scattered across many different human chromosomes. However there have been a few genes identified that appear to be abnormal in a substantial proportion of schizophrenic cases. These genes include?

A
encoding for neuregulin 1
dysbindin 
catechol-O-meth-yltransferase (COMT) 
G27 
 disrupted in schizophrenia 1 (DISC1)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

genes encoding for neuregulin 1 participatein?

A

NMDA, GABA and ACh receptor regulation.

abnormality identified in schizophrenics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

dysbindin is a gene implicated in what?

A

synaptic plasticity

abnormality identified in schizophrenics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

catechol-O-meth-yltransferase (COMT) is a gene involved in what?

A

metabolizing dopamine

abnormality identified in schizophrenics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

G27 is a gene thought to contribute to what?

A

to glutamatergic activity.

Abnormality identified in schizophrenics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

How does paternal age play a role in schizophrenia?

A

Older fathers are more likely than younger men to have children with schizophrenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Why may paternal age play a role in schizophrenia?

A

Perhaps the sperm of older men, which are the product of more cell divisions than the sperm of younger men, have accumulated more mutations by errors in copying the chromosomes; these mutations may increase likelihood of schizophrenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what are the ventricular abnormalities in patients with schizophrenia?

A

Many have enlarged cerebral ventricles especially the lateral ventricles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

How does duration of hospitalization and length of illness affect the size of the ventricles in schizophrenics?

A

It does NOT affect it at all.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

How does ventricular enlargement predict the responsiveness to anti-psychotic drugs?

A

Patients with more enlarged ventricles tend to show poorer response to these drugs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What happened to transgenic mice with a mutated version of the gene DISC1?

A

They developed enlarged lateral ventricles.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is the significance of enlarged ventricles of schizophrenics?

A

Since the overall size of the brain does not increase the enlarged ventricles must come at the expense of brain tissue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Among twins who are discordant for schizophrenia, the twin that is ill tends to have two brain structures smaller than the healthy one. what are they?

A

1) Hippocampus

2) Amygdala

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

How does the size of the ventricles and the size of hippocampus and amygdala correlated in schizophrenia?

A

The hippocampus and amygdala help form the walls of the lateral ventricles. Atrophy of the hippocampus and amygdala would cause enlargement of lateral ventricles and smaller hippocampus and amygdala structures. Which is what you see in schizophrenics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Besides the hipocampus, amygdala and ventricles what other brain structures seems to be abnormal?

A

parahipocampal regions/cortex , entorhinal cortex, and cingulate cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

When comparing the structure of the hippocampus of a schizophrenic to a person of the same age without the illness what were the differences discovered?

A

The Pyramidal cells of schizophrenic were disorganized, possibly resulting from abnormal synaptic arrangements of both the inputs and outputs of these cells. The most impaired individuals exhibited greatest disorganization.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

The cellular disorganization of schizophrenia probably arises when?

A

during early cell development but because new neurons are made throughout life, especially in the hippocampus, abnormal neurogenesis or disordered integration of newly born cells could contribute to development of schizophrenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

How do schizophrenics and controls differ structurally in the corpus callosum?

A

Schizophrenics tend to have a more accelerated loss of gray matter at adolescence than controls

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What has test sensitive to frontal cortical lesions told us about schizophrenics?

A

Schizophrenics tend to be impaired on neuropsychological test that are sensitive to frontal cortical lesions. Raising the possibility that the frontal cortex was impaired in schizophrenics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

PET scans indicate what about schizophrenic patient’s frontal lobes?

A

That there is is relatively less metabolic activity in the frontal lobes compared to the posterior lobes. While in control subjects there is more-equal activation of frontal and posterior cortex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

In schizophrenic discordant twins frontal blood flow is reduced in which twin?

A

Only in the one with schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Neurons in the frontal cortex of schizophrenic patients compared to controls?

A

the neurons in schizophrenic patients have dendrites with a reduced density of synaptic spines compared with control subjects., which may contribute to less active frontal cortex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

hypofrontality hypothesis for schizophrenia

A

Suggest that schizophrenia may be caused by the underactivation of the frontal lobes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Cortical abnormalities in schizophrenics include what?

A

thicker corpus callosum and

altered function in this structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

lobotomy

A

surgical separation of a portion of the frontal lobes from the rest of the brain, as a treatment for schizophrenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Did lobotomies cure schizophrenia?

A

No, they may have made the patients easier to handle but they were rarely able to leave the mental institution.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

How many lobotomies were performed in the United States?

A

~40,000 people. Used for almost all mental disorders not just Schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What replaced lobotomies in 1954 as treatment for schizophrenia?

A

Chlorpromazine (trade name Thorazine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Did Chlorprozamine actually work?

A

yes and in fact the symptoms that responded to chlorprozamine were exactly those that kept people in the mental institution.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Chlorproamazine could powerfully reduce what symptoms of schizophrenia?

A
Positive symptoms of schizophrenia, including: 
 auditory hallucinations 
delusions 
disordered thinking 
*ONLY POSITIVE SYMPTOMS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the dopamine hypothesis for schizophrenia?

A

People with schizophrenia suffer from an excess or either dopmaine release or dopamine receptors.

77
Q

Neuroleptics

A

antipsychotic drugs

chlorpromazine is an example of a neuroleptic

78
Q

Chlorprozamine and later antipsychotic drugs that came along were found to share what specific action?

A

They block post synaptic dopamine receptors, particularly dopamine D2 receptors. Which lead to dopamine hypothesis.

79
Q

How did drug abuse of amphetamines support the dopamine hypothesis?

A

people who took extremly large amount of amphetamine (as much as 3000 mg a day instead of 5 mg used to combat sleepiness) developed symptoms of schizophrenia. It turns out amphetamines promote the release of dopamine and prolongs the action of the released transmitter by blocking reuptake.

80
Q

amphetamine psychosis

A

When individuals take such large dosages of amphetamine they develop symptoms of schizophrenia.

81
Q

Can amphetamine psychosis be reversed?

A

yes; chlorpromazine treatment rapidly reverses amphetamine psychosis.

82
Q

Drugs like LSP and mescaline produce some perceptual, cognitive and emotional changes but what is the difference between these hallucinations and schizophrenic hallucinations.

A

Drugs like LSP and mescaline produce perceptual hallucinations while schizophrenic hallucinations are auditory.

83
Q

All typical neuroleptics are what?

A

D2 blockers; D2 receptor antagonist

84
Q

How can the clinically effective dose of a typical neuroleptic be predicted?

A

By its affinity for D2 receptors, as the dopamine hypothesis would predict.

85
Q

Which typical neuroleptic has a greater affinity for D2 receptors chlorpromazine or haloperidol?

A

Haloperidol, which quickly became the new widely used drug.

86
Q

How can the treatment of parkinson induce schizophrenia-like symptoms

A

Those treated with L-dopa (metabolic precursor of dopamine) may induce schizophrenic-like symptoms, presumably by boosting the synaptic availability of dopamine.

87
Q

What are the problems with the dopamine model?

A

there is no correspondence between the speed with which drugs block dopamine receptors (quite rapidly-within hours) and how long it takes symptoms to diminish (usually on the order of weeks). Thus the relation is more complex than just hyperactive dopamine synapses.
Some schizophrenics do not respond at all to dopamine antagonist.

88
Q

dyskinesia

A

a symptom of typical neuroleptics

maladaptive motor symptoms; distortion in voluntary movement

89
Q

when does dyskinesia occur

A

If dosage is to high when reduced they go away
Prolonged drug treatment, sometimes after months and sometimes years can cause drug induced motor changes. At this point they are effectively permanent.

90
Q

tardive dyskinesia

A

characterized by repetitive, involuntary movements, especially involving the face, mouth, lips and tongue.

91
Q

What are common uncontrollable movements involved in tardive dyskinesia?

A

incessant rolling movements of the tongue
sucking or smacking of the lips
twisting
sudden jerking movements of arms and legs

92
Q

When does tardive dyskinesia occur?

A

frequently takes a long time to develop and tends to be irreversible.

93
Q

Difference between D1 and D2 receptor binding of patients with tardive dyskinesia and those without symptom?

A

There is no difference.

94
Q

What does prolonged blockage if dopamine receptors using antipsycotics tend to do to the number of dopamine receptors?

A

seems to increase the number of dopamine receptors and lead to receptor supersensitivty.

95
Q

What type of drug treatment tends to have fewer dyskinesia side effects than typical neuroleptics?

A

atypical neuroleptics but are more likely to cause weight gain.

96
Q

Why do atypical neuroleptics tend to have the motor side effects of typical neuroleptics?

A

atypical neuroleptics generally don’t have high affinity for dopamine receptors like typical neuroleptics but instead have a high affinity for other types of receptors.

97
Q

Clozapine

A

an atypical neuroletic that selectively block serotonin receptors (especially 5HT2A receptors) as well as other receptor types.

98
Q

Are atypical neuroleptics just as effective as typical neuroleptics?

A

Yes

99
Q

clozapine increases _____ in the ______

A

dopamine; frontal cortex

100
Q

How do atypical neuroleptics not support the dopamine hypothesis?

A

Atypical neuroleptics like clozaprine actually release dopamine and infact supplementing neuroleptics with L-dopa (increasing dopaminergic activity) actually helps reduce symptoms of schizophhrenia.

101
Q

Are atypical antipsychotics better treatment fro schizophrenia than typical antipsychotics?

A

No they were found to be equally as effective. Although atypical neuroleptics are less likely to cause side effects in motor control but more likely to cause weight gain.

102
Q

The Glutamate Hypothesis of schizophrenia

A

schizophrenia results from underactivity of glutamate receptors.

103
Q

psychotomimetic

A

A drug that induces a state resembling schizophrenia

104
Q

what is Phencyclidine (PCP)

A

is a potent psychotomimetic; produces phenomena strongly resembling both the positive and negative symptoms of schizophrenia.

105
Q

Users of PCP usually experience what?

A

auditory hallucinations
strange depersonalization
disorientation
May become violent as a consequence of their drug-induced delusions.

106
Q

PCP acts as a ______ receptor _____.

A

NMDA receptor antagonist

107
Q

What happened when moneys were treated with PCP for 2 weeks?

A

produced schizophrenic-like syndrome, including poor performance o a test sensitive to prefrontal damage.

108
Q

PCP as a NMDA receptor antagonist

A

PCP blocks the NMDA receptor’s central calcium channel, thereby preventing the endogenous ligand-glutamate- from having its usual effects.

109
Q

Ketamine

A

Have similar affects as PCP and is another NMDA antagonist.

110
Q

If glutamate hypothesis is true than compound that increase glutamatergic activity would be effective antischizophrenic drugs?

A

No these NMDA receptor agonist tend to produce seizures, so it is not an option.

111
Q

symptoms of amphetamine psychosis?

A

These symptoms include: delusions, auditory hallucinations, paranoia, suspicious and bizarre motor behavior.

112
Q

what are the affects of amphetamine on dopamine?

A

Amphetamine promotes the release of dopamine and prolongs the action of the released transmitter by blocking reuptake.

113
Q

chloropromazine is a treatment for what?

A

amphetamine psychosis

114
Q

when can super sensitivity psychosis emerge?

A

can emerge when drug doses are lowered; this reflects upregulation of receptors during treatment.

115
Q

Clozapine does what to dopamine release?

A

Increases dopamine release in frontal cortex hardly what would be expected if the problem of schizophrenia was an over stimulation of dopamine receptors since Clozapine is an atypical neuropletic.

116
Q

The glutamate hypothesis has been expanded to suggest that underactivation of ALL glutamate receptors, not just the NMDA subtype, contributes to schizophrenia. How may this help explain the effectiveness of atypical neuroleptics?

A

atypical neuroleptics act on 5HT2A serotonin receptors, because some metabotropic glutamate receptors form complexes with 5HT2A receptors. A typical neuroleptics that block 5HT2A receptors seem to make nearby mGluR’s more effective. So perhaps they reduce schizophrenia symptoms indirectly by boosting mGluR responsiveness. If so, then direct stimulation of the proper class of mGluR’s (there are atleast 8 subtypes) might provide a third generation of antipsychotics.

117
Q

PCP act as a _____ and prevents _____ from acting normally?

A

acts as a NMDA receptor antagonist and prevents glutamate from acting normally.

118
Q

What produces similar effects as PCP?

A

ketamine

119
Q

An integrated model suggest that schizophrenia will develop if a compromised brain is exposed to _______

A

environmental stressors.

120
Q

What environmental stress during pregnancy can cause an increase risk of schizophrenia?

A

If the mother has an infection while carrying the child, especially influenza. A baby that contracts influenza in the first trimester is 7 times more likely to develop schizophrenia.

121
Q

Does a baby that contracts influenza have a greater risk for schizophrenia?

A

Yes a baby that contracts influenza in the first trimester is 7 times more likely to develop schizophrenia.

122
Q

Does the season in which a baby is born correlate to increases of schizophrenia?

A

yes; People born in the late winter and early spring are more likely to develop schizophrenia probably due to mothers getting sick previous winter at some fetal stage that was particularly vulnerable.

123
Q

Does blood type between mother and baby affect changes of schizophrenia?

A

yes; Babies who have mothers with incompatible blood types have a higher risk for schizophrenia?

124
Q

Does the development of diabetes in a pregnant woman affect chances of baby developing schizophrenia?

A

Yes; if the mother develops diabetes during pregnancy the baby is at higher risk for schizophrenia.

125
Q

Is birth weight of a baby correlated to schizophrenia?

A

Yes babies with low birth weights have higher chances of developing schizophrenia

126
Q

Do birth complications that deprive a baby of oxygen increase probability of schizophrenia?

A

Yes, higher probability of development.

127
Q

What age is the prevalence of schizophrenia?

A

age groups between 18-25

128
Q

Is there evidence suggesting that living in a city or the country affect risks of developing schizophrenia?

A

yes; People born and raised in a medium-city are about 1.5 times as likely to develop schizophrenia than people living in the country. People in a big city are even more susceptible

129
Q

Does the length of time in the city affect changes of developing schizophrenia?

A

Yes; the longer in the city the higher the risk of development.

130
Q

Does moving out the city affect risks of developing schizophrenia?

A

yes; those that move out of the city have a reduced risk of development.

131
Q

What are specific features (main features) that increases susceptibility of schizophrenia at the different life stages besides genetics.

A

before birth- infection
at delivery- delivery complications (reduced O2)
adolescence- social stress
adulthood- social stress

132
Q

Depression is most common in people over the age of ____

A

40

133
Q

Is depression more common in men or women?

A

women

134
Q

Depression is characterized as what?

A

an unhappy mood; loss of energy, interest and appetite; difficulty in concentration; restless agitation. Pessimism seems to seek into every act.

135
Q

what is unipolar depression?

A

depression that alternates with normal emotional states.

136
Q

Does unipolar depression occur due to stress?

A

No it can occur with no readily apparent stress.

137
Q

Without treatment how long can depression last?

A

last for several months

138
Q

Depressive illness is estimated to afflict how much of the population?

A

13-20% at any one time

139
Q

Is inheritance a factor of depression?

A

yes; for monozygotic twins is ~ 60% and for dizygotic twins its ~ 20%. The concordance rate is ~ the same rather the twins are reared together or apart.

140
Q

Adoption shows that there is a higher rate in depression of (biological or foster parent)?

A

Higher rate in biological parents

141
Q

If it is genetic than what genes cause it?

A

No specific genes but an array of genes that make one more susceptible to depression

142
Q

about _____% of all suicide victims are profoundly depressed

A

80%

143
Q

What suggesting that suicides appear to be impulsive acts?

A

Of the 500 people who were prevented from jumping off the Golden Gate bridge only 6% later went on to commit suicide. Also in great Britain when coal gas containing deadly monoxide was replaced with natural gas for heating and cooking suicide went down and has stayed down for last 40+ years

144
Q

A more common name for manic-depressive disorder

A

bipolar disorder

145
Q

What characterizes bipolar disorder?

A

repeated fluctuation between depressive periods and episodes of euphoric, sometimes grandiose, positive mood (or mania).

146
Q

In depressed individuals there is an increase in blood flow to the ______ and _____

A

an increase in blood to the prefrontal cortex and amygdala

147
Q

In depressed individuals there is a decrease in blood flow to the _____, _____, and ____, systems implicated in _____

A

a decrease in blood flow to the parietal cortex, posterior temporal cortex and anterior cingulate, systems implicated in attention

148
Q

Fear is mediated by the ____

A

amygdala

149
Q

after depression is alleviated over time blood flow to the ____ persist

A

amygdala, which mediates fear.

150
Q

Descendants of people with severe depression have thinner cortex across large swaths of the _____ hemisphere.

A

Right

151
Q

Many report reduced volumes in the _____ in people with depression and reduced activation in this area in depressed people during ______ tasks

A

hippocampal; during memory task.

152
Q

what is Electroconvulsive shock therapy (ECT)

A

the intentional induction of a large-scale seizure by passing an electric current through the brain.

153
Q

ECT was first used to help those suffering from _____ but clinical observations soon revealed it could rapidly reverse severe _____.

A

schizophrenia; depression.

154
Q

ECT is now used only for _____ depression since medication treatment is now a thing.

A

severe, drug-resistant depression.

155
Q

Transcranial magnetic stimulation (TMS)

A

alters coritcal electrical activity, used for treating depression

156
Q

What is the most common treatment for depression today?

A

the use of drugs that affect monoamine transmitters.

157
Q

what do Monoamine oxidase (MAO) inhibitors do?

A

they are a treatment for depression; they inhibits the enzyme that inactivates the monoamines.: norepinephrine, dopamine and serotonin

158
Q

What are the three main monoamines?

A

Norepinephrine
dopamine
Serotonin

159
Q

MAO inhibitors ______ the raise the level of monoamines present in synapses suggests that depressed people do not ______ at those synapses.

A

raise; do not get enough stimulation

160
Q

reserpine

A

reduces norepinephrine and serotonin (both monoamines) release in the brain, can cause profound depression.

161
Q

tricyclics

A

second generation of antidepressants, conform to the monamine hypothesis because they inhibit the reuptake of monoamines, boosting their synaptic.

162
Q

Selective serotonin reuptake inhibitors (SSRIs)

A

a major class of modern antidepressants; such as prozac. These drugs are more effective than MAO inhibitors and tricylics and have fewer side effects.

163
Q

Prozac

A

Selective serotonin reuptake inhibitors (SSRIs)

164
Q

In rats, SSRIs ______ neurogenesis in the _____

A

increase; hippocampus

165
Q

SRRIs ____ production of brain steroids

A

Increase

166
Q

allopregnanolone

A

Is a brain steroid

167
Q

What may be a role of brain steroids?

A

It may contribute to the effectiveness of SSRIs by stimulating GABA receptors and reducing anxiety.

168
Q

zoloft

A

an SSRI

169
Q

Paxil

A

SSRI

170
Q

Nardil

A

MAO inhibitor

171
Q

Marplan

A

MAO inhibitor

172
Q

Parnate

A

MAO inhibitor

173
Q

SSRIs increase the risk of what is both adults and adolescents?

A

increase risk of suicide

174
Q

If serotonin levels get too high it can trigger what?

A

Serotonin syndrome

175
Q

Problems with theory of serotonin reduction as a cause of depression

A
  • Long lag time between treatment and reduction of symptoms.

- Not everyone is helped, and there is also a large placebo effect.

176
Q

How many people in a drug trial for the depression treatment SSRIs feel better on a placebo?

A

1/3rd

177
Q

what percent of depressed patients respond better to SSRIs than placebo

A

13% and these are the most sever cases

178
Q

% of patients on SSRI completely “cured”

A

50%

179
Q

% patients who have no improvements when on SSRIs?

A

20% so no improvement at all

180
Q

What is the problem with SSRIs and over-the-counter drugs?

A

A variety of over the counter drugs can synergize with the drugs to push synaptic serotonin levels too high, triggering serotonin syndrome

181
Q

What are symptoms associated with serotonin syndrome?

A

confusion muscle spasms, and fever.

182
Q

How many cases/deaths due to serotonin syndrome are reported each year?

A

Thousands of cases are reported, causing over 100 deaths.

183
Q

The glutamate receptor ketamine may be related to depression how?

A

It may be a potent antidepressant

184
Q

Vagal nerve stimulation

A

a treatment for depression; electrodes are surgically wrapped around the vagus nerve in the neck, and a pacemaker provides mild electrical stimulation at intervals

185
Q

Dexamethasone

A

a synthetic glucocorticoid, can suppress cortisol release in normal people but not in depressed patients.

186
Q

Phototherapy

A

administered in the morning can suppress melatonin, a hormone that is normally released from the pineal gland at night

187
Q

Melatonin

A

may aid SAD if given in the afternoon.

188
Q

In Cyclothymia

A

milder form of bipolar disorder—patients cycle between dysthymia (mild depression) and hypomania (increased energy).

189
Q

PTSD victims have decreased volume in the

A

right hippocampus