Class 23 - Psychiatric disorders Flashcards
What are the two subtypes of schizophrenia?
Acute schizophrenia (positive symptoms responsive to neuroleptics) and chronic schizophrenia (negative symptoms)
What are some DSM-IV symptoms of schizophrenia?
Hallucinations, delusions, disorganized speech and behavior, blunted emotions, loss of interest and drive
What are the brain abnormalities in schizophrenia?
Below average weight, enlarged ventricles, reduction in number and abnormal neurons in prefrontal cortex/hippocampus
What are the biochemical abnormalities implicated in schizophrenia?
Changes in dopamine, glutamate and GABA function
When does schizophrenia usually develop?
During late adolescence, but it can depend on a combination of genetics and environment
What are the three major features of depression?
Prolonged sad feelings, anhedonia, vegetative signs
What characterizes mania?
Excessive euphoria, hyperactivity and emotional lability
What is bipolar disorder?
Periods of depression and mania
What are some of the neurochemical bases of depression?
Not enough brain derived neurotrophic factors, reduction of monoamines, too much cortisol secretion
What is a treatment of depression?
Fluoxetine is an SSRI that can inhibit serotonin reuptake, stimulate BDNF and neurogenesis in the hippocampus
Where in depressed brains do we see increased activity? Decreased activity?
Decreased: dorsolateral and medial prefrontal regions
Increased: orbital regions (to inhibit amygdala activity), amygdala and medial thalamus
What neuropsychological traits do depressed people show deficits in?
Processing speed, attention and recall memory
Where is there a decrease in gray matter for bipolar patients?
Temporal lobe and cerebellum
What is the sensitization model for bipolar patients?
Bipolar patients are sensitive to stress and drugs and over time, their brain become primed to elicit bipolar responses
Can nutrition be responsible for mood symptoms?
Yes, through alterations in gene expression, epigenetic alterations, long latency effects and inborn metabolism errors
What are hyperkinetic and hypokinetic motor disorders?
Hyperkinetic: increased motor activity.
Hypokinetic: loss of movement
What is Huntington’s chorea?
A autosomal dominant genetic disorder that causes involuntary movements, personality changes, anxiety, bipolar and cognitive impairments
What are some brain abnormalities in Huntington’s disease?
Shrinkage of cortex, atrophy of basal ganglia and death of basal GABA and ACh neurons
What is Tourette’s Syndrome?
The combination of chronic motor and vocal tics (echolalia = repeating what others say, coprolalia = obscene or lewd speech)
Where is the origin of Tourette’s syndrome in the brain?
Small cells in the basal ganglia and frontal subcortical loops
What are some treatments for Tourette’s syndrome?
Antidopaminergic drugs and norepinephrine receptor agonists
Where is the degeneration in the brain for Parkinson’s disease?
degeneration in the substantia nigra
What are some of the positive symptoms of Parkinson’s disease?
Resting tremor, muscular rigidity, involuntary movements (akathesia and oculogyric crisis)
What are some of the negative symptoms of Parkinson’s disease?
Disorders of posture, righting, locomotion (festination, getting ahead of your feet), speech and akinesia
What are some of the causes of parkinsonism?
drug induced, post encephalitic, familial, viral origin
What are some of the treatments of Parkinson’s disease?
Physical therapy, pharmacological therapy (increase DA, decrease ACh), stem cell research, deep brain sitmulation
What are the two major characteristics of dementia?
Memory impairment and one other cognitive impairment
What is the difference between degenerative and non-degenerative dementias?
Degenerative = gets worse with age, non-degenerative = doesn’t get worse with age
What are the two characteristic brain pathologies of Alzheimer’s disease?
Neuritic (amyloid) plaques and paired helical filaments (neurofibrillary tangles)
What is the first sign of Alzheimer’s disease?
Impairment in recent memory
What are the neocortical changes in Alzheimer’s disease?
Degeneration/shrinkage of the association cortices (paralimbic cortex), shrinking of neurons and arborizations, reduction in two or more NT systems
What are some of the putative causes of Alzheimer’s disease?
Genetics, trace aluminum, immune reactions the degenerate neurons, low CNS blood flow, abnormal proteins that accumulate in the brain
