GAD and Schizophrenia

Question 1

what are anxiety disorders

Answer 1

fear = response threat,
anxiety = anticipiation of threat

Question 2

what is GAD?
+ diagnostics

Answer 2

intense worry about everyday things
worries interfere with functioning, long-lasting, +physical symptoms
relapsing
excessive anxiety most of time for 6+ months
cant control worry
+ 4 physical symptoms (fatigue, muscle tension etc)

Question 3

deszcribe a bit about aetiology of GAD

Answer 3

30& heritability
correlated with neuroticism
SNP in BDNF gene
environment = separation, overprotection, family dysfunction
gene x env = inc methylation glucocorticoid receptor

Question 4

GABA and anxiety

Answer 4

inhibitor
ionotropic GABAa (benzodiazepines), metaboropic GABAb
dec binding benzo in GAD, panic disorder + pTSD
dec GABA linked w anxiety
infusion of gaba antagonists can induce anxiety

Question 5

monoamines in anxiety

Answer 5

disrupted serotonin signalling
serotonin agonist exacerbates anxiety in GAD
low receptor binding 1A = highler anxiety (low in anterior cingulate)
inc release norepinephrine
NE + MHPG inc in blood + saliva =? correlates with symptoms

Question 6

brain circulatory patho anxiety

Answer 6

inc activity amygdala + prefrontal cortex => correlates with symptoms
act anterior cingulate cortex inc during decision making in GAD

Question 7

endocrinology patho anxiety

Answer 7

overactive HPA = inc waking cortisol,
inc CRF = greater startle response
overactivity in amygdala =? overstim HPA axis => HRC loss => loss of stop break

Question 8

pharm treaments anxiety serotonin

Answer 8

serotonin => block serotonin uptake, balance
HT1a implicated
\prsynaptic serotonin dec firing
postsynaptic limbic system + frontal cortices, regulated by glucocorticoids

Question 9

pharm treatments anxiety gaba

Answer 9

GABA => benzo eg valium
allosteric site GABA a, inc open prob, inc gaba transmission in aygdala

Question 10

pharm treatments anxiety - cannabidiol

Answer 10

endocannabinoid system
act cbir receptor is anxiolytic
signalling in hippo + amygala = red following chronic stress
stimulates 51a

Question 11

psychotic disorders diagnosis
+ what is schiz

Answer 11

positive, negative + cognitive symptoms
two or more (delusions, hallucinations, disorganised speech) + more
low level functioning
symptoms present for 6 months

Question 12

aetiologyu of schizo

Answer 12

80% heritability
dopamine d2 receptor, subunits NMDA, ERBB4
env = paternal age, drug abuse, maternal vit D deficiency

Question 13

ntsm patho schizo

Answer 13

dopamine hypothesis
interacts with D1 excit and D2 inhib
d2 antagonists improve psychosis
dopamine agonists = induce psychosis
=> high levels dopamine => schizo
antipsych can improve pos symptoms bu t not gneg/cog
hypothesis refines => mesolimbic pathway = overactive =? dop synth is increasedd2 stim
mesocortical pathway = underactive =? red dopamine in prefrontal cortex + low d1 in pFC

Question 14

glut hypothesis schizo

Answer 14

nmda receptors induce symptoms of schizo
also, nmdar antagonists inc firing neurons for excessive dopamine release
=? inc glut in schizo
schizo could be disinhibition

Question 15

brain structure patho schizo

Answer 15

global dec grey white matter, brain V, cortical thickness (prefrontal cortex)
inc ventricular V

Question 16

brain activity patho schizo

Answer 16

inc act midbrain salience processing (hallucinations + delusions)
inc auditory speech processing
dec amygdala to respond to emotional stim
dec act dorsolateral prefrontal cortex during executive functioning task

Question 17

1st and 2nd gen schizo pharm treatment

Answer 17

1st => d2 receptor antagonist anaesthetic improves symptoms + drugs with similar structure, but side effects = involuntary mvm
2nd => clozapine = . d2 + 5Ht, less motor side effects
minimal to no relief from cog and neg symptoms
looking at red glut release