Intro To Psychitry

Question 1

Whah diseases are considered neurological

Answer 1

Neurology- disorders of nervous system with established aetiologies, demonstrable anatomical pathology and physical symptoms (e.g. Parkinson’s, stroke, epilepsy, Huntington’s Disease, brain injury, etc.)

Question 2

Which disorders are considered psychiatric

Answer 2

Psychiatry- disorders of mood, thought & behaviour with no or only minor physical signs with no visible pathology.

Question 3

What is functional psychiatry

Answer 3

Functional – neurotic disorders (e.g. depression, anxiety, phobias) or psychotic disorders (e.g. schizophrenia, bipolar disorder)

Question 4

What is functional psychiatry

Answer 4

Organic- e.g. dementia, psychiatric manifestations of epilepsy or Parkinson’s or stroke, acquired or traumatic brain injury, Huntington’s disease, drug-induced states, etc.

Question 5

Why do we need classification

Answer 5

 To enable clinicians to communicate with each other about patients
 To understand implications of diagnosis (Sx, prognosis, treatment, etc.)
 To facilitate research
 & to relate research findings to everyday practice  To enable clinicians to communicate with each other about patients
 To understand implications of diagnosis (Sx, prognosis, treatment, etc.)
 To facilitate research
 & to relate research findings to everyday practice

Question 6

What is a disorder

Answer 6

a clinically recognisable set of symptoms or behaviour associated in most cases with distress and with interference with personal functions. Social deviance or conflict alone, without personal dysfunction, should not be included in mental disorder as defined here
(Most) psychiatric disorders:
 Not based on theoretical concepts or
aetiology
 Are based on recognisable clusters of symptoms and behaviours

Question 7

What are the criticisms of classification

Answer 7

 Categorisation denies consideration of unique personal difficulties
 Labels deviant behaviour as an illness
 Individuals do not fit neatly into categories  (stigma)

Question 8

What is dimensional classifitaon

Answer 8

 Various axes or dimensions (e.g. for personality disorder)

 Agreed definitions improve reliability  BUT criteria are often arbitrary (and
may not “carve nature at her joints”)  Many patients do not fit descriptions
 OR they meet criteria for two or more categories (CO-MORBIDITY)

Question 9

Wha is psychiatric genetics

Answer 9

• to aid classification
• risk estimation
• to assist in the development of new treatments

Question 10

What are study designs for psychiatric genetics

Answer 10

 Family study – familial aggregation suggests shared diseased genes &/or environment
 Twin study – if genes important then MZ>DZ concordance (note: if MZ concordance<100% then genes not sole factor)
 Adoption studies – genes v. environment

Question 11

How can genetics affect psychosis

Answer 11

 lifetime risk of 1% in the general population  risk in siblings (& DZ twins) is around 8–10%  risk increases as more relatives are affected
 monozygotic (MZ) twin pairs have ~45% concordance
 over 50% of MZ co-twins are unaffected, despite being virtually identical genetically, indicates that non-inherited risk factors are also important
 likely that the aetiology is multi-factorial, i.e. many genetic and environmental factors act together to influence risk, and a single risk factor is unlikely to cause the disorder on its own

Question 12

What are future problems of psychiatric genetics

Answer 12

 Problems with co-morbidities & classification (!)

 Need new approaches: e.g. candidate gene driven (rather than disorder driven)