L33 - Disease Flashcards
Cyclothymia
Mild bipolar
Dysthymia
Mild depression
Criteria for Major Depressive Episode - what are the 2 categories?
Category A - Five (or more) symptoms (weight gain/loss, fatigue, insomnia, erroneous self-evaluation and etc.) that have been present during the same 2- week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. (ahedonia)
Category B - The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.
Manic depression is aka
Bipolar disorder
During major depressive episodes or manic depression, what can be observed in the brain?
Abnormally high blood flow in ventral and media PFC, amygdala and mediodorsal nucleus of the thalamus. It decreases when depressive phase is over regardless of the treatment (or lack of) associated with remission
Treatment of Depression (3)
1) Electroconvulsive therapy - side effect is that it causes memory deficits
2) Psychotherapy
3) Antidepressants - Tricyclics (prevent reuptake of NT), SSRIs NERIs (selective serotonin reuptake inhibitor e.g. Fluoxetine, NA reuptake inhibitor), Monoamine oxidase inhibitors (MAO breaks down all MA (NA, A, Dop, Serotonin), hence inhibiting them leads to increase in NT)
How does lithium salts treat depression - esp. manic depression?
Mode of action not understood but may modulate phosphoinositol second messengers.
Psychoactive drugs
Drugs with “mind altering” effects - can be hedonic, psychedelic or stimulant
e.g. LSD - hallucinogen, serotonin agonist (complex mode of action and not well understood)
During dream state, there is depressed/elevated activity of PFC
Depressed activity of PFC as the odd things that happens in dreams are just accepted
Alcohol
- 2 billion users
- 3.2% of deaths and 4% of total years of life lost are caused by alcohol abuse
- Annual cost $4.5 billion (2.6 times the cost for illicit drugs)
- 2/3 costs are alcohol dependence-related
Alcohol
- 2 billion users
- 3.2% of deaths and 4% of total years of life lost are caused by alcohol abuse
- Annual cost $4.5 billion (2.6 times the cost for illicit drugs)
- 2/3 costs are alcohol dependence-related
Chronic alcohol-related disease
- Cancer, diabetes, CV diseases, GIT diseases
- Neuropsychiatric diseases (AUDs, unipolar major depression, epilepsy)
- Conditions arising during perinatal period
Chronic alcohol-related disease
- Cancer, diabetes, CV diseases, GIT diseases
- Neuropsychiatric diseases (AUDs, unipolar major depression, epilepsy)
- Conditions arising during perinatal period
Alcohol can act both as a depressant and stimulant (to some extent due to lack of inhibition)
Alcohol can act both as a depressant and stimulant (to some extent due to lack of inhibition)
Acute effects of alcohol (partial GABA agonist and antagonist)
- increases glutamate receptor sites in hippocampus
- increases serotonin and dopamine release
Acute effects of alcohol (partial GABA agonist and antagonist)
- increases glutamate receptor sites in hippocampus
- increases serotonin and dopamine release
Chronic effects of alcohol
- Reduces brain weight
- Reduces white matter volume (and some grey matter loss as neurons die), esp. superior frontal association cortex, hypothalamus and cerebellum
- Loss of PFC
- Thiamine (used for neuronal metabolism) deficiency exacerbates these changes
Chronic effects of alcohol
- Reduces brain weight
- Reduces white matter volume (and some grey matter loss as neurons die), esp. superior frontal association cortex, hypothalamus and cerebellum
- Loss of PFC
- Thiamine (used for neuronal metabolism) deficiency exacerbates these changes
Alcohol can enter blood placental barrier and affect foetus
This leads to FAS (foetal alcohol syndrome) where there’s a simian crease (2 lines of palm cross), low nasal bridge, small eye openings, short nose, small head, flat midface, thin upper lip, pronounced epicanthal folds, underdeveloped jaw and smooth philtrum.
-general cognitive deficits (IQ) below 3rd percentile
Alcohol can enter blood placental barrier and affect foetus
This leads to FAS (foetal alcohol syndrome) where there’s a simian crease (2 lines of palm cross), low nasal bridge, small eye openings, short nose, small head, flat midface, thin upper lip, pronounced epicanthal folds, underdeveloped jaw and smooth philtrum.
-general cognitive deficits (IQ) below 3rd percentile
Brain sparing
Severe malnutrition in mother = poor development of foetus but brain function is still preserved
Dorsolateral PFC
- Working memory
- Memory of the future (delayed gratification, plans, and goals)
- meaning behind things
- Estimate things
- Categorisation
- Problem solving, rule following, flexibility, preservation
Dorsolateral PFC
- Working memory
- Memory of the future (delayed gratification, plans, and goals)
- meaning behind things
- Estimate things
- Categorisation
- Problem solving, rule following, flexibility, preservation
Damage in Dorsolateral PFC
Distractibility, impulsiveness, perseverative errors
Stroop test
Supress something obvious, interfering with the time reaction of the task
e.g. words that are written in a different colour (e.g. the word blue written in the colour green)
The Tower of London/Hanoi - what is it and which BA is activated?
Three discs, move them so they are on each other in size order - it requires intermediate solution. BA 10
Theory of Mind
Kids 3 years old and above are able to think about what someone else is thinking. It builds a picture where I know what I know but I can also know what you are thinking based on what I know.
