Lecture final Flashcards
What are the brain differences in depression?
- less white & gray matter
-frontal cortex, atypical fMRI
How much is the concordance rate in twin studies for major depressive disorder?
30-40%
What is the difference between Bipolar I and Bipolar II?
Bipolar I: depression & mania
Bipolar II: depression & hypermania (less severe)
What are the symptoms of Mania for bipolar?
-prolonged period of overly happy
-extreme irritability
-racing thoughts, easily distracted
-little sleep
-unrealistic beliefs in one’s abilities
-impulsive, high risk behavior
-increased goal oriented
What are the symptoms of depression in bipolar?
-long periods of worry & emptiness
-loss of interest in enjoyable activities
-feeling tired, run down
-problems concentrating, remembering, making decisions
-restless or irritable
- changes in eating, sleeping
-suicide & death thoughts
-attempting suicide
-longer periods of lack of energy, motivation & interest
What are causal factors in bipolar disorders?
- disruption of calcium channels & proteins
-AP regeneration to Nodes of Ranvier
When do you use Lithium in Bipolar?
- for Bipolar depression
-mood stabilizer (stops mania)
What plays a role in major depressive disorders?
Seratonin
What plays a role in major bipolar disorders?
GABA & Glutamate
What is anxiety?
- chronic fear persisting in absence of direct threat
What is the most prevalent psychiatric disorder?
Anxiety
Are women twice as likely to suffer anxiety disorders than men?
YES! Woman 2x more
When is anxiety most prevalent?
Early to late adulthood
Does anxiety go down as you age?
Yes
What is generalized anxiety disorder?
Stress response and extreme feeling of worry and anxiety
What is post traumatic stress disorder?
Persistence pattern or psychological distress following exposure to extreme stress
What is the most prescribed drug?
Benzodiazepines
What are side effects of Benzos for anxiety?
-nausea
-ataxia
-tremor
-addictive
What are side effects of seratonin for anxiety?
- nausea
-dizzy
-insomnia
-headache
What are side effects of antidepressant drugs for anxiety?
Not effective
Is there a genetic link to anxiety?
No definite genes
No structural difference in anxiety
Is there a structural difference in depression?
Yes
What is seasonal affective disorder?
- happens every season
-cycling severe depression and elevated mood
What are symptoms of seasonal affective disorder? BEAR
-intense hunger
-gain weight
-sleep more
What is seasonal affective disorder?
- every winter
-cycle severe depression and elevated mood
-intense hunger
-gain eight
-sleep more
BEAR
What is the most prescribed medication for depression?
SSRI’s (Selective Monamine Reuptake Inhibitors)
What pharmacological treatment did they discontinue for depression?
-MAO’s
(monamine Oxidase inhibitors)
- discontinued because high risk of stroke and high blood pressure
What pharmacological treatment for depression if none of them work?
Atypical antidepressants
Which treatment do they use if none of them work for depression?
Atypical
What is considered catch all?
Atypical
What is tricyclic antidepressants?
- treatment for depression
- blocks reuotake of norepinephrine & seratonin
-safer than MAO’s
What are the two ways depression can be?
- Reactive triggered by a negative experience (external cause that can be worked on)
- Endogenous which has no apparent cause (don’t know)
When is it considered major depression? (Unipolar)
Lasts for 2 weeks
What is dysthymia?
-long lasting
-lethargic
-lack of energy & joy in life
How long does dysthymia last?
-long lasting
-at least 2 years
What is it called when you have both depressions?
Double depression
Are women diagnosed far more often than men for depression?
Yes
What is anhedonia?
Inability to experience pleasure
What are general symptoms of major depression (2 weeks+)?
-sadness
-worthlessness
-anhedonia: can’t experience pleasure
-suicidal behavior
How often do women experience postpartum depression?
- approx 19% pregnancies
-20% of women
How often is seasonal affective disorder from depression cases?
- reoccurs 10-20%
-common in Alaska, Canada and scandavia (coldest areas)
Percentages for major depressive episodes in U.S. adolescents (2020)?
-4.1 mil adolescents
-17% of U.S. pop 12-17
-higher among females (25.2%) compared to males (9.2%)
-highest amount adolescents 2 or more races (29.9%)
What is depression?
- exceeds 2 weeks
-feeling sadder to loss
What is difference between grief and depression?
Grief: recall happy moments
Depression: sense of worthlessness, no memory of good times
When was a major depressive episode highest? What age group?
18-25 (17%)
How much more was females more prevalent for depression disorder?
25%
Which depression hardest to treat?
Endogenous depression
What is greater concentration of genetics?
Bipolar
What are tumors?
- mass of cells that grows independently of rest of body (cancer)
What are the 3 types of tumors?
-meningoma
-infiltrating
-metastatic
How many of brain tumors are meningiomas?
20%
What are meningioma tumors?
-encapsulated in menengies
- growing with own membrane
-usually benign, surgically removeable
What are most brain tumors?
Infiltrating!
-grow through surrounding tissue
-malignant (difficult to remove or destroy)
How much of brain tumors are metastatic?
10%- they originated elsewhery
Where do metastatic tumors originate?
Usually in lungs
What happens in epidural hematoma?
Bleeding occurs between the tough outer membrane covering brain (dura) and skull
What happens in an intracerebral hemorrhage?
A type of intracranial bleed that occurs within the brain tissue or ventricles
What does long term Covid damage?
-neurons
-BBB
How does long term Covid effect our bodies?
-ace2 receptors allow Covid to stay in system
-cognitive fog
-activates microglia cells
What is tardive dyskinesia?
- motor disorders including smacking lips and rolling of tongue
-antipsychotic drugs cause it
Are some neurotoxins endogenous?
Yes! Produced by body I.e. auto immune disorders
What is nagleria fowleri?
- brain-eating amoeba
-found in fresh & warm water
What is a hemorrhage?
Bleeding into brain aneurysm (more serious, you don’t want)
What is ischemic?
Disruption of blockage of blood supply to brain
What is a stroke?
A sudden onset cerebrovascular event that causes brain damage
What is the third leading cause of death in the U.S. and most common cause of adult disability?
Cerebrovascular disorders
What are the common blast injuries on civilians?
1 shear stress causing diffuse axonal injury
2 brain acceleration and deceleration
3 compound fractured skull
4 contrecoup contusion
What is a cebrebral contusion?
Bleeding in brain; common in mood-severe head injuries
What are the 3 types of intracranial hemorrhages?
1 epidural
2 subdural
3 subarachnoid
What is an epidural?
Type of intracranial hemorrhage bleeding outside of brain with cooling of boood above dura matter, below skull
What is subdural?
Type of intracranial hemorrhage below dura matter
What is subarachnoid?
Type of intracranial hemorrhage bleed in the arachnoid space
What type of hemorrhage happens within brain?
1 intracerebral: in brain
2 intraventrical: in the ventricles
Is there any cause for schizophrenia?
No cause
What are the two different strokes?
1 cerebral hemorrhage
2 cerebral ischemia
What is a cerebral hemmorhage?
Cerebral blood vessel ruptures and blood seeps into surrounding neural damage
What’s is a cerebral ischemia?
Disruption of blood supply to brain
What is thrombosis?
Blocks blood flow at site of formation
What are the side effects of MAO’s?
-elevated blood pressure
-increase chance of stroke
Which meningitis is most common?
Viral meningitis
What about bacterial meningitis?
It can be deadly
What is schizophrenia caused too much of?
Dopamine
What are areas of brain affected in schizophrenia?
-hippocampus
-amygdala
-thalamus
-nucleus accumbens
What is nucleus acumen?
Obsessive behavior
What is the amygdala?
Emotional stimuli
What is thalamus?
Relay station for disillusions, hallucinations, obsessions
What are the brain structure anomalies in schizophrenia?
Enlargement of lateral ventricles due to cerebral atrophy
What is the neurodevelopmental hypothesis
Stressful experience during prenatal or neonatal development of the nervous sys produces brain abnormalities and behavioral deficits
What are neuroleptics effective for some patients?
Positive symptoms
Result from increased neural activity
What are antipsychotic drugs for schizophrenia
D2- halo/buty
D4- clozapine
What are Parkinson’s disease patients given
L-dopa
What is genetic link to schizophrenia?
-relatives show higher incident
-risk increases closer the relationship
-genetic relationship unclear
What is rate of occurrence in identical twins for schizophrenia
50%
What is percentage of fraternal twins with schizophrenia
15%
What are the positive symptoms of schizophrenia?- presence of
Delusions
Hallucinations
Inappropriate affect
Disorganized speech and thought
Odd behavior
Responsive to drug therapy
What are negative symptoms of schizophrenia
Affective flattening
Lack of motivation- abolition
Catalonia
Lack of social interaction
Speech deficits
What is acute schizophrenia
Symptoms go away and stay away
What is chronic schizophrenia
Hospitalization major part of life
What is episodic schizophrenia
Experiencing episodes
How many symptoms needed for schizophrenia ?
Only 2 for one month
What is best treatment for schizophrenia
Behavioral therapy
What is the 2 times window for schizophrenia
1 adolescent: recovery not good, symptoms don’t respond to meds
2 mid-late 20s: predisposition, trigger, good recovery, meds work
How much of the pop does schizophrenia affect
1-2%
What is neuropsychological
Brain dysfunction
What is psychiatric
Absence of brain pathology; experimental factors
What 3 things mean it’s a psychiatric disorder
1 early onset
2 prevalence
3 long term consequences
Why are psychiatric disorders difficult to treat
-what we consider to be normal changes
- symptoms overlap
First drug used for schizophrenia
Chloroprazimen
2nd drug for schizophrenia
Reserpine but not used due to low blood pressure
What are effects of bacterial infections
-leads to abscesses
-inflame meninges
-pockets of puss
-treat w penicillin
What are effects of viral infections
- attack neural tissues
-lie dormant for years
How do neurotoxins enter system
-from GI tract or lungs
-through skin
What is embolism?
Plug forms elsewhere and moved to brain
What are the two types of closed head injuries ?
Tbi’s and contusions
Does the skull need to be penetrated for tbi
No
What is a traumatic brain injury
Blow to head
What are contusions
Closed head injuries involved skate to cerebral circulatory system; bruise
What are concussions
Disturbance of consciousness following blow to held no evidence of structural damage
What is result to multiple concussions
Punch drunk syndrome = dementia
What is an arteriosclerosis
Wall of blood vessels thicken due to fat deposits
How does damage occur due to cerebral ischemia
Excess glutamate
Blood deprived neurons
Influx of Na+ & Ca2
Release more glutamate
Kill neuron
Ischemia brain damage takes time doesn’t occur equally to all parts of brain
What is a coma
Total unconscious
Unresponsive
Unaware
No sleep wake cycle
Diffuse of trauma
What is vegetable stare
Unconscious
Unaware
Sleep-wake cycle
Period of alertness
What is persistence vegetable state
Vegetable state longer than 30 days
What is an epidural hematoma
Bleeding occurs between tough outer membrane and skull
What is intracerebral hemmorage
Type of intracranial bleed
Occurs within brain tissue/ventricles
What is the third leading cause of death
Cerebral vascular disorders
What is 5th cause of dearth
Stroke
What is the dopamine theory of schizophrenia
Striatum’s in Parkinson’s disease patient depleted dopamine
What are side effects of MAO?
-elevated blood pressure
Increase chance of stroke
Cheese effect
What are side effects of tricyclic antidepressants
No effect on schizophrenia
What are side effects of SSRI;s
Fewer side effects
What are theories of bipolar
Lower levels of brain defied neural factors
How do MAOs function
Breaks down monoamine neurotransmitters in cytoplasm
How do tricyclic antidepressants work
Block reuptake of Seratonin and nonrepreine
How do SSRI’s work
Exert agnostic effects by blocking reuptake to seratonin from synapses
How do atypical antidepressants work
Own unique mechanisms of action
What is pregabalin?
Generalized anxiety; ability to modulate calcium channels affecting calcium levels
