Mental Disorders Flashcards
What are mood and anxiety disorders?
Extremes in brain states
What is schizophrenia in simple terms?
A loss of contact with reality, a disrupt or of thought, perception, mood, and movement
How common is schizophrenia? How about likelihood between sexes?
~1% in adults, 2x more likely in men
When does schizophrenia usually show in men?
Adolescence
When does schizophrenia usually show in females?
Later in life
What are the 3 symptom clusters for schizophrenia?
Positive, negative, and cognitive
Are all 3 clusters of symptoms exhibited by patients at one time?
No
What are positive symptoms?
Symptoms that are NOT present in healthy people
- delusions
- hallucinations
What are negative symptoms?
Impairments of normal functions
- reduced expression of emotion
- social withdrawal
- impoverished thought and speech
- lack of motivation
What are cognitive symptoms?
Impairment to working memory and executive function (so hard to treat)
How important is genetics in schizophrenia?
REALLY fucking important
What percent of identical twins get schizophrenia?
50%
Why don’t 100% of twins get schizophrenia?
Other factors need to turn the harmful genes on
What are other factors affecting schizophrenia?
Epigenetics and environmental factors (like drugs n shit)
What is the dopamine hypothesis?
Schizophrenia is caused by too MUCH dopamine (believed cus drugs that release tons of dopamine cause psychotic effects)
What are treatments that target the dopamine hypothesis?
D2 receptor antagonists
What is the Dopamine Imbalance Hypothesis?
Too much DA in the Mesolithic DA pathway and too little in the mesocortical DA pathway
What does the Substantia Nigra do?
Project axons to the striatum, initiate voluntary movement, degeneration of which causes PD
What is the VTA?
Ventral tagmental area
What two pathways do the VTA give rise to?
Mesolithic DA system (to nucleus accumbens which plays a part in reward and addiction)
Mesocortical dopamine system which goes to the prefrontal cortex
What is the neuro developmental hypothesis?
Early life stresses increase risk of schizophrenia
What is the evidence for the neuro developmental hypothesis?
Patients showing less gray matter in prefrontal cortex, temporal lobe, amygdala, hippocampus, and enlarged ventricles which many believe happen during in utero
What are some of treatments for schizophrenia?
- antipsychotic drugs (diminish positive symptoms)
- no meds benefit the cognitive symptoms
- d2 receptor antagonists
- Lithium
- 2nd and 3rd gen APs
What are some symptoms of D2 receptor antagonists?
- dystopia (muscle spasms)
- akathisia (motor restlessness)
- Parkinsonism (rigidity and tremor)
- tardive dyskinesia (jerky movements)
What are some 2nd generation APs?
- 5 HT and D2 antagonists
- better side effects
- works on positive AND negative symptoms
What are some third generation APs?
Partial agonists of D2 receptors
- use supported by DA imbalance hypothesis
What percent of the population has an anxiety disorder?
15-20%
Is anxiety genetic?
It tends to express in families
What characterizes anxiety disorders?
An inappropriate expression of fear that prevents normal function
What are 4 types of anxiety disorders?
Panic disorders, generalized anxiety disorder, social anxiety disorders, and phobias
What is the HPA axis?
Hypothalamus, Pituitary gland, Adrenal
What does the hypothalamus do in regards to anxiety?
It releases corticotropin releasing hormone in response to stress
What does the pituitary gland do in regards to anxiety?
Releases a hormone in response to CRH
What does the adrenal gland do in regards to anxiety?
Releases cortisol which triggers fight or flight in response to the hormone the pituitary released
How do the amygdala and hippocampus regulate the HPA axis?
In a push pull fashion
Amygdala - excites HPA
Hippocampus - inhibits HPA
Cortisol - Excites hippocampus
What do benzodiazepines do?
Theyre a sedative-hypnotic class of CNS
- sedates and decreases cognitive function
- acts on GABA receptors
- enhances GABA receptors
- suppresses stress response
What do SSRIs do?
Prolong actions of synaptic 5-HT by BLOCKING reuptake
- takes a while to work
- does not work for acute episodes
- side effects: feeling sick, insomnia, loss of libido
Describe OCD
Obsessive thoughts and compulsions
What are some characteristics of OCD?
Intrusive thoughts that are recurring
Repetitive rituals regarding your obsession
Feel no control over them
What is PTSD?
Having lots of flashbacks about a traumatic event that can lead to avoidance of stimuli, emotional distress, irritability, and increased suicide and substance abuse
What do both anxiety disorders and affective disorders have in common?
Negative emotional states, overlapping risk factors, and 60% of patients with MDD suffering from an anxiety disorder, and anxiety often precedes depression
What defines MDD?
Recurring episodes of dysphasia and negative thinking
What is the monoamine hypothesis?
That mood disorders come from depleted levels of serotonin, dopamine, and norepinephrine
What supports the monoamine hypothesis?
MAO inhibitors working and reserpine GIVING depression (cus it decreases those levels)
What are the limitations of the monoamine hypothesis?
Antidepressants take a while to work even though they affect NT’s immediately, other drugs increase NTs but not good for antidepressants
What are some treatments MDD?
Psychotherapy and antidepressants
What are 4 types of antidepressants?
Tricyclics (reuptake inhibitors of 5-HT and norep)
MAOIs (Inhibit breakdown of NTs)
SSRIs and SNRIs (prevents 5-HT reuptake)
Atypical antidepressants
What are ECT and DBS?
ECT - shocks
DBS - electrodes placed in the head to stimulate BA25 to release NT
What are the two types of Bipolar Disorder?
Manic and hypomanic
What is the difference between Bipolar 1 and Bipolar 2?
1: Manic episodes (with or without)
2: associated w MDD
What is hypomania?
Increase in efficiency, accomplishment, and creativity
Can mania or hyper mania contain psychotic symptoms?
Mania
What are some treatments of BPD?
Lithium, anticonvulsants, and atypical antipsychotics
What pathway is involved in substance use disorders?
Mesolimbic DA Pathways
What are the two important organs in the mesolimbic DA pathway?
VTA and NAcc, important for reward and reinforcing effects
What are 3 treatments for Alcohol?
Antabuse (blocks breakdown of alcohol and gets u sick)
Natlrexone (opioid receptor antagonist)
Acamprosate (helps withdrawal)
What are 3 treatments for opioids?
Methadone (substitute but reduces the high)
Suboxone (substitutes but reduces high)
Naltrexone (antagonist that prevents high)
What’s a treatment for cigarette smoking?
Nicotine replacement therapy
