Mental Illness Flashcards
What are the neuroimaging findings in depression?
Increased activity of the amygdala on PET
Increased activity and volume decrease of the subgenual ACC (anterior cingulate cortex)
Reduced reactivity of the dorsolateral prefrontal cortex
Which mental illnesses are associated with low activation of the COMT gene?
OCD and Schizophrenia
How is Prolonged Grief disorder defined by the ICD-11?
Prolonged and pervasive grief for >6 months
- Hx of bereavement
- Longing for or persistent preoccupation with the deceased
- Intense emotional pain
- Functional disturbance
What is the most common mental illness associated with HIV?
Depression
Followed by substance use disorder, anxiety, psychosis, adjustment disorder and BPAD.
Why is depression the most common mental disorder in the HIV population
Psychosocial consequences of HIV
HIV treatment especially efavirenz (associated with mania and suicidality)
Fluoxetine and paroxetine have evidence for depression in HIV
What are the early signs of HAND (HIV-associated neurocognitive disorder)?
- Psychomotor impairments e.g. gait instability, slowed movements
- Memory and attention impairments
- Impairments in mental agility and flexibility
- Personality changes e.g. irritability, apathy and inertia
- Behaviour changes e.g. social withdrawal, impaired ADLs
- Neurological signs e.g. poor coordination, balance and tremor
What are the lste signs of HAND (HIV-associated neurocognitive disorder)?
- Hyperreflexia
- Dysdiadochokinesia
- Ocular pursuit abnormalities
- Myoclonus
- Frontal lobe signs
How is HAND treated?
Antiretrovial medication
What is the most frequently reported cognitive difficulty in HIV positive patients?
Poor episodic memory
What are the neuroimaging findings in BPAD?
- Higher bilateral ventricular volumes
- Lower hippocampal volumes
- Lower amygdala volumes
- Lower thalamic volumes
Kufungisisa is a culture bound syndrome from Zimbabwe that translates to what?
‘Thinking too much’
Khyal cap is a culture bound syndrome from Cambodia describing what?
A cultural explanation of distress. It is characterised by symptoms such as dizziness, palpitations, shortness of breath, and neck tension which are believed to be caused by wind-like substances (khyal) blocking or flowing through the body.
Describe the culture bound syndrome of Taijin kyofusho
This term originates from Japan and involves intense fear that one’s body or bodily functions are offensive to others. This can manifest as social anxiety disorder.
What are the features of GAD in children/adolescents?
Tends to be more common in late adolescence with development of cognitive abilities that support the capacity for worry. Uncommon in children under the age of 5.
Manifestations of worry in children may include
- being overly concerned and compliant with rules
- strong desire to please others.
What is a Fregoli delusion?
Patient identifies a familiar person (usually a persecutor) in other people they meet
What is Ekboms’ syndrome?
A belief that one has been infected with insects
‘Delusional parasitosis’
What is Othello syndrome?
Belief that one’s sexual partner is cheating on them
What is syndrome of subjective doubles?
Belief that doubles of him/herself exist
What is Lycanthropy?
Belief that one has been transformed into an animal
What is De Clerambault’s syndrome?
Belief that a person is in love with them
What is Cotard’s syndrome?
Also called ‘Nihilistic delusions’, the belief that they are dead or do not exist
What is a referential delusion?
The belief that the TV/radio are speaking directly to or about the patient
What is Pseudocyesis?
Belief that one is pregnant when she is not
How would the dexamethasone suppression test effect a person with Major Depressive Disorder?
Cortisol levels are less likely to decrease compared to a healthy control
