Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychology & Neuroscience of Affective Disorders > Organic affective disorders > Flashcards

Organic affective disorders Flashcards

You may prefer our related Brainscape-certified flashcards:
AP® Psychology flashcards Psychology 101 flashcards GRE® Psychology flashcards
1
Q

What is the Triadic Diagnostic System of Mental Disorders?

A

Classical approach to psychiatric disorders based on Kraepelin’s Layer Rule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Kraepelin’s Layer Rule?

A
  1. Organic layer
  2. Endogenous layer - endogenous psychiatric disorder (“psychoses”)
  3. Exogenous layer - condition related to psychosocial experiences (“neuroses”)

Only when ruling out organic (1) and endogenous (2) layers can you consider the exogenous layer (3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is characteristic of Kraepelin’s Layer Rule?

A

> It is entailed in hierarchical superiority of mood disorders over adjustment disorder

> Not made explicit in ICD-10 or DSM-5

> It is implicit, as the cause of most disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are two key issues with the Triadic Diagnostic System of Mental Disorders?

A
  1. Problems with definition of organic disorders

2. Problems with definition of endogenous disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the problem with the definition of organic disorders in the Triadic Diagnostic System of Mental Disorders?

A

No clear definition of the threshold for causal relationship between biological disease and psychopathology

  • Organic affective disorders: obvious primary biological abnormalities
  • Bipolar disorder/MDD: subtle primary biological abnormalities
  • Adjustment disorder: no primary biological abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the problem with the definition of endogenous disorders in the Triadic Diagnostic System of Mental Disorders?

A

No clear definition of the strength of reaction to psychosocial factors and how pronounced biological abnormalities are to be considered endogenous or exogenous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the different organic mood (affective) disorders present in the ICD-10?

A
  • Organic manic disorder
  • Organic bipolar disorder
  • Organic depressive disorder
  • Organic mixed affective disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the aetiology of Parkinson’s disease?

A

Degeneration of dopaminergic neurons in substantial nigra

  • which is located in brain stem
  • sends projections primarily to motor system
  • complex interactions of dopaminergic and glutamtergic systems in prefronto-striatal loops
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the proportion of people with Parkinson’s disease attending neurology clinics that suffer from depressive symptoms?

A

50-70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How are depression and anxiety associated to Parkinson’s disease?

A

> Depression or anxiety may precede neurological symptoms of Parkinson’s disease

> People with depression have 3times higher risk of subsequent Parkinson’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do we learn form the case report of a 54-year old women that shows signs of depression as a first manifestation of a large intracerebral lymphoma?

A

> Symptoms: fatigue, loss of interests, persistent low mood, poor appetite, concentration problems

> Daughters noticed their mother’s reckless driving

  • > Doctors ordered MRI scan with contrast
  • > found lymphoma in right frontal lobe

=> watch out for symptoms that don’t match with depression or bipolar disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How are strokes associated to depression?

A

> More than 50% of stroke patients suffer from depressive symptoms

> Patients with non-organic old age depression show subtle white matter structural damage in areas often affected by small vessel cerebrovascular disease
- i.e. fronts

> Stroke might disrupt network -> increasing vulnerability to depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How are brain injuries associated to depression?

A

High proportion of people even with mild closed head injury suffer from major depression
- they show white matter disruption in areas also seen in non-organic major depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Can an MRI show white matter disruptions?

A

No

- you need to do a diffusion tensor scan to see them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the lead symptoms of dementia syndromes?

A

Slow progression (over more than 6 months) in:

  • impairment of recent memory
  • behavioural changes
  • impairment of language or speech
  • fluctuating confusional states or impairments of attention
  • visuo-spatial impairments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the potential diagnoses when the lead symptoms of dementia syndromes are rapidly progressive (3-6 months) or subacute (weeks)?

A

Creutzfeldt-Jakob, autoimmune or inflammatory encephalopathies

-> neurology referral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In which case is epilepsy the cause of an organic-mood disorder?

A

> Pre-ictal
- dysphoric or depressed mood disappears on remission of seizure

> Inter-ictal (2/3 patients)

  • dysthymia, major depressive or dysphoric syndrome, interictal dysphoric disorder:
  • > fluctuating symptoms, irritability, pain, anxiety, depressed and elevated mood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a pre-ictal epilepsy?

A

Prodrome of complex-partial seizure (i.e. before full seizure)

19
Q

What can be the neurological causes of organic affective disorders?

A
  • Parkinson’s disease
  • Brain tumour (e.g. lymphoma)
  • Cerebrovascular disease (e.g. stroke)
  • Brain injuries
  • Dementia (e.g. fronto-temporal)
  • Epilepsy
20
Q

What are the hormonal and vitamine-relate organic affective disorders?

A
  • Cushing’s syndrome (chronic hypercortisolism)
  • Thyroid dysfunction (severe hyper/hypothyroidism) in adults
  • Endocrine disorders
  • Vitamine deficiency (e.g. folic acid, vitamin B12)
21
Q

What are the signs and symptoms of Cushing syndrome (chronic hypercortisolism)?

A
  • Hirsutism (abnormal hair growth)
  • Round face
  • Hump
  • Easy bruising
  • Stretch marks
  • Abnormal weight gain
22
Q

What is exogenous hypercortisolism?

A

Due to cortisol

23
Q

What is endogenous hypercortisolism?

A

Most often caused by pituitary tumour

-> indirectly passing adrenal production

24
Q

What are the neuropsychiatric symptoms of Cushing’s syndrome (chronic hypercortisolism)?

A

> Initial phase

  • manic syndrome (minority)
  • irritability (86%)

> Chronic phase

  • major depression (57%)
  • depressed mood (74%)
  • anxiety and panic (66%)
25
Q

What are the types of thyroid dysfunction?

A

Excess of thyroid hormones in blood

26
Q

How is severe hyperthyroidism in adults associated to anxiety and depressive disorder?

A

> Approximately

  • 60% have anxiety disorder
  • 31-69% have depressive disorder

> You need marked abnormalities in thyroid function to cause symptoms of affective disorders
- mild abnormalities not clearly associated

27
Q

What are the symptoms of severe thyroid dysfunction (hyper or hypothyroidism)?

A
  • Psychomotor retardation
  • Decreased appetite
  • Fatigue lethargy
  • Severe cognitive impairment
  • Mimic melancholic depression
28
Q

How are endocrine disorders associated to affective disorders?

A

There is evidence of associations between affective disorders and endocrine disorders

However, it is a complex process

29
Q

How is vitamin deficiency associated to affective disorders?

A

Deficiency in folic acid can lead to developing depression
- percentage higher than vitamin B12 deficiency

-> Folic acid AND vitamin B12 need to be checked simultaneously

30
Q

What are the various substance/medication-induced affective disorders?

A
  • Drug-induced mania (no causal role from case reports)
  • Drug-induced depression
  • Substance-withdrawal induced depression
31
Q

Which drugs have been reported to be associated to mania-induction?

A
  • First monoamineoxidase inhibitor (Iproniazide): 15%
  • Dopamine D2 agonist (Bromocriptin): 20%
  • Levodopa for Parkinson’s: 12%
  • Cortisone and adrenocorticotrophic hormone: 1.5-9%
  • Phecyclidine (PCP) (originally anaesthetic)
  • D-Amphetamine
32
Q

Which drugs were reported as potential causes of depressive symptoms?

A
  • Corticosteroids
  • Contraceptives
  • Interferon-α
  • Interleukin-2
  • Mefloquine
33
Q

How is substance-withdrawal associated to depression?

A

Evidence of causal relationship

> Withdrawal from stimulants, opioids, alcohol dependence regularly associated with dysphoric mood, anxiety, anhedonia

> High rate of depressive disorders among stimulant-dependent patients during early abstinence

> 6% depression rates in male alcohol-dependent patients (no co-morbid prior mood disorders) after a month of abstinence

34
Q

Which elements play a role in the very high co-morbid mood disorders rates in substance-dependent patients?

A

> Chronic use of substances

> Failed self-treatment of mood disorders with substance use

35
Q

What is the lifetime rate of major depressive disorder in opioid-dependent patients?

A

54%

36
Q

What is the lifetime rate of major depressive disorder in alcohol-dependent patients?

A

38%

37
Q

What is the lifetime rate of major depressive disorder in stimulant-dependent patients?

A

32%

38
Q

In which cases can we suspect an organic cause of affective disorders?

A

> Visual hallucinations

> Focal-neurological symptoms (impairments in CNS)

> Cancers

> Diagnosed systemic disorders

> Diagnosed neurological disorders affecting the brain

> Treatment-resistant chronic course

> Unusual presentation of the patient
(e.g. not bothered by symptoms rather than disturbed)

> Failure to carry out simple activities of daily living

39
Q

When are executive frontal functions involved?

A

In all tasks that require active processing

- e.g. internal generation of concepts, task switching

40
Q

When are executive “frontal” functions regularly impaired in neurological patients?

A

> Patients with left dorsolateral frontal and subcortical lesions

> Severe psychiatric disorders

> Persistent in some patients even on remission of measurable symptoms

41
Q

Why are executive functions tests and active neuropsychological tasks useless to differentiate organic from non-organic conditions?

A

Impaired executive functions are common in non-organic psychiatric disorders

-> use passive neuropsychological tasks

42
Q

Which type of neuropsychological tasks are passive tasks?

A
  • Recognition memory
  • Simple visuo-spatial tasks (e.g. copy circle)
  • Naming pictures
  • Word to picture matching to test comprehension
43
Q

What is the meaning of observed impairment in passive neuropsychological tasks?

A

Organic causes need to be investigated

Psychology & Neuroscience of Affective Disorders (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions