Psychiatric Disorders Across the Lifecourse Flashcards

1
Q

What are the 4Ps?

A
  • predisposing
  • precipitating
  • perpetuating
  • protective factors
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2
Q

Which part of the brain matures faster than the prefrontal cortex?

A

the cortical areas associated with sensory and motor tasks.

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3
Q

Where the is maximum density of grey matter reached first?

A

the primary sensorimotor cortex

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4
Q

Where the is maximum density of grey matter reached last?

A

higher association areas (eg: the dorsolateral prefrontal cortex)

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5
Q

How long does it take for the volume of white matter reach it’s maximum?

A

increases continually from childhood to early adulthood
(inferior -> superior brain areas)
(posterior -> anterior brain areas)

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6
Q

Define the adolescent brain?

A

a period of neural imbalance caused by early maturation of subcortical brain areas and delayed maturation of prefrontal control areas

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7
Q

During adolescence, how does the brain react during highly emotional situations?

A

limbic and reward systems with affect behaviour more (more mature) than the prefrontal control system

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8
Q

How prevalent are mental health disorders?

A

the proportion of individuals (<18) with onset of any mental health disorders was 48.4%

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9
Q

What is the DSM-5 criteria (used to diagnose ADHD)?

A
  • persistant pattern of inattention and/or hyperactivity-impulsivity
  • at least 6 months
  • inappropriate for their development level
  • interferes with functioning or development
  • symptoms present before 12
  • symptoms present in 2 or more settings
  • not better explained by another mental disorder
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10
Q

How many symptoms of inattention and/or hyperactivity-impulsivity are required to fulfil the criteria?

A
  • 6+ for <16
  • 5+ for >17
  • at least 6 months
  • inappropriate for development level
  • disruptive
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11
Q

What are the genetic risk factors for ADHD?

A
  • no single gene, several (polymorphic) may increase vulnerability
  • first degree relatives have a 4-5x higher chance of developing ADHD
  • boys more vulnerable than girls
  • family history of antisocial personality disorder
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12
Q

What are the environmental risk factors for ADHD?

A
  • premature birth
  • low birth weight
  • prenatal tobacco exposure
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13
Q

What is dementia?

A

degenerative disease of the brain with:

  • cognitive and behavioural impairment
  • sufficiently severe to interfere significantly with social and occupational function
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14
Q

What is the most common cause of dementia (70%)?

A

alzheimers

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15
Q

What are the early symptoms of dementia?

A
  • absent-mindness
  • difficulty recalling names and words
  • difficulty learning new information
  • disorientation in unfamiliar surroundings
  • reduced social engagement
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16
Q

What are the symptoms of progressive dementia?

A
  • marked memory impairment
  • reduced vocabulary
  • loss of less complex speech patterns
  • mood swings / apathy
  • decline in ADLs sand social skills
  • emergency of psychotic phenomena
17
Q

What are the clinical features of advanced dementia?

A
  • monosyllabic speech
  • psychotic symptoms
  • behavioural disturbance
  • loss of bladder and bowel control
  • reduced mobility
18
Q

What are the psychiatric symptoms seen in dementia?

A
  • delusions (15%), usually paranoid
  • auditory/visual hallucinations (10-15%), may indicate rapid cognitive decline
  • depression (20% requiring treatment)
19
Q

What are some behavioural disturbances seen in dementia?

A
  • aggression
  • wandering
  • explosive temper
  • sexual disinhibition
  • incontinence
  • excessive eating
  • searching behaviour
20
Q

What are the personality changes are seen in dementia?

A

often reflects an exaggeration of premorbid traits with coarsening of affect and egocentricitiy

21
Q

What is the peak age at onset of ADHD?

A

9.5

22
Q

What is the peak age at onset of Autism?

A

5.5

23
Q

What is the peak age at onset of Eating Disorders?

A

15.5

24
Q

What is the prognosis associated with ADHD?

A
  • 70% of children with ADHD, will have it as teenagers

- 40-60% will still have ADHD as adults

25
Q

How does the risk of dementia increase with age?

A
  • 1% at 60yrs, doubles every 5yrs

- 40% of those aged 85 have dementia

26
Q

What do the scores on the mini mental state examination suggest (MMSE)?

A
25-30 = normal
21-24 = mild
10-20 = moderate
<10 = severe