Psychiatric Disorders Across the Lifecourse Flashcards
What are the 4Ps?
- predisposing
- precipitating
- perpetuating
- protective factors
Which part of the brain matures faster than the prefrontal cortex?
the cortical areas associated with sensory and motor tasks.
Where the is maximum density of grey matter reached first?
the primary sensorimotor cortex
Where the is maximum density of grey matter reached last?
higher association areas (eg: the dorsolateral prefrontal cortex)
How long does it take for the volume of white matter reach it’s maximum?
increases continually from childhood to early adulthood
(inferior -> superior brain areas)
(posterior -> anterior brain areas)
Define the adolescent brain?
a period of neural imbalance caused by early maturation of subcortical brain areas and delayed maturation of prefrontal control areas
During adolescence, how does the brain react during highly emotional situations?
limbic and reward systems with affect behaviour more (more mature) than the prefrontal control system
How prevalent are mental health disorders?
the proportion of individuals (<18) with onset of any mental health disorders was 48.4%
What is the DSM-5 criteria (used to diagnose ADHD)?
- 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
How many symptoms of inattention and/or hyperactivity-impulsivity are required to fulfil the criteria?
- 6+ for <16
- 5+ for >17
- at least 6 months
- inappropriate for development level
- disruptive
What are the genetic risk factors for ADHD?
- 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
What are the environmental risk factors for ADHD?
- premature birth
- low birth weight
- prenatal tobacco exposure
What is dementia?
degenerative disease of the brain with:
- cognitive and behavioural impairment
- sufficiently severe to interfere significantly with social and occupational function
What is the most common cause of dementia (70%)?
alzheimers
What are the early symptoms of dementia?
- absent-mindness
- difficulty recalling names and words
- difficulty learning new information
- disorientation in unfamiliar surroundings
- reduced social engagement
What are the symptoms of progressive dementia?
- marked memory impairment
- reduced vocabulary
- loss of less complex speech patterns
- mood swings / apathy
- decline in ADLs sand social skills
- emergency of psychotic phenomena
What are the clinical features of advanced dementia?
- monosyllabic speech
- psychotic symptoms
- behavioural disturbance
- loss of bladder and bowel control
- reduced mobility
What are the psychiatric symptoms seen in dementia?
- delusions (15%), usually paranoid
- auditory/visual hallucinations (10-15%), may indicate rapid cognitive decline
- depression (20% requiring treatment)
What are some behavioural disturbances seen in dementia?
- aggression
- wandering
- explosive temper
- sexual disinhibition
- incontinence
- excessive eating
- searching behaviour
What are the personality changes are seen in dementia?
often reflects an exaggeration of premorbid traits with coarsening of affect and egocentricitiy
What is the peak age at onset of ADHD?
9.5
What is the peak age at onset of Autism?
5.5
What is the peak age at onset of Eating Disorders?
15.5
What is the prognosis associated with ADHD?
- 70% of children with ADHD, will have it as teenagers
- 40-60% will still have ADHD as adults
How does the risk of dementia increase with age?
- 1% at 60yrs, doubles every 5yrs
- 40% of those aged 85 have dementia
What do the scores on the mini mental state examination suggest (MMSE)?
25-30 = normal 21-24 = mild 10-20 = moderate <10 = severe
