Psychiatric disorders, functional neurological disorders and epilepsy Flashcards
What percentage of the EU population suffer from a mental disorder?
38%
What is the hypothesis of schizophrenia?
Disorder of the pre-frontal cortex, hypothesis is there is an excess of dopamine
What are the two pathways in the brain that dopamine is involved in?
Mesocortical pathway (ventral tegmental to cerebral cortex). Helps in cognition and executive function
Mesolimbic pathway (ventral tegmental area in the midbrain to the ventral striatum of the basal ganglia). Helps in regulation of emotional behaviour
What are the symptoms of schizophrenia?
Delusions, hallucinations, disorganised thought, speech and behaviour, logia (lack of conversation) and abolition (lack of motivation)
What is the lifetime prevalence of depression?
Men 12%
Women 20%
What is the hypothesis of depressive disorders?
Disorder of limbic function (disruption in balance of reward and emotion)
Hypothesis= monoamine deficiency
How is depression treated?
Diet
Exercise
Drugs (SSRI, SNRI, TCA)
Psychotherapy
What is the hypothesis on anxiety disorders?
Disorder of limbic function, central role of amygdala- signalling is increased and has an overwhelming effect on PFC
What is treatment for anxiety?
Psychotherapy and drugs (SSRI, SNRI, TCA)
What are the 3 main clusters of personality disorders?
(a) odd/eccentric= paranoid, schizoid (avoid social activities)
(b) dramatic/emotional/erratic= antisocial, borderline, narcissistic and histrionic
(c) anxious/fearful= avoidant, obsessive compulsive and dependant
What is a functional neurological disorder?
- FND describes a disorder of the voluntary motor or sensory system with genuine systems including paralysis, tremor, dystonia, sensory disturbance (including visual loss), speech symptoms
- The hallmark is that such symptoms can be positively identified as internally inconsistent with recognised pathophysiological disease
- Functional neurologic disorder is related to how the brain functions, rather than damage to the brain’s structure
What is a functional disorder?
Where symptoms cannot be positively identified as internally consistent with recognised pathophysiological disease
What percentage of medical symptoms are ‘unexplained’?
30%
What is the Gordian knot and what are the different factors in it?
Helps identify where symptoms are coming from:
How do you diagnose a functional neurological disorder?
Make a list of all physical symptoms and consider all other pathological disease triggers including pain, injury
Make a diagnosis on the basis of positive physical symptoms and a familiar history NOT because the scan is normal
What are dissociative disorders?
Mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity.
Why can pain cause functional neurological disease?
Pain has an enormous attentional salience so there is consequences for cognitive capacity and sensory processing accuracy
Why can disability/disease cause functional neurological disease?
Models in PFC are plastic- if a leg is immobilised for a period the brain learns to expect that it will not move when standard voluntary pathways are activated. The model can persist after the immobilisation is removed.
What factors can trigger functional neurological disorders?
- Pain
- Disability
- Disease
- Mood disorders
How are functional neurological disorders treated?
Addressing the precipitating and sustaining factors:
- Pain
- Underlying disease and disability
- Mood disorders
- Reconditioning
Explain the condition, explain what rather than why as cause is often complicated/ we do not know
What is a seizure?
An abnormal excessive firing of brain cells
What is epilepsy?
The tendency to recurrent, abnormal spontaneous firing of neurones (having seizures)