Psychiatric Genetics

Question 1

Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Answer 1

used to diagnose mental illness

Question 2

Depression

Answer 2

depressed mood, diminished interest or pleasure in activities, feeling worthless, weight change, fatigue, significant distress

Question 3

Bipolar Disorder

Answer 3

• abnormally and persistently elevated/expansive/irritable mood, inflated self-esteem, racing thoughts, excessive involvement in high-risk activities
• mood fluctuates between manic, depressive, hypomanic, and euthymic states
• BDI = hospitalization
• BDII = no hospitalization

Question 4

Schizophrenia

Answer 4

delusions, hallucinations, disorganized speech, diminished emotional expression, catatonic behavior, profound disruption in cognition and emotion

Question 5

Schizoaffective Disorder

Answer 5

schizophrenia + major depressive episode, manic episode, or mixed episode

Question 6

Mental Illness Treatments

Answer 6

• pharmacotherapy/biologic therapies
• psychological therapies
• family interventions
• brain stimulation

Question 7

General Population Risk for Developing Schizophrenia/Bipolar Disorder

Answer 7

3%

Question 8

Empiric Risks for Mental Illnesses

Answer 8

• schizophrenia: 1% gen pop, 10-15% FDR
• bipolar: 1-2% gen pop, 10-15% FDR
• schizoaffective: 0.5-1% gen pop, 10-15% FDR
• major depression: 15-20% gen pop, 35-40% FDR
• GAD: 5% gen pop, 20% FDR
• OCD: 2-3% gen pop, 10-25% FDR

Question 9

Heritability of Mental Illnesses

Answer 9

• schizophrenia: 60-85%
• bipolar disorder: 70-85%
• major depression: 30-40%
• panic disorder: 35-46%

Question 10

T/F: Psychiatric conditions are inherited

Answer 10

False; not inherited but can inherit vulnerability to it

Question 11

T/F: Genetic testing is presently available to establish or confirm a diagnosis of a mental illness

Answer 11

False

Question 12

Testing Options for Mental Illness

Answer 12

• polygenic risk scores for predisposition
• microarray (useful in individuals with additional features)
• pharmacogenetic testing for drug response (cytochrome P450 complex, HLA complex)

Question 13

Genetic Syndromes with Psychiatric Features

Answer 13

• 22q11.2
• Wilson disease
• Tay-Sachs disease
• Homocystinuria
• OTC deficiency
• AIP
• HD
• mitochondrial disorders

Question 14

22q11.2

Answer 14

schizophrenia (25%), anxiety, depressive disorders

Question 15

Wilson Disease

Answer 15

psychosis, depression, personality changes, academic decline

Question 16

Tay-Sachs Disease

Answer 16

adult onset: psychosis, depression, mania (40%)

Question 17

Homocystinuria

Answer 17

anxiety, depression, OCD, psychosis

Question 18

OTC Deficiency

Answer 18

psychosis

Question 19

Acute Intermittent Porphyria

Answer 19

anxiety, insomnia, depression, hallucinations, confusion, paranoia, amnesia, altered consciousness

Question 20

Huntington Disease

Answer 20

depression, anxiety, psychosis, apathy, behavioral disturbances

Question 21

Gold Standard of Risk Calculation

Answer 21

family history

Question 22

Jar Model

Answer 22

used to explain etiology and inheritance of mental illness by demonstrating jar filled with set of genetic factors and relative amount of environmental factors needed to trigger an episode of illness as well as protective factors that can delay episode onset

Question 23

T/F: Women with mental illness are at increased risk for postpartum depression/postpartum psychosis

Answer 23

generally true