psychiatry through the lifecourse Flashcards
do cortical areas associated with sensory motor cortex or prefrontal cortex mature first?
cort areas associated with sensory and motor tasks
describe adolescence in terms of neurology
adolescence is a period of neural imbalance caused by early (have matured before adol) development of SUBCORTICAL brain areas and late development (are now starting to mature) of prefrontal control areas
what aspect of the brain is fully grown relatively soon after birth?
volume
what aspect of brain growth continues in adolescence?
structural maturation
median age onset of ASD- autistic spectrum disorder, ADHD and eating disorders
9 yrs, 12 yrs adhd, 17 ed
proportion of individuals with onset of ANY mental health disorder below age of 18
48.4% (proportionally so much more under 18- think about over 18 - around 6 decades vs 2 below so….
10 year old girl, doesn’t want to sleep in the room alone, gets raised heart rate, sweating and difficulty breathing in crowded places and does not like doing presentations in class
anxiety ( see ppt for more of these)
What usually happens to individual when asd not treated / addressed
Issues with socialization bc they don’t like plagying with loud, other children that put them in trouble ect
Issues academic- perform worse
More likely to end up in criminal justice system when they grow up
Hopefully treating early and trying to prevent these
what is an ego dystonic thought
a thought you dont like having
what is parasuicide?
accidental self caused death
who is a higher risk of parasuicide
self harm ppl although self harm ais very dif to suicide- may be happening for very different reasons
what is purging and examples
forcefully excreting matter from the body use of laxatives, vomiting, overexercising
definition of binging
overeating - over 2-3000 calories in one sitting
difference between anorexia and bulemia purging
just the weight
what are the 2 symptoms of ADHD (its in the name)
attention deficit hyperactivity disorder
1) inattention
2) hyperactivity/ impulsivity
can have only one but usually have both
Based on DSM- 5 how do you diagnose ADHD in below 16s and 17+s ?
1) below 16: six/ over 17: five or more symptoms of innatention OR hyperactivity and impulsivity
2) present for at least six months
3) they are innapropriate for developmental level and
4) interfere with functioning or development
(cant put shoes on, cant concentrate in class: educate: develop cognitive skills)
5) present in 2 or more settings
6) symptoms not better expained by other mental disorder
what is a common age up to which several symptoms have usually developed in ADHD and when should you think abt this and become skeptical?
below age 12, skptical when 20 yrs olds present for the first time ever… unlikely new adhd
rank subtypes for most common: mixed inatentive and hyperactive and each separately
1) mixed - 50-75%
2) inattentive 20-30%
3) hyperactive 15%
genetic risk factors of ADHD:
specific gene? heritability? birth sex?
no specific gene, multiple genes conferirng culnerability for developing it
HIGH heritability: 1) twin studies have shown up to 76%
2) first degree relatives of children with adhd have a diagnostic probability 4-5x higher than general
environmental adhd risk factors
premature birth
low birth weight
prenatal smokin exposure
prognosis of ADHD: progression along lifecourse: from child to teen to adult
70% of children with it will still have it as teens and only half of children will keep into adulthood! so its very common to stop
what is dementia in a few words 1) in temrs of pahtology 2) in therms of presentation
degenerative disease of the brain- like chronic brain failure
global cognitive and behavioural impairment
is dementia reversible? how does it progress?
irreversible and progressive changes: gets worse
what are some reversible causes of dementia- meaning person doesnt actually have chronic degenerative disease- if you take these away they will be fine
surgical: normal pressure hydrocephalus, intracranial tumours, subdural haematoma,
metabolic: b1, 6, 12 deficiency, folate deficiency, hypothyroidism,
infective: neurosyphilis,
psychiatric: delirium, depresison,
what are the commonest causes of actual degenerative dementia- rank top 3
theres 5 + mix + other
AD
vascular !!
mixed
lewy body dementia
other
parkinsons
frontotemporal!!
what things to look for in a brain ct of someone with dementia?
1) any type of degeneration
2) any signs of reversible causes such as normal pressure hydrocephalus - dilated ventricles (bc fluid in them)
what is the Hakim-Adams triad?
3 main clinical symptoms that present with normal pressure hydrocephalus
cognitive impairment/ confusion
urinary incontinence/ frequency
gait disturbance: magnetic stuck to the floor gait
is dementia prevalence expected to incr or decrease by 2030 and then 2050?
increase and increase even more
is dementia in the list of causes of death globally? in high income countries?
yes 7 and 2nd in high income
men and women cause of death dementia on list
women first, men second after heart disease
how does risk of AD incr with age
1% yr 60, doubles every 5 yrs, 40% of those above 85
how do you die form dementia?
self neglect: lose drive to eat drink ect, cand wallow, (due to brian degeneration) incr risk of falls ect.
some of the first issues in mild dementia
difficulty solving problems and finances
living independently but some supervision and support generally needed
may look fine to someone not close contact
moderate dementia additionla problems that werent in mild
requires support outside home
difficulties (Not unable ) in DALYS
significant memory loss
social judgement also sometimes compromised (was fine in mild)
people can tell you have it
severe dementia additions
disoriented to time and place
situational awareness impaired
depending on others for basic needs- bathing ect
urinary and faecal incontinence may emerge/
