psychiatry through the lifecourse

Question 1

do cortical areas associated with sensory motor cortex or prefrontal cortex mature first?

Answer 1

cort areas associated with sensory and motor tasks

Question 2

describe adolescence in terms of neurology

Answer 2

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

Question 3

what aspect of the brain is fully grown relatively soon after birth?

Answer 3

volume

Question 4

what aspect of brain growth continues in adolescence?

Answer 4

structural maturation

Question 5

median age onset of ASD- autistic spectrum disorder, ADHD and eating disorders

Answer 5

9 yrs, 12 yrs adhd, 17 ed

Question 6

proportion of individuals with onset of ANY mental health disorder below age of 18

Answer 6

48.4% (proportionally so much more under 18- think about over 18 - around 6 decades vs 2 below so….

Question 7

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

Answer 7

anxiety ( see ppt for more of these)

Question 8

What usually happens to individual when asd not treated / addressed

Answer 8

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

Question 9

what is an ego dystonic thought

Answer 9

a thought you dont like having

Question 10

what is parasuicide?

Answer 10

accidental self caused death

Question 11

who is a higher risk of parasuicide

Answer 11

self harm ppl although self harm ais very dif to suicide- may be happening for very different reasons

Question 12

what is purging and examples

Answer 12

forcefully excreting matter from the body use of laxatives, vomiting, overexercising

Question 13

definition of binging

Answer 13

overeating - over 2-3000 calories in one sitting

Question 14

difference between anorexia and bulemia purging

Answer 14

just the weight

Question 15

what are the 2 symptoms of ADHD (its in the name)

Answer 15

attention deficit hyperactivity disorder

1) inattention

2) hyperactivity/ impulsivity
can have only one but usually have both

Question 16

Based on DSM- 5 how do you diagnose ADHD in below 16s and 17+s ?

Answer 16

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

Question 17

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?

Answer 17

below age 12, skptical when 20 yrs olds present for the first time ever… unlikely new adhd

Question 18

rank subtypes for most common: mixed inatentive and hyperactive and each separately

Answer 18

1) mixed - 50-75%
2) inattentive 20-30%
3) hyperactive 15%

Question 19

genetic risk factors of ADHD:
specific gene? heritability? birth sex?

Answer 19

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

Question 20

environmental adhd risk factors

Answer 20

premature birth
low birth weight
prenatal smokin exposure

Question 21

prognosis of ADHD: progression along lifecourse: from child to teen to adult

Answer 21

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

Question 22

what is dementia in a few words 1) in temrs of pahtology 2) in therms of presentation

Answer 22

degenerative disease of the brain- like chronic brain failure

global cognitive and behavioural impairment

Question 23

is dementia reversible? how does it progress?

Answer 23

irreversible and progressive changes: gets worse

Question 24

what are some reversible causes of dementia- meaning person doesnt actually have chronic degenerative disease- if you take these away they will be fine

Answer 24

surgical: normal pressure hydrocephalus, intracranial tumours, subdural haematoma,

metabolic: b1, 6, 12 deficiency, folate deficiency, hypothyroidism,

infective: neurosyphilis,

psychiatric: delirium, depresison,

Question 25

what are the commonest causes of actual degenerative dementia- rank top 3

Answer 25

theres 5 + mix + other

AD
vascular !!
mixed

lewy body dementia
other
parkinsons
frontotemporal!!

Question 26

what things to look for in a brain ct of someone with dementia?

Answer 26

1) any type of degeneration

2) any signs of reversible causes such as normal pressure hydrocephalus - dilated ventricles (bc fluid in them)

Question 27

what is the Hakim-Adams triad?

Answer 27

3 main clinical symptoms that present with normal pressure hydrocephalus

cognitive impairment/ confusion

urinary incontinence/ frequency

gait disturbance: magnetic stuck to the floor gait

Question 28

is dementia prevalence expected to incr or decrease by 2030 and then 2050?

Answer 28

increase and increase even more

Question 29

is dementia in the list of causes of death globally? in high income countries?

Answer 29

yes 7 and 2nd in high income

Question 30

men and women cause of death dementia on list

Answer 30

women first, men second after heart disease

Question 31

how does risk of AD incr with age

Answer 31

1% yr 60, doubles every 5 yrs, 40% of those above 85

Question 32

how do you die form dementia?

Answer 32

self neglect: lose drive to eat drink ect, cand wallow, (due to brian degeneration) incr risk of falls ect.

Question 33

some of the first issues in mild dementia

Answer 33

difficulty solving problems and finances

living independently but some supervision and support generally needed

may look fine to someone not close contact

Question 34

moderate dementia additionla problems that werent in mild

Answer 34

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

Question 35

severe dementia additions

Answer 35

disoriented to time and place

situational awareness impaired

depending on others for basic needs- bathing ect
urinary and faecal incontinence may emerge/