S11: psychiatry 1

Question 1

Describe the hippocampus

Answer 1

Receives inputs from many parts of the cortex and processes their emotional content
Ultimately projects to the thalamus & hypothalamus
Also has a role in memory

Question 2

Describe the amygdala

Answer 2

Almond shaped structure sitting near the tip of the hippocampus
Receives many inputs from the sensory system
Major outputs to cortex & hypothalamus
Involved in behavioural and autonomic emotional responses

Question 3

Describe the role of the prefrontal cortex

Answer 3

Modulation of emotional responses

Perception of emotion?

Question 4

Describe the limbic system

Answer 4

Able to act on the hypothalamus to stimulate the secretion of stress hormones
Via the HPA axis
Release of cortisol from the adrenal cortex is part of the ‘chronic’ stress response

Question 5

Describe general adaptation syndrome

Answer 5

Refers to three stages that the body goes through during prolonged exposure to stressors
Stage 1: the alarm reaction – release of adrenaline and cortisol as well as sympathetic activation
Stage 2: resistance – chronic stress response, prolonged release of cortisol
Stage 3: exhaustion – chronic side effects of prolonged cortisol secretion start to occur

Question 6

Outline symptoms of anxiety

Answer 6

Palpitations
Sweating
Trembling or shaking
Dry mouth
Difficulty breathing
Chest pain/discomfort 
Nausea/abdominal distress 
Feeling dizzy, unsteady, faint/light-headed

Question 7

List types of anxiety disorders

Answer 7

Social phobia
Specific phobias 
Generalised anxiety disorder 
Panic disorder 
OCD
PTSD

Question 8

Describe the pathophysiology of anxiety disorders

Answer 8

Unclear
GABA levels appear to be low in some anxiety disorders
Increasing serotonin levels can help treat anxiety disorders

Question 9

Describe the treatment for anxiety disorders

Answer 9

Biological – short term benzodiazepines, SSRIs
Psychological – CBT
Social – support groups, charities

Question 10

Describe OCD

Answer 10

Obsessions: thoughts that persist and dominate an individual’s thinking despite their awareness that the thoughts are entirely without purpose, or have persisted and dominated their thinking beyond the point of relevance or usefulness
Compulsions: a motor act resulting from an obsession; acting out a compulsion may relieve the anxiety provoked by its associated obsession, but frequently carrying out the compulsion is also unpleasant

Question 11

Describe pathophysiology of OCD

Answer 11

Unclear, some hypotheses include:

1) Basal ganglia re-entrant circuits = overactivity in the direct pathway
2) Reduced serotonin levels
3) Altered activity in a range of cortical areas
4) Autoimmune aetiologies

Question 12

Describe treatment for OCD

Answer 12

Biological – SSRIs +/- antipsychotics, deep brain stimulation
Psychological – CBT & various other interventions
Social – family support, groups

Question 13

Describe PTSD

Answer 13

Can occur within six months following an exceptionally severe traumatic event
Causes repetitive, intrusive recollection or re-enactment of the event in memories, daytime imagery or dreams
Conspicuous emotional detachment, numbing of feeling & avoidance of stimuli that might arouse recollection of the trauma

Question 14

Describe the pathophysiology of PTSD

Answer 14

Unclear
Evidence of amygdala hyperactivity causing exaggerated behavioural responses
However, low levels of cortisol

Question 15

Describe treatment for PTSD

Answer 15

Biological – SSRIs, short term benzodiazepines
Psychological – CBT, eye movement desensitisation reprocessing therapy
Social – charities eg. help for heroes