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9 - Psychiatric Disorders Flashcards

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1
Q

define schizophrenia

A

severe mental disorder characterised by emotional dysregulation and cognitive deficits

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2
Q

difference between males and females

A

males have more severe forms, pronounced abnormalities and more resistant to treatment

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3
Q

male and female onset

A

15-25 in males

30 in females

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4
Q

what are the 4 courses of conditions

A

one episode
several with no impairment
impairment after first episode
exacerbated impairment

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5
Q

define alogia

A

reduced speech

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6
Q

define anhedonia

A

decreased ability to find pleasure in things one used to

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7
Q

define avolition

A

hard to initiate and pursue goal-directed behaviour

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8
Q

define affective flattening

A

lack of emotional and facial expressoin

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9
Q

define cognitive symptoms

A

difficulties with aspects of cognition which makes it harder to live a normal life and work

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10
Q

what are the wider areas of impact of schizophrenia

A 
more family stress
comorbidity
abuse
reduced employability and income
shame
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11
Q

define affective disorders

A

mood disorders where disordered feelings arise

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12
Q

some key things about the prevalence, incidence, onset, gender divide, etc. about depression are

A

15% p, 1% in, early adulthood, females get it more than males after 13 years old, can be continuous or episodes

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13
Q

some key things about the prevalence, incidence, onset, gender divide, etc. about bipolar are

A

1% p, 4% in, late adolescence, 50:50 males:females, manic and depressive episodes

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14
Q

how much longer are depressive episodes in bipolar than manic

A

three times longer

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15
Q

examples of manic mood and behaviour in bipolar

A

impulsivity, recklessness, euphoria

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16
Q

examples of psychotic symptoms in bipolar

A

delusions, hallucinations

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17
Q

examples of cognitive symptoms in bipoalr

A

distracted a lot, disorganised, inattentive

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18
Q

examples of dysphoric mood and behaviour symptoms in bipolar

A

depressopn, anxiety, suicide

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19
Q

in terms of genetics, schizophrenia is what and what other aspect causes it

A

polygenic

environment

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20
Q

define common variant

A

caused by a large number of genetic changes each of which has a small effect, involving single nucleotide polymorphism

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21
Q

with common variants in sz, what genes are responsible

A

MHC gene, DA system, Ca2+ channel functioning, glutamatergic system

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22
Q

define rare variant

A

rare but highly penetrant genetic changes where DNA has been deleted or duplicated

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23
Q

key gene with rare variants in sz

A

DISC1 - assoc w scaffolding protein for development, neurogenesis, synaptic/mitochondrial functioning

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24
Q

how does dopamine cause schizophrenia

A

DA synaptic overactivity in mesolimbic pathway causing +ive but underactivity in the mesocortical causing cognit/-ive

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25
how do low levels of glutamate in the cerbrospinal fluid cause sz
genes influencing glutamate transmission changes, reducing NMDA binding which is linked to neurodevelopment e.g. pruning
26
how do serotonin changes affect sz
linked to -ive symptoms and moderates dopamine
27
what's the neurodevelopmental approach towards sz
end of adolescence shows more marked difference in neurobiological processes
28
where is there less grey matter in those with sz
frontal and temporal cortex, as rapid loss in young adulthood
29
what do enlarged ventricles filled with water due to brain tissue loss correlate with
correlates with -ive symptoms, drug responsiveness, and cognitive symptoms
30
during hallucinations in schizphrenics, where is there activity and why
in auditory and visual cortices as brain can't distinguish between real and imagined sounds and images
31
define hypofrontality
less activity in the pre-frontal cortex, associated with cognit/ive symptoms
32
what causes less PFC activity in sz
PCP/ket and indirect NMDA receptor antagonists suppressing the dorsal-lateral PFC
33
when do MZ twins have a higher concordance rate
shared placenta
34
where the split of the zygote occurs affects what with MZ twins
how identical the prenatal environment is
35
6 schizophrenia risk factors
``` urban area pregnancy fever winter birth childhood cat maternal substance abuse birth comps ```
36
why does a winter birth increase risk of sz
can contract a virus, meaning toxins and antibodies affecting brain development and attacking foetal cells may be produced
37
how do early behavioural changes in individuals predict developing schizphrenia
sz triggered when neurons degenerate via pruning when the NS is developing connections
38
in the diathesis-stress model, how is the nervous system involved
genetic and env risks trigger expression of genes altering NS function, causing SZ behaviour
39
in depression, which gene is predisposed and ends with 8
GRM8 - metabolic glutamate production
40
what gene is predisposed which ends with A in depression
RORA - circadian rhythm control
41
name the 6 other genes which can predispose depression
``` APOE PCLO TOMM40 GNB3 MTHFER SLC6A4 ```
42
5 environmental factors risking depression
``` ethnic minority childhood maltreatment trauma prior trauma natural brain changes ```
43
3 materal environmental risk factors of depression
maternal stress in utero infections lack of nutrients
44
how do environmental stressors and serotonin transporter gene polymorphisms combine to cause depression
short allele assoc w poor serotonin functioning more likely to have it when experienced higher # of stressful life events and homozy rec
45
what things moderate depressive symptom severity experienced by those who have had child abuse
environmental stressors | single nucleotide polymorphisms in the brain-derived neurotrophic factor
46
what have twin studies shown about heritability of bipolar
MZ/DZ show higher heritability than combined data from twin studies
47
which gene, responsible for Wolfram syndrome, is associated with bipolar
WFS1 as comorbid with psychiatric disorders
48
what gene is associated with the rapid cycling of bipolar
RORB
49
what gene responsible for cortisol actions is associated with bipolar
CRH
50
what gene related to stress is associated with bipolar
encodes binding protein aiding glucocorticoid receptor heterocomplex which regulates cortisol effects of stress
51
3 other biological causes of bipolar
neurochemical changes brain damage hippocampus neurogenesis suppression
52
how can increasing prefrontal cortex activity treat bipolar symptoms
by decreasing subgenual anterior cingulate cortex activity
53
what does the prefrontal cortex do to cause negative emotional responses
inhibit the amygdala
54
environmental risk factors of bipolar
IBS head injury perinatal infection
55
in GxE, how does COMT relate to bipolar
responsible for breaking down dopamine, serotonin, and noradrenaline and risk depends on alleles and # stressful live events
56
in GxE, how does BDNF relate to bipolar
MET carriers of BDNF had more severe, earlier onset of bipolar when experienced child abuse
57
psych explanations of bipolar
negative explanatory style, learnt helplessness, gender differences
58
socio-cultural explanations of bipolar
traumatic life events, cultural expectations, and depress-evoked responses
59
how does the neurochemistry of bipolar and depression relate to stress hormones
higher cortisol/CSF lower hippocampus and PFC volume in depressed injecting CRH in rats causes depressive symptoms
60
how do monoamines relate to depression and serotonin
post-morterms after suicide show high # 5HT receptors | depleting tryptophan reduced 5HT causing lowered moods since it's a precursor protein
61
which drug treatments working on serotonin have a positive effect on depression
MAOA inhibitors, tricyclics which block reuptake, SSRIs which are more selective than tricyclics
62
in what season are most depressed people who commit suicide born in
summer
63
how does BDNF relate to depression and bipolar
stress reduces levels but SSRIs increase levels through neural plasticity so don't work straightaway
64
why are some atypical antipsychotics partial agonists
have a high affinity for particular receptors but activate it less than norma;
65
in what pathways are D2 receptors blocked by typical APs
all
66
what receptors do atypical APs act on
D2 and serotonin receptors on DA neurons to counterbalance D2 blockage
67
how do MAO inhibitors work to treat depression
inhibit MSO enzymes so DA, 5HT, NA broken down less but can cause hypertensive reactions
68
how do tricyclics work to treat depression
inhibits NA, 5HT reuptake and prolongs PSPs but affects cholinergic system and linked to dementia
69
how do SSRIs work to treat depression
inhibits 5HT or 5HT and NA reuptake with fewer non-specific effects but fewer side effects
70
another example of a drug treatment for depression
serotonin noradrenaline reuptake inhibitors
71
how does electroconclusive therapy for depression work
electrodes induce seizure activity which helps suicidal patients as relieves thoughts quickly by increasing seizure threshold and decreasing brain activity
72
transcranial magnetic stimulation works as a treatment how
localised magnetic field induces electrical current when applied to the prefrontal cortex without causing cognitive deficits
73
how does direct brain stimulation work as a depression treatment
electrodes implanted in subgenual anterior cingulate cortex and directed towards the nucleus accumbens to increase dopamine release
74
how does REM sleep deprivation work
wake up when patient is in REM
75
how does slow-wave sleep deprivation work
suppressing slow waves without waking person up to reduce time spent in REM
76
how does total sleep deprivation work
helps facilitate medication effects as brain produces depressogenic chemical when asleep but not awake
77
3 examples of bipolar drug treatments of which lithium is an example of one
mood stabilisers anticonvulsants antipsychotics
78
how does lithium treat bipolar
treats manic phase so depression doesn't occur and allows joy/sadness to be felt without any LT effects for intellect and emotion
79
what are lithium's biological effects
serotonin stabilised, increases neuroprotective proteins to reduce cell death, and grey matter increased

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