Flashcards in Anxiety and Obsessions Deck (25):
What are the two major components of the limbic system?
What are the main functions of the hippocampus?
Expressions of emotion
What are the main functions of the amygdala?
Drive related behaviours and process associated emotions
What do the prefrontal cortex and aneroid cingulate gyrus mainly do?
Both have modulatory effect on processes associated with the hypothalamus
Give 5 symptoms of anxiety
- trembling or shaking
- dry mouth
- dizzyness, faint, etc.
What is the link between benzodiazepines and GABA
GABA is an inhibitory neurotransmitter.
Benzodiazepines increase GABA so therefore reduce anxiety.
What happens to GABA in anxiety disorders?
GABA levels are decreased, so lost inhibition
Give 2 names from benzodiazepines.
What longterm treatment is given for anxiety?
(don't give benzos longterm)
What is the definition of an obsession?
"a THOUGHT that persists and dominates an individuals thinking DESPITE their AWARENESS that the thought is entirely WITHOUT PURPOSE, or has persisted and dominated their thinking beyond the point of relevance or usefulness"
- causes great anxiety and guilt
- repugnant to individual
Give 2 examples of obsessions
- I might harm my baby (I don't want to, but scared I might)
- I might be a paedophile (so scared i won't leave the house and avoid children at all costs)
What are compulsions?
"obsessions are MOTOR acts. May result from an obsessional impulse that leads directly to the action, or they may be the result of an obsessional mental image or fear"
- waste time
- mental compulsions exist, eg. repeating phrases
Obsessions and compulsions share 4 following features.
What are they?
1. Originate in the mind of the patient
2. Repetitive and unpleasant
3. Acknowledged as excessive or unreasonable
4. Patient tries to resist, but at least one obsession/compulsion is unsuccessfully resisted
What is the main difference between OCD and psychosis?
OCD have INSIGHT. They know their thoughts are not reasonable but cannot stop.
Psychosis: unreasonable beliefs but don't accept that they have them, or that they are untrue.
What is a re-entry circuit in basal ganglia?
Is is a pathophysiological explanation for OCD.
Involves HYPERACTIVITY of closed circuits btw Basal Ganglia and cortex.
Caudate nucleus is part of safety checking mechanism - it looks for hidden dangers: my hands might be dirty need to wash them, washing them provides closure. In OCD don't get closure.
Why is the caudate nucleus involved in OCD?
The caudate nucleus processes inputs from cortex and decides what to do.
Input: my hands are dirty
*Processing: DO I need to wash hands?*
Output: washing hands
In OCD reentry, "maybe my hands aren't really clean, I should wash them again"
What does the acronym PANDAS stand for?
Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection
How do PANDAS present?
Sudden onset of OCD symptoms or tics after infection with Group A beta-haemolytic strep
What is the pathophysiology behind PANDAS?
Antibodies cross-react with neurone in basal ganglia, causing symptoms
First line treatment of OCD?
CBT - looking to prevent you from performing the repetitive behaviour (which only provides short-term relief)
Second line treatment of OCD?
High dose SSRIs (higher and longer than for depression)
What is the treatment for treatment-resistant OCD?
Deep brain stimulation
- stimulate STN so therefore more stimulation of GPi&SNr and therefore more inhibition of thalamus.
What is PTSD?
Repetitive, intrusive recollection or re-enactment of a traumatic event of exceptional severity.
+ conspicuous emotional detachment, numbing of feeling and avoidance of stimuli
What is the pathophysiology of PTSD? (2)
1. hyperactivity of amygdala, causing exaggerated response to perceived threat
2. Cortisol inhibits traumatic memory retrieval and controls sympathetic response. BUT in PTSD, lower than normal levels of cortisol.