Lecture 10: Psychopathology Flashcards

Question

What is the mechanism of the effect of lithium on bipolar disorder?

Answer 1

Lithium works by balancing excitatory and inhibitory systems in the brain: - Less dopamine and glutamate (both excitatory) - More GABA (inhibitory) This helps smooth out the extreme highs and lows of bipolar disorder.

Answer 2

The person’s emotional expression seems unconnected with current experiences. For example, someone might giggle or cry for no apparent reason, or fail to react to good or bad news.

Answer 3

– Urban Areas: Stress, social isolation, drug use. – Cannabis-Using Regions: Netherlands, North America, Jamaica. – Scandinavian Countries: Sweden, Denmark – Low/Middle-Income Countries: India, Pakistan, parts of Africa

Answer 4

– Rural and Traditional Societies: Rural Africa, parts of China, Pacific Islands

Answer 5

■ Person must also have at least 2 symptoms from the following list, including at least one of the first three: 1. Delusions (unjustifiable beliefs, usually of a social nature, such as “Beings from outer space are controlling my actions”) 2. Hallucinations (false sensory experiences, such as hearing voices when alone) 3. Disorganized speech (rambling or incoherent) 4. Grossly disorganized behavior 5. Weak emotional expression, speech, and socialization

Answer 6

■ Conditions that resemble schizophrenia: – Substance abuse – Brain damage – Undetected hearing deficits – Huntington’s disease – Nutritional abnormalities

Answer 7

Positive - Behaviors that are present should be absent, ex hallucinations.

Answer 8

Absent behaviors that should be present (weak emotion, speech, and socialization)

Answer 9

Monozygotic twins have a higher concordance (agreement) for schizophrenia than dizygotic twins.

Answer 10

For adopted children who develop schizophrenia, the disorder is more common in their biological relatives than their adopting relatives. - Prenatal environment of the biological mother cannot be discounted.

Answer 11

DISC1 stands for Disrupted-in-Schizophrenia 1 — it's a gene that plays a key role in brain development and mental health. Abnormal DISC1 function has been linked to: ❗ Disrupted brain development ❗ Altered dopamine signaling ❗ Poor synaptic function

Answer 12

It is a gene involved in neurodevelopment. In schizophrenia, for example: - NRG1 may affect how neurons form and connect, leading to disrupted brain circuits - It also interacts with DISC1, another gene linked to schizophrenia

Answer 13

Loss of small sections of DNA.

Answer 14

Gain of small sections of DNA.

Answer 15

Abnormalities occurred in prenatal or neonatal nervous system development can produce abnormalities in the developing brain that predispose to schizophrenia.

Answer 16

■ Combination of a genetic predisposition and impacts from the environment in prenatal/neonatal development, later in life, or both. – First Hit: Genetic mutations, prenatal infections, obstetric complications. – Second Hit: Cannabis use during adolescence, chronic stress, urban living.

Answer 17

◼ Poor nutrition of the mother during pregnancy ◼ Premature birth ◼ Complications during delivery ◼ Mother/child blood type differences ■ If mother has a Rh-negative blood type and the baby is Rh-positive, the child is 2x more likely to develop schizophrenia.

Answer 18

Babies born in late winter and early spring months are at higher risk of “positive” schizophrenia ■ Note: Not fully supported

Answer 19

--> Increase cytokines in the mother that impair brain development of fetus ◼ Evidence: Babies born from mother who contracted flu in 1st trimester 7x more likely to develop schizophrenia ◼ Increased schizophrenia rates among people born 2-3 months after major influenza epidemics

Answer 20

– Physical, emotional, or sexual abuse during childhood increases the risk and the probable severity of later schizophrenia. – Living in a crowded city correlates with schizophrenia. – Childhood head injuries in early childhood. – Infection with the parasite Toxoplasma gondii

Answer 21

◼ Enlarged lateral ventricle and prominent sulci ◼ Decreased tissue cerebral gray matter ◼ Smaller PFC and hippocampus ◼ Less gray matter and white matter ◼ Reduced cortical connectivity and activity

Answer 22

It suggests that abnormal dopamine activity in the brain contributes to the symptoms of schizophrenia. 1. Positive symptoms (hallucinations, delusions) → Thought to be caused by overactive dopamine in the mesolimbic pathway 2. Negative symptoms (withdrawal, flat affect, low motivation) → Possibly due to underactive dopamine in the mesocortical pathway

Answer 23

Before antipsychotic drugs, the treatment was only a confined mental hospital.

Answer 24

Chlorpromazine & haloperidol - Blocks dopamine (D2) receptors

Answer 25

Amphetamine psychosis resembles schizophrenia ◼ Amphetamines (and cocaine) block DA reuptake thus increase DA levels. ◼ Amphetamines exacerbate symptoms

Answer 26

Clozapine, amisulpride, risperidone, olanzapine, aripiprazole ◼ Seldom produce movement problems ◼ Less effect on dopamine receptors more on serotonin receptors ◼ Side effects: weight gain and impairment of the immune system

Answer 27

Aripiprazole and brexpiprazole, ◼ Unique mechanism of action, which balances dopamine activity more precisely ◼ Avoids both the movement problems and the weight gain.

Answer 28

■ Two major dopamine pathways – Blocking the mesolimbocortical system helps relieve the symptoms of schizophrenia. – Blocking the path to the basal ganglia produces tardive dyskinesia, a movement disorder.

Answer 29

Schizophrenia due to dysfunction in glutamate transmission, particularly at N-methyl-D-aspartate (NMDA) receptors. According to the glutamate hypothesis of schizophrenia, the problem relates in part to deficient activity at glutamate synapses in the prefrontal cortex. In many brain areas, dopamine inhibits glutamate release, or glutamate stimulates neurons that inhibit dopamine release. Therefore, increased dopamine could produce nearly the same effects as decreased glutamate.

Lecture 10: Psychopathology Flashcards

(53 cards)