Week 1.2.3: Biological Underpinnings

Question 1

A mental disorder where a person loses touch with reality, experiencing delusions or hallucinations.

Answer 1

Psychosis

Question 2

A neurotransmitter in the brain that plays a key role in reward, motivation, and the regulation of mood.

Answer 2

Dopamine

Question 3

A part of the brain involved in the coordination of movement, reward, and the synthesis of dopamine.

Answer 3

Striatum

Question 4

A chronic and severe mental disorder affecting how a person thinks, feels, and behaves, often characterized by psychosis.

Answer 4

Schizophrenia

Question 5

A class of stimulant drugs that increase the activity of certain chemicals in the brain, leading to increased alertness, attention, and energy.

Answer 5

Amphetamines

Question 6

A powerful, highly addictive stimulant that affects the central nervous system.

Answer 6

Methamphetamines

Question 7

A stimulant drug that increases levels of dopamine in the brain circuits related to pleasure and movement.

Answer 7

Cocaine

Question 8

Some people develop schizophrenia after using drugs like amphetamines or methamphetamine. This has been known for over 60 years. High usage of these drugs can lead to psychosis, even in individuals who were normal during childhood.

Answer 8

Drug-Induced Schizphrenia

Question 9

A commonly used drug derived from the Cannabis plant, containing psychoactive compounds like THC.

Answer 9

Cannabis (Marijuana)

Question 10

The main psychoactive ingredient in cannabis that affects the brain.

Answer 10

THC (Tetrahydrocannabinol)

Question 11

A measure of association between an exposure and an outcome. An OR greater than 1 indicates an increased risk.

Answer 11

Odds Ratio (OR)

Question 12

This study, published in 1987, followed Swedish conscripts over 15 to 25 years. It found that those who used cannabis more than 50 times were much more likely to develop schizophrenia compared to those who used it less frequently or not at all.

Answer 12

Swedish Army Study

Question 13

This study followed individuals from childhood and found that those who started using cannabis by age 15 had a much higher risk of developing psychosis by age 26

Answer 13

Dunedin Study

Question 14

A high-potency form of cannabis known for its strong smell and high THC content (around 16%)

Answer 14

Skunk

Question 15

A traditional form of cannabis with lower THC content (around 3-4%)

Answer 15

Hashish (Resin)

Question 16

Lab-made substances designed to mimic the effects of THC, the main psychoactive ingredient in cannabis

Answer 16

Synthetic-Cannabinoids

Question 17

Such as Spice or K2, are often mixed with plant material and smoked.

They can cause psychosis much more quickly than natural cannabis, sometimes within days

Answer 17

Synthetic-Cannabinoids

Question 18

A receptor in the brain that interacts with cannabinoids like THC, affecting mood, memory, and pain sensation

Answer 18

CB1 Receptor

Question 19

Common names for synthetic cannabinoids, often marketed as “herbal incense” or “potpourri”

Answer 19

Spice/K2

Question 20

What is the difference between synthetic cannabinoids and natural cannabis?

Answer 20

Synthetic cannabinoids are much stronger than natural cannabis.

While natural cannabis has a partial effect on the CB1 receptor, synthetic cannabinoids have a full effect, making them much more potent

Question 21

What are the routes into psychosis?

Answer 21

• Developmental Route
• Drug Route
• Social Route

Question 22

This involves changes in the brain during growth that increase the risk of psychosis. These changes can be due to genetic factors or early life experiences.

Answer 22

Developmental Route

Question 23

This route involves individuals who develop psychosis due to drug use. These individuals often do not have childhood problems and may be very smart and resourceful.

Answer 23

Drug Route

Question 24

This involves social and environmental factors that increase the risk of psychosis.

Answer 24

Social Route

Question 25

What is the association between living in big cities and developing psychosis?

Answer 25

There is strong evidence that living in a big city increases the risk of developing psychosis. The risk of psychosis is higher in urban areas compared to rural areas.w

Question 26

What about living in big cities affects the development of psychosis?

Answer 26

Urban Stress: Living in a big city can be stressful due to factors like noise, pollution, and social stress. Population Density: Higher population density in cities means more social interactions and potential stressors, which can increase the risk of mental health issues

Question 27

What is the association between migration and psychosis?

Answer 27

Migrants, especially from Africa and the Caribbean, have a higher risk of developing schizophrenia due to stressful social factors in their new environment like discrimination and social isolation.

Question 28

What is the association between childhood abuse and psychosis?

Answer 28

Experiencing sexual or physical abuse as a child increases the risk of developing psychosis later in life

Question 29

What is the association between family arrangements and stress vulnerability - and also psychosis?

Answer 29

The number of times family arrangements changed (e.g., parental divorce, multiple step-parents) also affects stress vulnerability. Individuals who experienced more family rearrangements are more likely to release dopamine when stressed, making them more vulnerable to psychosis

Question 30

Central to the development of psychosis, influenced by genetic, developmental, and social factors

Answer 30

Dopamine Dysregulation

Question 31

What is the association between dopamine dysregulation and psychosis?

Answer 31

Individuals with a predisposition to psychosis or schizophrenia have an overreactive dopamine system. Acute psychosocial stress can cause excessive dopamine release, leading to abnormal processing of stimuli and misinterpretation of the environment

Question 32

What is the association between stress and psychosis?

Answer 32

Stressful experiences, especially in those with a difficult childhood, can lead to paranoid interpretations of environmental changes. This stress exacerbates psychosis, creating a cycle of increased dopamine release and worsening symptoms.

Question 33

What treatment approaches are available for psychosis?

Answer 33

Combining pharmacological interventions with social and cognitive approaches to reduce dopamine release and improve patient outcomes namely: - Antipsychotics - Stress Reduction - Cognitive Behavioral Therapy (CBT)

Question 34

Helping patients understand and reinterpret their experiences to reduce paranoia and stress

Answer 34

Cognitive Behavioral Therapy (CBT)

Question 35

Identifying and mitigating the sources of stress, such as improving family support or changing environmental factors.

Answer 35

Stress Reduction

Question 36

Medications that block dopamine receptors to reduce the effects of excessive dopamine.

Answer 36

Antipsychotics