Introduction to psychiatric disorders Flashcards Preview

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Flashcards in Introduction to psychiatric disorders Deck (27)
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1
Q

What are the 2 key characteristics of schizophrenia?

A

Hallucinations and delusions (positive symptoms)

2
Q

What is a hallucination?

A

Perception in the absence of an external stimulus that has qualities of a real perception
Auditory hallucinations of speech are common in schizophrenia, visual hallucinations are rare

3
Q

What is a delusion?

A

Belief held with conviction despite evidence to the contrary out of keeping with person’s social and cultural background

4
Q

What are some examples of first rank symptoms?

A

Delusions
Auditory hallucinations
Thought disorder e.g. withdrawal, broadcasting, insertion
Passivity experiences e.g. ‘made’ feelings, drives, volitional acts, alien penetration

5
Q

What are the ICD-11 criteria for schizophrenia?

A

A combination of positive and negative symptoms that do not arise as a feature of another mental and behavioural disorder.
Positive symptoms - persistent delusions, hallucinations, disorganised thinking, passivity experiences
Negative symptoms - blunt or flat affect, psychomotor disturbances

6
Q

How does ICD-11 classify unipolar depressive disorder?

A

Presence or history of one depressive episode where there is no history of prior depressive episodes, or at least 2 depressive episodes separated by at least several months without significant mood disturbance.
There have never been any prior manic, hypomanic or mixed episodes which would indicate BPAD

7
Q

What are the key characteristics of depressive disorder (ICD-11)?

A

Difficulty concentrating, excessive guilt, hopelessness, recurrent thoughts of suicide, change in appetite or sleep, psychomotor agitation, reduced energy

8
Q

Name some examples of dimensional measures used in depression, psychosis and alcohol misuse

A

Depression severity - MADRS, BDI, 12-item Hamilton
Psychosis - PANSS
Alcohol misuse - AUDIT
The higher the score the more severely ill the patient

9
Q

How are the anterior cingulate cortex and orbitofrontal cortex implicated in psychiatric disorders?

A

Limbic system linked to motivation - mood disorders, schizophrenia, addictions

10
Q

How are the basal ganglia, including nucleus accumbens, implicated in psychiatric disorders?

A

Limbic system linked to motivation - mood disorders, schizophrenia, addictions

11
Q

How are the brainstem, including the VTA, PAG and DRN, implicated in psychiatric disorders?

A

Dopamine and serotonin systems - mood disorders and schizophrenia

12
Q

How is the lateral habenula implicated in psychiatric disorders?

A

Inhibits brainstem dopamine reward systems, sensitive to aversive stimuli

13
Q

How is the temporal lobe implicated in psychiatric disorders?

A

Linked to hallucinations, amygdala/hippocampus linked to aversive stimuli - mood disorder

14
Q

How is the dorsolateral prefrontal cortex implicated in psychiatric disorders?

A

Cognition, planning, executive function (inferior region linked to emotion)

15
Q

How has the anterior cingulate cortex been used in treatment of highly treatment resistant depressive illness?

A

Anterior cingulotomy within the emotion region but no more posteriorly is associated with long term recovery

16
Q

What is the role of GABA and how is it involved in psychiatric illness?

A

Inhibits dopamine function in the brainstem

Involved in anxiety and fear

17
Q

What is the role of glutamate and how is it involved in psychiatric illness?

A

Opponent to GABA i.e. excitatory

Relatively new target for antidepressants

18
Q

How is acetylcholine involved in Alzheimer’s and PD?

A

Nucleus basalis of Meynert degeneration is seen in AD and PD

19
Q

What is the role of dopamine and how is it involved in psychiatric illness?

A

Prediction of rewards, motivation and ‘wanting’
Implicated in schizophrenia, addictions
Reduced reward related activity in VTA in depression

20
Q

What is the role of serotonin and how is it involved in psychiatric illness?

A

Responds to aversive stimuli
Opponent to systems such as dopamine
Target in antidepressants

21
Q

What is the role of opioids and how are they involved in psychiatric illness?

A

Liking (as opposed to wanting) with mu receptors

Heroin dependency, methadone maintenance

22
Q

What are the 2 dopamine nuclei in the midbrain called?

A

VTA - ventral tegmental area (limbic projections)

Substantia nigra pars compacta (motor)

23
Q

What are the 3 principal classes of opioid receptor?

A

Mu - linked to pleasurable experiences, agonist to morphine

Kappa and delta - lot less work to date on imaging these systems in humans

24
Q

Which areas of the brain are involved in the acetylcholine system?

A

Nucleus basalis of Meynert and brainstem nuclei project widely to rest of brain

25
Q

What does systems neuroscience involve?

A

Generates models of large scale brain function. These models are tested and refined in humans and animals

26
Q

What are some techniques used to explore neural valuation in humans and animals?

A

Reinforcement learning and neuroeconomics

27
Q

What is a biomarker and what is its requirements in medicine?

A
A measurable indicator of some biological state or condition.
Requirements:
objective measurement
good sensitivity and specificity
may or may not be 'mechanism' related