HNB2002 Mental Health Flashcards

Flashcard deck covering pathophysiology, brain structures, and specific mental health conditions including depression, anxiety, schizophrenia, and the recovery model.

Main function of neurotransmitters

To transmit messages between neurons.

Synaptic cleft

The location where communication between two neurons occurs.

Three main components of a synapse

Presynaptic ending, synaptic cleft, and postsynaptic ending.

Presynaptic ending contents

Neurotransmitters (chemical messengers).

Postsynaptic ending contents

Receptor sites that receive signals.

Main functions of dopamine

Reward, pleasure, motivation, reinforcement, attention, learning, and movement.

Behavioural effects of reduced dopamine

Contribution to reduced motivation, reduced pleasure/reward, and decreased drive.

Neutrotransmitter effects in depression

Reduced dopamine, seratonin, noradrenaline

Neurotransmitter effects in schizophrenia

Excessive dopamine.

Neurotransmitter effects in Parkinson's disease

Dopamine depletion.

Neurotransmitter effects in anorexia nervosa

Overproduction of dopamine.

Factors serotonin contributes to

Mood, anxiety, sleep, appetite, emotional processing, and behaviour.

Neurotransmitter effects in OCD

Serotonin dysregulation.

SSRIs mechanism in depression and anxiety

They increase serotonin availability at the synapse.

GABA neurotransmitter type

The brain's major inhibitory neurotransmitter.

Inhibitory neurotransmitter function

Reduces neuronal excitability, making neurons less likely to fire.

GABA contributions

Regulation of anxiety, arousal, relaxation, sleep, and neuronal excitability.

Neurotransmitter effects in anxiety disorders

Reduced GABA, serotonin, norepinephrine. Increased glutamate

Effect of reduced GABA in anxiety

Less inhibitory signalling can cause increased neuronal excitability and arousal.

Benzodiazepines mechanism of action

They enhance the effects of GABA, increasing inhibitory neurotransmission and reducing neuronal excitability.

GABA abnormality in epilepsy

GABA dysregulation, potentially alongside excessive glutamate.

GABA change in Huntington's disease

Reduced GABA.

Glutamate neurotransmitter type

The brain's major excitatory neurotransmitter.

Excitatory neurotransmitter function

Increases neuronal activity and makes neurons more likely to fire.

Glutamate contributions

Neuronal excitation, learning, memory, and information processing.

Glutamate change in anxiety disorders

Increased excitability of glutamate.

Effect of increased glutamate in anxiety

Increased excitatory signalling can contribute to heightened neuronal arousal.

Neurotransmitter contributors to anxiety excitability

Reduced GABA and increased glutamate excitability.

GABA vs. glutamate analogy

GABA = brake; glutamate = accelerator.

Glutamate abnormality in epilepsy

Overproduction of glutamate and/or GABA dysregulation.

Norepinephrine alternate name

Noradrenaline.

Norepinephrine contributions

Alertness, attention, arousal, energy, concentration, and the stress response.

Norepinephrine change in depression

Reduced norepinephrine/noradrenaline.

Effect of reduced norepinephrine in depression

Contribution to low energy, poor concentration, and reduced alertness.

Norepinephrine change in anxiety disorders

Reduced norepinephrine.

Acetylcholine contributions

Learning, attention, memory, and muscle activation.

Acetylcholine abnormality in Alzheimer's disease

Decreased acetylcholine receptors.

Neurotransmitter reductions in depression (summary)

Reduced noradrenaline, dopamine, and serotonin.

Neurotransmitter abnormality in OCD (summary)

Serotonin dysregulation.

Neurotransmitter changes in anxiety disorders (summary)

Reduced GABA, serotonin and norepinephrine, with increased glutamate excitability.

Neurotransmitter abnormality in schizophrenia (summary)

Excessive dopamine.

Neurotransmitter abnormality in Alzheimer's (summary)

Decreased acetylcholine receptors.

Neurotransmitter abnormality in Parkinson's (summary)

Dopamine depletion.

Neurotransmitter abnormalities in epilepsy (summary)

GABA dysregulation and/or glutamate overproduction.

Neurotransmitter abnormality in Huntington's (summary)

Reduced GABA.

Dopamine direction: Depression vs Schizophrenia

In depression, dopamine is reduced while in schizophrenia, dopamine is excessive.

Serotonin link across conditions

Serotonin is reduced in depression and anxiety, and dysregulated in OCD.

Frontal lobe function

Motor skills, planning, expression, reasoning, and problem solving.

Conditions associated with the frontal lobe

Mania, major depressive disorder, anxiety, personality disorders, bulimia nervosa, ADHD, and autism spectrum disorder.

Parietal lobe function

Translates signals such as touch, pain, and pressure; contributes to orientation and recognition.

Condition associated with the parietal lobe

Schizophrenia.

Occipital lobe function

Processes visual information.

Condition associated with the occipital lobe

Schizophrenia.

Temporal lobe function

Processes sounds and contributes to memory and speech perception.

Conditions associated with the temporal lobe

Schizophrenia, anxiety, and major depressive disorder.

Thalamus contributions

Pain perception, motor control, auditory and visual processing, and emotional expression.

Conditions associated with the thalamus

Schizophrenia, PTSD, and major depressive disorder.

Hypothalamus function

Regulates bodily functions including sleep, hunger, and thirst.

Conditions associated with the hypothalamus

Schizophrenia and major depressive disorder.

Amygdala function

Processes fear and anxiety and is involved in the fight-flight-freeze response.

Conditions associated with the amygdala

Anxiety, borderline personality disorder, major depressive disorder, anorexia nervosa, and bulimia nervosa.

Hippocampus function

Contributes to learning, development, emotional behaviour, and recalling happy and traumatic events.

Condition associated with the hippocampus

Major depressive disorder.

Depression (Definition)

A mood state characterised by significantly lowered mood and loss of interest or pleasure in normally enjoyable activities.

Depression mood vs. normal sadness

Distinguished by severity, persistence, duration, and characteristic symptoms.

Reduced neurotransmitters in depression pathophysiology

Noradrenaline, dopamine, and serotonin.

Emotional symptoms of depression

Depressed mood, loss of interest/enjoyment, reduced self-esteem/confidence, guilt, worthlessness, hopelessness, and pessimism.

Physical or behavioural symptoms of depression

Psychomotor agitation or retardation, sleep disturbance, appetite/weight changes, decreased libido, fatigue, and reduced concentration.

DSM-5 symptom threshold for major depression

$5$ or more symptoms during the same $2\text{-week}$ period, representing a change from previous functioning.

Mandatory core symptoms for major depression

Depressed mood OR loss of interest/pleasure.

Comprehensive depression assessment components

History/trauma, safety/psychological functioning, biopsychosocial assessment, MSE, physiological/psychomotor activity, behaviour/social activity, medical conditions, and drug reactions.

Suicide risk determination factors

Plan, intent, means/access, previous suicidal behaviours, risk factors, and protective factors.

CPR (Suicide risk acronym)

Current plan, Past history, Resources (including internal and external protective factors).

Examples of suicide protective factors

Social/emotional support, peer/family relationships, community connection, employment, stable income, and stable housing.

Identified psychotherapy and non-drug treatments for depression

Psychotherapy, CBT, brief dynamic therapy, family therapy, ECT, light therapy, and transcranial magnetic stimulation.

Patient monitoring in depression

Monitoring mood, mental state, and risk, plus documentation of findings.

Health-focused nursing interventions for depression

Healthy eating/exercise, adaptive coping, meaningful activities, and support groups.

Therapeutic nursing interventions for depression

Monitor MSE/risk, administer medications, psychoeducation, and CBT or motivational interviewing techniques.

Anxiety (Definition)

A state involving apprehension and activation of the autonomic nervous system in response to a vague, non-specific threat.

Normal vs. problematic anxiety

Normal is a short-term fight-or-flight response; problematic occurs when arousal becomes constant or prolonged.

Anxiety neurotransmitter changes

Reduced GABA, serotonin, and norepinephrine with increased glutamate excitability.

Generalised Anxiety Disorder (GAD)

Excessive, difficult-to-control anxiety and worry about multiple events or activities with restlessness or muscle tension.

Panic disorder

Recurrent unexpected panic attacks without triggers plus concern about more attacks or maladaptive behavioural change.

Agoraphobia

Fear of situations where escape is difficult or help unavailable if panic symptoms occur, leading to avoidance.

Specific phobia

Marked, unreasonable fear or anxiety about a specific object or situation that is actively avoided.

Social anxiety disorder

Excessive fear or anxiety about social situations involving possible scrutiny by others, leading to avoidance.

Obsession (OCD)

Recurrent persistent thoughts, urges, or images experienced as intrusive and unwanted that cause marked anxiety or distress.

Compulsion (OCD)

A repetitive behaviour or mental act that the person feels driven to perform to reduce anxiety generated by obsessions.

OCD (Neurotransmitter abnormality)

Serotonin dysregulation.

Assessment tool for GAD

$GAD\text{-}7$.

Assessment tool for OCD severity and impact

Yale-Brown Obsessive Compulsive Scale ($Y\text{-}BOCS$).

Interventions for anxiety disorders

Psychoeducation, social support, trauma-informed care, CBT, distraction, cultural support, relaxation/mindfulness, and medication.

Benzodiazepine action mechanism

They potentiate GABA, inhibiting neurotransmission and decreasing anxiety.

Diazepam

An example of a benzodiazepine identified in the lecture.

Alprazolam

An example of a benzodiazepine identified in the lecture.

Lorazepam

An example of a benzodiazepine identified in the lecture.

Clonazepam

An example of a benzodiazepine identified in the lecture.

Monitoring for benzodiazepines

Nurses monitor for over-sedation, cognitive impairment, and dependence.

Benzodiazepines and alcohol

Patients should not combine these medications with CNS depressants like alcohol.

Benzodiazepines safety warnings

Avoid driving and operating machinery.