Week 11 - Neuro

What is bipolar disorder

affects peoples mood spectrum, ranging from very elevated or manic to very depressed

How much of the population is affected by SMI

approx 5%

How are DALYs calculated

by adding the estimated years of life lived with a disability and the years of life lost

How does Schizophrenia rank amongst causes of disability

12th largest

How does Bipolar rank amongst causes of disability

54th largest

What has Schizophrenua been associated with in terms of its development

progressive reductions in grey matter volume

What are the genetic risk factors of SMI

Family history
String genetic component

What are the environmental risk factors of SMI

Trauma and psychosocial stressors 
Stressful life events 
Medical complications in neurodevelopmental period 
Poor lifestyle related behaviours

What is the gene-environment interaction

Genetic susceptibility can increase sensitivity to environmental risk factors
Supportive environments can reduce the risk in genetically predisposed individuals

What are the three categories of symptoms

Positive
Negative
Cognitive

What types of symptoms are Positive

Delusions
Hallucinations
Disorganised Speech

What types of symptoms are Negative

Deficits in motivation
Apathy
Social Withdrawal
Anhedonia

What types of symptoms are Cognitive

Poor attention
Impaired memory
Poor organisation
Deficits in executive function

What is the at risk mental state

ages 12-25

When is the usual first episode psychosis

ages 14-30

How much higher are rates of suicide with bipolar disorder

10-30 x higher

whats the difference between bipolar 1 and 2

Bipolar 1 involves more severe mania for longer periods, bipolar 2 is milder

What are the three broad treatments used in mental health

Pharmacotherapy
Psychotherapy
Psychosocial recovery

What medication is prescribed for psychosis and mania

Antipsychotics

What are 1st generation antipsychotics

less commonly used today, because they often came with a long list of side-effects

What were side effects associated with 1st generation antipsychotics

extrapyramidal side effects included involuntary muscle spasms, tremors, muscular rigidity

What are some 2nd generation antipsychotics

Risperidone, Olanzapine, and Clozapine

What are negative side effects of 2nd generation antipsychotics

drowsiness, restlessness, dry mouth, nausea, low blood pressure, and weight gain

What medication is prescribed for Bipolar disorder

Mood stabilisers like lithium, valporate or lamotrigine

What Side effects are included with Mood Stabilisers

Nausea, thirst, headache, mild tremor or weight gain

When can the mental health act be implemented

instances where people are at significant risk to themselves or others

What medications have huge weight gain potential

Lanzapine

People have an increased risk of developing mental illness if they have experienced

Musculoskeltal disorders
Chronic pain
Cancer diagnoses
Social Isolation
Obesity

Having mental illness can impact the management outcomes associated with chronic illness

Poor treatment compliance
Greater risk of complications
Longer hospital stay
Worse recovery outcomes

What are some barriers to PA among people with SMI

Physical health (tiredness/low energy)
Psychological Barriers (Stress Depression/ Disinterest)
Socio-ecological barriers (Lack of support/lack of time)

What are some strategies to enhance adherence

Schedule PA around medication
Adopt good clinical communication

How do exercise physiologists fit in with SMI care

Keeping the body in mind program in South Eastern Sydney Local Health District
team deliver lifestyle interventions for people aged 16-65

Clinical considerations of EP assessment in SMI

Clients goals and needs
Most appropriate for clients capacity
Risks or contraindications

Practical consideration of EP assessment in SMI

Time constraints
Availability of equipment
Competence of interpreting results
Timing of re-assessment and expected changes

What is a scale assessment for depressive symptoms of bipolar

Hamilton Depressio Rating Scale (HDRS)

What is a scale assessment for psychotic symptoms

Positive and Negative syndrome scale

What is a scale assessment for mania

The Altman Self rating mania Scale