Assessment Questions

Test and refresh your knowledge with these assessment questions:

1.What is unipolar depression and what is thought to cause it?

Answer:

Depression is an enduring mood disorder characterised by low mood, a loss of pleasure or interest, reduced energy and feelings of guilt or low self-worth. This is usually accompanied by sleep and/or appetite dysfunction, reduced concentration and, often, debilitating anxiety. It is primarily neurological in origin whereby there is inflammatory cytokine damage and destruction of neural tissue that results in a loss of volume in the hippocampus and pre-frontal cortex. The trigger for this process is exposure to anxiety and stress over time and it results in the mood circuitry of the brain subsequently being disrupted.

2.What are the three main neurotransmitters associated with mood disorders?

Answer:

Serotonin, dopamine and noradrenaline (norepinephrine) are the three key neurotransmitters central to the regulation of mood and the recovery of disrupted neural mood circuitry.

3.What is bipolar disorder and what is thought to cause it?

Answer:

Bipolar disorder is a severe, enduring mood disorder whereby the person experiences periods of mania, hypomania (when someone is persistently disinhibited and euphoric) alongside periods of depression. It is thought to be as a result of dysfunction in the neural circuitry that regulates mood, particularly the prefrontal cortex, as well as:

  • An imbalance in neurotransmitters within the circuitry, namely serotonin, noradrenaline and particularly dopamine (Grande et al. 2016).
  • Genetic susceptibility to the condition, which, when combined with some form of environmental trigger, leads to a set of biochemical circumstances that cause and progressively exacerbate inflammatory and oxidative stress damage.
  • Dendritic spine loss.
  • Oxidative stress that leads to neural damage, specifically as a result of reduced phosphates and pH along with lactate build-up.
  • Disruption to enzymes essential for cellular respiration in the neural mitochondria, particularly complex I, resulting in the neural disruption.

4.What common pathophysiological pathway do ASD and schizophrenia share?

Answer:

Schizophrenia and ASD both share an initial common pathway in that maternal infection is thought to trigger an immune-related response that impacts negatively on neurodevelopment.

5.What is thought to cause schizophrenia after the initial common pathway?

Answer:

The cerebral cortex is thinner than expected as a result of grey and white matter tissue loss secondary to latent immune abnormalities that resurfaces later in life; the excitotoxic response that occurs results in excessive stimulation of glutamate hippocampal neurons, resulting in toxic degeneration.

6.What is thought to cause ASD after the initial common pathway?

Answer:

The cerebral cortex is thicker than expected as a result of increased amounts of grey and white matter; persistent fetal inflammation as a result of maternal infection causes inflammatory and stress damage disrupting fetal brain gene expression.

7.What are the factors that people with mental ill-health feel positively influence their care?

Answer:

Care should be experienced in a family-like atmosphere where there is a shared sense of belonging between nurses and those in their care. People should be facilitated in finding meaning and purpose to their lives. Central to providing person-centred care is compassion and feeling accepted by those supporting them. People with mental ill-health need support and strategies to learn to live with the stigma of mental illness alongside engaging with therapeutic interventions.