Read the summary and the most important questions on Neuropsychology & psychiatric disorders

• Lecture 01

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• Similarities between neurology and psychiatry

  •  application of neurological methodology and diagnostics in psychiatric diseases
  •  interest of neurology in complex mental functions and psychiatric symptoms in neurilogical diseases
    

  
  
  increased recognition
  

  • profound cognitive concequences of primary psychiatric disorders (schizophrenia)
  • profound affective disorders of primary neurological disorders (Huntington)

• Approaches used in neurology and psychiatry

  • neurology used emperism and objectivity
  • psychiatry uses inerviewing skis, psycho-logical therapies and appreciation of individual differences 

  
  
  both can learn from each other 
  

  • neurologists assess psychiatric comorbidities
  • psychiatrist become familiar with neuroscience research tools (neuroimaging)

• contribution of neuropsychology to psychiatry

  • some brain bases for neuropsychological functions have been established to some degree 
  • our understanding of neural correlates of psychiatric symptoms is more hazy
  • neuropsychological processes may help our understanding of witch brain regions are involved in psychiatric disorders 

  
  
  Example
  

  • wisconsin card sorting test
  • perseverative errors > continues with a wrong sorting strategy 
  • perseverative errors have been associated with frontal lesions
  • same perseverative errors are made in patients with schizophrenia > means that frontal cortex is dysfunctional in schizophrenia

  
  Higher brain functions cannot be mapped to a specific region  
  
  most mental processes are regulated by complex neural networks that connect various brain regions 

• Improving diagnostic classification

  • patients with a specific psychiatric condition form a very heterogenous group
  • different pattern of performance on a neuropsychological test may be used to reduce the heterogeniety within disorders ans may improve diagnostic classifications 

• improving diagnostic classification comorbidity

  • comotbidity between psychiatric diagnoses is common and similar symptoms are often observed across different disorders
  • examining basic neuropsychological processes in psychiatric disorders may help to explain patterns of comorbidity between diagnostic entities 

  
  
  

  • high comorbidity of adhd and substance use disorders 
  • high levels of impulsivity in patients with adhd and patients with substance use disorders 

• improving diagnostic classification: identification of people at risk

  • neuropsychological evaluation can reveal changes in cognitive functions that may revael to later onset of psychopathology 
    
  • verbal memory and attention deficits in children predicted cases of adult schizophrenia 

• Lecture 02: ADHD in adulthood

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• Adult presentation of ADHD

  • symptoms diminish in severity and frequency 
  • higher impact if symptoms due to increased demands of adult environment 

• Adult presentation of ADHD: core symptom shift

  • reduction of motor symptoms 
  • reduction of impulsivity 
  • inattention more prominent 

• Adult presentation of ADHD: associated features

  • affective instability, emotional over-reaching resulting in poor tolerance of stress 
  • cognitive disturbances 
  • disorganisation 
  • marital problems 
  • occupational problems 
  • financial problems 
  • substance abuse 
  • increased risk behaviour 
  • delinquency 

• Adult presentation of ADHD: diagnosis

  • ADHD in adults is often misdiagnosed or overlooked 

  
  
  

  • either diagnosed in children (easy to recognise) or never diagnosed before (difficult to recognise)
  • 91-98% self-referral
  • diagnosis in childhood, family members trigger self-recognition of symptoms, learning about condition through media