Ch 27; Psychiatric Disorders Flashcards
Schizophrenia
Delusion or beliefs that distort reality Hallucinations Disorganized speech, senseless rhyming Disorganized, agitated behavior Blunted emotions, loss of interest and drive
Structural abnormalities in schizophrenia brains
weight less enlarged ventricles reduction of neuron in prefrontal cortex abnormal cellular structure in prefrontal and hippocampus hypofrontality during card sorting
Biochemical abnormalities in schizo
Decreased glutamate
decreased dopamine
increased GABA
Type of Schizophrenia
Type I; Acute Schizophrenia
Positive symptoms and more responsive to neuropleptics (anti-psychotics)
Type II Chronic Schizophrenia
Negative symptoms and structural abnormalities in the brain
Schizophrenia as Disorder of Development
Develops during late adolescence.
Slow emergence of brain abnormalities.
Combination of genetics and environment (no single gene and more combo of adverse events)
Neuropsychological assessment
poor performance on long term verbal and nonverbal memory
poor frontal-lobe funtioning
Mood Disorders
Clinical Depression
Prolonged feelings of worthlessness and guilt, behavioral slowing, and disrupted eating and sleeping
Mood Disorders
Mania
Excessive euphoria
Hyperactivity
Mood disorders
Bipolar disorders
Periods of depression and mania
Depression
Reduction of monoamines
Brain-derived neurotrophies factors (BDNF):
upregulated by SSRIs, downregulated by stress, and dysfunction may affect functioning of monoamine synapses
Fluoxetine (prozac)
SSRI and stimulates BDNF and neurogenesis in the hippocampus
Bipolar DIsorder
decrease in gray matter in the temporal lobe and cerebellum; decrease correlates with number of episodes
sensitization model; bipolar patients are sensitive to stress and drugs and episodes of mood disorder change the brain
neurobiological aspects of bipolar disorder
sensitization model;
genetically predisposed individuals may be more sensitive
there is a link between psychomotor-stimulants and mania
bipolars are at high rish for drug abuse and may be especially sensitive to the effects
Mood and micronutrients
Vitamins, minerals, and food
related to; inborn errors in metabolism, alterations in gene expression, epigenetic alterations in genes, and long-latency effects of nutritional abnormalities
Psychiatric symptoms of cerebral vascular disease
post-stroke patients
some experience depression and some generalized anxiety
psychosurgery
rarely performed, smaller lesion, does not replace activity
Motor Disorder
hyperkinetic; increased motor activity
hypokinetic; loss of movement
Hyperkinetic; huntington’s chorea
genetic disorder, intellectual deterioration and abnormal movements, begins as a reduction of activity and a restriction of interest, and involuntary movement begin about a year later
Symptoms of huntington’s chorea
movements; entail whole limbs, irregular, no pattern and affect head, face, trunk, and limbs
behavioral symptoms; personality changes, cognitive impairments, and anxiety, depression, mania and schizo-like psychoses
Brain abnormalities; shrinkage of the cortex, atrophy of the basal ganglia, imbalance among the neurotransmitter systems (death of GABA and ACh neurons in the basal ganglia)
poor performance on memory and frontal-lobe tests
Tourette’s syndrome
three stages;
1. multiple tics
2. inarticulate cries are added to the tics
3. articluate words-echolalia; repeating what other say, coprolalia; obscene or lewd speech
treatment; antidopaminergic drugs and norepinephrine receptor agonists
subcortical origin - small cells in the basal ganglia
abnormalities in cognitive functions supported by right hemisphere
Hypokinetic Disorders;
Parkinson’s disease
degeneration of the substantia nigra, loss of dopamine, variety of symptoms that vary from pt to pt, and symptoms resemble changes in motor activity that occur with age
symptoms; rigidity, tremor, akinesia, and postural disturbances
Positive and negative symptoms
Positive; resting tremor, muscular rigidity and involuntary movements;
akathesia - cruel restlessness
oculogyric crisis - involuntary turns of the head and eyes to the side
negative symptoms;
disorders of posture, righting,, locomotion, and speech and akinesia
clinical symptoms for parkinsonism
tremors in the hand, face becomes masklike and movements slow, 10-20 yrs progression on-again-off-again quality
causes of parkinsonism
idiopathic - familial, part of the aging process, and viral origin
postencephalitic - occurs after
drug induced - ingest of tranquilizers, contaminant of heroin, environmental toxins, or depletion of dopamine
psychological aspects of parkinson’s disease
cognitive functions - generalized behavior slowing, show symptoms similar to frontal lobe and basal ganglia lesion and impaired on the WAIS
dementia
memory and other cognitive deficits
impairment in social and occupational functioning
Alzheimer’s disease
neuritic plaques and neurofibrillary tangles
neocortical changes - shrinkage of the cortex and neurons, loss of dendritic aborization
putative causes of alzheimers disease
genetics, trace metals ( aluminum) and immune reactions (antibrain antibodies that cause neuronal degeneration) blood flow (decreased) abnormal proteins (increased)
progression of alzheimer’s disease
gradual progression
impairment on the WAIS
language impairments
impaired on nearly all test of memory
