Final: Biopsychology of Psychiatric Disorders Flashcards
psychiatric disorder
disorders of psychological function that require treatment by a mental health professional
Along with neuropsychological disorders, what are psych disorders a product of
a dysfunctional brain
Historically what was believed about neuropsych vs. psychiatric disorders
brian problems vs. mind problems
What tends to influence psych disorders
experiential factors like stress
What kinds of brain pathology are psych disorders in general a product of
more subtle forms
may have yet to identify the underlying dysfunctions
effective treatments suggest they exist
What does the word schizophrenia mean and what does it refer to
splitting of psychic functions
the breakdown of integration of emotion, thought and action
prevalence of schizophrenia
1% of population
what does schizophrenia possibly account for (in prevalence)
more than 50% of psych hospital admissions
When does schizophrenia usually first appear
early adulthood (20-30)
5 symptoms of schizophrenia
disorders of perception
hallucinations
disordered thoughts
delusions
disorders of emotion
example of disorder of perception
schizophrenia
hearing voices, smelling poison
hallucinations
schizophrenia
reported sensory experiences where no such sensory input exists
disorders of though
schizophrenia
thoughts loosely associated with each other
free flowing
delusions
schizophrenia
distructed thought patterns like persecution or grandeur
disorders of emotion (examples)
schizophrenia
inappropriate laughing or crying with rapid shifts
5 examples of odd behavior associated with schizophrenia
catatonia
lack of personal hygiene
talking in rhyme
echolalia
no social interaction
3 examples of incoherent thoughts
schizophrenia
illogical thinking
odd associations among ideas
belief in supernatural forces
inappropriate affect
failure to react with an appropriate level of emotionality to positive and negative events
what symptoms need to be present for schizophrenia diagnosis and for how long
2 symptoms
1 month
genetic basis for schizophrenia
some people may inherit an increased risk for it
it may or may not be activated by experience
Causes of schizophrenia
- several chromosomes implicated
- early issues like infections, autoimmune reactions, toxins, traumatic injury, and stress
Basic types of schizophrenia
type 1 - positive symptoms
type 2 - negative
type 1 schizophrenia
bizarre additions to behavior - hallucinations, thought disorders, delusions
type 2 schizophrenia
behavioral deficiencies
lack of affect, inanimate postures, loss of spontaneous speech, general lack of motivation
what do some psychiatrists disagree on about the types of schizophrenia
some patients show both types of symptoms
brain disturbances - positive symptoms
little/no brain abnormalities
brain abnormalities with negative symptoms of schizophrenia
- loss of brain size
- cerebellum shrinkage
- enlargement of cerebral ventricles
what happens to neurons in some schizophrenics and where
hippocampul neurons
abnormal shape, position, frequency
another name for antipsychotic drugs
neuroleptics
what has taught us a lot about schizophrenia
the drugs that are able to treat it
2 drugs used to treat schizophrenia
chlorpromazome
reserpine
chlorpromazome
calms agitated schizophrenics
activates emotionally blunted ones
reserpine for schizophrenia
effective but causes dangerous drop in BP so it is no longer used
effectiveness of both chlorpromazome and reserpine for schizophrenia
what do they indicate
not effective for 2-3 weeks and cause parkinson like motor effects
suggest a role from DA
how are antipsychotic drugs effective for schizophrenics
they decrease dopamine levels
what about the drugs makes scientists believe that schizophrenia is a result of DA overactivity
reserpine - depletes DA and other monoamines by making vesicles leaky
chloropromazim - antagonizes DA activity by binding and blocking DA receptors
the higher affinity a drug has for DA receptors….
the more effective it is at treating schizophrenia
what makes haloperidol different
most antipsychotics bind to D1 and D2 receptors
this binds to D2 receptors
what is correlated with the effectiveness of neuroleptics
the degree to which they bind to D2 receptors
2 limitations to the D2 theory of schizophrenia
-dozapine
neuroleptics act quickly at the synapse but dont alleviate symptoms for weeks - some slow change must occur
dozapin
atypical and effective neuroleptic drug
acts at D1, D4 and 5-HT receptors but also some binding to D2
schizophrenia studies with psychadelic drugs
LSD - positive symptoms
ketamine (a dissociate anethetic) - negative symptoms
characteristics of mania
overconfidence, incessant talkativeness, impulsivity, distractibility and high energy
types of depression
unipolar - depression only
bipolar - depression with manic periods
how is depression divided into 2 categories
reactive - triggered by negative effect
endogenous - no apparent cause
prevalence of affective disorders
about 6% unipolar at some point
1% bipolar
concordance rates for twins with affective disorders
60% for identical
15% for fraternal
more for bipolar than unipolar
what is the evidence for stress and affective disorders
more likely to cause PTSD than depression
likely cause of SAD
where is it most common
what helps
decreased sunlight
in northern and southern latitudes
light therapy
4 types of antidepressant drugs
- monoamine oxidase inhibitors
- tricyclic
- selective monoamine reuptake inhibitors
monoamine oxidase inhibitors
- prevent breakdown of monoamines
- avoid foods high in tyramine “cheese effect”
tricyclic antidepressants
block reuptake of 5-HT and NE
safer than MAOIs
3 types of selective monoamine reuptake inhibitors
SSRIs
SNRIs
Drugs that block the reuptake of more than one monoamine neurotransmitter (like Wellbutrin)
SSRIs
no more effective than tricyclics
- few side effects
- effective at treating other conditions
mood stabilizer
lithium
Lithium
what is it used to treat
how do therapeutic levels of it affect normal individuals
mania and bipolar disorder
nearly nothing happens
Lithium: how does it treat
highly specific in relieving symptoms without over sedating
2 theories of depression
monoamine theory
diathesis-stress model
monoamine theory of depression
- underactivity of 5HT and NE synapses
- consistent with drug effects
Diathesis-Stress Model of Depression
Diathesis - inherited genetic susceptibility
+ stress leads to depression
depressed people tend to release more stress hormones
3 areas of brain damage seen with unipolar depression
amygdala
prefrontal cortex
terminal structures of mesotelencephalic DA system
what are the damaged amygdala and prefrontal cortex (amygdala) associated with
perception and experience of emotion
what is the damage seen in the mesotelencephalic DA system consistent with for depressives
anhedonia that is experienced
Brain pathology and bipolar affective disorder
shrinkage reported in amygdala, cingulate cortex, Prefrontal cortex
most consistent findings with amygdala and anterior cingulate cortex
what area shows effectiveness with chronic electrical stimulation
near anterior cingulate gyrus
5 physical symptoms of anxiety
- tachycardia (rapid hb)
- hypertension
- sleep disturbances
- nausea
- high glucocorticoid levels
most prevalent psychiatric disorder
anxiety
5 classifications of anxiety disorders
GAD
phobic
panic
OCD
PTSD
GADs
stress responses and extreme feelings of anxiety without any causal stimuli
Phobic anxiety disorders
like GADs but triggered by stimulus
agoraphobia
Panic disorders
rapid onset attacks of extreme fear and severe symptoms of stress
can occur without disorders, but also occur as seperate disorders
OCDs
obsessive ideas alleviated by compulsive (repeated) actions
PTSD
persistant pattern of psych distress after exposure to extreme stress
pharm treatment for anxiety
Benzodiazepines
Serotonin agonists
What are benzos also used to treat
hypnotics, anticonvulsants, muscle relaxants
how do benzos work
GABAa agonists
bind to receptors and facilitate effects of GABA
highly addictive
2 types of serotonin agonists
buspirone
SSRIs
Buspirone
selective agonistic effect at 5-HT 1a receptors
reduces anxiety without sedation and other side effects of benzos
neural bases for anxiety DOs
- drugs suggest role for 5-HT and GABA
- amygdala thought to be involved (fear and defensive behavior)
what evidence has been found about the amygdalae and anxiety disorders
over-activity in patients with phobias viewing feared objects
Tourette’s syndrome
what is it
when does it stary
cause?
tics, involuntary movements and or vocalizations
childhood
major genetic component
what other disorders might also people with tourettes have
signs of ADHD and OCD
what is an issue with finding a cause for tourettes
- no animal models
- no genes ID’d
- imaging difficult
how is tourettes treated
with neuroleptics - total effectiveness not well-established
deep-brain stimultion
where is abnormality thought to occur for tourettes and why
basal ganglia-thalamus-cortex feedback circuit
positive results of D2 blockers
