Medical Models + Treatment

Question 1

What is the biochemical explanation

Answer 1

Dopamine hypothesis

Question 2

Outline the biochemical explanation (5) of scz

Answer 2

Imbalance of neurotransmitters called dopamine

Dopamine enhances feelings of arousal rewards and motivation

In the pre frontal cortex there is low levels of dopamine due to low levels of D1 receptors which leads to negative symptoms like low moods and loss of appetite

In ventral striatum there is excess D2 receptors so there in increased dopamine which leads to positive symptoms like hallucination s, relations and disorganised speech and behaviour

Question 3

What are 3 evidences for the dopamine hypothesis

Answer 3

Drug research - amphetamines and cocaine etc increase levels of dopamine and that’s why it leads to symptoms that resembles psychosis

Post mortem Brian scans of people wit sz shows they higher density of d2 receptors than neuro typical brains

Drug levodopa used to treats Parkinson’s disease enhances dopamine and patients experience psychotic side effects mimicking sz symptoms

Question 4

What is an example of a biological treatment

Answer 4

Drugs
Specifically clozapine used for schizophrenia

Question 5

How does clozapine works as treatment for scz

Answer 5

Atypical antipsychotic drug

It binds to the D2 dopamine receptors tk block dopamine being absorbed by the brain to reduce positive symptoms

They only temporarily occupy the dopamine receptors so that there a less movement side effects

Clozapine however also affects 4 other receptors like serotonin and histamines

Question 6

What is the other type of antipsychotic drug

Answer 6

Typical drugs - permanently binds to d2 receptors which stops dopamine entering synapses permanently

But has many side effects incoming movement - uncontrolled movements and tremors

Question 7

What are 3 strengths of biological treatment

Answer 7

It is effective treatment - study shown its top 3 most effective treatment for reducing a relapse un cohort study of 290000 patients

It is effective on patients who have been resistant to other medications - (30% bi relief from 3 other antipsychotics, only 4% for clozapine)

Less movement side effects than anti psychotic drugs

Question 8

What are 3 weaknesses of biological treatment

Answer 8

Side effects like tremors, muscle spasms

Cateful monitoring of blood cell count - life threatening reductions in 1-2% of patents weakness immune system so need regular blood testing

Ethical issues - sometimes sued without consent when patients highly disturbed pose threat to themselves and others

Question 9

What is the brain abnormality explanation of mental illness

Answer 9

Mental illness caused by differences in brain structure

Question 10

Outline the brain abonormality explanation of mental illness

Answer 10

Mental illness is caused by differences in brain structure

People with scz have large ventricles (fluid culled cavities ) so those with scz have lighter brains - research by swayze support this

People with scz have smaller nucleus accummbens and larger palladium which are part of reward circuit

Smaller amygdala and hippocampus linked to learning and memory

But large verticals can be linked to anti psychotic drugs (beng choon ho)

Question 11

What 2 resrwcah support the brain abnormality explanation
What goes against it

Answer 11

Swayze and van erp

Beng Choon Ho

Question 12

What was swayze study

Answer 12

Swayze reviewed 50 studies of sz and found that many had abnormally large amounts of liquid n ventricles of Brian

Question 13

What is study by van erp

Answer 13

Analysed mri scan of Brian of 2028 scz patients and 2540 health controls

Those with scz had smaller hippocampus and amygdala - linked to memory and learning

They had larger pallidum and ventricle volumes - linked to rewards circuit

Question 14

What is study by beng choon ho

Answer 14

Larger ventricles actually linked to anti psychotic medicine which is what makes the ventricles larger

Question 15

What was the aim of gottesman study

Answer 15

To determine the risk of offspring receiving a diagnosis of schizophrenia, bipolar disorder, depression or any other diagnosis from parents who both have a diagnosis of schizophrenia or bipolar disorder

Question 16

What was the design of gottesman

Answer 16

National register based cohort study

Question 17

What was the sample

Answer 17

2.7 million people born in Denmark
Alive in 1968 or born later than 1968 with register link to their mother and father and aged 10 or older in 2007

Question 18

What were the 2 sources of data - gottesman

Answer 18

The danish civil registration system - info of all people born between (1968 and 1997 is what they were interest in)

The danish psychiatric central register - all psychiatric admission in Denmark from 1970 to 2007 (icd8 and icd10)

Question 19

What was the procedure of gottesman

Answer 19

Data of the children linked with the parents psychiatric history

Using civil register they identified parents to see if they were also on psychiatric register

Using psychiatric register identified anyone with diagnosis of bipolar or scz or depression

Question 20

What are 3 results from gottesman

Answer 20

2 parents with schizophrenia - 67.5% chance of any disorder or 27.3% or scz

1 parents with schizophrenia, 7% chance of child with scz

No partners with disorder - only 0.86% chance scz

Question 21

Outline the genetic explanation of mental illness

Answer 21

We inherit characteristic from our parents - 23 pairs of chromosomes and one form each pair from each parents

Chromosomes have the genes and there are different forms the the same gene - alleles

These genes can explain mental illness inherited

Supporting study - gottesman family studies

And twin studies by hilker

Question 22

Who was the twin studies by and what did they outline (results )

Answer 22

Hilker

Based on danish twin registry and danish paychiatrix

With monozygotic twins Concordance rate of sz is33%

And 7% in dyzigotic