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Psychological Disorders (Schizophrenia (Possible environmental effects…

- - - - schizophrenia by overactivity of dopaminergic synapses - probably those in the mesolimbic pathway
    - - a 'typical neuroleptic', a dopamine receptor blocker
      - commonly prescribed antischizophrenic drug
    - - an 'atypical neuroleptic', an antipsychotic drug that blocks the D4 receptors in the nucleus accumbens
- - - - depressed mood most of the time
      - loss of pleasure in normally fun activities
      - sleep disturbances
      - eating disturbances
      - lack of energy or restlessness
      - difficulty concentrating
      - feelings of hopelessness, worthlessness
      - suicidal thoughts
      - 12% of men & 21% of women may experience MDD during their lifetimes
      - most patients experience 5-6 episodes during their lifetime
    - - happy mood associated with activity in the left frontal lobes
      - depression is correlated with increased right frontal lobe activity & decreased left frontal lobe activity
      - left hemisphere damage due to stroke & other medical causes associated with depression
    - - enter REM earlier
      - spend little time in stage 3 & 4
      - awaken frequently
      - REM deprivation reduces depression
      - most antidepressants reduce REM to some extent
    - - reserpine depletes available monoamines and produces profound depression
      - antidepressant medications act on monoamines
      - MAO inhibitors suppress MAO, which breaks down monoamines
      - trycyclic antidepressants inhibit the reuptake of serotonin & norepinephrine
      - SSRIs inhibit the reuptake of serotonin
  - - - inflated self-esteem (grandiosity)
      - reduced need for sleep
      - talkativeness
      - racing thoughts
      - distractibility
      - goal-oriented behaviour
      - excessive involvement in pleasurable activities
    - - females more likely to be diagnosed 3:2
    - - similar structural abnormalities seen in schizophrenia
      - smaller white matter volume
      - thinner parahippocampus & right orbitofrontal cortex
      - thicker temporoparietal & left superior motor cortices
      - enlargement of the amygdala may occur
    - - monoamines may be involved
      - bipolar is associated with a decreased need for sleep
      - sleep deprivation may trigger mania
      - patients have more monoamine binding sites than healthy controls
    - - enhances norepinephrine reuptake
      - if lithium can't be tolerated, patients may use SSRIs
      - benzodiazepines, neuroleptics & anticonvulsant drugs
  - - - panic disorder
      - general anxiety disorder
      - social anxiety disorder
    - - pathways connecting the brainstem, amygdala & related subcortical structures & decision-making areas of frontal lobes - involved with generating fear in the presence of danger
      - HPA axis: involved in the response to stress
      - norepinephrine, serotonin & GABA neurotransmitter systems: GABA agonists reduce subjective experience of anxiety
    - - SSRIs, SNRIs & GABA-agonists, plus CBT
- - - - candidate genes regulate brain development
        
        synaptic changes & increased parental age
      - concordance rate in identical twins of 76-88%
    - - perinatal complications; increased parental age; exposure to infection, pesticides, & nutritional factors; maternal use of antidepressants; NOT due to vaccines
  - - - high neurotrophic levels, excess cerebrospinal fluid
- - - - lead contamination
      - low birth weight
      - prenatal exposure to tobacco, alcohol, etc.