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Schizophrenia

Schizophrenia. Onset - late adolescent and early adulthood Symptoms - delusions - inappropriate affect - hallucinations - incoherent thought - odd behavior (extreme - catatonia). Causes Genetic - some role concordance in identical twins - 45% Suceptibility idea

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Schizophrenia

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  1. Schizophrenia Onset - late adolescent and early adulthood Symptoms - delusions - inappropriate affect - hallucinations - incoherent thought - odd behavior (extreme - catatonia)

  2. Causes • Genetic - some role • concordance in identical twins - 45% • Suceptibility idea • - environment plays some role • - flu (or related virus) in 2nd trimester? • - the latitude effect • - the seasonality effect • (born in feb to may - slight increase)

  3. Dopamine hypothesis Chlorpromazine - surgical antihistamine - blocks DA receptors - neuroleptics Refinement - D2 receptors most important too much dopamine - schizophrenic behavior Block dopamine - schizophrenia gets better Too much dopamine? - no evidence too many receptors - some evidence (but changes due to treatment?) - more sensitive to dopamine

  4. - ventral tegmental area - just above S.N. (mesocortical - mesolimbic system) - nucleus accumbens - receives dopamine from VTA - perhaps screwed up systems rewards bad thoughts and behaviors - process gets worse and worse - or VTA -> prefrontal area -> Limbic system - damage to prefrontal cortex (which INHIBITS Limbic system) - hypoactivity of prefrontal cortex (PET Studies) - hyperactivity in limibc system (goes wild - no inhibition) - amygdala - emotion - increased activity of dopamine system in temporal lobe ** positive symptoms & negative mental symptoms ** negative physical symptoms - the other dopamine system - basal ganglia - brain damage - enlarged ventricles

  5. Affective Disorders • Depression • Reactive • endogenous (unipolar) - 6% • - twice as high in women (?) • - 10% suicide • Mania (bipolar disorder) • - about 1% • - no sex difference

  6. Causal Factors Genetic - concordance in identical twins - 60% (origin - organic vs experience?) - why gender difference? - genetic? (X chromosome?) - experience/behavioral? Experience - stress - acute (precipitating factor/ trigger) - sustained (?)

  7. Brain changes - lower volume of prefrontal cortex - fewer glial cells - fewer and smaller neurons - enlarged ventricles (means?) - cerebellum & basal ganglia? - due to depression or the drug treatment Amygdala involvement? - too active? - involved in negative emotion

  8. Treatment - monoamine oxidase inhibitors (MAOI) - agonist effect - problem - tyramine (cheese, wine) - usually metabolized by MAO - if not, raises blood pressure - stroke - tricyclics - block reuptake - serotonin - norepinephrine

  9. Lithium • - bipolar disorder • - much faster, but low compliance • - effects serotonin system? - receptors • SSRI’s • - here and anxiety disorders • - effective on lots of things (previously psychther) • - few side effects?? • ECT - Shock therapy • - still used • - also magnetic stimulation

  10. Anxiety disorders - generalized - phobic - panic - obsessive compusive Cause - genetic component - experience - more individual/more closely linked

  11. Treatment Benzodiazepines - 10% of adults taking them?? - GABA agonist (increase binding) Serotonin agonists - MAOI, TriC, SSRIs - anxiolytic

  12. Tourette’s Syndrome • Tics - motor, vocal, simple, complex • Treatment - dopamine receptor blockers (neuroleptic) • suggests basal ganglia is involved (motivation for action) • - also limbic cortex (emotional/control)

  13. Exam 5 - Monday Term projects - Friday Have a good summer.

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