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Chapter 16 Schizophrenia and Affective Disorders
 

Chapter 16 Schizophrenia and Affective Disorders

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    Chapter 16 Schizophrenia and Affective Disorders Chapter 16 Schizophrenia and Affective Disorders Presentation Transcript

    • Chapter 16 Schizophrenia and Affective Disorders
      • Schizophrenia
        • Description
        • Schizophrenia:
          • A serious mental disorder characterized by:
            • Disordered thoughts
            • Delusions of persecution or grandeur
            • Hallucinations (mostly auditory)
            • Behaviors (withdrawn or detached, odd movements))
      • Schizophrenia
        • Description
        • Positive symptom: (known by their presence)
          • delusions, hallucinations, abnormal movements, or thought disorders.
        • Negative symptom: (characterized by absence)
          • social withdrawal, lack of affect, and reduced motivation.
      • Schizophrenia
        • Possible Causes:
          • Heritability: In its simplest form, if schizophrenia was determined by a single dominant gene, about 75% of children from schizophrenic parents would get it. If it was recessive, about 50% would inherit the disorder. An incidence less than 50% suggests that the disease is determined by multiple genes and that only a susceptibility is passed on.
      • Schizophrenia
        • Evidence for heritability
          • Concordance rates:
            • Most studies suggest between 25-40% in identical twins and about 5-20% in fraternal twins.
            • Clearly, the environment is an important contribution.
      • Schizophrenia
        • Biochemical Causes
          • Dopamine Hypothesis: schizophrenia is caused by excessive dopamine activity in the mesolimbic system.
          • Supporting evidence: drug treatment, amphetamine psychosis, treatment for Parkinson’s disease
          • Additional evidence: increased DA activity, increased D3 & D4 receptors in mesolimbic system,
      • Schizophrenia
        • Pharmacology of Schizophrenia
        • Chlorpromazine: A phenothiazine
          • A “typical neuroleptic”; a nonspecific dopamine receptor blocker; first prescribed antischizophrenic drug.
        • Clozapine:
          • An “atypical neuroleptic”; an antipsychotic drug that blocks D 4 receptors in the nucleus accumbens. Little effect on D2 receptors
    • Copyright © 2004 Allyn and Bacon
    • Copyright © 2004 Allyn and Bacon
      • Schizophrenia
        • Consequences of Long-Term Drug Treatment of Schizophrenia
        • Tardive dyskinesia:
          • A movement disorder that can occur after prolonged treatment with antipsychotic medication, characterized by involuntary movements of the face and neck.
        • Supersensitivity:
          • The increased sensitivity of neurotransmitter receptors; caused by damage to the afferent axons or long-term blockage of neurotransmitter release.
      • Schizophrenia
        • Evidence for neurological abnormalities Negative symptoms
        • Schizophrenics with negative symptoms have similar symptoms as those with fromtal lobe damage.
          • Frontal lobe size
          • Ventrical size
          • Cerebral gray matter decreases
    • Copyright © 2004 Allyn and Bacon
    • Copyright © 2004 Allyn and Bacon
      • Schizophrenia
        • Possible Causes of the Brain Abnormalities
        • Epidemiology:
          • The study of the distribution and causes of diseases in populations.
          • Research suggest several environmental factors:
            • -Season of birth: greatest during winter months
            • -Viral epidemics: associated with viral diseases
            • -Latitude: increased incidence further from equator
            • -Prenatal malnutrition: ?
            • -Rh incompatibility: ?
            • -Maternal stress: ?
    • Copyright © 2004 Allyn and Bacon
    • Copyright © 2004 Allyn and Bacon
    •  
    • Copyright © 2004 Allyn and Bacon
    • Copyright © 2004 Allyn and Bacon
      • Major Affective Disorders
        • Description
        • Major affective disorders:
          • A serious mood disorder; includes major depressive disorder and bipolar disorder.
          • May effect as many as 5% of US population in a given year. Perhaps as many as 25% over lifetime.
      • Major Affective Disorders
        • Description
        • Major depressive disorder:
          • A serious mood disorder that consists of unremitting depression or periods of depression that do not alternate with periods of mania.
        • Bipolar disorder:
          • A serious mood disorder characterized by cyclical periods of mania and depression.
      • Major Affective Disorders
        • Causes of Depression
        • Genetic contributions:
          • Bipolar disorder may be caused by a single dominant gene. Location still not confirmed, but heritability studies reveal strong link.
        • Major depressive disorder:
          • Less likely caused by single gene than bipolar disorder.
          • Amine hypothesis: deficiencies in activity of one or several amine neurotransmitter systems (NE, SE)
      • Major Affective Disorders
        • Drug Treatment for Depression
        • Tricyclic antidepressants:
          • A class of drugs used to treat depression; inhibits the reuptake of norepinephrine and serotonin; named for the specific molecular structure. Amitriptyline (Elavil)
        • Monoamine oxidase inhibitors (MAOIs):
          • Prevent degradation of NT in synapse.
          • phenelzine (Nardil)
        • Serotonin specific reuptake inhibitor (SSRI):
          • A drug that inhibits the reuptake of serotonin without affecting the reuptake of other neurotransmitters.
          • fluoxetine (Prozac)
      • Major Affective Disorders
        • Physiological Treatments
        • Lithium
          • A chemical element; lithium carbonate is used to treat bipolar disorder
        • Carbamazepine:
          • An anticonvulsive drug (trade name: Tegretol) that is used to treat seizures originating from a focus, also used to treat mania in bipolar disorder.
    • Copyright © 2004 Allyn and Bacon
      • Major Affective Disorders
        • Physiological Treatments Electroconvulsive therapy (ECT):
          • A brief electrical shock that induces a seizure; used therapeutically to alleviate severe depression when medication is not effective.
          • Transcranial Magnetic Stimulation (TMS):
          • Magnetic field causes a weak electrical field and electrical current within the brain. Has been useful in some cases of depression.
    • Copyright © 2004 Allyn and Bacon
      • Major Affective Disorders
        • Evidence of Brain Abnormalities
        • Brain abnormalities:
          • Research suggests abnormalities in the prefrontal cortex, basal ganglia, hippocampus, thalamus, cerebellum, and temporal lobes.
          • Some evidence suggests increased size of the cerebral ventricles may suggest the loss of neural tissue.
      • Major Affective Disorders
        • Evidence of Brain Abnormalities
        • Silent cerebral infarction (SCI):
          • A small cerebrovascular accident (stroke) that causes minor brain damage without producing obvious neurological symptoms.
      • Major Affective Disorders
        • Role of Circadian Rhythms
        • REM Sleep Deprivation:
          • Selective deprivation of REM sleep through EEG monitoring, is one of the most effective antidepressant treatments; suggests a close relationship between REM sleep and mood.
          • Antidepressant effects require several weeks of deprivation.
    • Copyright © 2004 Allyn and Bacon
    • Copyright © 2004 Allyn and Bacon
    • Copyright © 2004 Allyn and Bacon
      • Major Affective Disorders
        • Role of Circadian Rhythms
        • Total Sleep Deprivation:
          • Total sleep deprivation has antidepressant effect that are immediate; however, the procedure is not very practical.
          • Some individuals do not respond to total or selective sleep deprivation.
      • Major Affective Disorders
        • Role of Zeitgebers
        • Seasonal affective disorder (SAD):
          • A mood disorder characterized by depression, lethargy, sleep disturbances, and craving for carbohydrates during the winter months.
        • Summer depression:
          • A mood disorder characterized by depression, sleep disturbances, and loss of appetite.
      • Major Affective Disorders
        • Role of Zeitgebers
        • Phototherapy:
          • Treatment of seasonal affective disorder by daily exposure to bright light.