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PSY-2 Ch12: Psychopathology
- 1. CH 12: Psychopathology 1 ➔Schizophrenia ➔Mood Disorders ➔Anxiety & Related Disorders
- 2. PSYCHOPATHOLOGY • 1 in 3 experience symptoms during their life • 19% have symptoms during a given year • 5% are currently suffering from serious mental illness 2
- 3. • Historically believed to be a result of weak will, demonic possession, or misbehavior 3
- 4. PSYCHOPATHOLOGY • In 1900, 25% of psychiatric patients suffered from paralytic dementia • 1911: Syphilis discovered to be the cause; treatable with antibiotics 4 Hideyo Noguchi
- 5. SCHIZOPHRENIA SCHIZOPHRENIA: a disordered state with unusual symptoms 5
- 6. SCHIZOPHRENIA SCHIZOPHRENIA: a disordered state with unusual symptoms 6
- 7. SCHIZOPHRENIA SCHIZOPHRENIA: a disordered state with unusual symptoms 7
- 9. SCHIZOPHRENIA • Affected identical twin tends to have: –Lower birth weight –Physiological distress –Sensitive behavior –Impaired motor coordination 9
- 10. SCHIZOPHRENIA 10
- 11. SCHIZOPHRENIA • Genes that influence schizophrenia: –Some participate in synaptic plasticity –DISC1—a mutant, disabled version of a gene disrupted in schizophrenia • Epigenetic factors: father’s age 11
- 12. • Schizophrenia is likely caused by the interaction of genetic factors and stress • Stressors include: – Transition from childhood to adulthood – Prenatal stress, maternal illnesses – Urban living 12 SCHIZOPHRENIA
- 13. 13 SCHIZOPHRENIA
- 14. 14 SCHIZOPHRENIA
- 15. • Brain changes in patients with schizophrenia: – Enlarged cerebral ventricles: twins studies 15 SCHIZOPHRENIA
- 16. 16 SCHIZOPHRENIA • Brain changes: – Enlarged cerebral ventricles: Mice with mutated DISC1
- 17. • Brain changes: – Cortical abnormalities • Thicker corpus callosum • Abnormal prenatal neuron migration in frontal cortex • Loss of gray matter 17 SCHIZOPHRENIA
- 18. • Brain changes: – HYPOFRONTALITY HYPOTHESIS: frontal lobes are underactive 18 SCHIZOPHRENIA
- 19. SCHIZOPHRENIA • LOBOTOMY: is the surgical separation of the frontal lobes from the rest of the brain 19 António Egas Moniz Walter Freeman
- 20. SCHIZOPHRENIA • My Lobotomy, by Howard Dully 20
- 21. • CHLORPROMAZINE: can reduce positive symptoms • FIRST-GENERATION ANTIPSYCHOTICS: antagonists at dopamine D2 receptors 21 SCHIZOPHRENIA
- 22. 22 SCHIZOPHRENIA
- 23. SCHIZOPHRENIA • Antipsychotic drugs can have side effects: – TARDIVE DYSKINESIA
- 24. SCHIZOPHRENIA 24 • Antipsychotic drugs can have side effects: – TARDIVE DYSKINESIA
- 25. • DOPAMINE HYPOTHESIS: schizophrenia is caused by excessive dopamine release • Evidence: –First-generation antipsychotics block D2 receptors –Amphetamine use = schizophrenia symptoms 25 SCHIZOPHRENIA
- 26. • DOPAMINE HYPOTHESIS: schizophrenia is caused by excessive dopamine release • Problems with the dopamine hypothesis: – Drugs block D2 receptors faster than symptoms are reduced – Some patients don’t respond – Newer drugs don’t have high affinity for D2 26 SCHIZOPHRENIA
- 27. • SECOND-GENERATION ANTIPSYCHOTICS: block serotonin receptors as well as D2 receptors EX: Clozapine • Some increase dopamine levels in the frontal cortex 27 SCHIZOPHRENIA
- 28. CH 12: Psychopathology 28 ➔Schizophrenia ➔Mood Disorders ➔Anxiety & Related Disorders
- 29. • UNIPOLAR DEPRESSION: mood disorder characterized by – Dysphoria – Anhedonia – Changes in appetite and sleep – Difficulty in concentration – Pessimism & suicidality 29 MOOD DISORDERS
- 30. • Brain changes with depression: – Increased blood flow to the frontal cortex and amygdala – Decreased blood flow to attention areas – Cortex of the right hemisphere is thinner 30 MOOD DISORDERS
- 31. Treatments for depression: – ELECTROCONVULSIVE THERAPY (ECT): causes a seizure—an electrical current is passed through the brain – TRANSCRANIAL MAGNETIC STIMULATION (TMS): also alters cortical electrical activity 31 MOOD DISORDERS
- 36. • Problems with idea of serotonin reduction as a cause of depression: – Delay between medication and results – Not everyone is helped and placebo effect – Risk of suicide in children and adolescents 36 MOOD DISORDERS
- 38. • Other treatments being researched: – Ketamine and leptin – Vagal nerve stimulation – DEEP BRAIN STIMULATION (DBS) – COGNITIVE BEHAVIORAL THERAPY (CBT) 38 MOOD DISORDERS
- 40. • More women than men suffer from depression – Help-seeking patterns – Gender differences in hormone levels – POSTPARTUM DEPRESSION immediately precedes or follows childbirth 40 MOOD DISORDERS
- 41. • Sleep is altered by depression: – Stage 3 of slow-wave sleep is reduced 41 MOOD DISORDERS
- 42. 42 MOOD DISORDERS • Sleep is altered by depression:
- 43. • Some signs of depression are observable behaviors: – LEARNED HELPLESSNESS: • An animal is exposed to a repetitive stressful stimulus • Linked to a decrease in serotonin function 43 MOOD DISORDERS
- 44. • BIPOLAR DISORDER: depressive periods alternating with periods of expansive mood, or mania 44 MOOD DISORDERS
- 45. • BIPOLAR DISORDER: depressive periods alternating with periods of expansive mood, or mania –Enlarged ventricles and reduced gray matter –LITHIUM is an effective treatment, but its use must be monitored for side effects 45 MOOD DISORDERS
- 46. CH 12: Psychopathology 46 ➔Schizophrenia ➔Mood Disorders ➔Anxiety & Related Disorders
- 47. ANXIETY DISORDERS • ANXIETY DISORDERS: – PHOBIC DISORDERS: intense irrational fears centered on an object, activity, or situation that a person avoids – PANIC DISORDER: recurrent attacks of intense fearfulness – GENERALIZED ANXIETY DISORDER: persistent, excessive anxiety and worry 47
- 48. Treatments for Anxiety Disorders –BENZODIAZEPINES: bind to GABA receptors and enhance the inhibitory activity GABA –Serotonin agonists and SSRIs can also treat anxiety 48 ANXIETY DISORDERS
- 49. • Endogenous anxiolytics may interact with the GABA receptor • GABA receptors are widely distributed in the cortex, hippocampus, and amygdala 49 ANXIETY DISORDERS
- 50. • POSTTRAUMATIC STRESS DISORDER (PTSD): occurs when a person has difficulty recovering from a traumatic event – Memory changes – Flashbacks – Hypervigilance – Avoidance – Deficits in short-term memory 50 ANXIETY DISORDERS
- 53. • OBSESSIVE-COMPULSIVE DISORDER (OCD): marked by recurring, repetitive acts – In OCD patients: • Routine acts become compulsions • Recurrent thoughts become obsessions –OCD responds to SSRIs –Depression and OCD often occur together and may be related 53 ANXIETY DISORDERS
- 54. • OCD is often CO-MORBID with Tourette’s syndrome— both involve disorders of the basal ganglia • OCD may be triggered by infections • Treatments in addition to drugs include: – PSYCHOSURGERY: brain lesions used to modify severe psychiatric disorders – CINGULOTOMY: lesions of the cingulate cortex 54 ANXIETY DISORDERS
- 56. • TOURETTE’S SYNDROME: –Heightened sensitivity –May fling their arms, kick, or make violent shoulder movements –Diagnosed early, at 6–7 yrs –Many also exhibit ADHD or OCD 56 ANXIETY DISORDERS
- 57. • TOURETTE’S SYNDROME: – In twin studies, an affected twin has more dopamine D2 receptors in the caudate nucleus of the basal ganglia – Treatments include haloperidol, a D2 receptor antagonist, atypical antipsychotics, behavior modification, and deep brain stimulation 57 ANXIETY DISORDERS