Chapter 16: Psychological disorders (copy)

Schizophrenia

Serious mental DO characterized by disordered thoughts, delusions, hallucinations, and often bizarre behaviors

Schizophrenia positive symptoms

Thought disorders, delusions, and hallucinations

Schizophrenia negative symptoms

Flattened emotional response, poverty of speech, lack initiative and persistence, anehdonia, and social withdrawal

Schizophrenia cognitive symptoms

Difficulty in sustaining attention, low psychomotor speed, deficits in learning and memory, poor abstract thinking, and poor problem solving

Thought disorder

disorganized, irrational thinking

Delusions

Belief that is clearly in contradiction with reality

Hallucinations

Perception of nonexistent object or event

The mesolithic dopamine pathway — positive symptoms

Begins in central tegmental area and ends in nucleus accumbens and amygdala — release excessive dopamine/more dopamine receptors

Chlorpromazine

Dopamine receptor blocker; “first-generation” antipsychotic drug — used to reduce shock/anxiety after surgery

Dopamine antagonists (D2 and D3)

Reduce positive symptoms, agonists increase

Glutamate

Decreased glutamate activity, resulting in hypofrontality, may contribute to negative and cognitive symptoms in schizophrenia

Depression (1)

Very little energy, move and talk slowly, may pace around restless and aimlessly, crying, and unable to experience pleasure

Depression (2)

Unhealthy sleep patterns, constipation, or even strong feelings of guilt

Major depressive disorder

Serious mood disorder that consists of unremitting depression or periods of depression that do not alternate with mania

Bipolar disorder

Serious mood disorder characterized by cyclical period of mania and depression

Monoamine hypothesis

Depression is caused by low level of activity of one or more monoaminergic synapses — norepinephrine and serotonin

Selective serotonin reuptake inhibitor (SSRI)

An antidepressant drug that specifically inhibits the reuptake of serotonin without significantly affecting the reuptake of other neurotransmitters

Serontonin and norepinephrine reuptake inhibitor (SNRI)

An antidepressant drug that specifically inhibits the reuptake of norepinephrine and serotonin without significantly affecting the reuptake of other neurotransmitters

Ketamine

NMDA antagonist — treatment resistant depression; symptoms not relieved after trials of several different treatments

Electroconvulsive therapy (ECT)

Brief electrical chock, applied to the head, the results in electrical serizure. Anesthesia, respirator, electrodes on non-language hemisphere.

Electroconvulsive Therapy (ECT) — result

Typically, 3x/wk and about 6-12 treatments total. Remission is greater than 50% but relapse is common problem

Transcranial magnetic stimulation

Applied to PFC; benefits of ECT (but about 30% response rate) without cognitive impairment or memory loss

Deep brain stimulation

Electrodes just below subgenual anterior cingulate cortex (subgenual ACC); plays a role in depressive sxs