Neurobiology of psychotic illnesses
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psychotic illnesses? nonpsychotic illnesses?
- Psych: Schizophrenia and Mood Disorders (Major Depressive Disorder and Bipolar Disorders)
- Nonpsych: Anxiety disorders, neurodevelopmental disorders, personality disorders, eating disorders.
- All have other subclasses.
schizophrenia etiologies? pathophysiology? Clinical manifestations?
- etiologies: chemical imbalance (dopamine and glutamate) -- the dopamine hypothesis: dopamine 1 and 2. -- genetic factors -- exposure to virus during gestation.
- Patho: genetic predisposition and environmental factors. Changes in the hippocampus, temporal lobes, and dopamine pathways that go to the limbic system.
- CM: Positive, negative, and cognitive symptoms.
- Positive symptoms: excessive Dopamine 2 (hallucinations, delusions, diorganized speech, etc)
- Neg. Sym.: Mediated by dopamine 1 (loss of interest, social withdrawal, autism)
- Cog. Symp: memory probs and inability to sustain attention.
Major depression Disorder chrts? dysthymia? SAD? etiologies?
- It is the most common mental disorder.
- requires presence of multiple symptoms intense enough to cause distress and persistently impair psychosocial functioning.
- Dysthymia: Depression w 1 or 2 symptoms that last 2 years or more. Pt can interact in society but is always down (half glass full type of pt)
- SAD: It is a seasonal pattern (fall or winter) to depression.
- Eti: Unknown -- neurobiological and psychosocial factors -- Norepinephrine and serotonin -- serotonin below normal or the ratio is altered. -- MRI demostrates it.
Bipolar disorders chrts? types? CM?
- Alernating periods of mania and depression.
- Depression episode: low energy, poor appetie, weight loss, decreased libido and thoughts of guilt and suicide.
- Mania: Abnormally and persistantly elevated, expansive, or irritable mood. Inflated self-esteem or grandiosity, can reach delusional proportions.
- Bipolar I: at least one episode of mania as well as major depression.
- Bipolar II: No episodes of mania and at least one episode of hypomania and major depression -- don't have Mania episodes and don't show strong signs as Bipolar I.
anxiety disorders chrts? categories?
- They are non-psychotic disorders -- characterized by irrational fears (probably related to seratonin).
- 4 categories: Panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder.
Panic disorder chs? causes? CM?
- symptoms that are unexpected, sudden, recurrent, and generate intense feelings of fear.
- Causes: excess of norepinephrine, family history, substance abuse, and major life stress.
- CM: dyspnea, palpitations, chest discomfort, light-headedness, fainting, sweating, tremor, expressed fear of dying.
- attacks may last 5 to 30 mins.
Generalized anxiety disorder chts?
- Moderate degree of anxiety w/o discrete periods of acute attacks.
- Persistent worry may lead to multiple symptoms including fatigue, muscle tension, muscle pain, etc.
- Need to rule out fibromialgia.
Obsessive-Compulsive Disorder chts? etiologies?
- Obessive: are repeated, persistent, unwanted ideas, thoughts, images, and have a common theme.
- Compulsive: are repetitive, ritualistic behaviors prevent or reduce anxiety related to obsessions.
- Etio: Have something to do w serotonin.
Psttraumatic Stress Disorder chts? Symptoms? new therapy?
- Precipitated by a traumatic events.
- Acute stress disorder occurs up to 1 month of the event, PTSD occurs beyond 1 month.
- Symptoms: Intrusive symptoms like flashbacks, dreams, recurring thoughts abt the event.
What are the neurodevelopmental Disorders?
- Attention Deficit Activity Disorder.
- Autism Spectrum Disorder.
Attention Deficit Hyperactivity Disorder chrst? types? CM?
- characterized by difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity.
- types: predominantly hyperactive - impulsive behavior -- predominantly inattentive -- combined hyperactive-impulsive and inattentive.
- CM: inattentive and hyperactivity.
autism spectrum disorder chts? causes?
- Social/communication deficits, fixated interests and repetitive behaviors.
- Some intellectual problems (66-75E%)
- Male predominance 4:1.
- ideopathic -- no literature linking the disorder w immunizations.
What are the personality disorders?
- Inappropiate behavior withing a cultural context.
- Borderline personality disorder.
- Antisocial disorder.
Borderline Personality Disorder chrts? causes? CM?
- Dependent interpersonal relationships.
- Pervasive instability in mood.
- Causes: Unknown.
- CM: intense, unstable, dependent relationships, self destructive behavior, panic when left alone. (ppl that r getting married all the time)
Antisocial Diorder chts? causes? new links?
- Lack of anxiety or guilt, cold-bloodedness, careless indifferences.
- Men are 3:1.
- Found in prison.
- Environmental and possible genetic components.
- Linked w ADHD.
What are eating disorders?
- Typically illnesses of young adult women.
- Anorexia Nervosa.
- Bulimia Nervosa.
Anorexia Nervosa chts? CM?
- Eating disorder characterized by excessive dietary restrictions, weight loss greater than 15%.
- CM: amenorrhea, hypthermia, edema, hypotension, anemia.
- Usually the cause of death is hypokalemia, which could cause a dysrhythmia.
Bulimia Nervosa chts? causes?
- Chracterized by episode of binging (eating to the excess)
- laxative abuse.
- May fall in normal range for age and weight but fear weight gain.
- Behavior done secretly.
- Causes: genetic, psychological, sociocultural.
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