Schizophrenia

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

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

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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 (?)
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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
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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
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Lithium - bipolar disorder - much faster, but
low compliance - effects serotonin system? -
receptors SSRIs - here and anxiety
disorders - effective on lots of things
(previously psychther) - few side effects?? ECT
- Shock therapy - still used - also magnetic
stimulation
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Anxiety disorders - generalized - phobic -
panic - obsessive compusive Cause - genetic
component - experience - more individual/more
closely linked
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Treatment Benzodiazepines - 10 of adults
taking them?? - GABA agonist (increase
binding) Serotonin agonists - MAOI, TriC,
SSRIs - anxiolytic
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• Tourettes Syndrome
• Tics - motor, vocal, simple, complex
• Treatment - dopamine receptor blockers
  (neuroleptic)
• suggests basal ganglia is involved (motivation
  for action)
• - also limbic cortex (emotional/control)

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