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PSYB65 - Lec 6 (near verbatim).docx

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University of Toronto Scarborough
Ted Petit

PSYB65: Lec 6 Today’s lecture will be on midterm exam, next Monday’s lecture won’t be on midterm.  Psychiatric Diseases and Neurodegenerative Disease  Psychiatric Disorders (more pharmacological): o Psychological assistance programs, social work etc; o Schizophrenia, mood disorders (dep/mania), AD  Schizophrenia: o Problem w/ dopamine (overactive) o Most commonly associated w/ hallucinations & delusions o Age of onset: around 30 years, rare to have onset of schizo after age 30 o Sudden onset around age 20-30s; but recent research shows that when you look at ppl when they’re younger (ex: teenage years), can see there were some beh in them that weren’t quite normal (even if they didn’t have overt hallucinations/delusions); oftentimes you’ll find that when younger they didn’t have warm, normal relationship w/ ppl (not a lot of friends, social interactions) o Even if age of onset is around age 30, there may have been some personality traits which may be shown earlier on o Hallucinations: most freq auditory, can be visual (hear ppl talking = most common = typically auditory) o Delusions: weird thoughts (martians are trying to shoot her) o Most commonly auditory hallucinations and delusions o Have psychotic break = what they have in mind don’t make any sense o Neuropsychological symptoms: any region of the brain that has a problem?  Poor performance on frontal lobe fxn tests  Deficits in memory tasks (verbal & non-verbal)  Most other neuropsych. tests show that they’re completely normal  Primarily pharamacological  Some of the problems shown by neuropsychological tests could be due to the fact that these ppl have been on antipsychotics for years (antipsychotic meds = major tranquilizers = like you being on Valium/barbiturates for 20 yrs = memory not as good)  Don’t know if due to actual dysfxn of memory/frontal cortex fxn or due to meds… o Enlarged ventricles, lighter brain weight  If these ppl have been on tranquilizers for years which are dulling the brain down, has that caused brain to shrink? (secondary effect to meds)  Not ethical to take away meds and see what happens o Don’t know what’s going on neuropsychologically but know what’s going on pharmacologically. o Genetics:  As late as 1960’s-70’s, all was very Freudian (absent father, overprotective mom)  Primary theory at that time was that schizo was a psychological problem and they were trying to treat it psychologically; it was really a neuroscience problem  1% in pop’n = schizophrenic; not a rare disease  If you look at families of schizophrenics, 10-15% of the immediate family of schizophrenics is also schizophrenic (parents, siblings, children = immediate family)  Genetic basis, but psychologists didn’t want to give up the disease to neuroscience  Started looking at twin studies  definitely showed it was a biological disorder, not purely a psychological one; biological disorder w/ psychological disorder (obv this is a psychological disorder = anything that effects the brain, pretty much affects beh; but the real cause wasn’t behavioral, it was biological)  Non-identical twins (dizygotic): one schizo, checked out other twin to see if had schizo; if one had schizo, 10-15% likelihood that the other would have schizo also (same as w/in immediate family)  If monozygotic twins (identical): btn 40-75% of other twin is also schizo if other twin is schizo o Clearly genetically inherited disorder, but isn’t 100%  Pharmacological breaks:  Antihistamines discovered (for colds & such): caused calming effect on ppl = drowsy, tired  Give antihistamines to schizophrenics (long time ago) o Worked reasonably well, reduced psychotic symptoms, calmed ppl down o Looked at other drugs that would calm schizophrenics down:  Most effective: antipsychotics = ones that were dopamine antagonists = reduced fxn’l activity of dopamine  Most effective w/in the dopamine antagonists: phenothiazines  chlorpromazine = most commonly used/effective  Knew what the drugs did (a whole bunch), but didn’t what it was doing to the brain and why it was effective  These drugs blocked the receptor sites from the biogenic amines (monoamines); DA, 5HT, NEPI  Receptor antagonists most selective to DA  therefore, the most effective drugs that could block schizophrenic symptoms are drugs that can block DA receptor; didn’t know that it was the DA receptor that was the problem, it was by deduction from what the drugs did  Any kind of dopamine stimulant (amphetamine = most powerful) = did 2 things: o Cause schizo symptoms in completely normal ppl (high dose 24-48 hrs solid) = hear voices, hallucinations, delusional; indistinguishable from real schizophrenics; until amphetamines wear off o If you have schizophrenic who is functioning normally, if given small amount of amphetamine (dopamine stimulus) = will immediately go into florid schizophrenic episode o Therefore, has to do w/ dopamine  Check out dopamine in ppl’s brains o No difference in the levels of dopamine btn normals and schizophrenia o Problem in the # of DA receptors (specifically too many D4 dopamine receptors = 6X as many) o Delicate balance btn PD and schizo  Block too many dopamine receptors (high dose) = PD symptoms  Mood Disorders: o Depression:  Food intake, sleep-wakefulness, suicidal/kill others = clinical diagnosis  Electro-convulsive shock therapy = crude, only in worst case, when meds don’t work  Extremely serious disorder  Can cycle, often long-term, sometimes may be followed by mania o Manic:  So excited about life, everything’s great  Artistic ppl seem to be borderline manic, highly fxn’l  When reality kicks in, may cycle into depression  Manics usu don’t want to take meds b/c everyday is the best day of life; problem w/ compliance o Bipolar:  When a person cycles from depression to mania  Some research suggesting that manics are always cyclic, when they are manic and go back to normal (although not worse enough to go into depression) -multi-genes for all of them involved fxn different amounts (around 5-6) -none of these are separate disorders (schizophrenia, mania, depression = all related)  A lot of the drugs that work for schizophrenics also for depressive ppl  Anti-depressants great 4 OCD ppl and hyperactive ppl  Complicated o Depression:  Early research: gave ppl bp meds (Aldomet = primarily used to decrease bp)  Bp tends to increase as you get older  Bp meds caused ppl to get depressed (side-effect) even though bp = ok
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