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

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)

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

- 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 -> prefrontal area -> 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

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

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 (?)

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

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

Lithium - bipolar disorder - much faster, but low compliance - effects serotonin system? - receptors SSRI’s - here and anxiety disorders - effective on lots of things (previously psychther) - few side effects?? ECT - Shock therapy - still used - also magnetic stimulation

Anxiety disorders - generalized - phobic - panic - obsessive compusive Cause - genetic component - experience - more individual/more closely linked

Treatment Benzodiazepines - 10% of adults taking them?? - GABA agonist (increase binding) Serotonin agonists - MAOI, TriC, SSRIs - anxiolytic

Tourette’s Syndrome Tics - motor, vocal, simple, complex Treatment - dopamine receptor blockers (neuroleptic) -suggests basal ganglia is involved (motivation for action) -- also limbic cortex (emotional/control)

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