Disorders of Thought, Mood, and Memory

Schools of Thought on Mental Disease
Biologic psychiatry
Mental disorders are due to anatomic, developmental, and functional disorders of the brain
Psychosocial psychiatry
Mental disorders are due to impaired psychological development, a consequence of poor child rearing or environmental stress
Functions of the Frontal Lobe
Abstract vs. concrete reasoning
Motivation/volition
Concentration
Decision making
Purposeful behavior
Memory, sequencing, making meaning of language
Speech organization and production
Aspects of emotional response
Functions of the Temporal Lobe
Visual-spatial recognition
Attention
Motivation
Emotional modulation and interpretation
Impulse and aggression control
Interpretation and meaning of social contact
Aspects of sexual action and meaning
Functions of the Parietal Lobe
Sensory integration and spatial relations
Bodily awareness
Filtration of background stimuli
Personality factors and symptom denial
Memory and nonverbal memory
Concept formation
Function of Occipital lobe
Vision
Possible information holding area
Origin of the Manifestations of Mental Illness
Alterations in brain neuron functioning
Destruction of those neurons
Alteration in the neural connections among the brain regions
Neuromediators
Acetylcholine
Dopamine
Norepinephrine and epinephrine
Serotonin
γ-aminobutyric acid, glutamate, aspartate, and glycine
Disorders of Perception
Hallucinations
Sensory perceptions that occur without external stimulation of the relevant sensory organ
Delusions
Characterized by a false belief and the persistent, unshakable acceptance of the false belief
Types of Delusions
Delusions of persecution
Delusions of influence
Delusions of ill health
Delusions of grandeur
Delusions of poverty
Delusions of possession

Steps of Neurotransmission
Synthesis of a transmitter substance
Storage and release of the transmitter
Binding of the transmitter to receptors on the postsynaptic membrane
Removal of the transmitter from the synaptic cleft
Major Groups of Antipsychotic Agents for Schizophrenia
Typical antipsychotics
Include the phenothiazines (chlorpromazine), butyrophenones (haloperidol), and thioxanthenes (chlorprothixene)
Atypical antipsychotics
Exemplified first by clozapine, are more effective in treating the negative symptoms of schizophrenia and produce fewer extrapyramidal effects
Manifestations of Schizophrenia
Negative symptoms
Reflect the absence of normal social and interpersonal behaviors
Positive symptoms
Reflect the presence of abnormal behaviors

Negative Symptoms of Schizophrenia
Alogia (tendency to speak very little)
Avolition (lack of motivation for goal-oriented activity)
Apathy
Affective flattening (lack of emotional expression)
Anhedonia (an inability to experience pleasure in things that ordinarily are pleasurable)
Positive Symptoms of Schizophrenia
Disorganized, incomprehensible speech
Delusions (that one is being controlled by an outside force)
Hallucinations (hearing voices is the most common)
Grossly disorganized or catatonic behavior

Diagnosis of Schizophrenia
Two or more of the following symptoms must be present for a significant portion of 1 month:
Delusions
Hallucinations
Disorganized speech
Grossly disorganized or catatonic behavior
Negative symptoms
One or more areas of functioning must be significantly impaired and continuous signs of the disturbance must persist for at least 6 months

Goals of Treatment for Schizophrenia
Initially the goal may be primarily to reduce agitation and the risk of physical harm
Induce a remission
Prevent a recurrence
Restore behavioral, cognitive, and psychosocial function to premorbid levels
Classification of Major Depression
Unipolar
Characterized by a persistent unpleasant mood
Bipolar
Characterized by alternating periods of depression and mania
Characteristics of Depression
Depressed mood
Anhedonia (inability to experience pleasure)
Feelings of worthlessness or excessive guilt
Decreased concentration
Psychomotor agitation or retardation
Insomnia or hypersomnia
Characteristics of Depression (cont.)
Decreased libido
Change in weight or appetite
Thoughts of death or suicidal ideation

Treatments for Unipolar and Bipolar Illnesses
Antidepressant drugs
Electroconvulsive therapy
Lithium
Anticonvulsants
Psychotherapy
Types of Anxiety Disorders
Panic disorder
Generalized anxiety disorder
Obsessive-compulsive disorder
Social anxiety disorder
Types of Dementia
Alzheimer’s disease
Vascular Dementia
Pick’s Disease
Creutzfeldt-Jakob Disease
Wernicke-Korsakoff Syndrome
Huntington’s Disease