PSYCHOLOGICAL DISORDERS AND DISEASES

BY: Vivian Alfonso

PSY/240
Professor: Desra Hohlbein

February 20, 2015

Abstract

The biopsychology of Psychiatric disorders (disorders of psychological function sufficiently severe to require treatment). One of the main difficulties in studying or treating the psychiatric disorders is that they are difficult to diagnose. Because they cannot identify the specific brain pathology associated with various disorders, their diagnosis usually rests entirely on the patients symptoms. The diagnosis is guided by the DSM-IV-TR (the current edition of the Diagnostic and statistical Manual of the American Psychiatric Associations. I will be discussing the following psychiatric disorders Schizophrenia, Anxiety Disorders, Affective (emotional) disorders, Anxiety Disorders and Tourette syndrome. These disorders are all very important and are treatable. Most people can live happy and healthy lives if treatments are followed by a doctor.

The major difficulty in studying and treating schizophrenia is accurately defining it (Heinrichs, 2005; Kreuger & Markon, 2006). Its symptoms are complex and diverse; they overlap greatly with those of other psychiatric disorders and frequently change during the progression of the disorder. Also, various neurological disorders have complex partial epilepsy; have symptoms that might suggest a diagnosis of schizophrenia. In recognition of the fact that the current definition of schizophrenia likely includes several different brain diseases some experts prefer to use the plural form to refer to this disorder: the schizophrenias (Wong & Van Tol, 2003). At this time, no one knows exactly what causes Schizophrenia or why this condition affects some people and not others. Studies show that Schizophrenia may be caused by an imbalance of chemicals in the brain that causes messages in the brain to get mixed up. Scientists believe that Schizophrenia, like many other conditions may result from a combination of genetic and environmental factors. The symptoms associated with Schizophrenia are typically separated into two categories:
Positive symptoms (Extra feelings or behaviors that are usually not present such as: 1. Believing that what other people are saying is not true (delusions). 2. Hearing, seeing feeling, or smelling things that others do not experience (hallucination). 3. Disorganized speech or behavior.

Negative symptoms a lack of behaviors or feelings that usually is present such as: 1. Losing interest in everyday activities, like bathing, grooming or getting dressed. 2. Feeling out of touch with other people, family or friends. 3. Lack of feeling or emotion (apathy). 4. Having little emotion or inappropriate feelings in certain situations. 5. Having less ability to experience pleasure.
Schizophrenia affects different people differently and symptoms can vary from person to person. Over the last 30 years, there have been a number of medication options developed for people who suffer with Schizophrenia. While there is no cure for this condition, medicine has been proven to help with managing symptoms. Today’s Schizophrenia treatment options include medication that only has to be taken once a month instead of every day. Some of the medications used in treatment are: InvegaSustenna, Thorazine, Haldol. The side effects of these medications as all have some side effects such as: dry mouth and voluntary movements among other side effects. My next disorder that I will discuss is Affective disorders such as Depression and Mania. Depression is an affective disorder (any psychiatric disorder characterized by disturbances of mood or emotion). Mania is also an affective disorder, is in some respects the opposite of depression; it is characterized by the overconfidence, impulsivity, distractibility, and high energy. Affective disorders are also commonly known as mood disorders. Many depressive patients experience periods of mania. Those who do are said to suffer from bipolar affective disorder. Those depressive patients who do not experience periods of mania are said to suffer from unipolar affective disorder. Depression is often further divided into two categories. Depression triggered by a negative experience such as the death of a loved one, the loss of a good job; is called reactive depression; and depression with no apparent cause is called endogenous depression. Genetic factors contribute to the differences among people in the development of affective disorders. Twin studies of affective disorders suggest a concordance rate of about 60% for identical twins and 15% for fraternal twins, whether they are reared together or apart. Most of the research on the causal role of experience in affective disorders has focused on the role of stress in the etiology of depression. Indeed, depression is often described as a stress related disorder (Bale, 2005). However good evidence linking stress to affective disorders is sparse. Several studies have shown that stressful experiences can trigger attacks in people already suffering from depression (e.g., Brown, 1993) but there is little evidence showing that stress can increase the susceptibility to affective disorders. There are four major classes of drugs that have been used in the treatment of affective disorders (see Berton & Nestler, 2006): monoamine oxidase inhibitors, tricyclic antidepressants, selective monamine-reuptake inhibitors and mood stabilizers. In the late 1980’s a new class of drugs the selective serotonin-reuptake inhibitors was introduced for treating clinical depression. Selective serotonin-reuptake inhibitors or (SSRIs) are serotonin agonists that exert agonistic effects by blocking the reuptake of serotonin from synapses. The first drug Fluoxetine, which is marketed as Prozac, was the first SSRI to be developed. Now there are many more such as Paxil, Zoloft, Luvox and Remeron. The most recent and exciting advance in the study of affective disorders was the demonstration that chronic brain stimulation through implanted electrode has a significant therapeutic effect in depressed patients who had repeatedly failed to respond to conventional treatments. The treatment of Depression with Brain Stimulation. Lozano and colleagues (2008) implanted the tip of a stimulation electrode into an area of the white matter of the anterior cingulate gyrus just ventral to the anterior end of the corpus callosum. The stimulator, which was implanted under the skin; delivered continual pulsed of electrical stimulation that could not be detected by the patients. Anxiety disorder is the chronic fear that persists in the absence of any direct threat is a common psychological correlate of stress. Anxiety is adaptive if it motivates effective coping behaviors; however, when it becomes so severe that it disrupts normal functioning, it is referred to as an anxiety disorder. All anxiety disorders are associated with feelings of anxiety (fear, worry, despondency) and with a variety of physiological stress reactions for example: tachycardia (rapid heartbeat), hypertension (high blood pressure), nausea, breathing difficulty, sleep disturbances, and high glucocorticoid levels. There are five major classes of anxiety disorders: Generalized anxiety disorder which is characterized by stress responses and extreme feelings of anxiety that occur in the absence of any obvious participating stimulus, some others are Phobic Anxiety disorders, Agoraphobia the pathological fear of public places and open spaces, Panic disorder, Obsessive-compulsive disorders and Posttraumatic stress disorder. Like other psychiatric disorders, anxiety disorders have a significant genetic component –heritability estimates range from 30% to 40% in various studies (Leonardo & Hen, 2006). The concordance rates for various anxiety disorders are substantially higher for identical twins than for fraternal twins. However, the timing and focus of anxiety disorders often reflect the particular experiences of the patient (see Gross & Hen, 2004). No specific genes have yet been linked to anxiety disorders (Gordon & Hen, 2004). There are three categories of drugs that are effective against anxiety disorders: benzodiazepines, serotonin agonists, and antidepressants. Some of the medications prescribed for anxiety is Librium, diazepam, and valium are some of the medications used to treat this disorder. Also, Serotonin Agonists, buspirone is widely used in the treatment of anxiety disorders. Buspirone appears to have selective agonist effects at one subtype of serotonin receptor, the 5-HTiA receptor. It’s mechanism of action is not totally understood but it does not function as an SSRI. Antidepressant drugs have some complications in studying other anxiety disorders and depression is the comorbidity, the type of medication given for this disorder are anxiolytic drugs or (anti-anxiety drugs) are often effective against depression as well. The last psychiatric disorder that I will describe is Tourette syndrome. Tourette syndrome is the disorder of tics (involuntary, repetitive, stereotyped movements or vocalizations) (Gerard & Peterson, 2003). It typically begins early in life usually in childhood or early adolescence with simple motor tics, such as eye blinking or head movements, but the symptoms tend to become more complex and severe as the patient grows older. Common complex motor tics include hitting, touching objects, squatting, hopping, twirling, and sometimes even making lewd gestures. Common verbal tics include inarticulate sounds like barking, coughing and grunting, repetition of another’s words, and repetitions of one’s own words. Medications for treating Tourette’s syndrome are treated with neuroleptics (the D2 receptor blockers that are used in the treatment of schizophrenia). Neuroleptics can reduce tics by about 70%, but in practice their benefits are only modest because patients often refuse, or are not allowed by their parents, to take them because of the adverse side-effects; such as weight gain, fatigue, and dry mouth). Although tics are a defining feature of Tourette syndrome, treatment typically begins by focusing on other aspects of the disorder. First, the patient, family member, friends, and teachers are educated about the nature of the syndrome. Second, the treatment focuses on the ancillary emotional problems (anxiety and depression). Once these first two steps have been taken, it is then that attention turns to treating the symptoms. It is my own opinion that people with Tourette syndrome can live happy, healthy and productive lives.

References

1. Biopsychology Eighth Edition, Chapters 16, 18, by John P.J. Pinel. Published by Allyn & Bacon. Copyright 2011, by Pearson Education Inc. 2. National Institute of Mental Health; Schizophrenia Health Center. 3. www.treatment-for-shcizophrenia.com/ 4. The American Journal of Psychiatry Volume 149, Issue 7, July 1992 pp. 936-943.