Psychopathology of mental illness

Psychopathology of Mental Illness

1. PSYCHOPATHOLOGY OF MENTAL ILLNESS By: Prof Sathish Rajamani

2. What is Psychopathology? Psychopathology refers to the study of mental illness, behaviours and experiences which may be indicative of mental illness or psychological impairment.

3. BRAIN STRUCTURE AND FUNCTIONS REVIEW

4. HUMAN BRAIN Human brain is made up of nerve cells which interacts with rest of the body through the spinal cord and nervous system. Several chemicals are also located in the brain which help the body to maintain homeostasis, or a sense of overall comfort, Keeping these chemicals balanced and the nerve cells firing properly are essential to healthy brain function.

5. PARTS OF THE BRAIN AND ITS FUNCTIONS 3 main parts of the brain are: Forebrain – Cerebrum, thalamus and hypothalamus. Midbrain – Tectum and tegmentum Hindbrain – Cerebellum, pons and medulla ( Midbrain + pons + medulla = brain stem)

6. CEREBRUM Largest part of the brain Divided into four section (temporal lobe, occipital lobe, parietal lobe and frontal lobe) Cerebrum is divided into right & left hemisphere, which are connected by the axons.

7. CEREBRUM LOBES Frontal lobe – responsible for creative thoughts, problem solving, intellect, judgement, behavior, attention, abstract thinking, physical reaction, muscle movements, smell and personality. Parietal lobe – responsible for comprehension, visual function, reading, internal stimuli, tactile sensation and sensory comprehension.

8. CEREBRUM LOBES Temporal lobe – responsible for visual and auditory memories Wernicke’s area – this is the portion of the temporal lobe, it helps in speech formation and understanding. Occipital lobe – located in the back of the head, it helps in vision control. Broca’s area – this area controls facial neurons as well as understanding of the speech and language.

9. CEREBELLUM Referred as ‘Little brain’. It controls essential functions such as balance, posture, coordination and allow humans to move properly and maintain their structure.

10. Limbic System It contain glands to relay emotions. Many hormonal responses that the body generates are initiated in the area. Limbic system includes amygdala, hippocampus, hypothalamus and thalamus.

11. Limbic System (Parts) Amygdala – helps the body responds to emotions. Memories and fear. Hippocampus – learning memory, converting temporary memories into permanent memories. Helps people to analyze and remember spatial relationships. Hypothalamus – the hypothalamus control mood, thirst, hunger and temperature. It also control hormonal processes.

12. Limbic System (Parts) Thalamus – located in the center of the brain. It helps to control the attention span, sensing pain and monitors input that moves in and out of the brain to keep track of the sensations the body is feeling.

13. BRAIN STEM All basic life functions originated in the brain stem, including heart beat, blood pressure and breathing. Midbrain – Tegmentum and tectum (regulate body movements, vision and hearing) Pons – It interprets information that is used in sensory analysis or motor control. It also creates level of consciousness necessary for sleep. Medulla – Maintains vital body functions such as the heart rate and breathing.

14. NEUROTRANSMITTERS Neurotransmitters are the endogenous chemicals that transmit signals across a synapse from one neuron to another. These chemicals plays a major role in shaping everyday life and functions, More than 100 chemical messengers have been identified.

15. Chemical classification There are many different ways to classify neurotransmitters. Dividing them into amino acids, peptides and monoamines etc. Amino acids – Glutamate aspartate, D – Serine, Gama amino butyric acid (GABA) Monoamines – Dopamine (DA), Norephinephrine , noradrenaline, ephinephrine , histamine, serotonin.

16. Chemical classification Trace amines – Phenylamine Peptides – Somatostatin, Substance P, Amphetamines Gastro transmitters – Nitric oxide (NO) Carbon Monoxide (CO), Hydrogen sulfide (H2S) Others – Acetylcholine (Ach) Adenosine anandamide etc.

17. FUNCTIONS OF NEUROTRANSMITTERS Neurotransmitters Functions Clinical Implications Glutamate Learning and memory Decrease in stroke, epilepsy, Alzhiemer’s disease, Huntington’s disease and Parkinson’s disease GABA Controls fear or anxiety Decrease in anxiety disorder Acetyl Choline Contracts smooth muscles, dilates blood vessels, increases bodily secretions and slows heart rate Decrease in Alzheimer's disease Increase in depression Dopamine Regulates motor behavior and emotional arousal Play’s important role in Parkinson’s disease and schizophrenia Decrease in depression Increase in schizophrenia and mania

18. FUNCTIONS OF NEUROTRANSMITTERS Neurotransmitters Functions Clinical Implications Serotonin Regulates appetite, sleep, memory and learning, temperature, mood, behavior, muscle contraction and CVS system and endocrine system. It has a role in depression. Decrease in depression, dysthymia and suicidal ideation Increase in anxiety disorders (GAD, Panic, OCD etc ) Norephinephrine Increases HR, Blood pumping from the heart, increases BP, Helps in fat breakdown increases blood sugar level to provide energy to the body. Decrease in anxiety, sleep disorders and depression Increase in schizophrenia and mania. Epinephrine It is synthesized from tyrosine and takes part in controlling the adrenal glands. Plays a role in sleep, becomes alert in the fight or flight response Decrease in anxiety, sleep disorders and depression Increase in schizophrenia and mania.