Psychiatry

Source:  Psychiatry    Tag:  schizophrenia heredity

Psychiatry
By: Ali Hunt

Section I: Intro

Why do we think the that way we do? Why dosome people have multiple personalities or unbearable depression? Psychiatry is the branch of medicine that deals with these disorders, and strives to treat them. From the CT and MRI scan to antidepressants and schizophrenia medicine, psychiatry, which branched from biology and philosophy, seeks to cure the many strange things that occur in our brains. Although psychiatry dates as far back to Plato and Aristotle in the 300’s-400’s BC, science is teeming with discoveries that have contributed to understanding our minds. The CT scan was introduced by British engineer Godfrey Hounsfield in 1971, and MRI scan invented by Raymond Damadian in 1984. In 1954, chlorplazine, introduced by Henri Labriot, was approved to help mental patients cope with Schizophrenia. In the late 1960’s, antidepressants were found by organic chemists Bryan Molloy and Klaus Schmiegal, who were synthesizing compounds with the antihistamine Benadryl.


Section II- Discovery

Three sublets of psychiatry that I would like to address are the discovery of the MRI and CT scan, the discovery of the antidepressant Prozac, and the discovery of schizophrenia-treating drugs.

The discovery of the MRI and CT S

can- Sir Godfrey Hounsfield discovered the CT scan in 1971. One day on the countryside, Hounsfield, a radiologist, conceived the idea fo

r a CT scan. He wanted “to determine what was in a box by taking readings at all angles through it.” (Radiology Society of North America, 2010). He combined X-Rays with a computer, using a rotate-translate system that allowed him to differentiate between white and grey matter in a brain specimen. He originally used a gamma source, but he replaced it with an x-ray tube, which made the scanning more efficient. In 1972, he tested it out on a patient with a brain tumor. He was able to locate the size and place of the tumor using the CT scan. In 1979 he was awarded the Nobel Prize for Medicine.

Figure 1

The discovery of Antidepressants-

Since the i

nvention of Thorazine, psychiatrists have been looking for new ways to treat mental illnesses. In 1987, the antidepressant Prozac (flouxetine hydrochloride) was introduced. Not only did Prozac have less side effects, but it made patients feel better

than ever. Scientists Byran B. Molloy and Klaus K. Schmiegel, organic chemists, started working on it in the late 1960’s. They worked for Eli Lilly& Company, and they were working on synthesizing compounds based on the antihistamine Benadryl, led by scientist Ray Fuller. When put on the market in 1988, Prozac started flying off the

shelves. More than 65,000 prescriptions were being filled

monthly. (PBS, 1998) Prozac works by increasing levels of serotonin in the brain, which is connected to mood, aggression, hunger, and sleep. It affects the brain’s neurotransmitters receptors. Prozac is the most highly distributed and processed antidepressant in America.

The discovery of Schizophrenia-treating drugs- These drugs were introduced in 1952, by a Parisian surgeon named Henri Laboriot. He was working on a surgery, and looking for a way to reduce shock in patients. He tried antihistamines (typically used for allergies) at first, and kept upping the doses to watch the patient’s mental stages change. He then tried the drug chlorpromazine, and though it might be useful in psychiatry. In 1954, chlorpromazine was accepted by the US Food and Drug Administration. Patients who were frozen in psychical states and had extremely aggressive or violent behavior were no

w acting completely different. This drug has amazing chemical effects on the brain. Correlations with this drug led to the founding of dopamine and other neurotransmitters that would later play a role in brain function and behavior.


Section III-

Types of Mental Disorders and Their Treatments

· Serotonin Reupta

ke Inhibitors (SSRI)

- fluoextine (Prozac), set

raline (Zoloft), and citalopram

(Celexa) treat depression. Depression is a mental illness where you have symptoms of minor depression for over two weeks. Symptoms include, but are not limited to: agitation, change in appetite, weight gain/loss, ex

cessive sleeping or insomnia, suicidal thoughts, self-hate, guilt, fatigue, and inactivity and withdrawal from activities.

· Antipsychotic Drugs- risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), and ziprasidone (Geodon) are u

sed to treat anxiety disorders, like panic and phobic disorders. Panic disorder is an illness that causes unexpected and repetitive attacks of fear. Symptoms include: tight chest, trouble breathing, dizziness, fear

of dying and losing control, tre

mbling, sweating, hot flashes, and feelings of choking and detachment. Phobic disorders are extreme, limiting phobias that take away from daily life, for example: Agliophobia the fear of pain, Arsonphobia, the fear of fire, and Arrhenphobia, the fear of men.

· Mood stabilizers- these drugs deal with manic-depressive illnesses, such as bipolar disorder. These include lithium (Lithoboid), cabramazpine (Tergetoral), and valporate (Depacon). Bipolar disorder is the swing between “mania” and depression. Symptoms: elevated mood, inflated self-esteem, hyperactivity, lack of control, reckless behaviors (mania) and fatigue, oversleeping or insomnia, loss of appetite, loss of interest in activities, and suicidal thoughts (depression).

· Other forms of treatment:

o Electroconvulsive Therapy- electrodes are attached to the head, and electroshocks are delivered to the brain. This creates a minor seizure, which is effective in dealing with major depression. This has fewer side effects than many drugs and is known to deal with major depression.

o Repetitive transcranial magnetic stimulation (rTMS) and vagal nerve stimulation- follow the same patterns as electroconvulsive therapy, but are still under study and may be helpful for those with depression whom are not responding to drugs.

o Psychotherapy- “talk therapy”, which is formed through a supportive and trusting relationship with a psychotherapist. This is often used to treat not only mental disorders, but “family therapy” and “couples therapy” which supports happy and healthy relationships in a home setting. There are many different kinds of this, such as: Psychodynamic psychotherapy which indentifies unconscious thoughts and thinking patterns, cognitive therapy, behavior therapy, and interpersonal therapy.

Section IV:

Psychiatric Impact on the World

The study of Psychiatry has impacted the world in phenomenal ways. People so depressed that they are on the verge of suicide can be treated with an antidepressant or talk to a consoler and get help. Psychiatrists can save lives daily. When Schizophrenia drugs and CT scans were identified, people that had multiple personalities- those that hear voices and do crazy, incomprehensible things were suddenly normal. People diagnosed with Bipolar disorder, uncontrollably swinging from mania to depression were consistently acting normal. The technology and science that has spawned since Plato and Aristotle in ancient Greece is fascinating. Radiology, MRI and CT scans, different medications, and different types of therapists have helped so many people with mental disorders all over the world. Not only can they help treat people with these problems, but they can also help us understand why certain people have these disorders. It is a product of the interaction between our genetics and environment. Since Sigmund Freud’s invention of psychoanalysis (a person lies on a couch 4-5x a week and says the first thoughts that come to their mind), there have been many innovations in psychiatry. Different types of therapy (cognitive focuses on brain patterns, psychodynamic focuses on unconscious thoughts, behavior ignores genetic heredity and focuses on actions and reactions of a person, genetic studies how genes impact our lives, and so on) have changed the quality of so many people’s lives.

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Section V-

Analysis of Journal

American Journal Psychiatry 2010,

(Published online June 1, 2010)

© 2010 American Psychiatric Association

Prenatal and Neonatal Brain Structure and White Matter Maturation in Children at High Risk for Schizophrenia

John H Gilmore, MD, Chaeryon Kind, MA, Dianne Evans, MA, Honor M Wolfe, J Kieth Smith, MD, Jeffrey A Liberman, MD, Weili Lin, PhD, Robert M. Hamer, PHD, Martin Styner, PhD, and Guido Gerig, PhD.

Summary: Schizophrenia, a neurodevelopment disorder, is associated with abnormal structures in the brain and white matter. Even though we don’t know much about the cause of these abnormalities, a study was conducted to identify these abnormalities in prenatal and neonatal period to see if there is a genetic risk for Schizophrenia. Scientists did this by using a prenatal ultrasound and neonatal structural magnetic resonance imaging (MRI) and diffusion tensor imagining in the embryo of a women with schizophrenia. They looked for similarities in size of head, neonatal fluid, gray and white matter, and volume of the lateral ventricle.

It was shown that although the size of head and lateral ventricle tests were unsuccessful to conducting evidence, there was still some success in the experiment. Females at high risk had significantly higher amount of gray matter than those children that are not at high risk for schizophrenia. Males also had larger intracranial brain structure, more gray matter, and a lateral ventricle volume. There were no differences in the white matter or tensor properties in either the male or female subjects.

This study has shown the first evidence for the possible genetic risk for schizophrenia. Schizophrenia is a serious disorder that makes it hard to discern from real and unreal experiences. People are known to have erratic behavior or no response at all. It is possible to hear voices and have hallucinations. There are five types:

· Catatonic Type: decreased motor skills, rigid muscles, no response, stupor, and lessened sensitivity to pain.

· Paranoid Type: hallucinations, anger, anxiety, subject is quick to argue.

· Disorganized Type: regressive behavior (acts child-like), hallucinations, withdrawal from social situations, continuous/repetitive behaviors, uncontrollable laughter.

· Undifferentiated Type: Has symptoms of more than one of the types of Schizophrenia. For example, one might act child-like in withdrawing from social situation, while they start to lose their motor skills and muscle control.

· Residual Type: Symptoms of the disorder have gone away, but some problems still remain, like hallucinations or social withdrawal.

Side effects may include: alcohol problems and weight gain. Although there medicine to treat schizophrenia, there is no cure for it….yet!

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Section VI- References

Bellis, M. (2010). Prozac: The Making of a Miracle Cure? - The History of Prozac.. Retrieved from http://inventors.about.com/library/weekly/aa980225.htm

Depression. (2010). Retrieved from www.google.com/health

Gilmore, J.H. (June 1,2010)

Prenatal and Neonatal Brain Structure and White Matter Maturation in Children at High Risk for Schizophrenia. Retrieved from: http://ajp.psychiatryonline.org/cgi/content/abstract/appi.ajp.2010.09101492v1

Isherwood, I. (2010). Retrieved from http://radiology.rsna.org/content/234/3/975.full

Miller, G.A. (2010). Retrieved from wordnetweb.princeton.edu/perl/webwn

National inventors hall of fame, . (2002). Raymond v. damadian . Retrieved from http://www.invent.org/hall_of_fame/36.html

PBS, . (1997). Drug for treating schizophrenia identified. Retrieved from http://www.pbs.org/wgbh/aso/

Plato, aristotle and the history of astrology. (1991). Retrieved from http://www.myastrologybook.com/Plato-Aristotle-history-of-astrology.htm

Sharp, M. (2009). Treatment of Mental Illness . Retrieved from http://www.merck.com/mmhe/sec07/ch098/ch098d.html

Bipolar Disorder. (2010). Retrieved from www.google.com/health

Schizophrenia. (2010). Retrieved from www.google.com/health

Figure 1: http://www.google.com/imgres?imgurl=http://www.magnet.fsu.edu/

Figure 2: http://www.google.com/imgres?imgurl=http://vote08.freedomblogging.com/

Figure 3:

http://www.google.com/imgres?imgurl=http://www.isgtw.org/images/Brain_schizo3.jpg