BiologicalBasisOfPsychiatry

BiologicalBasisOfPsychiatry - Medical Neuroscience Wayne K....

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Unformatted text preview: Medical Neuroscience Wayne K. Goodman, MD Professor and Chair Department of Psychiatry Neurochemical Basis of Psychiatry Objectives Illustrate some approaches used today to understand the neurobiological mediators of psychiatric illness by examining role of serotonin in Major Depression and Obsessive Compulsive Disorder (OCD). Highlight exciting recent discoveries about gene- environment interactions in the pathogenesis of Depression. End with encouraging data from a study of Deep Brain Stimulation (DBS) in intractable OCD "The intention [of this project] is to furnish a psychology that shall be a natural science: that is, to represent psychical processes as quantitatively determinate states ". A. Tom Insel, Director, National Institute of Mental Health B. Dennis Steindler, Director, McKnight Brain Institute C. Sigmund Freud, Viennese Neurologist and Psychoanalyst D. B.F. Skinner, Harvard psychologist and author of Walden II Who wrote this? ? This is the opening line from the introduction of the "Project", written by Sigmund Freud in 1895 One of Freud's attempts to explain psychological phenomena in physical science terms. The limited knowledge of the day hampered these efforts. Project for a Scientific Psychology "The intention [of this project] is to furnish a psychology that shall be a natural science: that is, to represent psychical processes as quantitatively determinate states ".- Robert Pyles, Psychiatric News 1999 Examples of Major Psychiatric Disorders Depression Bipolar Disorder Schizophrenia OCD Tourettes Panic Disorder Anorexia Nervosa PTSD Alcohol & Drug Dependence Autism & Other Developmental Causes of DALYs (Disability-Adjusted Life Year) (percentage of total) in Developed Regions in descending order, 1990 Rank Disease or Injury DALYs (thousands) % of Total All Causes 160 994 1 Ischaemic heart disease 15 950 9.9 2 Unipolar major depression 9 780 6.1 3 Cerebrovascular disease 9 425 5.9 4 Road Traffic accidents 7 064 4.4 5 Alcohol use 6 446 4.0 6 Osteoarthritis 4 681 2.9 7 Trachea, bronchus and lung cancers 4 587 2.9 8 Dementia and other degenerative and hereditary CNS disorders 3 816 2.4 9 Self-inflicted injuries 3 768 2.3 10 Congenital anomalies 3 480 2.2 11 Chronic obstructive pulmonary/disease 3 365 2.1 12 Conditions arising during the perinatal period 3 120 1.9 13 Schizophrenia 3 106 1.9 14 Diabetes mellitus 3 022 1.9 15 Bipolar disorder 2 543 1.6 16 Falls 2 448 1.5 17 Lower respiratory infections 2 392 1.5 18 Cirrhosis of the liver 2 345 1.5 19 Colon and rectum cancers 2 298 1.4 20 Obsessive-compulsive disorder 2 098 1.3 Burden of Disease: Leading Causes of Morbidity Challenges in Psychiatry Diagnoses are reliable (agreement) but not necessarily valid (truth) Problematic dependent measures Reliant on behavior and self-report Few good peripheral biomarkers Inaccessibility and complexity of brain Limitations of animal models Stigma: mental weakness, not brain ailment Progress in Psychiatry...
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BiologicalBasisOfPsychiatry - Medical Neuroscience Wayne K....

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