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Predisposing and Precipitating Factors To Mental Illness
Predisposing and Precipitating Factors To Mental Illness
Predisposing and Precipitating Factors To Mental Illness
Schizophrenia
Bipolar Disorder and Major Depressive
disorders
first degree relatives – 8 – 18x
monozygotic twins – 33-90%
concordance
Tourette’s Disorder – autosomal
dominant
BIOLOGICAL
II. PSYCHONEUROENDOCRINOLOGY
- refers to the structural and functional
relations between hormonal system and CNS
and the behaviors that modulate and arise from
it.
HYPOTHALAMIC-PITUITARY-ADRENAL
1.Cushing’s Syndrome (inc. cortisol)
> 50% mood disturbances
> 10% psychosis and suicidal thoughts
>cognitive impairments
- Decreasing the cortisol level normalizes mood
3.Depression
> increased cortisol concentration
> failure to suppress cortisol in response to
dexamethasone
> increased adrenal size and sensitivity to
ACTH
> blunted ACTH response to CRH
> increased concentrations of CRH in the
brain
4.Insulin – involved in learning and memory
> lower insulin concentration in CSF of
patients with Alzheimer’s Disease.
>depression is frequent in patients with
diabetes
> antipsychotic effects dysregulate insulin
metabolism
HYPOTHALAMIC-PITUITARY-GONADAL
AXIS
1.Testosterone
> associated with increased violence and
aggression in animals;
> testosterone improves mood and
decreases irriability in hypogonadal males
> anabolic-androgenic steroids –
euphoria, increased energy, sexual arousal;
irriability, mood swings, violent feelings,
anger and hostility;
> DHEA improves well-being and
functional status in both depressed and
normal individuals.
HYPOTHALAMIC-PITUITARY-THYROID
AXIS
TRH - neuronal excitability, behavior,
neurotransmitter regulation.
Hyperthyroidism – fatigue, irritability,
GROWTH HORMONE
stressful experiences – decreased GH
dec. GH – major depressive disorder and
dysthymia
ENDOGENOUS OPIOIDS - eating behavior
(jetlag)
- increases speed of falling asleep
OXYTOCIN – sex
SUBSTANCE P - memory
III.PSYCHONEUROIMMUNOLOGY
IV.
> Stress lowers immune response.
> HIV – depression
> neurosyphilis – neuropsychiatric
manifestations
> Schizophrenia
> Major Depressive Disorder
> Alzheimer’s disease
> Chronic fatigue syndrome
IV.BIOLOGICAL RHYTMS
* SLEEP
> deprivation leads to breakdown in
concentration, motor skills, self-care,
attention, judgement, communication;
hallucinations and illusions.
PSYCHOLOGICAL
I. FREUD
STAGES OF PSYCHOSEXUAL
DEVELOPMENT
1.ORAL STAGE ( 0 – 1)
- to establish a trusting dependence on
nursing and sustaining objects;
- to establish comfortable expression and
gratification of oral libidinal needs without
excessive conflicts or ambivalence from
oral sadistic wishes.
PATHOLOGICAL: extremes of oral gratification
3.URETHRAL STAGE (2 – 3)
- transitional; issues of control and
shaming
4.PHALLIC STAGE ( 3 – 6)
- castration anxiety; penis envy;
- identification from parental figures
- foundation for an emerging sense of
sexual identity
- oedipal conflict resolution
- internal source of regulation - superego
personality
Too rigorous toilet training – stingy,
meticulous, selfish
Too much shaming – delinquent behavior;
impulsive behavior
3.INITIATIVE VS GUILT ( 3 – 5)
- active and intrusive
- Oedipus complex
If excessive guilt – GAD and phobias
inadequacy
Extremes – feelings of inadequacy;
8.INTEGRITY VS DESPAIR
- acceptance
- Psychosomatic illnesses,
Hypochondriasis, Depression
- suicide rate is highest over age 65
SOCIAL FACTORS
STRESS
- Stress Diathesis Model of
Schizophrenia
- Social Causation hypothesis
SOCIAL STATUS
LIFE EVENTS/ TRAUMATIC EVENTS
PHYSICAL TRAUMA/PHYSICAL ILLNESS
MALNUTRITION
POLLUTION
CROWDING
STRESS DIATHESIS MODEL
A person can learn by imitating the
behavior of another person, but
personal factors are involved
.
- relies on role models,
identification, and human interactions.
THANK YOU & GOOD DAY