Dopamine and Psychosis Overview
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Which of the following is considered a negative symptom of schizophrenia?

  • Hallucinations
  • Delusions
  • Avolition (correct)
  • Disorganized speech

    • What is the primary consequence of dysfunction in the nigrostriatal pathway?

  • Increased anxiety and depression
  • Motor control impairments and movement disorders (correct)
  • Visual hallucinations
  • Memory loss and disorientation

    • What is the main impact of altered functioning in the tuberoinfundibular pathway?

  • Increased appetite and weight gain
  • Hyperprolactinemia leading to breast changes (correct)
  • Enhanced dopamine receptor sensitivity
  • Improved cognitive function

    • Which type of psychosis is characterized by persistent delusions without other psychotic symptoms?

    <p>Delusional Disorder</p> Signup and view all the answers

    Antipsychotic medications primarily target which neurotransmitter to help manage psychosis?

    <p>Dopamine</p> Signup and view all the answers

    Which disorder is characterized by psychotic symptoms lasting less than one month?

    <p>Brief Psychotic Disorder</p> Signup and view all the answers

    What role does excess dopamine in the mesolimbic pathway play in psychosis?

    <p>It contributes to the development of positive psychotic symptoms</p> Signup and view all the answers

    Which of the following best describes schizoaffective disorder?

    <p>Psychotic symptoms coinciding with major mood episodes</p> Signup and view all the answers

    What are negative symptoms of schizophrenia primarily associated with?

    <p>Cognitive deficits and social withdrawal</p> Signup and view all the answers

    What effects are associated with the nigrostriatal pathway?

    <p>Motor control and extrapyramidal symptoms</p> Signup and view all the answers

    Excess dopamine in the tuberoinfundibular pathway can lead to which of the following?

    <p>Hyperprolactinemia</p> Signup and view all the answers

    How can psychosis be characterized for diagnostic purposes?

    <p>By assessing dopamine levels in specific pathways</p> Signup and view all the answers

    Which statement is true regarding antipsychotic medications and the mesocortical pathway?

    <p>They can exacerbate negative symptoms due to dopamine reduction.</p> Signup and view all the answers

    What is the role of the mesolimbic pathway in psychosis?

    <p>Acts as the primary pathway for positive symptoms.</p> Signup and view all the answers

    Which disorder is most commonly used to understand psychotic disorders?

    <p>Schizophrenia</p> Signup and view all the answers

    What is a key feature of the mesocortical pathway related to schizophrenia?

    <p>Reduced dopamine leads to impaired cognitive functions</p> Signup and view all the answers

    What is a potential consequence of antipsychotic medications on the nigrostriatal pathway?

    <p>Extrapyramidal symptoms (EPS)</p> Signup and view all the answers

    Which of the following describes the impact of the tuberoinfundibular pathway disruption by antipsychotics?

    <p>Development of hyperprolactinemia</p> Signup and view all the answers

    How is psychosis differentiated from a psychiatric diagnosis?

    <p>Psychosis is simply a symptom</p> Signup and view all the answers

    Which type of hallucination is most commonly associated with psychotic disorders?

    <p>Auditory hallucinations</p> Signup and view all the answers

    What are the abnormal movements caused by antipsychotic medications referred to as?

    <p>Thorazine shuffle</p> Signup and view all the answers

    What type of hallucination indicates a more likely organic cause?

    <p>Gustatory hallucinations</p> Signup and view all the answers

    Which of the following is NOT a potential effect of disrupted dopamine activity from antipsychotic medication?

    <p>Improved psychotic symptoms</p> Signup and view all the answers

    What is a major aim of antipsychotic medications regarding dopamine activity?

    <p>To control dopamine activity in the mesolimbic pathway while minimizing effects on other pathways</p> Signup and view all the answers

    What is a key characteristic of Depersonalization/Derealization Disorder?

    <p>Feeling detached from oneself.</p> Signup and view all the answers

    In which type of dissociative amnesia does a person not recall events from a specific time frame?

    <p>Localized amnesia</p> Signup and view all the answers

    Which condition is characterized by sudden travel away from home accompanied by memory loss for identity?

    <p>Dissociative Fugue</p> Signup and view all the answers

    What is often a common trigger for switching identities in Dissociative Identity Disorder (DID)?

    <p>Severe stress</p> Signup and view all the answers

    Which symptom is NOT typically experienced in Somatic Symptom Disorder?

    <p>Identifiable medical causes</p> Signup and view all the answers

    What is a potential prognosis for continuous dissociative amnesia if the duration is long?

    <p>Poorer prognosis is likely</p> Signup and view all the answers

    Which of the following is a requirement for the diagnosis of Dissociative Amnesia?

    <p>Inability to recall distressing information</p> Signup and view all the answers

    How do symptoms of Somatic Symptom Disorder generally respond to typical medical treatments?

    <p>No response occurs</p> Signup and view all the answers

    What is the typical duration of symptoms for a diagnosis of schizophreniform disorder?

    <p>Less than 6 months</p> Signup and view all the answers

    Which of the following disorders involves symptoms of schizophrenia alongside a mood disorder?

    <p>Schizoaffective Disorder</p> Signup and view all the answers

    What type of hallucination is commonly associated with stochastic causes like infection or migraines?

    <p>Olfactory hallucinations</p> Signup and view all the answers

    What condition may result from the disruption of the tuberoinfundibular pathway due to antipsychotic medications?

    <p>Hyperprolactinemia</p> Signup and view all the answers

    Which type of psychosis is primarily triggered by substance use?

    <p>Substance-Induced Psychosis</p> Signup and view all the answers

    Which type of hallucination is most commonly associated with conditions of psychosis?

    <p>Auditory hallucinations</p> Signup and view all the answers

    Which of the following symptoms is indicative of akathisia caused by antipsychotic treatment?

    <p>Inability to sit still</p> Signup and view all the answers

    Which symptom of dissociative disorder represents an experience that should not be present?

    <p>Feeling detached from the body</p> Signup and view all the answers

    What are common types of delusions seen in psychotic disorders?

    <p>Grandiosity and persecution</p> Signup and view all the answers

    What differentiates delusional disorder from other psychotic disorders?

    <p>Lack of hallucinations with persistent delusions</p> Signup and view all the answers

    What is a significant side effect of antipsychotics related to movement disorders?

    <p>Extrapyramidal symptoms</p> Signup and view all the answers

    Which factor is often implicated in contributing to psychosis as stated in the key takeaways?

    <p>Excess dopamine in the mesolimbic pathway</p> Signup and view all the answers

    What best describes the nature of abrupt onset in dissociative disorders?

    <p>Sudden and unrelated to external circumstances</p> Signup and view all the answers

    Which of the following is true regarding visual hallucinations?

    <p>They can occur in psychotic disorders and in certain organic conditions.</p> Signup and view all the answers

    What condition is a notable symptom of hyperprolactinemia caused by antipsychotics?

    <p>Galactorrhea</p> Signup and view all the answers

    What is the primary goal of newer antipsychotic medications?

    <p>To balance dopamine activity across multiple pathways</p> Signup and view all the answers

    What role does the mesolimbic pathway play in the context of psychosis?

    <p>It is associated with positive symptoms of schizophrenia due to excess dopamine.</p> Signup and view all the answers

    Which statement accurately describes the mesocortical pathway's impact on schizophrenia?

    <p>It is involved in regulating emotional responses linked to negative symptoms.</p> Signup and view all the answers

    What is the primary function of the nigrostriatal pathway in relation to antipsychotic medication?

    <p>It is involved in motor control, and its disruption can lead to extrapyramidal symptoms.</p> Signup and view all the answers

    What is a potential side effect of antipsychotic treatment associated with the tuberoinfundibular pathway?

    <p>Hyperprolactinemia leading to endocrine disturbances.</p> Signup and view all the answers

    Which of the following best illustrates the difference between dopamine pathways affected by schizophrenia?

    <p>Different pathways affect various symptoms independent of each other.</p> Signup and view all the answers

    Excess dopamine binding at D2 receptors in the mesolimbic pathway is associated with which outcome?

    <p>Enhancement of hallucinations and delusions.</p> Signup and view all the answers

    How does reduced dopamine in the mesocortical pathway affect patients with schizophrenia?

    <p>It can worsen negative symptoms and cognitive impairments.</p> Signup and view all the answers

    What is the relationship between dopamine pathways and motivational aspects in psychosis?

    <p>The mesolimbic pathway enhances motivation through excessive dopamine activity.</p> Signup and view all the answers

    What condition is characterized by altered voluntary motor or sensory function with no neurological explanation?

    <p>Conversion Disorder</p> Signup and view all the answers

    In which disorder does a person have a preoccupation with having or acquiring a serious illness despite being healthy?

    <p>Illness Anxiety Disorder</p> Signup and view all the answers

    Which of the following is true about Factitious Disorder Imposed on Self?

    <p>Patients often undergo unnecessary medical procedures.</p> Signup and view all the answers

    What is a primary motive behind malingering?

    <p>To avoid work or gain financial compensation</p> Signup and view all the answers

    What differentiates Malingering from Factitious Disorder?

    <p>Factitious Disorder symptoms are deliberately fabricated for attention.</p> Signup and view all the answers

    What is one of the characteristics of Conversion Disorder symptoms?

    <p>Symptoms often produce significant distress or disability.</p> Signup and view all the answers

    Factitious Disorder Imposed on Another often involves which of the following?

    <p>A caregiver falsifying illness in another for sympathy.</p> Signup and view all the answers

    What is a common characteristic of psychological factors affecting other medical conditions?

    <p>Mental health conditions can worsen physical ailments.</p> Signup and view all the answers

    Study Notes

    Dopamine and Psychosis

    • Excess dopamine in the mesolimbic pathway is strongly associated with psychosis.
    • Psychosis can be caused by various factors, not just schizophrenia.
    • Schizophrenia is the most common psychotic disorder, used as a foundation for discussion.

    Dopamine Pathways in Schizophrenia

    • Four pathways are involved in dopamine signaling and schizophrenia: mesolimbic, mesocortical, nigrostriatal, and tuberoinfundibular.
    • Mesolimbic: Involved with positive symptoms of schizophrenia (hallucinations, delusions).
    • Mesocortical: Involved with negative and cognitive and affective symptoms of schizophrenia (flat affect, cognitive deficits, social withdrawal, executive function, appropriate expression of emotion/cognition, problem solving).
    • Nigrostriatal: Involved with extrapyramidal symptoms and tardive dyskinesia, which can be side effects of medication.
    • Tuberohypophyseal: Involved with hyperprolactinemia, which can be a side effect of medication.

    Mesolimbic Pathway

    • The "psychotic pathway".
    • Connects the ventral tegmental area (VTA) to the nucleus accumbens (reward centre).
    • Implicit in motivation, pleasure, reward.
    • Excess dopamine leads to increased pleasure, reward, and motivation, as well as positive symptoms of schizophrenia (hallucinations, delusions).
    • Implicated in all forms of psychosis.

    Mesocortical Pathway

    • Connects the VTA to the prefrontal cortex (PFC).
    • Reduced dopamine leads to negative symptoms of schizophrenia (flat affect, cognitive deficits, social withdrawal, executive function, appropriate expression of emotion/cognition, problem solving).
    • Negative symptoms are associated with poorer long-term outcomes (important diagnostic marker).
    • Antipsychotics can worsen negative symptoms by further reducing dopamine in this pathway.

    Nigrostriatal Pathway

    • Connects the substantia nigra to the striatum (motor control).
    • Normally unaffected in schizophrenia.
    • Antipsychotics can disrupt this pathway, leading to extrapyramidal symptoms (EPS), including involuntary movements (e.g., tremors, rigidity).
    • Deficiencies of dopamine are implicit in movement disorders (Parkinson's).
    • "Thorazine shuffle": controls psychoses but causes abnormal movements.
    • Akathisia: Restlessness and inability to sit still.

    Tuberoinfundibular Pathway

    • Connects the substantia nigra to the hypothalamus (prolactin production).
    • Normally unaffected in schizophrenia.
    • Antipsychotics can disrupt this pathway, leading to hyperprolactinemia (elevated prolactin levels), galactorrhea (milk production outside of breastfeeding), and menstrual irregularities/difficulty conceiving.

    Antipsychotic Medications

    • Aim to control dopamine activity in the mesolimbic pathway while minimizing effects on other pathways.
    • Newer antipsychotics are generally better at achieving this balance.

    Differentiating Among Psychoses

    • Psychosis is a symptom, not a diagnosis.
    • Important to characterize the type of psychosis.
    • Hallucinations: Sensory perceptions without external stimuli (auditory, visual, tactile, olfactory, gustatory).
    • Delusions: Fixed, false beliefs despite evidence to the contrary or rational argument.
    • Auditory hallucinations are most commonly associated with psychotic disorders.
    • Visual hallucinations can be associated with psychotic disorders or organic conditions (tumors along the optic pathway).
    • Gustatory hallucinations are more likely to be an organic problem such as allergies, head injury, or a medical condition requiring imaging.
    • Olfactory hallucinations (phantosmia) can be caused by infection, dental disease, stroke, nasal polyps, or migraines.
    • Tactile hallucinations can be caused by stimulants, excess ethanol consumption, or neurological disease.

    Psychotic Disorders

    • Schizophrenia: Chronic psychotic disorder with positive symptoms (hallucinations, delusions), negative symptoms, and functional impairment. Requires symptoms for at least 6 months.
    • Schizoaffective Disorder: Meets criteria for both schizophrenia and a mood disorder (MDD, BPD I, BPD II).
    • Schizophreniform Disorder: Symptoms of schizophrenia but for less than 6 months.
    • Brief Psychotic Disorder: Psychotic symptoms lasting less than one month.
    • Delusional Disorder: Persistent delusions without other psychotic symptoms.
    • Substance-Induced Psychosis: Psychosis caused by substance use.
    • Psychotic Disorder Due to a Medical Condition: Psychosis caused by an underlying medical condition (i.e., head injury, metabolic imbalance, organic lesion).
    • Paraphrenia: Chronic psychotic disorder similar to schizophrenia but with better-preserved affect and functioning.

    Key Takeaways

    • Excess dopamine in the mesolimbic pathway is a key factor in psychosis.
    • Different dopamine pathways are involved in various aspects of schizophrenia and its treatment.
    • Antipsychotics aim to control psychosis while minimizing side effects.
    • It's important to differentiate between various types of psychotic disorders to ensure appropriate treatment.

    Introduction to Dissociation

    • Definition of dissociation: Disconnection between a person's thoughts, memories, feelings, or sense of self.
    • Everyone dissociates sometimes.
    • Dissociation is not a disorder unless it disrupts social or occupational function.
    • Normal vs. abnormal dissociation:
      • Everyday examples (daydreaming, highway hypnosis).
      • Therapeutic uses (hypnosis).
      • Dissociation as a coping mechanism (trauma, accidents, crime victim).

    Characteristics of Dissociative Disorder

    • Abrupt onset and offset.
    • Positive and negative disruptions:
      • Positive: Experiences that shouldn't be there (e.g., feeling detached from your body).
      • Negative: Lack of experiences that should be there (e.g., memory loss).
    • Triggered by psychological conflict or trauma.
    • Impaired functioning or distress.

    Dopamine and Psychosis

    • Excess dopamine binding at D2 receptors in the mesolimbic pathway is strongly associated with psychosis.
    • Psychosis is a symptom that can be caused by various factors, not just schizophrenia.
    • Schizophrenia is the most common psychotic disorder.

    Dopamine Pathways in Schizophrenia

    • There are four major dopamine pathways in the brain: mesolimbic, mesocortical, nigrostriatal, and tuberoinfundibular.
    • The mesolimbic pathway is involved in positive symptoms of schizophrenia (hallucinations, delusions).
    • The mesocortical pathway is involved in negative and cognitive symptoms of schizophrenia (flat affect, cognitive deficits, social withdrawal).
    • The nigrostriatal pathway is involved in extrapyramidal symptoms and tardive dyskinesia (side effects of medication).
    • The tuberoinfundibular pathway is involved in hyperprolactinemia (a side effect of medication).

    Mesolimbic Pathway

    • It connects the ventral tegmental area (VTA) to the nucleus accumbens (reward center).
    • Excess dopamine leads to increased pleasure, reward, and motivation.
    • Implicated in all forms of psychosis.

    Mesocortical Pathway

    • It connects the VTA to the prefrontal cortex (PFC).
    • Reduced dopamine leads to negative symptoms of schizophrenia.
    • Negative symptoms are associated with poorer long-term outcomes.
    • Antipsychotics can worsen negative symptoms by further reducing dopamine in this pathway.

    Nigrostriatal Pathway

    • It connects the substantia nigra to the striatum (motor control).
    • Normally unaffected in schizophrenia.
    • Antipsychotics can disrupt this pathway, leading to extrapyramidal symptoms (EPS) like tremors, rigidity, and akathisia.

    Tuberoinfundibular Pathway

    • It connects the substantia nigra to the hypothalamus (prolactin production).
    • Normally unaffected in schizophrenia.
    • Antipsychotics can disrupt this pathway, leading to hyperprolactinemia, galactorrhea, and menstrual irregularities.

    Antipsychotic Medications

    • Aim to control dopamine activity in the mesolimbic pathway while minimizing effects on other pathways.
    • Newer antipsychotics are generally better at achieving this balance.

    Differentiating Among Psychoses

    • Psychosis is a symptom, not a diagnosis.
    • It is important to characterize the type of psychosis.
    • Auditory hallucinations are most commonly associated with psychotic disorders.
    • Visual hallucinations can be associated with psychotic disorders or organic conditions.
    • Gustatory, olfactory, and tactile hallucinations are more likely to have organic causes.

    Psychotic Disorders

    • Schizophrenia is a chronic psychotic disorder with positive symptoms, negative symptoms, and functional impairment.
    • Schizoaffective disorder meets criteria for both schizophrenia and a mood disorder.
    • Schizophreniform disorder has symptoms of schizophrenia but for less than 6 months.
    • Brief psychotic disorder involves psychotic symptoms lasting less than one month.
    • Delusional disorder has persistent delusions without other psychotic symptoms.
    • Substance-induced psychosis is caused by substance use.
    • Psychotic disorder due to a medical condition is caused by an underlying medical condition.
    • Paraphrenia is a chronic psychotic disorder similar to schizophrenia but with better-preserved affect and functioning.

    Introduction to Dissociation

    • Dissociation is a disconnection between a person's thoughts, memories, feelings, or sense of self.
    • Everyone dissociates sometimes.
    • Normal dissociation includes daydreaming and highway hypnosis.
    • Dissociation can be used therapeutically in hypnosis.
    • It can also be a coping mechanism for dealing with trauma.

    Characteristics of Dissociative Disorder

    • Abrupt onset and offset.
    • Positive and negative disruptions:
      • Positive: Experiences that shouldn't be there (e.g., feeling detached from your body).
      • Negative: Lack of experiences that should be there (e.g., memory loss).
    • Triggered by psychological conflict or trauma.
    • Impaired functioning or distress.

    Types of Dissociative Disorders

    • Depersonalization/Derealization Disorder:
      • Depersonalization: Detachment from oneself.
      • Derealization: Feeling that surroundings are unreal.
    • Dissociative Amnesia:
      • Inability to recall important personal information, usually related to trauma.
    • Dissociative Fugue:
      • Sudden, unexpected travel away from home with amnesia for identity.
    • Dissociative Identity Disorder (DID):
      • Presence of two or more distinct personalities with unique attributes.
      • Often associated with severe childhood trauma.
    • Somatic Symptom Disorder:
      • Distressing physical symptoms with no identifiable medical cause.
    • Conversion Disorder:
      • Altered voluntary motor or sensory function with no neurological explanation.
    • Illness Anxiety Disorder:
      • Healthy people with a serious fear of a life-threatening illness.
    • Psychological Factors Affecting Other Medical Conditions:
      • Mental health conditions impacting physical health.

    Factitious Disorder

    • Factitious Disorder Imposed on Self:
      • Deceptive falsification of physical or psychological symptoms for the purpose of assuming the sick role.
    • Factitious Disorder Imposed on Another:
      • Falsification of symptoms in another person, typically a child, for the purpose of gaining attention or sympathy.

    Malingering

    • Intentional fabrication or exaggeration of symptoms for external gain.

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    Week 3 Notes NUR 6970: Physiology of Psychosis PDF

    Description

    This quiz explores the role of dopamine in psychosis, highlighting its association with schizophrenia. It discusses how excess dopamine in different pathways leads to various symptoms and conditions. Delve into the significance of mesolimbic, mesocortical, nigrostriatal, and tuberoinfundibular pathways.

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