PSYCHOLOGICALFREUDSTAGES OF PSYCHOSEXUAL DEVELOPMENTORAL 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 can result in libidinal fixations - excessive optimism, narcissism, pessimism, demandingness oral traits - envy and jealousyĪNAL STAGE (1 – 2) - a period of striving for independence and separation from dependence PATHOLOGICAL:Fixation – orderliness, obstinacy, stubbornness, willfulness, frugality, and parsimonyIf less effective – heightened ambivalence, lack of tidiness, messiness, defiance, rage ad sadomasochistic tendencies.URETHRAL STAGE (2 – 3) - transitional issues of control and shaming > HIV – depression > neurosyphilis – neuropsychiatric manifestations > Schizophrenia > Major Depressive Disorder > Alzheimer’s disease > Chronic fatigue syndromeīIOLOGICAL RHYTMS * SLEEP > deprivation leads to breakdown in concentration, motor skills, self-care, attention, judgement, communication hallucinations and illusions. PSYCHONEUROIMMUNOLOGY > Stress lowers immune response.

GH – major depressive disorder and dysthymiaENDOGENOUS OPIOIDS - eating behaviorMELATONIN – circadian phase disorders (jetlag) - increases speed of falling asleepOXYTOCIN – sexSUBSTANCE P - memory Prolactin > increased PRL – depression, decreased libido, stress intolerance, anxiety, increased irritability > severity of tardive dyskinesiaHYPOTHALAMIC-PITUITARY-THYROID AXISTRH - neuronal excitability, behavior, neurotransmitter regulation.Hyperthyroidism – fatigue, irritability, insomnia, anxiety, restlessness, weight loss, emotional lability marked impairment in memory and concentration delirium and dementia psychotic feature : paranoiaĬhronic hypotyroidism – fatigue, decreased libido, memory impairment, irritability suicidal ideation common.GROWTH HORMONE stressful experiences – decreased GH dec. > Estrogen has mood-enhancing properties > Premenstrual dysphoric disorder > 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.Estrogen and Progesterone > antipsychotic effect changes over menstrual cycles > risk of tardivedyskinesia depends partly on estrogen concentration > Estrogen administration decreases risks ad severity of Alzheimer’s dementia. >depression is frequent in patients with diabetes > antipsychotic effects dysregulate insulin metabolismHYPOTHALAMIC-PITUITARY-GONADAL AXISTestosterone > associated with increased violence and aggression in animals > testosterone improves mood and decreases irriability in hypogonadal males Insulin – involved in learning and memory > lower insulin concentration in CSF of patients with Alzheimer’s Disease. > replacement of glucocorticoids resolves the above symptoms.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 cortisol) > 50% mood disturbances > 10% psychosis and suicidal thoughts >cognitive impairments- Decreasing the cortisol level normalizes mood and mental statusĪddison’s Disease (Adrenal insufficiency) > apathy, withdrawal, impaired sleep and decreased concentration.

PSYCHONEUROENDOCRINOLOGY - refers to the structural and functional relations between hormonal system and CNS and the behaviors that modulate and arise from it.HYPOTHALAMIC-PITUITARY-ADRENALCushing’s Syndrome (inc. MD, FPPAīIOLOGICALGENETICS - many major psychiatric disorders have shown to have strong hereditary predispositions.Examples:SchizophreniaBipolar Disorder and Major Depressive disordersfirst degree relatives – 8 – 18xmonozygotic twins – 33-90% concordanceTourette’s Disorder – autosomal dominantīIOLOGICALII. PREDISPOSING AND PRECIPITATING FACTORS TO MENTAL ILLNESSHyacinth C.

Tidiness and mental health