• positive symptoms
• negative symptoms 
• cognitive symptoms

1 positive plus 1 or more of any

• 1 or more major areas of functioning (ex work, relationships, self-care) are markedly below the level achieved prior to onset. 
• If during childhood it consists of failure to meet expectations.

1. Genetics 
2. Gestational and/or Brain complications
3. Winter birth
4. Early history of ADHD

• Hallucinations 
• Delusions
• Disorganized speech/formal thought disorder
• Disorganized/bizarre/catatonic behavior

• Alogia
• Affective blunting
• Andedonia
• Avolition/amotivational
• Asocial

• Tangentiality
• Loss of goals 
• Incoherence 
• Looseness of associations
• Neologisms

• Reductions in neocortical gray matter volume 
• Dec neuronal size in corticolimbic structures 
• Diffuse ventricular enlargement 
• Reduced dendritic spine density and inc neuronal disarray in neurons of the prefrontal cortex
• Dec metabolic activity esp in prefrontal cortex

• Mesolimbic DA excess = positive symptoms
• Mesocortical DA deficiency = negative symptoms

• Abnormal fetal brain development and migration
• Loss of ability to make new connections
• Excess pruning 
• Neurodegeneration

• Serotonin 
• GABA 
• Neuropeptides

1. Depressed mood (irritability in adolescents)
2. Anhedonia (diminished interest of pleasure)
3. Significant weight gain or loss (not from dieting)
4. Insomnia or hypersomnia 
5. Psychomotor agitation or retardation 
6. Fatigue or loss of energy 
7. Feeling of worthlessness or unfounded guilt
8. Indecisive, unable to think or concentrate 
9. Recurrent thoughts of death or suicide

• Women 2X more likely
• 1.5-3 fold greater risk w/ pos family history
• Marital status (Divorced or separated=higher rates, married males=lower rates, and married females= higher rates)
• 6 months postpartum
• Neg life events/early parental death inc risk

• 1.5% worldwide
• Primary family = 10% risk 
• Monozygotic twin = 80% risk 
• Men just as likely as women

Involves cycles of depression 

• Inflated self-esteem or grandiosity
• More talkative or pressure to keep talking
• Subjective feelings that thoughts are racing 
• Distractibility
• Inc goal-directed behavior 
• Psychomotor agitation 
• Excessive involvement in risky activities
• Mood disturbances sufficiently severe to cause marked impairment      

• Antidepressant drugs: inc 5HT and NE levels
• Suicidal patients: less 5HT turnover
• Tryptophan can improve depression 

Suicide victims have inc 

• 5HT-1A somatodendritic autoreceptors
• 5HT-2 postsynaptic receptors

• Dec connection between neurons
• Inhibits: CRF → ACTH → cortisol/adrenaline 

A defect in substance P or Neurokinin 1 receptors 

Clinical trials: Neurokinin 1 antagonist have antidepressant actions

• Hypothalamic-pituitary-adrenal-axis
• Hypothalamic-pituitary-thyroid axis 

• shorten latency and inc duration of REM
• Sleep deprivation = transient improvement in mood
• Seasonal depression = melanin and pineal component
• Menstrual

1. Dispositional
2. Functional 
3. Learned 
4. Cross-Tolerance
5. Reverse tolerance - Sensitizaton

Change in body's response to drug - same con at site of action

• Dec GABA receptors→ lead to dependence 

Usually opposite to initial drug effects - severity often determined by pharmacokinetics

• Probably based on PD tolerance 
• short half life = worse abstinence
• prolonged withdrawal syndrome triggers craving

• Reinforcing effects
• Pharmacokinetics variables 
• Cost, availability

• Genetics: diff genes control alcohol sensitivity, tolerance, dependence and addiction
• Behavioral: past use (including fetal), personality, psychiatric symptoms

• Societal norms
• Stressors
• Other reinforcers (include jobs/education/religion)

• Correct: a natural disease that originates in the brain rather than a curse from God
• Incorrect: believed epilepsy was caused by surplus of cold phelgm from the brain flowing down into the warm blood

• Correct: noted some seizures are preceded by auras 
• Incorrect: seizures can originate in the body and spread to the brain

• Correct: alcohol can inc the risk of having a seizure
• Incorrect: herbal remedies can provide a cure 

• Some seizures do not involve consciousness (partial seizures)
• Jacksonian March (partial → generalized seizure)

• Seizure focus: originate in a small group of neurons 
• Symptomatology depends on the location

• Do not impair consciousness 
• Last less than 2 min 
• Usually preceded by an aura

A symptom or a set of symptoms perceptible only by the patient

• a sudden sense of fear 
• rising feeling in abdomen
• Specific sensory perceptions 

1. Motor: changes in motor activity 
2. Sensory: causes perceptional changes of any sense
3. Autonomic: changes in systems under autonomic control
4. Psychic: changes in how people think, feel, or experience things

• Impair consciousness and short-term memory
• Lasts 30-120 sec 
• Leave patient tired and confused after 
• May involve apparently purposeful movements
• Seizure focus: temporal or frontal lobe 

Involve tonic clonic movement

• AKA petit mal 
• Defined y brief episodes of staring 
• Last 10-20 sec 
• Begin and end abruptly
• Awareness and responsiveness are impaired 
• Patients do not realize they are having a seizure  

Share all the features of simple absence but also involve changes in muscle activity such as:

• blinking of eyes 
• slight movements of the mouth 
• Rubbing of hands
• Contraction and relaxation of muscles

• Defined by episodes of staring 
• Last 10-30 sec
• Begin and end gradually 
• Patient aware of seizure 
• May or not be associated w/ motor movements
• Associated with low intelligence 

• Are brief shock like jerks of a muscle or a group of muscles 
• Last 1-2 sec
• Involve muscle groups on both sides of the body

• Muscle tone is greatly inc - stiffening movements
• Less than 20 sec
• Consciousness present
• Often during sleep 
• If standing, then fall 
• Involve most or all of the brain 

• consist of rhythmic jerking 
• length of time is highly variable 
• occur in rare cases 
• Not followed by periods of tiredness

• Most common form of seizure
• aka grand mal 
• Duration 2-3 min 
• Consciousness is lost 
• After patient will be very tired, confused, etc

• Type of seizure
• Age of onset 
• The cause 
• Area of the brain involved 
• Factors that promote
• Severity, frequency, and time of seizure 
• EEG

• Tonic-clonic seizures in children (3 mo-5yr) when they have high fevers
• Tend to run in families 
• Fever reduction does not prevent seizure 
• No seizure after 5 yr 

• Absence seizures in children (4-8yr)
• Tonic-clonic w/ or w/o fever may appear before CAE
• 2-8% of epilepsy
• Primarily genetic 

• Observed in morning or after waking 
• One of the most common forms 
• 15% of CAE will develop 
• likely in people with relatives with epilepsy 
• Initiated with strobe lights, TVs, etc (photosensitive seizures)

• Partial epilepsy arising from temporal lobe 
• Often include auras
• Simple partial, complex partial, and secondarily generalized seizures are common
• Mild memory deficits 
• At any age - observed after head injury or cerebral infection

• Partial seizures 
• Both simple and complex can be observed 
• Wide array of presentations 
• Complex partial seizures = automatisms 
• Diagnosis requires EEG

• head trauma
• drug intoxication/withdrawal 
• cerebral infection 
• stroke 
• brain tumors

1. Defined by presence of recurrent seizures
2. Requires thorough history and neuro exam 
3. EEG is a useful tool 

1. Time scale is slow 
2. Data represents population activity, not individual neurons 
3. Spikes should not be confused w/ action potential
4. Nature of cortical synaptic events can't be determined

• a large (20-40 mV), long lasting (50-200 sec) suprathreshold depolarization
• an afterhyperpolization

• Activation of Glu receptors
• Voltage gated Ca²⁺ channels

• Activation of GABA receptors 
• Ca²⁺ activated K⁺ channels

• Amplitude ~ 3Hz
• similar to activity of sleep spindles 

1. Awake/Alert: more depolarized - act normal
2. Sleep: less tonic excitability - more intrinsic firing neurons - oscillate at 3 Hz b/c of extensive projections to cerebral cortex