Summary brain in trouble

A snapshot of the summary - brain in trouble

• Etiology of brain disorders

• What is the problem with most brain disorders?

  They are very complex, multifactorial disorders
• What should etiological models for psychiatric diseases need to be?

  Pluralistic or multilevel
• What is the problem with the nature vs nurture discussion?

  Dichotomy should be broken down, but the brain should be viewed as in constant interaction with environment, society and culture.
• Why are more molecular abnormalities not more penetrant at behavorial level?

  Multiple genes complementary/redundant effects
  Risk genes are not necessary sufficient to cause mental illness
  Combination with environmental risk factors
• What are pre/perinatal risk factors?

  Maternal stress
  Maternal nutritional deficiency
  Maternal use of tobacco
  
  Birth complications
  
  Perinatal nutritional deficiency
  Maternal separation
• What is the circuit of the HPA axis?

  Cortisol binds to glucocorticoid receptor
  GR acts as transcription factor and can alter gene expression
  
  GR in hypothalamus, hypophysis and hippocampus: negative feedback loop shuts down CRF loop
• What happens in early life stress with the HPA axis?

  life long overactive(=less GR=less negative feedback to shut system down)
• how does parentl care influence the activity of the neural systems that regulate stress reactivity and cognition in offspring?

  Through epigenetic regulation of gene expression

• Addiction is a brain disease

• What are key characteristics of drug addiction?

  A chronic disease process that develops into a relatively rigid pattern of behavior.
  
  Compulsive use of a substance
  High probability of relapse
  Difficulty stopping
• What is the most harmful drug in our society? What was a substantial contributor to compiling the list?

  Alcohol
  Drug specific mortality and economic cost