Psychiatry and Clinical Neuroscience: A Primer

Paperback | February 7, 2014

byCharles Zorumski, Eugene Rubin

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Research in neuroscience is revolutionizing how we think about psychiatric diagnosis and treatment. Psychiatric disorders reflect dysfunction of the human mind and involve changes in cognition, emotion, and motivation. Understanding how the neural networks that underlie these mental functionsbecome dysfunctional holds great promise for devising innovative approaches to diagnosis and treatment. Scientific progress is being driven, in part, by advances in human functional neuroimaging, which is being used to characterize the activity of specific brain circuits at rest and during theperformance of specific tasks. Moreover, advances in clinical neuroscience are being coupled with expanding knowledge about genetics and cellular and synaptic neuroscience. Taken together, these advancements offer the hope of much more mechanism-based approaches to treatment in the future. Better understanding of neural circuits also can provide the basis for innovative psychotherapeutic strategies that take advantage of brain plasticity for purposes of neurorehabilitation. In this book, we examine recent developments in the field of network neuroscience and their potential impact onclinical psychiatry, including the way that psychiatrists are trained and interact with other medical specialties and mental health professionals.

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Research in neuroscience is revolutionizing how we think about psychiatric diagnosis and treatment. Psychiatric disorders reflect dysfunction of the human mind and involve changes in cognition, emotion, and motivation. Understanding how the neural networks that underlie these mental functionsbecome dysfunctional holds great promise for...

Dr. Zorumski is the Samuel B. Guze Professor and Head of the Department of Psychiatry and Professor of Neurobiology at Washington University in St. Louis - School of Medicine, where he is also Psychiatrist-in-Chief at Barnes-Jewish Hospital and Director of the McDonnell Center for Cellular and Molecular Neurobiology. His research focu...

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Format:PaperbackDimensions:320 pages, 9.25 × 6.12 × 0.68 inPublished:February 7, 2014Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0199360561

ISBN - 13:9780199360567

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Table of Contents

1. Psychopathology 101a. Mental status examinationb. The nature of psychiatric symptoms: insights from behavioral neurologyc. Cognitive symptoms: psychotic and non-psychotic thinkingd. Disturbances in the form of thoughte. Disturbances in emotionsf. Disturbances in motivation: the role of salience and personalityg. Disturbances in memoryh. Points to remember2. Depression and Dementia: An Introduction to Systems Neuroscience and Psychiatrya. Some basic concepts about systems neuroscience and psychiatryb. Depressionc. Dementiasi. Dementia of the Alzheimer's type (DAT)ii. Behavioral variant frontotemporal dementia (bvFTD)d. Points to remember3. Systems Neuroscience and Psychiatry: Basic Principlesa. The brain is complex but not hopelessb. Network theory and brain systemsc. Organization of the braind. "Big picture" principles of brain functione. Basic principles of ICNsf. Points to remember4. Brain Networks and the Human Minda. Cognition (Thinking)i. Working memory and prefrontal cortex (PFC)ii. How does the brain select thought content?iii. PFC does more than working memoryiv. PFC and neuropsychiatric disordersv. Perception is cognitively complexvi. Lateralized brain function and cognitionvii. Intelligence and cognitive flexibilityb. Emotions: computing values and meaningi. What values, what meaning?ii. How are emotions processed?iii. Other emotions and other brain regionsiv. What triggers emotional responses in the brain?c. Motivation: the importance of having goalsi. How does motivation work?ii. What determines our expectations?d. Summary: a simplified overview of brain systems and minde. Points to remember5. Psychiatric Disorders and Brain Networksa. Psychiatric disorders and defects in mental error correctionb. Why do individuals with psychiatric disorders fail to correct mental errors?c. Rethinking psychiatric classification and endophenotypesd. What do we know about ICNs and psychiatric disorders?i. Cognitive disorders: psychosisii. Obsessive-compulsive disorder (OCD): cognitive or emotional disorder?iii. Anxiety disorders as primary emotional disordersiv. Emotional disorders: primary major depressionv. Motivational disorders: substance abusevi. Other abused drugs: hallucinogense. Summary: recurring themesf. Points to remember6. The Hippocampus: Synapses, Circuits, and Networksa. Why is the hippocampus important?b. What is the hippocampus?c. How does information flow within the hippocampal system?d. What do hippocampal subregions do?e. Synaptic plasticity: how the hippocampus learnsf. The hippocampus does not act aloneg. Sleep and the hippocampush. Neurogenesis (new neurons) and the hippocampusi. Information flow: a reprisej. Points to remember7. Network Dysfunction: Stress, Psychiatric Disorders and the Hippocampusa. Psychiatric disorders and structural changes in the hippocampusb. Causes of hippocampal changes in psychiatric illnessesc. The stressed hippocampus: lessons from animal modelsd. Recent human studies in mood and psychotic disorderse. Can defects in connectivity be corrected? Potential therapeutic targetsf. What about other brain regions and networks?g. Points to remember8. Genetics, Epigenetics, and Plasticitya. Genetics and psychiatryb. Epigenetics, the environment, and psychiatryc. Stress, allostasis, and psychiatryd. Molecules, networks, and treatmentse. Points to remember9. Conceptualizing causes of psychiatric disordersa. Developmental abnormalitiesb. Abnormalities of ICN connectivity that develop later in lifec. Abnormalities resulting from exogenous or endogenous substancesi. Exogenous substancesii. Endogenous substancesd. Abnormalities resulting from traumatic brain injurye. Abnormalities resulting from defects in brain metabolismf. Abnormalities due to agingg. Points to remember10. Neurotransmitters and Receptorsa. Neurotransmitters and receptorsi. The brain uses a variety of neurotransmittersii. Transmitters use a variety of receptorsb. Neurotransmitters and synapses: complex signaling devicesc. Transmitters, synapses, and brain rhythmsd. Why antidepressants take time to work while benzodiazepine anxiolytics act quicklye. Points to remember11. Methods of Determining Diagnosis and Causea. Current methods of diagnosisb. Current use of laboratory and imaging proceduresc. Current use of psychological testingd. Future approaches to diagnosise. Future trends related to psychiatric diagnosesf. Points to remember12. Why Do Some Psychiatric Disorders Become Chronic Problems?a. Problems with current treatments and practiceb. Brain mechanisms contributing to refractory illnessesc. Connectivity networks, brain mechanisms and refractory disordersi. Anosognosiaii. Anergiaiii. Amotivationiv. Aplasticityv. Asocialityd. How can psychiatry take advantage of synaptic plasticity?i. The brain needs to learnii. The brain needs noveltyiii. Social interactions are importantiv. Lifestyle can have huge and non-linear effects on outcomese. Points to remember13. Approaches to Treatmenta. Psychopharmacologyi. Mechanisms of actionii. Antidepressantsiii. Anxiolyticsiv. Antipsychoticsv. Mood stabilizersvi. Anti-dementia agentsvii. Stimulantsviii. Drugs of abuseb. Brain stimulation methodsi. Electroconvulsive therapy (ECT)ii. Vagus nerve stimulation (VNS)iii. Transcranial magnetic stimulation (TMS)iv. Deep brain stimulation (DBS)c. Psychotherapiesd. Lifestyle interventionse. Rehabilitative versus etiologic therapiesf. The role of the patient and others in treatmentg. Points to remember14. The Future of Psychiatrya. Psychiatry and clinical neuroscienceb. Psychiatric diagnosis and treatmentc. Psychiatry and rehabilitative medicined. Psychiatry and primary caree. Psychiatry and public healthf. Training future psychiatrists15. AppendixIndex