Unit 1.

2
Biological Implications and
Predisposing Factors
NFDN 2007
Karen Joy
2019
Role Of Neurotransmitters And
Endocrine Functioning In The
Development Of Common Mental Health
Disorders
How neurotransmitters effects can be found in mental health disorders
SLO 1
 Synaptic Transmission

• CNS/PNS/ANS
• Neurotransmitters: Small molecules directly or
indirectly responsible for opening or closing ion
channels.
•  The chemical messengers released from neurons at
synapses so that they can “talk” to neighboring cells. 

• Influx of Ca++ into the neuron stimulates release of

neurotransmitters into the synapse.
• Receptors: Proteins for specific neurotransmitter,
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“lock and key.”
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Receptors

• Sensitivity can change, developing either a greater or a

lesser response to the neurotransmitter.
• Receptor subtypes:
• Each major neurotransmitter has several different subtypes for
the chemical, allowing for different effects on the brain.
• Each major neurotransmitter has several different subtypes
(e.g., dopamine: D1, D2).
• They are also classified by whether their action causes
physiologic activity to occur (excite) or to stop occurring (inhibit)
• The development of mental illness and the medications used to
treat the mental illness commonly are excitatory except, GABA,
which is inhibitory.
Neurotransmitter Criteria

• Synthesized inside the neuron.

• Present in the presynaptic terminal.
• Released into the synaptic cleft, causing a particular
effect on the postsynaptic receptors.
• An exogenous form of the chemical can be administered
as a drug, which causes identical action.
• Neurotransmitters
• Excitatory: causes activity to occur
• Inhibitory: causes activity to decrease
• *This is what common medications “work” on
Cholinergic Receptor

• ACh primary cholinergic neurotransmitter

• Communication – PNS
• Decrease in neuron loss – Alzheimer’s and Down’s
syndrome – memory difficulties and other cognitive deficits.
• Many psychiatric medications are anticholinergic – block
effects of Ach.
• Side effects:
• Dry mouth, blurred vision, constipation, urinary retention,
tachycardia – severe confusion and delirium – older patients

• See page 161 text

 Biogenic Amines (Bioamines)

• Consist of small molecules that contain an amine

group.
• Dopamine
• Norepinephrine
• Epinephrine
• Serotonin
• Histamine (not discussed this class)

Most central to current reasons of

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 Dopamine
• An excitatory transmitter
• Involuntary movement
• Different pathways –
• linked to reward system
• strongly influences emotions – memory and auditory
• Lower levels – Parkinson’s – shakiness/trembling
• Higher levels – Schizophrenia – emotions/auditory hallucinations
• Severe side effects from antipsychotic medications
 Norepinephrine

• An excitatory transmitter
• Play a major role in mood states.
• Decreased levels associated with depression
• increased levels associated with mania.
• Process of reinforcement – facilitates learning
• Pathways - the sleep/wake cycle and fight or flight
• Fight or flight response to threats in the
environment – plays a role in the physical
symptoms of anxiety
 Epinephrine
• Very similar to norepinephrine chemically; except only very small
amounts are produced and released into the brain.
• Few neurons use it as a neurotransmitter; the ones that do are
located in the pons and the medulla.
• Found in much higher concentrations in the rest of the body
(adrenal glands) for “fight or flight”
 Serotonin
• Excitatory neurotransmitter
• Involved in regulation of emotion, cognition,
sensory perceptions, sleep, and appetite
• Involved in control of food intake, hormone
secretion, sexual behaviour, thermoregulation,
cardiovascular regulation (constriction), and
pain control
• Decreased levels associated with depression
and insomnia
• Increased levels associated with mania
• Dysfunction of pathways – obsessive-
compulsive disorder
• Numerous subtypes of receptors control of:
• Anxiety, aggression and depression
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 Amino acids
• Are building blocks of protein.
• Function as neurotransmitters in many sites in the brain
• Coexist with other neurotransmitters
• Two types
• GABA
• Glutamate
Gamma-Aminobutyric Acid (GABA)

• Inhibitory neurotransmitter for the CNS

• Inhibitory role in control of spinal reflexes and cerebellar
reflexes
• Major role in control of neuronal excitability through the
brain (decreases feelings of fear and anxiety)
• Inhibits activity of i.e. Dopamine provides balance
• Levels drop – threatened – anxiety disorder.
• Decreased GABA activity – seizure disorders
• Receptor sites :
• Alcohol, anesthetics, antianxiety drugs, sedative-hypnotic
drugs
• Alcohol is frequently used to self-treat anxiety
 New Fields of Study

• Psychoendocrinology
• Examines relationships between the nervous system,
endocrine system and behaviour
• Addison’s disease – depression, apathy, fatigue and
psychosis
• Hypothyroidism – depression and some anxiety
• Steroids – depression, hypomania, irritability and
psychosis
• Diagnostic approaches
• Biologic markers
• Lab tests – blood and urine
• Electroencephalography (EEG)
 Question

• Which neurotransmitter has a direct effect on the

sleep/wake cycle?
A. GABA
B. Histamine
C. Acetylcholine
D. Norepinephrine
Answer

• D. Norepinephrine

• Rationale: Norepinephrine projects pathways in the

locus ceruleus that are involved in the sleep/wake
cycle, among its many stimulatory effects.
 Foundation of Biologic Basis of Behaviour, Emotions and Cognition

• Symptom Expression
• Term referring to the behavioural symptoms seen in mental
illness
• Link to the neurobiologic basis of the symptom

• Symptoms
• Patients’ psychiatric symptoms – what are they displaying?
• The probable alterations in brain functioning linked to those
symptoms
• The rationale for treatment and care practices
 Foundation of Biologic Basis of
Behaviour, Emotions and Cognition
• Genetics
• Increased risk for developing the mental disorder if in your family.
• Environment also plays a key role
• May be genetic, biologic, psychological, or social.

• Families who have one member with one major mental disorder have in
increased risk for the same disorder:
• Schizophrenia
• Bipolar disorder
• Panic disorder

• See page 115 of text

 Structural Neuroimaging

• Allows for visualization of the brain

• Commonly used techniques:
• Computed tomography (CT)
• X-rays and computers
• Iodinated contrast materials administered IV
• Magnetic resonance imaging (MRI)
• Place the patient in long tube with magnets
• Can reconstruct three-dimensional structures
• More costly and complicated than CT
Functional Neuroimaging

• Measurement of physiologic activities

• Two primary imaging procedures (both require
administration of radioactive materials):
• Positron emission tomography (PET).
• Single photon emission computed tomography (SPECT).
• The patient can perform functions during this time.
Question

• MRIs and CTs are used to do which of the following

tasks?
A. Structural neuroimaging
B. Functional neuroimaging
C. Psychological neuroimaging
D. Profiling
Answer

• A. Structural neuroimaging

• Rationale: MRIs and CTs are used for structural

imaging. PET and SPECT scans are used in functional
imaging. Psychological imaging is accomplished by
communication with the patient.
Questions?