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Behavioral Health Forum: Integrating the Science and the Practice for the Future University of Texas MD Anderson Cancer Center Houston, Texas – June 8, 2012. Stuart C. Yudofsky , M.D. D.C. and Irene Ellwood Professor and Chair; Distinguished Service Professor; and

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Behavioral Health Forum:Integrating the Science and the Practice for the FutureUniversity of Texas MD Anderson Cancer CenterHouston, Texas – June 8, 2012

Stuart C. Yudofsky, M.D.

D.C. and Irene Ellwood Professor and Chair;

Distinguished Service Professor; and

Drs. Beth K. and Stuart C. Yudofsky Presidential Chair of Neuropsychiatry

Menninger Department of Psychiatry and Behavioral Sciences

Baylor College of Medicine

what is psychiatry
What is Psychiatry?
  • A specialty of medicine…
  • Dealing with dysfunctions and illness…
  • That affect behavior, mood, thought and perception…
what is the organ of psychiatry
What is the “organ” of Psychiatry?


1. We’re not urologists

2. We’re not cardiologists

the human brain
The Human Brain
  • 100 billion nerve cells-mostly neurons
  • Hundreds of trillions of synapses
  • 60 known neurotransmitters
  • 300 putative neurotransmitters
  • Enzymes
    • Synthesis
    • Degradation
  • Transport mechanisms, storage, and release
  • 2 to 10+ receptor subtypes
  • Second messenger systems
  • Ion channels-binary action potentials of axons
the dsm iv tr
  • Utilizes objectifiable clusters of signs and symptoms
  • To define specifically over 300 psychiatric illnesses
  • Common diagnostic language worldwide among mental health professionals
biopsychosocial approach
Biopsychosocial Approach

1. Biological features

  • Genetic predispositions
  • Brain lesions and disorders
  • Endocrine dysfunctions
  • Toxins (e.g. alcohol)
  • Somatic disorders (e.g. diabetic Ketoacidosis)
biopsychosocial approach1
Biopsychosocial Approach

2. Psychological features

a. Life experience

b. Memory stores

c. Unconscious processes

d. Thinking patterns

biopsychosocial approach2
Biopsychosocial Approach

3. Social features

a. Cultural effects

b. Family setting

c. Occupation

d. Interpersonal relationship

e. Spiritual life

f. Values

the human costs of mental illness and addictive disorders stigma
The Human Costs of Mental Illness and Addictive Disorders -Stigma-


Stigma, fear, and embarrassment are universally associated with mental illness.

Many Americans with treatable psychiatric disorders refuse to seek care.

a survey conducted by the national mental health association nhma of 1022 adults found
A survey conducted by the National Mental Health Association (NHMA) of 1022 adults found:

1. Half of American adults reported that they or a family member have suffered from depression.

2. Forty-three percent see depression as a “personal weakness,” with another 11% uncertain whether it is a personal weakness or a health problem.

3. Two-thirds of those suffering from depression will not seek treatment.

public perceptions of mental illness
Public Perceptions of Mental Illness

Due to Emotional Weakness


Caused by Bad Parenting


Victim’s Fault; Can will it Away




Consequence of

Sinful Behavior


Has Biological Basis; Involves the Brain


the good news about mental illness and psychiatry
The Good News About Mental Illness and Psychiatry
  • Through neuroscience discovery, important knowledge is being gained about the causes and effective treatments of psychiatric disorders.
  • Examples: 70% of the people with manic depression respond dramatically to lithium treatment.
  • The use of lithium has been estimated to have saved $6.5 billion annually in treatment costs alone.
the good news about mental illness and psychiatry1
The Good News About Mental Illness and Psychiatry
  • Between 80-90% of individuals suffering from major depression respond fully to psychiatric treatment that includes both medications and counseling.
the good news about mental illness and psychiatry2
The Good News About Mental Illness and Psychiatry
  • Increasingly neuroscience research is shedding light as to the causes of such illnesses as Alzheimer’s disease, schizophrenia, and even alcoholism and other substance use disorders.
  • These discoveries open the way to innovative pharmacologic and other types of biological interventions.
the promise of biological research
The Promise of Biological Research

1. Genetics

  • Localization on chromosomes of the genetic bases of specific psychiatric illness
  • Unlock physiological processes by which genes “trigger” psychiatric disorders
  • Development of tests to diagnose people at risk of transmitting severe psychiatric disorders

d. Development of more specific interventions

the promise of biological research1
The Promise of Biological Research

2. Neuroscience Discovery

a. Major technological advances in neuroscience research will be applied to psychiatric questions such as the development of pharmacologic and electrophysiologic treatments.

b. Example-Deep Brain Stimulation for major depression and OCD.

the promise of biological research2
The Promise of Biological Research

3. Brain Imaging

a. Magnetic Resonance Imaging (MRI)

b. Regional Cerebral Blood Flow (RCBF)

c. Positron Emission Tomography (PET)

d. Single Photon Emission Computer Tomography (SPECT)