TYPES OF MENTAL ILLNESS

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TYPES OF MENTAL ILLNESS
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SCHIZOPHRENIA
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DISABILITIES

• POOR SOCIAL, FAMILY, AND WORK RELATIONSHIPS
• SIDE EFFECTS OF MEDICATION
• VIOLENCE WHEN IN PSYCHOTIC STATE
• SOCIAL STIGMA

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CAUSES

• USED TO THINK BAD FAMILIES WERE CAUSE
  (SCHIZOPHRENOGENIC MOTHER)
• NOW THOUGHT TO BE BRAIN DISORDER WITH GENETIC OR
  BIOLOGICAL CAUSE

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CORRELATES

• ABOUT 1 PREVALENCE IN WIDE VARIETY OF TIMES AND
  PLACES
• NO SEX DIFFERENCES
• NO ETHNIC DIFFERENCES
• NO INTELLIGENCE DIFFERENCES
• EARLY ONSET - 16-25 YEARS
• LOWER SOCIAL CLASS - CAUSE?
• FEW ARE MARRIED

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PROGNOSIS (COURSE)

• USED TO THINK DEGENERATIVE
• NOW THOUGHT TO BE VARIABLE
• 1/3 CHRONIC 1/3 EPISODIC 1/3 RECOVER
• HIGH RATE OF SUICIDE - 10

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TREATMENT

• USED TO BE LONG STAYS IN MENTAL HOSPITALS
• NOW BRIEF, EPISODIC HOSPITAL STAYS ALONG WITH
  COMMUNITY TREATMENT (OR NEGLECT)
• MEDICATION SINCE 1950S
• PHENOTHIAZINES AND CLOZAPINE

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TREATMENT

• MEDICATION DOESNT CURE, BUT CONTAINS - BUT MUST
  TAKE IT
• PSYCHOSOCIAL TREATMENTS - SOCIAL AND JOB SKILLS,
  HOUSING
• PSYCHOTHERAPY LESS CRITICAL
• HARDEST TO TREAT - MICA (MENTALLY ILL CHEMICAL
  ABUSERS)

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MAJOR PROBLEMS

• INADEQUATE FUNDING FOR TREATMENT
• MANY DONT ADMIT THAT THEY ARE ILL - STOP TAKING
  MEDICATIONS
• WHEN GET IN TROUBLE PUT IN JAILS AND PRISONS

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BI-POLAR DISORDER
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DYSREGULATION OF MOOD

• ALTERATIONS OF WILD ELATION AND DEEP DEPRESSION
• CAN BE ACCOMPANIED BY DELUSIONS AND
  HALLUCINATIONS
• VERY DIFFERENT INTERPERSONALLLY THAN
  SCHIZOPHRENIA - CONNECTEDNESS

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MANIC PHASE

• SUPER-CHARGED ENERGY WHEN MANIC (67)
• CREATES BEHAVIOR PROBLEMS (74)
• CAN BE VIOLENT (120)
• HIGH RATE OF ALCOHOL AND DRUG ABUSE
• HIGH CREATIVITY AND PRODUCTIVITY

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DEPRESSIVE PHASE

• TOTAL BLEAKNESS WHEN DEPRESSED (111)
• HIGH RATE OF SUICIDE

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CAUSE

• RUNS IN FAMILIES
• PROBABLE GENETIC CAUSE
• SEEMS TO BE UNIVERSAL

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CORRELATES

• PREVALENCE BETWEEN 1/2 TO 1
• NO SOCIAL CLASS DIFFERENCES
• NO ETHNIC DIFFERENCES
• SLIGHT SEX DIFFERENCE
• ONSET WAS 30-50 BUT GETTING YOUNGER

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COURSE AND TREATMENT

• HIGHLY VARIABLE COURSE, BUT USUALLY CHRONIC
• MUCH HIGHER SOCIAL FUNCTIONING THAN SCHIZOPHRENIA
• LITHIUM MOST COMMON TREATMENT SINCE 1950S
• CAN CONTROL CYCLES

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JAMISON - UNQUIET MIND

• DIFFICULTIES OF TREATMENT
• AMBIVALENCE TOWARD MEDICATION (98)
• IMPORTANCE OF SOCIAL SUPPORT - INFORMAL AND
  PROFESSIONAL
• YAVI ASPECT?

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DEPRESSION
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DEPRESSION

• MUCH MORE COMMON THAN SCHIZ AND BIPOLAR
• 10 EACH YEAR 20 OVER LIFETIME
• SEEMS TO BE INCREASING

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Depression Articles 1966-2001
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Treatment for Depression
Kessler et al. 2003
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Diagnoses in Psychotherapy
Olfson et al. 2002
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MOOD

• EITHER (OR BOTH) PRESENCE OF NEGATIVE MOOD
• OR ABSENCE OF POSITIVE MOOD

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PHYSICAL SYMPTOMS

• LOW ENERGY, FATIGUE
• SLEEP DISTURBANCES
• APPETITE DISTURBANCES
• VULNERABILITY TO MANY PHYSICAL ILLNESSES

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PSYCHOLOGICAL SYMPTOMS

• EMOTIONAL - SADNESS, APATHY, LACK OF PLEASURE
• COGNITIVE - HOPELESSNESS AND HELPLESSNESS, LOW
  SELF-ESTEEM
• BEHAVIORAL - WITHDRAWAL, SUICIDE ATTEMPTS

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TYPES

• MAJOR DEPRESSION - ABOVE
• PSYCHOTIC - MORE SEVERE, IMMOBILE, SUICIDAL
• DYSTHYMIC - LONGER LASTING (TWO YEARS) FEWER
  SYMPTOMS
• DISTRESS - REACTIVE TO LIFE EVENT, NOT A DISORDER

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CAUSES

• VARIED
• SOME GENETIC
• EARLY LOSS EVENTS AND ABUSE
• CURRENT LOSSES AND TRAUMAS

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CHARACTERISTICS

• GREAT VARIANCE ACROSS SOCIETIES (3 - 30)
• 2/3 WOMEN
• INVERSE WITH SOCIAL CLASS
• MOST AMONG YOUNG, ELDERLY

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PROGNOSIS (COURSE)

• COURSE HIGHLY VARIABLE
• OFTEN FREQUENT AND CHRONIC
• OFTEN ENDS WITH FRESH START EVENTS

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TREATMENT

• TREATED WITH SELECTIVE SEROTONIN REUPTAKE
  INHIBITORS (SSRI) - PROZAC, PAXIL, XOLOFT

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TREATMENT

• COGNITIVE THERAPY
• PSYCHOTHERAPY
• COMBINATION OF THERAPIES