Module 23

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Module 23

• Mood Disorders Schizophrenia

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MOOD DISORDERS

• Mood disorders
• Prolonged, disturbed emotional state that affects
  almost all of a persons thoughts, feelings, and
  behaviors
• Major depression
• Major depressive disorder
• Marked by at least two weeks of continually being
  in a bad mood, having no interest in anything,
  and getting no pleasure from activities
• Four of the following symptoms problems eating,
  sleeping, thinking, concentrating, or making
  decisions lacking energy thinking about
  suicide feeling worthless or guilty

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MOOD DISORDERS (CONTD)

• Bipolar I disorder
• Marked by fluctuations between episodes of
  depression and mania
• Manic episode goes on for at least a week during
  which a person is unusually euphoric, cheerful,
  and high
• Also has three of the following symptoms great
  self-esteem, little need for sleep, rapid speech
  and frequently racing thoughts, easily
  distracted, and in constant pursuit pleasurable
  activities

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MOOD DISORDERS (CONTD)

• Dysthymic disorder
• Characterized by being chronically but not
  continually depressed for a period of two years
• Person experiences at least two of the following
  poor appetite, insomnia, fatigue, low
  self-esteem, poor concentration, feelings of
  hopelessness

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MOOD DISORDERS (CONTD)

• Causes of mood disorders
• Biological factors underlying depression
• genetic, neurological, chemical, and
  physiological components that may predispose or
  put someone at risk for developing a mood
  disorder
• Psychosocial factors
• personality traits, cognitive styles, social
  supports, and the ability to deal with stressors
  interact with predisposing biological factors to
  put one at risk for developing mood disorders

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MOOD DISORDERS (CONTD)
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MOOD DISORDERS (CONTD)

• Treatment of mood disorders
• Major depression and dysthymic disorder
• antidepressant drugs
• increase levels of a specific group of
  neurotransmitters (monoamines-serotonin,
  norepinephrine, and dopamine) involved in the
  regulation of emotions and moods
• SSRIs
• selective serotonin reuptake inhibitors
• Prozac, Zoloft
• psychotherapy

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MOOD DISORDERS (CONTD)

• Treatment of mood disorders
• Bipolar I disorder
• past drug of choice was lithium (mood stabilizer)
• also included with lithium are antipsychotics and
  antidepressants
• Mania
• lithium has been found to be effective in
  treatment

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ELECTROCONVULSIVE THERAPY

• Definition and usage
• Electroconvulsive therapy, or ECT
• involves placing electrodes on the skull and
  administering a mild electric current that passes
  through the brain and causes a seizure
• treatment consists of 10 to 12 sessions about
  three times per week
• used when antidepressant medication fails to
  decrease depression
• serious side effect of ECT is memory loss

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ELECTROCONVULSIVE THERAPY (CONTD)
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ELECTROCONVULSIVE THERAPY (CONTD)

• Definition and usage
• New treatment
• Transcranial magnetic stimulation (TIMS)
• noninvasive technique that activates neurons by
  sending pulses of magnetic energy into the brain

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ELECTROCONVULSIVE THERAPY (CONTD)
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PERSONALITY DISORDERS

• Definition
• Inflexible, long-standing traits that
  significantly impair functioning or cause great
  distress in ones personal and social life
• DSM-IV-TR describes 10 personality disorders
• Seven of the most common types
• paranoid personality disorder
• pattern of distrust and suspiciousness and
  perceiving others as having evil motives
• schizotypical personality disorder
• acute discomfort in close relationships,
  distortions in thinking, and eccentric behavior

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PERSONALITY DISORDERS (CONTD)

• Seven common types
• histrionic personality disorder
• excessive emotionality and attention seeking
• obsessive-compulsive personality disorder
• intense interest in being orderly, achieving
  perfection, and having control
• dependent personality disorder
• pattern of being submissive and clingy because of
  an excessive need to be taken care of

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PERSONALITY DISORDERS (CONTD)

• Seven common types
• borderline personality disorder
• pattern of instability in personal relationships,
  self-image, and emotions, as well as impulsive
  behavior
• antisocial personality disorder
• refers to a pattern of disregarding or violating
  the rights of others without feeling guilt or
  remorse

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PERSONALITY DISORDERS (CONTD)

• Borderline personality disorder
• Treatment
• dialectical behavior therapy
• type of cognitive-behavioral therapy
• helps patient identify thoughts, beliefs, and
  assumptions that make their life challenging and
  teaches them different ways to think and react

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SCHIZOPHRENIA

• Definition and types
• Schizophrenia
• serious mental disorder that lasts for at least
  six months and includes at least two of the
  following symptoms delusions, hallucinations,
  disorganized speech, disorganized behavior, and
  decreased emotional expression
• symptoms interfere with personal or social
  functioning

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SCHIZOPHRENIA (CONTD)

• Subcategories of schizophrenia
• Paranoid schizophrenia
• characterized by auditory hallucinations or
  delusions, such as thoughts of being persecuted
  by others or thoughts of grandeur
• Disorganized schizophrenia
• marked by bizarre ideas, often about ones body
  (bones melting), confused speech, childish
  behavior, great emotional swings, and often
  extreme neglect of personal appearance and hygiene

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SCHIZOPHRENIA (CONTD)

• Subcategories of schizophrenia
• Catatonic schizophrenia
• characterized by periods of wild excitement or
  periods of rigid, prolonged immobility
• sometimes the person assumes the same frozen
  posture for hours on end

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SCHIZOPHRENIA (CONTD)

• Chance of recovery
• Type I schizophrenia
• includes having positive symptoms, such as
  hallucinations and delusions
• distortion of normal functioning
• no intellectual impairment, good reaction to
  medication
• good chance of recovery

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SCHIZOPHRENIA (CONTD)

• Chance of recovery
• Type II schizophrenia
• includes having negative symptoms, such as dulled
  emotions and little inclination to speak, which
  are a loss of normal functions
• has intellectual impairment
• poor reaction to medication
• poor chance for recovery

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SCHIZOPHRENIA (CONTD)

• Symptoms
• Disorder of thought, attention, and perception
  (hallucinations)
• Motor disorders
• Emotional (affective) disorders
• Biological causes
• Genetic predisposition
• Genetic markers
• identifiable gene(s) or a specific segment of a
  chromosome directly linked to some behavioral,
  physiological, or neurological trait or disease

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SCHIZOPHRENIA (CONTD)
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SCHIZOPHRENIA (CONTD)

• Neurological causes
• Ventricle size
• 80 of brains of schizophrenics show larger than
  normal ventricles
• Frontal lobe prefrontal cortex
• less activation of the prefrontal cortex
• frontal and temporal lobes are smaller

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SCHIZOPHRENIA (CONTD)
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SCHIZOPHRENIA (CONTD)

• Environmental causes
• Incidences of stressful events and how
  individuals cope
• Hostile parents, poor social relations, the death
  of a parent or loved one, and career or personal
  problems can contribute to the development and
  onset of schizophrenia
• Diathesis stress theory
• some people have a genetic predisposition (a
  diathesis) that interacts with life stressors to
  result in the onset and development of
  schizophrenia

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SCHIZOPHRENIA (CONTD)

• Treatments
• Positive symptoms of schizophrenia
• reflect a distortion of normal functions
  distorted thinking results in delusions
  distorted perceptions result in hallucinations
  distorted language results in disorganized speech
• Negative symptoms of schizophrenia
• reflect a decrease in, or loss of, normal
  functions decreased range and intensity of
  emotions decreased ability to express thoughts
  and decreased initiative to engage in
  goal-directed behaviors

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SCHIZOPHRENIA (CONTD)

• Treatments
• Neuroleptic drugs (also called antipsychotic
  drugs)
• used to treat serious mental disorders, such as
  schizophrenia, by changing the levels of
  neurotransmitters in the brain
• Typical neuroleptics
• primarily reduce levels of the neurotransmitter
  dopamine
• Dopamine theory
• dopamine neurotransmitter system is somehow
  overactive and gives rise to a wide range of
  symptoms

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SCHIZOPHRENIA (CONTD)

• Treatments
• Atypical neuroleptics
• clozapine and risperidone lower levels of
  dopamine and also reduce levels of other
  neurotransmitters, especially serotonin
• reduce positive symptoms, may improve negative
  symptoms, and reduce relapse

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SCHIZOPHRENIA (CONTD)

• Evaluation of neuroleptic drugs
• Typical neuroleptics
• phenothiazines
• can produce unwanted motor movements
• Tardive dyskinesia
• appearance of slow, involuntary, and
  uncontrollable rhythmic movements and rapid
  twitching of the mouth and lips, as well as
  unusual movements of the limbs

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SCHIZOPHRENIA (CONTD)

• Evaluation of neuroleptic drugs
• Atypical neuroleptics
• risperidone, olanzapine
• very low rate of tardive dyskinesia
• can cause increased levels of glucose or blood
  sugar (hyperglycemia), excessive weight gain, and
  onset of, or worsening of, diabetes

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DISSOCIATIVE DISORDER

• Definition
• Characterized by a person having a disruption,
  split, or breakdown in his or her normal
  integrated self, consciousness, memory, or sense
  of identity
• Dissociative amnesia
• Characterized by the inability to recall
  important personal information or events and is
  usually associated with stressful or traumatic
  events
• Dissociative fugue
• Disturbance marked by suddenly and unexpectedly
  traveling away from home or place of work and
  being unable to recall ones past

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DISSOCIATIVE DISORDER (CONTD)

• Dissociative identity disorder
• Formerly called multiple personality disorder
• Presence of two or more distinct identities or
  personality states, each with its own pattern of
  perceiving, thinking about, and relating to the
  world