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Chapter XII Module 65
Chapter XII Module 65

... Major Depressive Disorder Major Depressive Disorder: A mood disorder in which a person experiences, in the absence of drugs or another medical condition for longer than two weeks. To understand what major depression is like imagine combining the anguish of grief with the sluggishness of bad jet lag ...
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...  May be admitted to an inpatient facility but must have an Axis I diagnosis also (alcoholism, depression and anxiety)  The most common personality disorder inpatient is Borderline Personality Disorder  Most are treated outpatient in individual or group therapy  May be in drug treatment center  ...
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... • Stressful events related to work, marriage and close relationships often precede depression • With each new generation, depression is striking earlier and affecting more people ...
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... • 5-10% will eventually be dx’d w/ Bipolar - more likely with: • onset of depression in adolescence • family history of Bipolar • ‘mixed features’ • dz course does not typically change as one ages • 6% lifetime Suicide risk (Davies S et al, 2001); u [15% w/ severe MDD] ...
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... focused on the relationship between types of worry and GAD. In the social and sociocultural dimensions stressful conditions such as poverty, poor housing, prejudice, and discrimination can also contribute to GAD. Treatments include Benzodiazepines which have been successful in treating GAD, but beca ...
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... traumas that are a metaphor for a history of woundedness. Working through the trauma inevitably activates work on developmental failures, helping people build strengths to not repeat childhood’s wounds in their life today. Finally, the individual develops the capacity to cope with life today in the ...
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... anxiety and excessive self-consciousness in everyday social situations. Social phobia can be limited to only one type of situation — such as a fear of speaking in formal or informal situations or eating or drinking in front of others — or, in its most severe form, may be so broad that a person exper ...
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... always been a visible tendency to immediate schizophrenia diagnosing in people coming from some culture origins (for example Afro-Caribbean). However, it probably does not prove the differences in frequency of schizophrenia occurrence, but rather shows lack of understanding of cultural distinctness. ...
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... If you encounter someone with antidepressant-induced mania, search very carefully for evidence of spontaneous episodes. It is important to ask about symptoms of depression. This is to rule out a mixed episode and also to see if there were prior episodes. Ask about current stressors Also make sure pa ...
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... primarily mean the medical condition of major depressive disorder. Psychiatric epidemiological studies indicate that depression now afflicts about 10 percent of adults in the United States each year and about a quarter of the population at some point in their lives. This number has been steadily gro ...
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... whether this will represent an overall advance on current systems remains to be seen, although the potential utility for mood disorders is clear. There have been a number of recent studies on people with apparent major depressive disorder who after more detailed enquiry clearly have some bipolar sym ...
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... Among patients with schizophrenia not only strictly symptom dimensions of schizophrenia are observed. For example, factor analytic studies of early and chronic schizophrenia both identify a positive symptom dimension that includes hallucinations and delusions,17,18 and a negative symptom dimension i ...
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Schizoaffective disorder



Schizoaffective disorder (abbreviated as SZA or SAD) is a mental disorder characterized by abnormal thought processes and deregulated emotions. The diagnosis is made when the patient has features of both schizophrenia and a mood disorder—either bipolar disorder or depression—but does not strictly meet diagnostic criteria for either alone. The bipolar type is distinguished by symptoms of mania, hypomania, or mixed episode; the depressive type by symptoms of depression only. Common symptoms of the disorder include hallucinations, paranoid delusions, and disorganized speech and thinking. The onset of symptoms usually begins in young adulthood, currently with an uncertain lifetime prevalence because the disorder was redefined, but DSM-IV prevalence estimates were less than 1 percent of the population, in the range of 0.5 to 0.8 percent. Diagnosis is based on observed behavior and the patient's reported experiences.Genetics, neurobiology, early and current environment, behavioral, social, and experiential components appear to be important contributory factors; some recreational and prescription drugs may cause or worsen symptoms. No single isolated organic cause has been found, but extensive evidence exists for abnormalities in the metabolism of tetrahydrobiopterin (BH4), dopamine, and glutamic acid in people with schizophrenia, psychotic mood disorders, and schizoaffective disorder. People with schizoaffective disorder are likely to have co-occurring conditions, including anxiety disorders and substance use disorder. Social problems such as long-term unemployment, poverty and homelessness are common. The average life expectancy of people with the disorder is shorter than those without it, due to increased physical health problems from an absence of health promoting behaviors including a sedentary lifestyle, and a higher suicide rate.The mainstay of current treatment is antipsychotic medication combined with mood stabilizer medication or antidepressant medication, or both. There is growing concern by some researchers that antidepressants may increase psychosis, mania, and long-term mood episode cycling in the disorder. When there is risk to self or others, usually early in treatment, brief hospitalization may be necessary. Psychiatric rehabilitation, psychotherapy, and vocational rehabilitation are very important for recovery of higher psychosocial function. As a group, people with schizoaffective disorder diagnosed using DSM-IV and ICD-10 criteria have a better outcome than people with schizophrenia, but have variable individual psychosocial functional outcomes compared to people with mood disorders, from worse to the same. Outcomes for people with DSM-5 diagnosed schizoaffective disorder depend on data from prospective cohort studies, which haven't been completed yet.In DSM-5 and ICD-9 (which is being revised to ICD-10, to be published in 2015), schizoaffective disorder is in the same diagnostic class as schizophrenia, but not in the same class as mood disorders. The diagnosis was introduced in 1933, and its definition was slightly changed in the DSM-5, published in May 2013, because the DSM-IV schizoaffective disorder definition leads to excessive misdiagnosis. The changes made to the schizoaffective disorder definition were intended to make the DSM-5 diagnosis more consistent (or reliable), and to substantially reduce the use of the diagnosis. Additionally, the DSM-5 schizoaffective disorder diagnosis can no longer be used for first episode psychosis.
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