Download APPsychSchizophrenia and mood dis

Disorders II: Mood Disorders
and Schizophrenia
Module 23
By Samantha Kops
Mood Disorders
• A Mood disorder is a prolonged and
disturbed emotional state that affects
all of a person’s thoughts and behaviors.
• The DSM-IV lists 10 different mood
disorders
• The three most common are Major
Depressive Disorder, Bipolar I (or
manic-depressive disorder) and
Dysthymic Disorder
Major Depressive Disorder
Major Depressive Disorder
is characterized by at least
2 weeks of being in a bad
mood, having no interest in
anything and getting no
pleasure in any activities.
Victims must also have 4 of
the following symptoms:
o Problems eating
o Problems sleeping
o Problems thinking
o Problems concentrating
o Problems making decisions
o Lacking energy
o Thoughts of suicide
o Feelings of worthlessness or
guilt
17% of surveyed adults
reported at least one
episode of major
depression
More common in women
than men (21% to 13%)
Bipolar I Disorder
• Bipolar I is marked by fluctuations between episodes of
depression and mania
• A manic episode goes on for about a week during which a
person is unusually euphoric, cheerful and high.
• Must have at least 3 of the following symptoms
Great self-esteem
Little need for sleep
Speaks rapidly and frequently
Has racing thoughts
Is easily distracted
Pursues pleasurable activities
•Less than 1% of the general population has bipolar I
disorder
Dysthymic Disorder
• Dysthymic Disorder is
characterized by
being chronically but
not continuously
depressed for a
period of 2 years.
• While depressed, the
person must
experience at least 2
of the following
symptoms:
 Poor appetite
 Insomnia
 Fatigue
 Low self-esteem
 Poor concentration
 Feelings of
hopelessness
• Afflicts 6% of
population
Causes of Mood Disorders
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About 15 million Americans develop a
mood disorder each year
2 categories of causes:
1.
Biological Factors
2.
Psychosocial Factors
Is not one or the other, both interact
to form causes of development of
disorder.
Mood Disorders
Biological Factors

A.
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The Biological Theory of Depression states that there are
underlying genetic, neurological and physiological factors
that may predispose a person to develop a mood disorder.
Genetic Factors
Studies with twins prove there is a genetic correlation
Study showed that if one twin has bipolar disorder:
- In identical twins, the other has an 80%
chance of developing the disorder
- In fraternal twins, the other has a 16%
chance of developing the disorder
Researchers have not yet identified the specific gene or
genes contributing the development of mood disorders.
Mood Disorders
Biological Factors
B. Neurological Factors
◊ Researchers have identified a certain
group of neurotransmitters involved in
mood disorders.
◊ Research has also found that the
prefrontal cortex area of the brain was
40% smaller in depressed patients.
Mood Disorders
Psychosocial Factors
Psychosocial factors including personality traits,
amount of social support and the ability to deal
with stressors are believed to interact with
predisposing biological factors, combining to put
one at risk to develop a mood disorder.
 Self-esteem plays an important role in
personality factors.
 Those with lower self-esteem create additional
stressors on themselves, thereby increasing the
chance of developing a mood disorder.

Treatment of Mood Disorders
• Due to their separate diagnosis, each disorder
is treated differently
• Most treatment combines drug therapy and
Psychotherapy
• If that does not work, some patients proceed to
Electroconvulsive Therapy
Drug Treatment
Antidepressant Drugs
• Antidepressants increase levels of a specific
group of neurotransmitters.
• They are commonly used on Major Depressive
Disorder and Dysthymic Disorder
• About 80% of prescribed antidepressants are
selective serotonin reuptake inhibitors
• These drugs work by raising serotonin levels
• Prozac is a popular one due to its lack of major
side-effects.
Drug Treatment
Lithium
 Lithium is a naturally
occurring mineral salt.
 Lithium is the most
effective treatment for
bipolar I disorder
because it reduces or
prevents manic
episodes.
 30-60% of bipolar
patients were greatly
helped by the use of
lithium.
 30-50% were partially
helped
 Has some serious side
effects including weight
gain and toxic effects
 Many bipolar patients
stop using lithium on
their own because they
miss the sense of
euphoria caused by
their manic episodes
Electroconvulsive Therapy
• Electroconvulsive Therapy or ECT is a last
resort effort to treat those with mood disorders
• Involves placing electrodes on the skull and
administering a mild electric current through the
brain, causing a seizure.
• Treatment consists of a
series of 10-12 ECT
sessions, about 3 per week.
Personality Disorders
 Personality Disorders are inflexible, longstanding, maladaptive traits that cause
significantly impaired functioning or great
distress in one’s personal and social life,
 Found in 12% of the adult population in the
United States
 Common in serial killers
 10 different types described in DSM-IV
Types of Personality Disorders
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Paranoid Personality Disorder: a pattern of distrust and
suspiciousness, often perceiving others as having evil
motives.( 0.5-2.5% of population)
Schizotypical PD: an acute discomfort in close
relationships, distortions in thinking, and eccentric
behavior.(3-5% of population)
Histrionic PD: excessive emotionality and attentionseeking. (2% of population)
Obsessive- Compulsive PD: an intense interest in being
orderly, achieving perfection, and having control. (4% of
population)
More Types of Personality Disorders
► Dependent
PD: A pattern of being
submissive and clingy because of an
excessive need to be taken care of. (2% of
population)
► Antisocial PD: A pattern of disregarding or
violating the rights of others without feeling
guilt or remorse. (3% of population,
predominantly males)
People with Personality Disorders
Individuals with Personality Disorders often
have one or more of the following:
Troubled childhoods
Childhood problems continuing to
adulthood
Maladaptive or poor personal relationships
Extreme abnormal behaviors
Antisocial Personality Disorder is most
commonly associated with serial killers and is
often covered in the media.
Antisocial Personality Disorder
•
Those diagnosed with antisocial personality disorder are
more commonly referred to as psychopaths or
sociopaths.
• Their symptoms form a continuum at which one end are
the chronic delinquents, bullies and lawbreakers; at
the other are the serial killers.
• Psychopaths have two common characteristics:
1) A Consistent pattern of disregard for the violation of the
rights and/or properties of others where they might steal,
harass or beat others, destroy property, kidnap or kill.
2) Their dishonesty, lying or deceitful manipulation of others
• Psychopaths are more likely to be men (2-4.5%) than
women (0.5-1%)
Psychopaths
Becoming a psychopath is caused by both
biological and psychological factors
Psychopaths are notoriously hard to treat due
to the fact that they usually are convincing
liars, have no guilt or remorse, impulsive and
reckless and fail to learn from experience.
Common treatment for psychopaths comes in
the form of serotonin-raising antidepressants.
Psychotherapy usually has little or no effect
Schizophrenia
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Schizophrenia is a serious
disorder lasting for at least
six months and including
at lest 2 of the following
symptoms:
Delusions
Hallucinations
Disorganized speech
Disorganized behavior
Decreased emotional
expression
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No two cases are exactly
alike
The DSM-IV describes 5
different subcategories of
schizophrenia.
The three most common
are paranoid,
disorganized and
catatonic.
Types of Schizophrenia
• Paranoid schizophrenia: Having auditory hallucinations
or delusions, such as thoughts of being persecuted by
others or thoughts of grandeur.
• Disorganized schizophrenia: marked by bizarre ideas,
often about one’s body (Ex: bones melting), confused
speech, childish behavior (giggling uncontrollably, making
faces at people), mood swings (fits or laughing or crying),
and extreme neglect of personal appearance and
hygiene.
• 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.
• Disordered thought processes and delusions are common
among all types or schizophrenics.
Classifying Schizophrenics
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The chances of recovery differ depending on the patient’s
symptoms.
Schizophrenics classified into two general categories
according to the connotations of their symptoms.
Type I schizophrenia includes having positive symptoms,
such as hallucinations and delusions which are distortions
of normal functions. This group has no intellectual
impairment, a good reaction to most medication, thus a
good chance of recovery.
Type II schizophrenia includes having negative symptoms
including dulled emotions and little inclination to speak,
which are a loss of normal functions. In addition, this
group has intellectual impairments, poor reactions to
medication, thus a poor chance of recovery.
Biological Causes of Schizophrenia
• A recent study with identical twins showed that if one twin
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was diagnosed with schizophrenia, then there was an 83%
chance that the other also had it.
This proved that some people inherit a predisposition for
the disease.
For the past 10 years, scientists have been searching for
genetic markers that might trigger the disease.
A newer theory is that a specific part of chromosome 6
could be associated with the disease.
Researchers believe that genetic factors act primarily
during the 20th-30th week of fetal development
Most scientists agree that a predisposition for
schizophrenia is often the result of faulty development of
certain structures of the brain; they develop it.
Neurological Causes of
Schizophrenia
• One study found that out of a pair of identical twins
(one with schizophrenia, one without) the diagnosed
one had larger ventricles.
• Many schizophrenics have a significantly smaller
thalamus, which may result in a defect in neural
circuitry.
• Some schizophrenics also a less active prefrontal
cortex than most healthy people.
♥♥ The Diathesis Stress Theory of schizophrenia states
that some people have a genetic predisposition that
interacts with life stressors to result in the onset and
development of schizophrenia.
Treatment of Schizophrenia
• Neuroleptic drugs are the most common
form of treatment for schizophrenia
• Neuroleptic drugs (or antipsychotic drugs)
are used to treat serious mental disorders,
like schizophrenia, by changing the levels
of neurotransmitters in the brain.
• There are two types: typical and atypical.
Neuroleptic Drugs
• Typical neuroleptic drugs
reduce the levels of the
neurotransmitter dopamine.
• Two of the most common
are phenothiazines and
butrophenones.
• These drugs reduce
positive symptoms and have
no effect on negative
symptoms.
• The dopamine theory
states that in
schizophrenia the dopamine
neurotransmitter is
overactive and results in a
wide range of symptoms.
• Atypical neuroleptic
drugs also lower
dopamine levels, but
more importantly lower
levels of other
neurotransmitters,
especially serotonin.
• One common group are
benzamides such as
clozapine.
• These drugs primarily
reduce positive
symptoms and may
slightly improve negative
symptoms.
Problems with Neuroleptic Drugs
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Typical neuroleptics, specifically phenothiazines, can produce
unwanted motor movements or tardive dyskinesia.
Tardive dyskinesia is the appearance of slow, involuntary, and
uncontrollable rhythmic movements and rapid twitching of the
mouth and lips as well as unusual movement of the limbs.
Usually associated with the usage of typical neuroleptics.
Atypical neuroleptics have a less chance in the development of
tardive dyskinesia, but a greater increase of side-effects
including:
- fatigue
- emotional indifference to one’s surroundings
- loss of white blood cells
Dissociative Disorders
 A Dissociative Disorder is characterized by a person having a
disruption, split, or breakdown is his or her normal integrated
self, consciousness, memory, or sense or identity.
 The DSM-IV lists 5 dissociative disorders however the 3 most
common are dissociative amnesia, dissociative fugue and
dissociative identity disorder.
 Dissociative Amnesia: is the inability to recall important
personal information or events and is usually associated with
stressful or traumatic events.
The importance or the extent of information forgotten
is too great to be explained by normal forgetfulness.
 Dissociative Fugue: is a disturbance marked by suddenly and
unexpectedly traveling away from home or place of work and
being unable to recall one’s past or may be confused about his
or her new, assumed identity.
Dissociative Identity Disorder
 Dissociative Identity Disorder: (formerly multiple
personality disorder) is the presence of two or more
distinct identities or personality states, each with its own
pattern or perceiving, thinking about, and relating to the
world.
Different personalities might take control of the
individual’s thoughts and behaviors at different times.
The personalities are often very different and complex
and the original personality is usually unaware of their
existence.
Two theories why:
1) A traumatic childhood episode split the identities
as a defense mechanism.
2)People are using it as an excuse to manipulate
others for personal gain. (Ex: in a court of law)
Majority of cases are women. (89%)
Depression
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Mild depression is generally has less of an impact on a
person’s functioning than Major Depression.
According to Beck’s theory of depression, we have
automatic negative thoughts that we rarely notice
throughout the day. These thoughts distort how we
perceive and interpret the world and influences our
behaviors and feelings, resulting in depression.
Depression can be more easily avoided through
improving social skills and increasing social support.