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Chapter 21 Mental Health Diseases and Disorders Copyright Copyright © 2010 © 2010 Delmar, Delmar, Cengage Cengage Learning. Learning. ALLALL RIGHTS RIGHTS RESERVED. RESERVED. Common Signs and Symptoms • Typically begin with behavioral changes • Slow-developing and very subtle • May not be noticed early in development of disorder • Forgetfulness, anxiety, and temper tantrums Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diagnostic Tests • Physiologic tests – Brain scans, EEGs, and MRIs • Referral to psychiatrist for psychological testing – Aptitude and personality tests Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Developmental Mental Health Disorders • Intellectual disability – Formerly known as mental retardation – Symptoms: • Decreased intelligence • Decreased ability to learn, socialize, and mature – Known causes: • Genetic • Acquired Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Developmental Mental Health Disorders • Attention deficit hyperactivity disorder – Symptoms: • Inability to concentrate • Hyperactivity • Impulsiveness – Cause unknown, but seems familial – Treatment: • Amphetamines Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Developmental Mental Health Disorders • Eating disorders – Compulsion to eat or avoid eating that affects individual’s mental and physical condition – Most common: • Anorexia nervosa • Bulimia Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Developmental Mental Health Disorders • Tic disorders – Sudden, rapid muscle movement or vocalization • E.g., eye blinking, facial grimacing, neck or shoulder jerking, throat clearing, snorting, grunting • Enuresis – Bedwetting – Urinary incontinence after toilet training Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Substance-Related Mental Disorders • Diagnosis used – Instead of drug addiction • Common terms: – – – – Addiction Dependency Tolerance Withdrawal Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Substance-Related Mental Disorders • Alcohol – Alcoholism • Physical and mental dependence on alcohol – Chronic – Progressive – Often fatal Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Substance-Related Mental Disorders • Marijuana – Also known as pot – Euphoric effect • Cocaine – Accelerant to CNS and anesthetic Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Substance-Related Mental Disorders • Methamphetamine – Fastest growing abused drug today – Addictive potent CNS stimulant • Caffeine and nicotine – Most common addictive substances • Sedatives or depressants – Anti-anxiety medications Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Substance-Related Mental Disorders • Amphetamines – Release epinephrine leading to increased heart rate, respiration, and digestion • Hallucinogens – Also known as psychedelic drugs – E.g., lysergic acid diethylamide (LSD), mescaline, phencyclidine (PCP) Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Substance-Related Mental Disorders • Narcotics – Depressants primarily prescribed as analgesics – E.g., heroin, opium • Inhalants – Abused legal substances – Taken by huffing, snuffing, and bagging – E.g., glue, nail polish, lighter fluid Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Substance-Related Mental Disorders • Anabolic steroids – Abused by athletes to produce increases in muscle strength, lean body mass, and improved performance – Dangerous long-term effects Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Organic Mental Disorders • Associated with physical cause • Affect cognition and ability to think, remember, and make judgments • May be temporary or permanent Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Organic Mental Disorders • Dementia – Deterioration of mental abilities due to physical changes in brain • Delirium – Acute condition from medications, alcohol, fever, or illness • Alzheimer’s disease – Progressive, irreversible form of dementia Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Psychosis • • • • Disintegration of one’s personality Impaired communication skills Inability to deal with life’s demands Delusions and hallucinations Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Psychosis • Schizophrenia – Loss of touch with reality – Delusions • Delusional disorders – Belief in delusion in otherwise normally adjusted and balanced personality – Treatment: • Antipsychotic medications Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Psychosis • Delusional disorders – Types: • • • • • Grandiose Jealous Erotomanic Persecutory Somatic Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mood or Affective Disorders • Depression – Prolonged feeling of extreme sadness, unhappiness, despair, or discouragement • Seasonal affective disorder – Depressive condition during winter months Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mood or Affective Disorders • Bipolar disorder (manic depressive) – Extreme depression and mania occur – Mood disorder questionnaire (MDQ) aids physician in identifying symptoms Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Dissociative Disorders • Changes in identity or consciousness • Types: – – – – Psychogenic amnesia Psychogenic fugue Depersonalization Multiple personality Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anxiety Disorders • Anxiety – Usual temporary response to stress becomes chronic • May be related to genetic factors, severe stress, biochemical alterations, and in some cases, physical causes – E.g., hyperthyroidism Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anxiety Disorders • Types: – – – – – Generalized anxiety disorder Panic disorder Phobia disorder Obsessive-compulsive disorder Post-traumatic stress disorder Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Somatoform Disorders • Physical symptoms, but no organic cause found • Conversion – Hysterical neurosis • Hypochondriasis – Abnormal anxiety about one’s body and health Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Somatoform Disorders • Pain disorder – Pain does not have physiologic cause • Malingering – False display of symptoms for financial or personal reward • Munchausen syndrome – Simulation of illness for no other reason than to receive treatment Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Personality Disorders • Types: – – – – – Paranoid Schizoid Antisocial Narcissistic Histrionic Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Gender Identity Disorder • Individual uncomfortable or distressed with sexual identity • Adults may seek hormonal or surgical intervention for sex change Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Sexual Disorders • Types: – – – – Exhibitionism Fetishism Transvestic fetishism Frotteurism Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Sexual Disorders • Types: – – – – Pedophilia Sexual sadism Sexual masochism Voyeurism Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Sleep Disorders • Types: – – – – – – Insomnia Narcolepsy Sleep apnea Nightmare disorder Sleep terror Sleepwalking Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma • Grief – Natural process of coping with loss • Suicide – Major concern with teenagers Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. The Older Adult • Disorders may occur in early childhood or later in life • Important to distinguish if actual mental health problem or physiologic or system-specific disorder • Some symptoms due to aging process or side effects of medications Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.