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Disorders II: Mood Disorders and Schizophrenia Module 23 By Samantha Kops

Disorders II: Mood Disorders and Schizophrenia

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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 - PowerPoint PPT Presentation

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Page 1: Disorders II: Mood Disorders and Schizophrenia

Disorders II: Mood Disorders and Schizophrenia

Module 23

By Samantha Kops

Page 2: Disorders II: Mood Disorders and Schizophrenia

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

Page 3: Disorders II: Mood Disorders and Schizophrenia

Major Depressive DisorderMajor Depressive DisorderMajor Depressive Major Depressive Disorder is characterized Disorder is characterized by at least 2 weeks of by at least 2 weeks of being in a bad mood, being in a bad mood, having no interest in having no interest in anything and getting no anything and getting no pleasure in any activities. pleasure in any activities.

Victims must also have 4 Victims must also have 4 of the following of the following symptoms:symptoms:

o Problems eatingProblems eatingo Problems sleepingProblems sleepingo Problems thinkingProblems thinking

o Problems concentratingProblems concentratingo Problems making decisionsProblems making decisions

o Lacking energyLacking energyo Thoughts of suicideThoughts of suicide

o Feelings of worthlessness or Feelings of worthlessness or guiltguilt

17% of surveyed adults 17% of surveyed adults reported at least one reported at least one episode of major episode of major depressiondepression

More common in More common in women than men (21% women than men (21% to 13%)to 13%)

Page 4: Disorders II: Mood Disorders and Schizophrenia

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

Page 5: Disorders II: Mood Disorders and Schizophrenia

Dysthymic DisorderDysthymic 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 InsomniaFatigue

Low self-esteemPoor concentration

Feelings of hopelessness

• Afflicts 6% of population

Page 6: Disorders II: Mood Disorders and Schizophrenia

Causes of Mood Disorders About 15 million Americans

develop a mood disorder each year 2 categories of causes:

1. Biological Factors2. Psychosocial Factors

Is not one or the other, both interact to form causes of development of disorder.

Page 7: Disorders II: Mood Disorders and Schizophrenia

Mood DisordersBiological Factors 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.

A. 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.

Page 8: Disorders II: Mood Disorders and Schizophrenia

Mood DisordersBiological 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.

Page 9: Disorders II: Mood Disorders and Schizophrenia

Mood DisordersMood DisordersPsychosocial FactorsPsychosocial Factors

Psychosocial factors including personality Psychosocial factors including personality traits, amount of social support and the traits, amount of social support and the ability to deal with stressors are believed to ability to deal with stressors are believed to interact with predisposing biological factors, interact with predisposing biological factors, combining to put one at risk to develop a combining to put one at risk to develop a mood disorder. mood disorder.

Self-esteem plays an important role in Self-esteem plays an important role in personality factors.personality factors.

Those with lower self-esteem create Those with lower self-esteem create additional stressors on themselves, thereby additional stressors on themselves, thereby increasing the chance of developing a mood increasing the chance of developing a mood disorder. disorder.

Page 10: Disorders II: Mood Disorders and Schizophrenia

Treatment of Mood DisordersTreatment of Mood Disorders

• Due to their separate diagnosis, each Due to their separate diagnosis, each disorder is treated differentlydisorder is treated differently

• Most treatment combines drug Most treatment combines drug therapy and Psychotherapytherapy and Psychotherapy

• If that does not work, some patients If that does not work, some patients proceed to Electroconvulsive Therapyproceed to Electroconvulsive Therapy

Page 11: Disorders II: Mood Disorders and Schizophrenia

Drug TreatmentAntidepressant 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.

Page 12: Disorders II: Mood Disorders and Schizophrenia

Drug TreatmentDrug TreatmentLithiumLithium Lithium is a naturally Lithium is a naturally

occurring mineral salt.occurring mineral salt. Lithium is the most Lithium is the most

effective treatment for effective treatment for bipolar I disorderbipolar I disorder because it reduces or because it reduces or prevents manic prevents manic episodes. episodes.

30-60% of bipolar 30-60% of bipolar patients were greatly patients were greatly helped by the use of helped by the use of lithium.lithium.

30-50% were partially 30-50% were partially helpedhelped

Has some serious side Has some serious side effects including effects including weight gain and toxic weight gain and toxic effectseffects

Many bipolar patients Many bipolar patients stop using lithium on stop using lithium on their own because their own because they miss the sense of they miss the sense of euphoria caused by euphoria caused by their manic episodestheir manic episodes

Page 13: Disorders II: Mood Disorders and Schizophrenia

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.

Page 14: Disorders II: Mood Disorders and Schizophrenia

Personality Disorders

Personality Disorders are inflexible, long-standing, 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

Page 15: Disorders II: Mood Disorders and Schizophrenia

Types of Personality Types of Personality DisordersDisorders

► Paranoid Personality DisorderParanoid Personality Disorder:: a pattern of a pattern of distrust and suspiciousness, often perceiving others distrust and suspiciousness, often perceiving others as having evil motives.( 0.5-2.5% of population)as having evil motives.( 0.5-2.5% of population)

► Schizotypical PDSchizotypical PD:: an acute discomfort in close an acute discomfort in close relationships, distortions in thinking, and eccentric relationships, distortions in thinking, and eccentric behavior.(3-5% of population) behavior.(3-5% of population)

► Histrionic PDHistrionic PD:: excessive emotionality and excessive emotionality and attention-seeking. (2% of population)attention-seeking. (2% of population)

► Obsessive- Compulsive PDObsessive- Compulsive PD:: an intense interest in an intense interest in being orderly, achieving perfection, and having being orderly, achieving perfection, and having control. (4% of population)control. (4% of population)

Page 16: Disorders II: Mood Disorders and Schizophrenia

More Types of Personality More Types of Personality DisordersDisorders

►Dependent PDDependent PD:: A pattern of being A pattern of being submissive and clingy because of an submissive and clingy because of an excessive need to be taken care of. excessive need to be taken care of. (2% of population) (2% of population)

►Antisocial PDAntisocial PD:: A pattern of A pattern of disregarding or violating the rights of disregarding or violating the rights of others without feeling guilt or remorse. others without feeling guilt or remorse. (3% of population, predominantly (3% of population, predominantly males)males)

Page 17: Disorders II: Mood Disorders and Schizophrenia

People with Personality Disorders

Troubled childhoodsChildhood problems continuing to adulthoodMaladaptive or poor personal relationships

Extreme abnormal behaviors

Individuals with Personality Disorders often have one or more of the following:

Antisocial Personality Disorder is most commonly associated with serial killers and is often covered in the media.

Page 18: Disorders II: Mood Disorders and Schizophrenia

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%)

Page 19: Disorders II: Mood Disorders and Schizophrenia

PsychopathsPsychopathsBecoming a psychopath is caused by both Becoming a psychopath is caused by both biological and psychological factorsbiological and psychological factors

Psychopaths are notoriously hard to treat Psychopaths are notoriously hard to treat due to the fact that due to the fact that they usually are they usually are convincing liars, have no guilt or remorse, convincing liars, have no guilt or remorse, impulsive and reckless and fail to learn impulsive and reckless and fail to learn from experience. from experience.

Common treatment for psychopaths Common treatment for psychopaths comes in the form of serotonin-raising comes in the form of serotonin-raising antidepressants. antidepressants.

Psychotherapy usually has little or no Psychotherapy usually has little or no effecteffect

Page 20: Disorders II: Mood Disorders and Schizophrenia

Schizophrenia 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

No two cases are exactly alike

The DSM-IV describes 5 different subcategories of schizophrenia.

The three most common are paranoid, disorganized and catatonic.

Page 21: Disorders II: Mood Disorders and Schizophrenia

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.

Page 22: Disorders II: Mood Disorders and Schizophrenia

Classifying SchizophrenicsClassifying Schizophrenics The chances of recovery differ depending on the The chances of recovery differ depending on the

patient’s symptoms.patient’s symptoms. Schizophrenics classified into two general categories Schizophrenics classified into two general categories

according to the connotations of their symptoms.according to the connotations of their symptoms. Type I schizophreniaType I schizophrenia includes having positive includes having positive

symptoms, such as hallucinations and delusions symptoms, such as hallucinations and delusions which are distortions of normal functions. This group which are distortions of normal functions. This group has no intellectual impairment, a good reaction to has no intellectual impairment, a good reaction to most medication, thus a good chance of recovery. most medication, thus a good chance of recovery.

Type II schizophrenia Type II schizophrenia includes having negative includes having negative symptoms including dulled emotions and little symptoms including dulled emotions and little inclination to speak, which are a loss of normal inclination to speak, which are a loss of normal functions. In addition, this group has intellectual functions. In addition, this group has intellectual impairments, poor reactions to medication, thus a impairments, poor reactions to medication, thus a poor chance of recovery. poor chance of recovery.

Page 23: Disorders II: Mood Disorders and Schizophrenia

Biological Causes of Biological Causes of SchizophreniaSchizophrenia

• A recent study with identical twins showed that if one A recent study with identical twins showed that if one twin was diagnosed with schizophrenia, then there twin was diagnosed with schizophrenia, then there was an 83% chance that the other also had it. was an 83% chance that the other also had it.

• This proved that some people This proved that some people inheritinherit a a predisposition for the disease.predisposition for the disease.

• For the past 10 years, scientists have been searching For the past 10 years, scientists have been searching for genetic markers that might trigger the disease.for genetic markers that might trigger the disease.

• A newer theory is that a specific part of chromosome A newer theory is that a specific part of chromosome 6 could be associated with the disease.6 could be associated with the disease.

• Researchers believe that genetic factors act primarily Researchers believe that genetic factors act primarily during the 20during the 20thth-30-30thth week of fetal development week of fetal development

• Most scientists agree that a predisposition for Most scientists agree that a predisposition for schizophrenia is often the result of faulty schizophrenia is often the result of faulty development of certain structures of the brain; they development of certain structures of the brain; they developdevelop it. it.

Page 24: Disorders II: Mood Disorders and Schizophrenia

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.

Page 25: Disorders II: Mood Disorders and 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.

Page 26: Disorders II: Mood Disorders and Schizophrenia

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.

Page 27: Disorders II: Mood Disorders and Schizophrenia

Problems with Neuroleptic Problems with Neuroleptic DrugsDrugs

Typical neuroleptics, specifically phenothiazines, can Typical neuroleptics, specifically phenothiazines, can produce unwanted motor movements or produce unwanted motor movements or tardive tardive dyskinesiadyskinesia..

Tardive dyskinesia is the appearance of slow, Tardive dyskinesia is the appearance of slow, involuntary, and uncontrollable rhythmic movements involuntary, and uncontrollable rhythmic movements and rapid twitching of the mouth and lips as well as and rapid twitching of the mouth and lips as well as unusual movement of the limbs. Usually associated unusual movement of the limbs. Usually associated with the usage of typical neuroleptics. with the usage of typical neuroleptics.

Atypical neuroleptics have a less chance in the Atypical neuroleptics have a less chance in the development of tardive dyskinesia, but a greater development of tardive dyskinesia, but a greater increase of side-effects including: increase of side-effects including:

- fatigue - fatigue

- emotional indifference to one’s - emotional indifference to one’s surroundingssurroundings

- loss of white blood cells- loss of white blood cells

Page 28: Disorders II: Mood Disorders and Schizophrenia

Dissociative DisordersA 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.

Page 29: Disorders II: Mood Disorders and Schizophrenia

Dissociative Identity DisorderDissociative Identity DisorderDissociative Identity DisorderDissociative Identity Disorder: (formerly multiple : (formerly multiple

personality disorder) is the presence of two or more personality disorder) is the presence of two or more distinct identities or personality states, each with its own distinct identities or personality states, each with its own pattern or perceiving, thinking about, and relating to the pattern or perceiving, thinking about, and relating to the world. world.

Different personalities might take control of the Different personalities might take control of the individual’s thoughts and behaviors at different times. individual’s thoughts and behaviors at different times.

The personalities are often very different and complex The personalities are often very different and complex and the original personality is usually unaware of their and the original personality is usually unaware of their existence.existence.

Two theories why:Two theories why:1) A traumatic childhood episode split the 1) A traumatic childhood episode split the

identities as identities as a defense mechanism. a defense mechanism. 2)People are using it as an excuse to 2)People are using it as an excuse to

manipulate manipulate others for personal gain. (Ex: in a court of others for personal gain. (Ex: in a court of law)law)

Majority of cases are women. (89%)Majority of cases are women. (89%)

Page 30: Disorders II: Mood Disorders and Schizophrenia

Depression

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.