Schizophrenia/Depression/Bipolar disorders

Schizophrenia

Main category oh psychotic disorders

Hallucinations

occur in any of the senses (smell, taste, touch, see, hear)

most common is the auditory hallucinations 

hearing voices in your head

voices can be present when fully awake

perceiving the voices as distinct

Delusions

involve strange or sometimes bizarre beliefs

disturbances in content of thought

persecution - most common, individual feels they are being followed, watched, or out to get them (government)

Grandiosity - special position in life

reference - directed at you, secret message for you

Disorganized speech

disturbances in the form of thought, how the person speaks

loose associations: one topic loosely to another topic

clanging: get kind of stuck on a repeated sound or word

Disorganized behavior

unpredictable behavior

not knowing what to expect from someone

goal-directed behavior - might be functioning well in life than a drop in life

social functioning

catatonic behavior - problems with movement, catatonic excitement

Flat Affect

refers to emotionality, lack of emotion

avolition

poverty of behavior

Alogia

poverty of speech - failure to say much when getting asked direct questions

Anhedonia

lack of experiencing pleasure, and lack of happy things from the past

Asociality

lack of interest in social interactions

DSM requirements

need at least 2 of 5 symptoms

one has to be hallucinations, delusions, or organized speech

clear reduction of function (work, relationships, self-care)

symptoms need to be at least 6 months

Paranoid schizophrenia

focus on delusions

delusions have a theme/story

presence of auditory hallucinations

disorganized schizophrenia

disorganized speech, behaviors, may have delusions

Age

late teens to 30

earlier for men than women

men - early 20s women - late 20s

does not come out of nowhere

Major Depressive Disorder

one or more major depression episode (5out of 9) one has to be depressed mood or decreased interest in pleasurable activities

Major depressive episode

depressed mood, decreased interest in pleasurable activities, disturbed appetite, disturbed sleeping patterns, low energy level, feelings of worthlessness/guilt, poor concentration, psychomotor, suicidal ideation, lasts for at least two weeks, twice as common in women than men, prevalence rate around 7%

persistent depressive disorder (dysthymia disorder)

chronic depressive mood, more days than not adults 2-year period children 1 year having that depressed mood, focuses on mood, little easier to overlook, can be diagnosed with both, two times more likely in women

Manic Episodes

characterized by a persistent elevated mood beyond what is typically perceived as normal, really irritable, inflated self-esteem, decreased need of sleep, talkative/pressured speech, racing thoughts, distractible, goal directed activity, excessive involvement in pleasurable activities, lasts at least one week

Bipolar 1

manic depressive disorder, main feature is manic episodes, manic episodes, alternate between manic episodes and major depressive episodes, tends to be reoccurring episodes, equally diagnosed in men and women, 1 week or fossilization for any given time

Bipolar II disorder

major depressive episodes, hypomanic episodes, disruption functioning, less severe than bipolar 1, typically no need for hospilization

Cyclothymic Disorder

consists of chronic fluctuating mood, hypomanic symptoms, alternating over time with depressive symptoms, not as extreme, DSM says 2 years

Suicide

depression is obvious lead to suicide, fairly high suicide rate of bipolar 1, not all people who are suicidal not are necessarily depressed, sometimes something happened and the act was impulsive

Suicide rates

25 attempts: 1 completion

100-200 attempts: 1 completion (adolescents)

4 attempts: 1 completion (65+)

women 3x more likely 3:1 (attempt)

men 4x more likely 4:1 (commit)

men use guns, women use pills

Drug/alc - suicide = close connection

irrational thinking

Schizophrenia genetic vulnerability

supported by twin/family studies

50% concordance rate in identical twins

disorder linked to multiple genes

schizophrenia dopamine hypothesis

idea that excess dopamine causes disorder

correlation not causation

1st gen antipsychotics blocked dopamine receptors

schizophrenia diathesis-stress model

genetic predisposition and environmental stress cause disorder stressors related to relapse expressed emotion: family member giving criticism, hostility, and overinvolvement

schizophreniform disorder

lasts 1-6 months

doesn’t have to impair functioning

brief psychotic disorder

1 day - 1 month

doesn’t have to impair functioning

schizoaffective disorder

symptoms characteristic of schizophrenia and mood disorder psychotic features present 2+ weeks in absence of mood symptoms

delusional disorder

persistent delusion without odd behavior