Study Notes on Mental Health Diseases and Disorders

Chapter Objectives

By the end of this chapter, you should be able to:
21.1 Identify important signs and symptoms associated with mental health disorders.
21.2 Describe common diagnostic tests used to determine the type and/or cause of mental health disorders.
21.3 State genetic and acquired causes of intellectual disabilities.
21.4 Differentiate between types of eating disorders.
21.5 Describe substance use disorders and their symptoms.
21.6 Identify common organic mental health disorders.
21.7 Describe the typical course and management of the common mental health disorders.
21.8 State the mental health disorders found in the older population and the effects of these disorders.

Common Signs and Symptoms

• Mental health disorders typically begin with behavioral changes that can be subtle and slow-developing.
• Early signs may not be recognized, and therefore symptoms might not be noticed until the disorder has progressed.
   - Common early symptoms include:
    - Forgetfulness
    - Anxiety
    - Temper tantrums

Diagnostic Tests

• Various tests can aid in diagnosing mental health disorders:
    - Physiologic tests
    - Laboratory tests
    - Brain scans (e.g. CT scans, MRIs)
    - EEGs (Electroencephalograms)
    - Referral to a psychiatrist for psychological testing
    - Aptitude and personality tests are also utilized to help determine the mental state and capabilities of individuals.

Developmental Mental Health Disorders

Intellectual Disability

• Causes: Often unknown; however, they can be categorized under:
    - Genetic causes
    - Acquired causes
• Symptoms:
    - May not manifest until the child enters school.
    - Characterized by decreased ability to learn and developmental slowness.
• Prevention: Two preventable causes include:
    - Fetal Alcohol Syndrome
    - Kernicterus

Attention-Deficit Hyperactivity Disorder (ADHD)

• This disorder is characterized by:
    - Inability to concentrate
    - Hyperactivity
    - Impulsiveness
• The exact causes are unknown, but familial patterns suggest a genetic element.
• Treatment: Includes the use of amphetamines and behavior modification.

Eating Disorders

• These are characterized by a compulsion to eat or, conversely, to avoid eating, severely affecting both mental and physical well-being.
• The most common types include:
    - Anorexia Nervosa: Characterized by self-imposed starvation.
    - Bulimia: Involves episodes of binge eating followed by purging behaviors.
• The specific cause remains unknown.

Substance-Related Mental Disorders

General Overview

• The term substance-related mental disorder is used in place of drug addiction.
• Common terms in this context include:
    - Addiction
    - Dependency
    - Tolerance
    - Withdrawal

Alcohol Use Disorder (AUD)

• Defined as a physical and mental dependence on alcohol, it is one of the most prevalent mental health disorders.
• It is chronic and can cause significant damage to almost every organ system in the body, leading to complications such as:
    - Heart disease
    - Hypertension
    - Cirrhosis
    - Pancreatitis
    - Peripheral neuropathy
    - Gastrointestinal problems
• Symptoms of AUD include:
    - States of intoxication
    - Withdrawal symptoms
    - Hallucinations
    - Experiences of delirium tremens
• This disorder can often result in fatal consequences.

Marijuana

• Commonly referred to as pot, it imparts a euphoric effect.
• Synthetic Cannabis Abuse: Known colloquially as fake weed or K2.

Cocaine

• Recognized as one of the most addictive drugs available, functioning both as a stimulant and an anesthetic.

Methamphetamine

• Currently considered the fastest growing abused drug in society today.
• It is a potent central nervous system stimulant that is highly addictive.

Other Substances

• Common addictive stimulants include caffeine and nicotine.
• Sedatives or depressants can include antianxiety medications and amphetamines which stimulate the release of epinephrine, causing increases in heart rate, respiration, and digestion.

Organic Mental Disorders

• These disorders are closely linked to a physical cause, which impacts cognition along with the ability to think, remember, and make judgements.
• They can manifest temporarily or be permanent in nature.
• A couple of examples include:
    - Dementia: Refers to the deterioration of mental abilities due to physical changes in the brain.
    - Delirium: Not classified as a disease but rather a clinical syndrome characterized by a set of symptoms caused by factors such as medications, alcohol, fever, or other illnesses.

Psychosis

Definition and Symptoms

• Psychosis involves a disintegration of one’s personality and loss of contact with reality.
• Symptoms: Include but are not limited to:
    - Delusions
    - Hallucinations
    - Impaired communication skills
    - Inability to meet life’s demands

Schizophrenia

• Commonly referred to as split mind, though it is crucial to note that this is distinct from split personality.
• Individuals with schizophrenia lose touch with reality and may act based on imagined or fantasized realities.
• Treatment: Commonly includes medication, continuous monitoring, and rehabilitation strategies.

Delusional Disorders

• These disorders entail a firm belief in a delusion while still showcasing otherwise normal personality adjustments.
• Types of delusions include:
    - Grandiose
    - Jealous
    - Erotomanic
    - Persecutory
    - Somatic
• Treatment typically involves the administration of antipsychotics.

Mood or Affective Disorders

Depression

• Defined as prolonged feelings of extreme sadness, unhappiness, despair, or discouragement.
• Seasonal Affective Disorder: A depressive condition experienced particularly during the winter months.
• Bipolar Disorder: Characterized by extreme swings between depression and mania.
• Mood Disorder Questionnaire (MDQ): This tool aids physicians in identifying symptoms associated with mood disorders.

Dissociative Disorders

• Involves escape from reality through involuntary or unhealthy coping mechanisms.
• Symptoms can include:
    - Suppression of memories
    - Assuming alternate identities
• Types of dissociative disorders consist of:
    - Psychogenic Amnesia
    - Psychogenic Fugue
    - Depersonalization
    - Multiple Personality Disorder

Anxiety Disorders

General Overview

• Anxiety becomes chronic when the usual temporary response to stress persists longer than intended periods.
• Factors contributing to anxiety may include genetic predispositions, severe stress, biochemical changes, and, in certain cases, identifiable physical causes.
• Types of anxiety disorders:
    - Generalized Anxiety Disorder
    - Panic Disorder
    - Phobia Disorder
    - Obsessive-Compulsive Disorder (OCD)

Somatoform Disorders

Overview of Manifestations

• These disorders manifest as physical symptoms without any identifiable organic cause.
• Examples:
    - Conversion Disorder
    - Hysterical Neurosis
    - Hypochondriasis: Characterized by abnormal anxiety regarding personal health or body.
    - Pain Disorder: Exhibits pain not attributed to a physiologic cause.

Specific Conditions

• Malingering: The intentional fabrication or exaggeration of symptoms for financial or personal gain.
• Munchausen Syndrome: Involves simulation of illness purely to receive treatment.
• Munchausen by Proxy: Similar to Munchausen syndrome, but involves a parent projecting the disorder onto their child.

Personality Disorders

• Personality forms during the early years of life and is influenced by genetics and environmental factors. It stabilizes by adulthood.
• Common types of personality disorders include:
    - Paranoid Personality Disorder
    - Schizoid Personality Disorder
    - Antisocial Personality Disorder
    - Narcissistic Personality Disorder
    - Histrionic Personality Disorder

Gender Identity Disorder

• Individuals may feel uncomfortable or distressed about their sexual identity.
• Such individuals might express a preference for the opposite sex or adopt the clothing and interests of the opposite gender.
• Adults may seek interventions, including hormonal or surgical procedures, to transition sexes.

Sleep Disorders

Definition and Types

• Sleep disorders, medically referred to as somnipathy, represent a range of medical issues related to sleep.
• Types of sleep disorders include:
    - Insomnia
    - Narcolepsy
    - Sleep Apnea
    - Nightmare Disorder
    - Sleep Terror
    - Sleepwalking

Trauma

Grief

• Grieving is a natural and healthy process for coping with loss.
• Cultures vary in their methods of grieving.
• Dr. Elisabeth Kübler-Ross is notable for her work regarding the stages of grief.

Suicide

• Suicide is a significant concern, particularly among teenagers.
• Common emotions associated with suicidal thoughts include depression, guilt, hopelessness, and helplessness.

The Older Adult

• Various mental health disorders can impact older adults.
• Symptoms such as memory lapses, behavioral changes, and confusion can resemble those of mental health disorders but might relate to physiological changes associated with the aging process.
• Common issues faced by older adults include depression, insomnia, social isolation, stress, and disorders linked to other systemic diseases.
• It is vital to differentiate between actual mental health issues and symptoms indicative of aging.
• Medications that older adults might take can also elicit symptoms resembling mental health problems.