Week three (8, 13, 14)

• Schizophrenic Diagnosis needs:

  1. hallucinations
  2. delusions
  3. disorganized speech
  4. disorganized behavior
  5. negative symptoms

  you need one of 1, 2 or 3, and then another one
• selective serotonin reuptake inhibitors (SSRIs) Like Prozac and Paxil, are used in Depression and Panic disorders but cause sexual dysfunction
• Lithium: used for Bipolar disorder and occationally Depressive OCD
• mixed features: Condition in which the individual experiences both elation and depression or anxiety at the same time.
• major depressive disorder: Mood disorder involving one (single episode) or more (separated by at least two months without depression, recurrent)
• For Major Depressive Disorder requires either Depressed mood, or marked loss of interest or both of them
• Major Depressive disorder Criteria:

  1. Has to be one or both of:
  2. depressed mood
  3. marked loss of interest or pleasure
  4. weight loss or weight gain
  5. hypersomnia or insomnia 
  6. psychomotor agitation or retardation 
  7. fatigue or loss of energy
  8. feelings of guilt or sense of worthlessness
  9. slowed or disrupted thinking, or indecisiveness
  10. suicide ideation 
• Persistent Depressive Disorder:

  1. Depressive mood for most of the day for the last 2 years
  2. Two or more of the following
  3. Low Appetite or overeating
  4. Insomnia or Hypersomnia
  5. Low energy
  6. Low Self Esteem
  7. Poor concentration
  8. Feelings of Hopelessness
  9. Within the 2 years, has never been without symptoms
  10. Criteria for MDD for 2 years
  11. Never been a manic or hypomanic
  12. Not better explained by another disorder
  13. Not due to drugs
  14. causes distress
• Specifiers of Persistent Depressive Disorder:

  • Anxious distress
  • Atypical
  • Partial remission
  • full remission
  • Early Onset (before 21)
  • late onset (after 21)
  • Pure Dysthymic (not met mdd)
  • Persistent Major (mdd before the 2 years)
  • Intermittent MDE with current episode (currently in episode)
  • Intermittent MDE without current episode (not currently in episode)
• seasonal affective disorder (SAD); Mood disorder involving a cycling of episodes corresponding to the seasons of the year, typically with depression occurring during the winter.
• Specifiers of Major Depressive Disorder:

  1. Single/reoccurring
  2. Mild/moderate/severe
  3. partial/full remission
  4. psychotic features (mood-congruent or mood-incongruent)
  5. anxious distress (mild to severe) (sub-threshold w/anxiety)
  6. mixed features
  7. melancholic features (will not cheer up)
  8. atypical features (will cheer up)
  9. catatonic features
  10. peripartum onset
  11. seasonal pattern
• Phases of Depression

  • Prodromal - Mild anxiety or depressive symptoms
  • Active - untreated lasts 4-6 months - meets diagnostic criteria
  • Residual or premorbid functioning (coming out of it)
• Bipolar 1: manic episodes with depression lasting over a week
• Bipolar 2: hypomania with depressive states lasting at least 4-7 days
• cyclothymic disorder: low levels of depression and mania
• Personality disorder: persistent inflexable pattern of emotions, cognitions, and behaviors, which are maladaptive and last a long time. They are hard to treat, and are natural to the individual with the disorder
• Personality disorders are worse degrees of personality traits seen in people
• Five Factors of personality are

  • Extraversion
  • Agreeableness
  • Conscientiousness
  • Neuroticism
  • Openness to experience
• Cluster A is Odd or eccentric (paranoid)

  Cluster B is Dramatic or erratic (Antisocial)

  Cluster C is Anxious or Fearful (Dependent)
• Females have a tendency to get

  • Paranoid Personality Disorder
  • Borderline ''
  • Histrionic ''
  • Avoidant ''
  • dependent ''
  • Obsessive-compulsive ''
• Males have a tendency to get

  • Schizoid Personality Disorder
  • Antisocial ''
  • Narcissistic ''
• Some Cultural Factors can be at play if someone has a Paranoid Personality Disorder
• Dialectical Behavior Therapy (DBT) helps those with Bipolar and Borderline Personality Disorder
• What are Psychosis - Hallucinations and delusions
• Delusions: can be bizarre or non-bizarre but are fixed false beliefs
• Hallucinations: perception of things that are not ther, but are vivid and clear. Only about 75% of people with Psychotic have hallucinations, but most of them are auditory
• Disorganized speech: Derailment, loose association, or incoherence
• Grossly disorganized or abnormal behaviour: Childlike silliness, unpredictability, lack of goal-directed activity, or catatonic behavior
• Negative Symptoms: Deminitioned affect, lack of drive, lack of speech, lack of pleasure, lack of human contact
• Schizotypal comes with major depression about 50% of the time
• Delusional Disorder:

  1. Delusions for 1 month
  2. Never diagnosed with schizophrenia
  3. not Impaired
  4. only brief mood
  5. Not due to drugs or medical condition
• In Delusional Disorder, Erotomania is the belief that they are in love with a person of higher status. They will often try to visit the person, they will read meaning into ideas that support their belief
• In Delusional Disorder, Grandiose disorder is when someone believes they have a relationship with a deity or famous person, that they have unrecognizable talent
• In Delusional Disorder, Jealous disorder is when someone is convinced that their partner is unfaithful. Men are typically more affected
• In Delusional Disorder, Persecutory disorder is the most common type, with themes of conspiracy, cheated, spied on, followed or drugged. Makes appeals to law for help
• In Delusional Disorder, Somatic type is when someone is convinced that they have a physical illness
• In Delusional Disorder usually caused by a stressor in the life of the individual
• Brief Psychotic Disorder criteria:

  1. Sudden onset of one of the four, but can not have negative symptoms
  2. Delusions
  3. hallucinations
  4. disorganized speech
  5. disorganized or catatonic behavior
  6. 1 day to 1 month
  7. Not due to drugs, another disorder, or condition
• Brief Psychotic Disorder can be specified with postpartum onset which can happen during pregnancy or 4 weeks of birth
• Schizophreniform Disorder:

  1. Two or more of the following (Schizophrenia)
  2. 1-6 months
  3. Not another disorder
  4. Not drugs