CHAPTER 18 (almost there)

Major Mental Disorders & Treatment

What’s the difference?

• Organic Psychosis: – Psychosis caused by brain injury (gunshot

wound) or disease effecting the brain

• Functional psychosis– Based on unknown causes or psychological

factors

Organic Psychosis• Dementia: – Most common organic psychosis; serious mental

impairment in old age caused by brain deterioration

– Archaically known as senility (senile dementia)• Alzheimer’s Disease: – Symptoms include impaired memory, confusion,

and progressive loss of mental abilities– Ronald Reagan most famous Alzheimer’s victim – (Page 587)

Delusional…

Delusional Disorders: pg 588 chartMarked by presence of deeply held false beliefs (delusions)

May involve delusions of grandeur, persecution, jealousy, or somatic delusions

Experiences could really occur!Paranoid Psychosis:

Most common delusional disorderCenters on delusions of

persecutionUFO abduction

4 Types of SchizophreniaDisorganized (Hebephrenic) Type:

Incoherence, grossly disorganized behavior, bizarre thinking, and flat or inappropriate emotions

Catatonic Type: Marked by stupor, unresponsiveness, posturing, and mutism

Paranoid Type: Preoccupation with delusions; also involves auditory hallucinations that are related to a single theme, especially grandeur or persecution

Undifferentiated Type: Any type of schizophrenia that does not have specific paranoid, catatonic, or disorganized features or symptoms

Causes of Schizophrenia• Environment

– Psychological Trauma: • Psychological injury or shock, often caused by violence,

abuse, or neglect– Disturbed Family Environment:

• Stressful or unhealthy family relationships, communication patterns, and emotional atmosphere

– Deviant Communication Patterns: • Cause guilt, anxiety, anger, confusion, and turmoil

– Double-bind communication: • Places the listener in an unsolvable emotional conflict, or

“no-win” situation

Causes of Schizophrenia• Heredity– Some individual inherit a potential for

developing schizophrenia– They are more vulnerable to the disorder than

others are• EX: If 1 identical twin becomes schizophrenic

(identical twins have identical genes) then the other twin has a 48% chance of also becoming schizophrenic

Name the Scan

Computer-generated color image of brain activity; radioactive sugar solution is injected into a vein,

eventually reaching the brainActivity is abnormally low in frontal lobes of

schizophrenics

•PET Scan

Computer enhanced X-ray of brain or body

•CAT Scan• Look at pg 594

250 × 227 - cancerresearchuk.org

MRI scanComputer enhanced three-dimensional

image of brain or body; based on magnetic field

MRIs show schizophrenic brains as having enlarged ventricles

Tell me what does this next picture have to do with mental disorders?

Let’s read page 592:Brain Chemistry

BRAIN & SCHIZOPHRENIA

• Biochemical Abnormality: – Disturbance in brain’s chemical systems

or in the brain’s neurotransmitters• Dopamine: –Neurotransmitter involved with

emotions and muscle movement–Works in limbic system– Dopamine excess and overactivity in

brain suspected cause of schizophrenia

Causes of Schizophrenia

• Stress-Vulnerability Hypothesis: – Combination of environmental stress

and inherited susceptibility cause schizophrenic disorders

Moderate Mood Disorders

Dysthymic Disorder: Moderate depression that lasts for at

least two yearsCyclothymic Disorder:

Moderate manic and depressive behavior that lasts for at least two years

Major Mood DisordersLasting extremes of mood or emotion and sometimes with

psychotic features (hallucinations, delusions)

Major Depressive Disorder: A mood disorder where the person has suffered one or

more intense episodes of depression; one of the more serious mood disorders

Bipolar I Disorder: Extreme mania and deep depression; one type of manic-

depressive illness Mania: Excited, hyperactive, energetic, grandiose behavior

Bipolar II Disorder: Person is mainly depressed but has one or more

hypomanic episodes (mild mania)

Affective psychosis: Combination of mood disorder and a break with reality

Causes of Major Mood DisordersEndogenous Depression:

Depression that seems to be produced from inside the body (due to chemical imbalances) and NOT from life events

• Read pg 597

Feeling Sad? It Could Be SAD

• Pg 598

Postpartum Depression• Postpartum Depression: –Moderately severe depression that

begins within three months following childbirthMarked by mood swings, despondency,

feelings of inadequacy, and an inability to cope with the new baby

May last from two months to one yearProblem often due to dramatic hormonal

changes

Therapeutic Interventions• Psychotherapy: – Any psychological treatment for behavioral or

emotional problems• Typically involves two people talking about one’s

personal problems

• Somatic Therapies:– Bodily

• Drug therapy, hospitalization, or psychosurgery

• Pharmacotherapy:– Use of drugs to alleviate the symptoms of

emotional disturbance

Pharmacotherapy• What type of drugs are used in

pharmacotherapy?– Tranquilizers• Drugs (Valium) that produce relaxation or

reduce anxiety– Antidepressants• Are mood elevating drugs used to combat

depression (Zoloft)

More Pharmacotherapy– Stimulants

• Psychoactive drugs, activate motivational centers and reduce anxiety

• Increase serotonin, dopamine and norepinephrine neurotransmitters

• Treat narcolepsy and ADHD , ex) Ritalin– Antipsychotics

• Neuroleptics: powerful meds that lesson agitated bx, reduce tension, improve social bx and improve sleep pattern

• Have tranquilizing effects, also tend to reduce hallucinations and delusional thinking (Thorazine)

• Often treatment for schizophrenia

• Read pg. 601

Tardive Dyskinesia

• Side effects anyone?• 15% of patients taking major tranquilizers

develop these

http://www.youtube.com/watch?v=k67PujOawfI

Other Biological Treatments

• Repetitive Transcranial magnetic stimulation (rTMS)

• Used for treatment of depression, autism, addiction and anxiety

• Repeated pulses surge through a magnetic coil Administered daily for a few weeks, or weekly basis

• Works by stimulating the left frontal lobe• http://www.youtube.com/watch?v=E3tPuB31CYc

What is ECT?

Electroconvulsive Therapy

Psychosurgery

• Psychosurgery– Any surgical alteration of the brain, all forms

are irreversible

– Best known psychotherapy• Prefrontal lobotomy: The frontal lobes are

surgically disconnected from the other areas of the brain

• Deep lesioning: Small target areas are destroyed in the brain’s interior– http://www.youtube.com/watch?v=_0aNILW6ILk

Hospitalization

• Mental Hospitalization• Partial Hospitalization

• What is Deinstitutionalization?• What are half-way houses?

Community Health Programs

• Community Health Centers• Crisis intervention

• What is a paraprofessional?

Homework

• Read 613 to 629• Define all the bold faced terms