MOOD DISORDERS AND SCHIZOPHRENIA

Ch. 9 & 11

Symptoms of Depression

Cognitive Poor concentration, indecisiveness, poor self-esteem, hopelessness, suicidal thoughts, delusions

Physiological and Behavioral

Sleep or appetite disturbances, psychomotor problems, catatonia, fatigue, loss of memory

Emotional Sadness, depressed mood, anhedonia (loss of interest or pleasure in usual activities), irritability

Major Depression Dysthymic Disorder

5 or more symptoms including sadness or loss of interest or pleasure

3 or more symptoms including depressed mood

At least 2 weeks in duration

At least 2 years in duration

Nu

mb

er

of

sym

pto

ms

Du

rati

on

Subtypes of Depression

w/Melancholic features w/Psychotic features w/Seasonal patterns w/Catatonic features w/Atypical features w/Postpartum onset

Andrea Yates

Prevalence and Prognosis

Among adults, 15-to-24-year olds are most likely to have had a major depressive episode in the past month.

Depression is less common among children than among adults.

Depression may be most likely to leave psychological and social scars if it occurs initially during childhood, rather than during adulthood

Age Differences in Depression

0

1

2

3

4

5

6

7

15-24 25-34 35-44 45-54Age (in years)

Perc

en

t w

ith

m

ajo

r d

ep

ressio

n

in last

mon

th

Biological Theories

Genetic Neurotransmitter Neurophysiological abnormalities Neuroendocrine abnormalities

Risk of Bipolar Disorder

0

10

20

30

40

50

60

70

MZ twins DZ twins Sibs, parents,children

Biological parentsof BP adoptees

Second-degreerelatives

General population

Perc

ent

wit

h b

ipola

r dis

ord

er

Bipolar Disorder

Bipolar I vs. Bipolar II Bipolar I – depression & mania Bipolar II – depression & hypomania

Cyclothymic Disorder

Living with Bipolar Disorder

Psychological Theories of Mood Disorders

Behavioral TheoriesLewinsohn’s theoryLearned helplessness theory

Cognitive TheoriesAaron Beck’s Theory

Psychodynamic TheoryIntrojected hostilityDependency on others’ evaluations

Social Perspectives

The Cohort Effect Social Status Cross-Cultural Differences

Biological Treatments

Electroconvulsive Therapy (ECT) Light Therapy Drug treatments

Lithium, antipsychotics (Bipolar Disorder) Antidepressants

Tricyclic SSRIs MAOIs

Psychological Treatments for Depression

Behavioral TherapyIncrease positive reinforcers and decrease aversive

events by teaching the person new skills for managing interpersonal situations and the environment

Cognitive-Behavioral TherapyChallenge distorted thinking and help the person learn

more adaptive ways of thinking and new behavioral skills

Psychodynamic TherapyHelp the person gain insight to unconscious hostility and

fears of abandonment to facilitate change in self-concept and behaviors

Schizophrenia

Positive Symptoms: Type 1 Delusions

Persecutory Delusion of Reference Grandiose Delusions

Hallucinations Disorganized Thought and Speech Disorganized or Catatonic Behavior

Schizophrenia

Negative Symptoms: Type II Affective Flattening Alogia Avolition

DSM-IV Criteria for Schizophrenia

A. Core symptoms: two or more of the following present for at least a 1-month period 1. Delusions

2. Hallucinations 3. Disorganized speech 4. Grossly disorganized or catatonic

behavior 5. Negative symptoms

DSM-IV Criteria for Schizophrenia, continued

B. Social/occupational functioning: significant impairment in work, academic performance, interpersonal relationships, and/or self-care

C. Duration: continuous signs of the disturbance for at least 6 months; at least 1 month of this period must include symptoms that meet Criterion A.

DSM IV Criteria for Schizoaffective Disorder

A. An uninterrupted period of illness during which, at some time, there is either a major depressive episode, a manic episode, or a mixed episode concurrent with symptoms that meet Criterion A for schizophrenia.

DSM IV Criteria for Schizoaffective Disorder, continued

B. During the same period of illness, there have been delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms.

C. Symptoms that meet criteria for a mood episode are present for a substantial portion of the total duration of the active and residual periods of the illness

Prognosis of Schizophrenia

Age and Gender Factors Sociocultural Factors

Biological Theories of Schizophrenia

Genetic Theories

Structural Brain Abnormalities

Birth Complications & Prenatal

Viral Exposure

Neurotransmitter Theories

Schizophrenia – Ventricle Abnormalities

Treatments for Schizophrenia Biological Treatments Behavioral, Cognitive and Social

Interventions Cross-Cultural Treatments

Theories of Schizophrenia

Psychological Theories

Controlling parents, schizophrenogenic mothers (scientific scrutiny of this theory)

Sociocultural Perspectives

Impact of stressful social situations, environmental conditions

Family Interactions and Schizophrenia

Family communication theories, communication deviance, expressed emotion

Stress and Schizophrenia

Rare that anyone would experience full-blown schizophrenia in response to a stressful event. Still, it is more likely that those with schizophrenia may live in a more stressful environment