SCHIZOPHRENIA

DISABILITIES POOR SOCIAL, FAMILY, AND WORK RELATIONSHIPS SIDE EFFECTS OF MEDICATION VIOLENCE WHEN IN PSYCHOTIC STATE SOCIAL STIGMA

CAUSES USED TO THINK BAD FAMILIES WERE CAUSE (SCHIZOPHRENOGENIC MOTHER) NOW THOUGHT TO BE BRAIN DISORDER WITH GENETIC OR BIOLOGICAL CAUSE

CORRELATES ABOUT 1% PREVALENCE IN WIDE VARIETY OF TIMES AND PLACES NO SEX DIFFERENCES NO ETHNIC DIFFERENCES NO INTELLIGENCE DIFFERENCES EARLY ONSET YEARS LOWER SOCIAL CLASS - CAUSE? FEW ARE MARRIED

PROGNOSIS (COURSE) USED TO THINK DEGENERATIVE NOW THOUGHT TO BE VARIABLE 1/3 CHRONIC; 1/3 EPISODIC; 1/3 RECOVER HIGH RATE OF SUICIDE - 10%

TREATMENT USED TO BE LONG STAYS IN MENTAL HOSPITALS NOW BRIEF, EPISODIC HOSPITAL STAYS ALONG WITH COMMUNITY TREATMENT (OR NEGLECT) MEDICATION SINCE 1950’S PHENOTHIAZINES AND CLOZAPINE

TREATMENT MEDICATION DOESN’T CURE, BUT CONTAINS - BUT MUST TAKE IT PSYCHOSOCIAL TREATMENTS - SOCIAL AND JOB SKILLS, HOUSING PSYCHOTHERAPY LESS CRITICAL HARDEST TO TREAT - MICA (MENTALLY ILL CHEMICAL ABUSERS)

MAJOR PROBLEMS INADEQUATE FUNDING FOR TREATMENT MANY DON’T ADMIT THAT THEY ARE ILL - STOP TAKING MEDICATIONS WHEN GET IN TROUBLE PUT IN JAILS AND PRISONS

DYSREGULATION OF MOOD ALTERATIONS OF WILD ELATION AND DEEP DEPRESSION CAN BE ACCOMPANIED BY DELUSIONS AND HALLUCINATIONS VERY DIFFERENT INTERPERSONALLLY THAN SCHIZOPHRENIA - CONNECTEDNESS

MANIC PHASE SUPER-CHARGED ENERGY WHEN MANIC (67) CREATES BEHAVIOR PROBLEMS (74) CAN BE VIOLENT (120) HIGH RATE OF ALCOHOL AND DRUG ABUSE HIGH CREATIVITY AND PRODUCTIVITY

DEPRESSIVE PHASE TOTAL BLEAKNESS WHEN DEPRESSED (111) HIGH RATE OF SUICIDE

CAUSE RUNS IN FAMILIES PROBABLE GENETIC CAUSE SEEMS TO BE UNIVERSAL

CORRELATES PREVALENCE BETWEEN 1/2% TO 1% NO SOCIAL CLASS DIFFERENCES NO ETHNIC DIFFERENCES SLIGHT SEX DIFFERENCE ONSET WAS BUT GETTING YOUNGER

COURSE AND TREATMENT HIGHLY VARIABLE COURSE, BUT USUALLY CHRONIC MUCH HIGHER SOCIAL FUNCTIONING THAN SCHIZOPHRENIA LITHIUM MOST COMMON TREATMENT SINCE 1950’S CAN CONTROL CYCLES

JAMISON - UNQUIET MIND DIFFICULTIES OF TREATMENT AMBIVALENCE TOWARD MEDICATION (98) IMPORTANCE OF SOCIAL SUPPORT - INFORMAL AND PROFESSIONAL YAVI ASPECT?

DEPRESSION MUCH MORE COMMON THAN SCHIZ AND BIPOLAR 10% EACH YEAR; 20% OVER LIFETIME SEEMS TO BE INCREASING

Depression Articles

Treatment for Depression Kessler et al. 2003

Diagnoses in Psychotherapy Olfson et al. 2002

MOOD EITHER (OR BOTH) PRESENCE OF NEGATIVE MOOD OR ABSENCE OF POSITIVE MOOD

PHYSICAL SYMPTOMS LOW ENERGY, FATIGUE SLEEP DISTURBANCES APPETITE DISTURBANCES VULNERABILITY TO MANY PHYSICAL ILLNESSES

PSYCHOLOGICAL SYMPTOMS EMOTIONAL - SADNESS, APATHY, LACK OF PLEASURE COGNITIVE - HOPELESSNESS AND HELPLESSNESS, LOW SELF-ESTEEM BEHAVIORAL - WITHDRAWAL, SUICIDE ATTEMPTS

TYPES MAJOR DEPRESSION - ABOVE PSYCHOTIC - MORE SEVERE, IMMOBILE, SUICIDAL DYSTHYMIC - LONGER LASTING (TWO YEARS) FEWER SYMPTOMS DISTRESS - REACTIVE TO LIFE EVENT, NOT A DISORDER

CAUSES VARIED SOME GENETIC EARLY LOSS EVENTS AND ABUSE CURRENT LOSSES AND TRAUMAS

CHARACTERISTICS GREAT VARIANCE ACROSS SOCIETIES (3% - 30%) 2/3 WOMEN INVERSE WITH SOCIAL CLASS MOST AMONG YOUNG, ELDERLY

PROGNOSIS (COURSE) COURSE HIGHLY VARIABLE OFTEN FREQUENT AND CHRONIC OFTEN ENDS WITH FRESH START EVENTS

TREATMENT TREATED WITH SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRI) - PROZAC, PAXIL, XOLOFT

TREATMENT COGNITIVE THERAPY PSYCHOTHERAPY COMBINATION OF THERAPIES