1. Psychological Disorders

2. DSM-IV
What is it?
A book (manual) that includes the most common mental disorders including: a description, criteria for diagnosis, treatment and research findings.

3. DSM-IV Diagnostic and Statistical Manual of Mental Disorders - Fourth
Edition (DSM-IV), was published by
the American Psychiatric Association,
Washington D.C., in 1994.

4. “medical student syndrome”
A word of warning…….
“medical student syndrome”
Students can come to believe that they suffer from
almost all of the disorders with which they are made
familiar because the symptoms of disorders usually
overlap with experiences that are universal to the
human condition. For example, feelings of sadness are
not uncommon among people with healthy minds, even
though they are a symptom of depression.

5. Psychological Disorders
Diagnosis/categorization of mental illnesses can be very subjective…
Homosexuality until 1973
Body Dysmorphic Disorder
While in the DSM-IV, is not recognized by HMO’s
Koro – Southeast Asia
Men can develop a fear that one’s penis will withdraw into one’s abdomen, causing death
Winigo – Algonquin Indian hunters
Intense fear of being turned into a cannibal by supernatural monster

6. Psychological Disorders
Diagnosis/categorization of mental illnesses can be very subjective…
Rosenhan (1973) study
Mentally healthy confederates were admitted with schizophrenia into psychiatric hospitals
They then behaved normally in the hospitals, but their normal behavior was interpreted as pathological based on previous diagnosis

7. DSM-IV The mental disorders in the DSM-IV are listed in 17 categories.
The Five most common are:
Mood disorders
Psychotic Disorders
Anxiety Disorders
Eating Disorders
Somatoform Disorders

8. Mood Disorders Major Depressive Disorder (Depression)
Bipolar Depression

9. Major Depressive Disorder
Overwhelming feelings of sadness, despair, hopelessness
Loss of interest in pleasurable activities

12. Bipolar Disorder
Manic episodes & extreme depression mixed with normal affect
Mania involves delusional levels of optimism, euphoria, & energy
Equally common in both sexes
Sufferers make poor decisions while manic, withdraw when depressed

14. Genetic Connection Moderate in major depressive disorder
Strong in bipolar depression

15. Causes & Treatments Depression: low norepinephrine&serotoninlevels
Mania:
high norepinephrinelevels
Major Depressive Disorder:
Antidepressants (serotoninselective reuptake inhibitors, e.g. Prozac)

16. Causes & Treatments Bipolar Depression: lithium carbonate
Neurotransmitter levels may be symptomatic of depression, not causal

17. Cognitive Theory
Cognitive theory attributes depression to distorted thinking
Distorted thinking includes negative views of the world, the future, and the self
Tied to poor reality testing, learned helplessness

22. Suicide Facts
10-14% of those who attempt suicide will eventually succeed in a later attempt
Suicide rates are highest among the elderly
Most suicidal people leave clues of their intentions

23. Suicide Facts
Most suicidal people have not made a definite decision to die
Suicide is less frequent for married people and women with children
The majority of suicide victims are suffering from depression

24. Eating Disorders
Anorexia Nervosa
Bulimia
Compulsive Overeating

25. Quick Facts
An estimated 7,000,000 women & 1,000,000 men in the U.S. suffer from eating disorders.
41% of high school students suffer from an eating disorder.
Of all psychological diseases, eating disorders have the highest mortality rates.
Men and women, both young and old, rich and poor, all minorities, suffer from eating disorders.
Eating disorders are more common in women than in men.

26. What is an eating disorder?
The term “Eating Disorder” is used to describe a variety of eating patterns which are considered abnormal and potentially harmful.
These behaviors may be expressed in the following ways…
Overeating.
Binge eating/eating large amounts of food in a short period of time.
Refusing to eat/self-starvation.
Compulsive exercising.
Overusing diet pills.
Overusing laxatives.
Vomiting.

27. Anorexia Nervosa
Anorexia Nervosa is a serious, potentially live-threatening eating disorder where an individual refuses to maintain a minimally normal body weight by self-starvation tactics.
Those who suffer from anorexia nervosa often:
Have an irrational fear of becoming fat.
See themselves as fat no matter how much they weigh.
Strive for perfection and set high standards for themselves.
Feel a need for control in their lives.
Suffer from low self-esteem.
Suffer from depression.
Withdraw from social interactions.

28. Anorexia Nervosa Characteristics
Self-starvation with weight loss.
Refusal to eat, except in tiny portions.
Food preoccupation and rituals.
Denial of hunger.
Absence or irregular menstrual cycles.
Compulsive exercising.
Distorted body image.
Intense fear of gaining weight.
Hair loss.
Sensitivity to cold.
Lanugo - Light hair covering face and forearms that appears after someone has lost a great amount of weight due to inadequate protein in the diet.
Denial of any unusual eating behaviors.
Lack of concentration.
Some or all of these characteristics may be present

29. Anorexia Nervosa Health Effects
Lowered body temperature.
Decreased heart rate.
Iron deficiency.
Depressed immune system.
Dehydration.
Constipation.
Low Blood Potassium - this is the most common cause of death in a long-time anorexic as it an contribute to an irregular heart beat.
Swelling or puffiness often in ankle and feet.
Bloating.

30. Bulimia Nervosa
Bulimia Nervosa is a serious, potentially life-threatening eating disorder where an individual binges and purges, usually in secret, in an attempt to avoid weight gain.
Binge - Eating abnormally large amounts of food.
Purge - Self-induced vomiting, abuse of laxatives or diuretics or periods of “fasting” to get rid of consumed food.
People suffering from Bulimia often:
Suffer from depression.
Have low self-esteem.
Strive for the approval of others.
Do realize they have a problem.
Have shame and guilt - and mood swings.
Withdraw from usual social interactions.

31. Bulimia Nervosa Characteristics
Binge eating, usually in secret.
Preoccupation with food.
Vomiting after binging.
Abuse of laxatives, diuretics, diet pills or drugs to induce vomiting.
Feeling a lack of control.
Depression/Isolation.
Usually normal weight or slightly above normal.

32. Bulimia Nervosa Health Effects
Broken blood vessels in the eyes - a result of the pressure from vomiting.
Tooth/gum erosion due to the stomach acid from vomiting.
Russell’s sign - scar tissue on the knuckle of finger used to induce vomiting.
Swollen salivary glands.
Dehydration.
Constipation.
Low blood potassium.
Poisoning.
Tears in the esophagus.
Ruptured stomach.
Ulcers.
Serious heart, kidney and liver damage.

33. Causes of Eating Disorders
Generally, there is more than the issue of wanting to be thin that leads to eating disorders. Eating disorders are a sign that deeper personal/ emotional problems exist.
Some issues that lead to an eating disorder include:
Depression, anxiety, anger & loneliness.
Low self-esteem.
Feelings of inadequacy or lack of control in life.
Troubled family or personal relationship.
History of being teased based on size or weight.
History of physical or sexual abuse.