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SCHIZOPHRENIA
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DISABILITIES POOR SOCIAL, FAMILY, AND WORK RELATIONSHIPS SIDE EFFECTS OF MEDICATION VIOLENCE WHEN IN PSYCHOTIC STATE SOCIAL STIGMA
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CAUSES USED TO THINK BAD FAMILIES WERE CAUSE (SCHIZOPHRENOGENIC MOTHER) NOW THOUGHT TO BE BRAIN DISORDER WITH GENETIC OR BIOLOGICAL CAUSE
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CORRELATES ABOUT 1% PREVALENCE IN WIDE VARIETY OF TIMES AND PLACES NO SEX DIFFERENCES NO ETHNIC DIFFERENCES NO INTELLIGENCE DIFFERENCES EARLY ONSET - 16-25 YEARS LOWER SOCIAL CLASS - CAUSE? FEW ARE MARRIED
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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%
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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
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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)
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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
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DYSREGULATION OF MOOD ALTERATIONS OF WILD ELATION AND DEEP DEPRESSION CAN BE ACCOMPANIED BY DELUSIONS AND HALLUCINATIONS VERY DIFFERENT INTERPERSONALLLY THAN SCHIZOPHRENIA - CONNECTEDNESS
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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
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DEPRESSIVE PHASE TOTAL BLEAKNESS WHEN DEPRESSED (111) HIGH RATE OF SUICIDE
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CAUSE RUNS IN FAMILIES PROBABLE GENETIC CAUSE SEEMS TO BE UNIVERSAL
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CORRELATES PREVALENCE BETWEEN 1/2% TO 1% NO SOCIAL CLASS DIFFERENCES NO ETHNIC DIFFERENCES SLIGHT SEX DIFFERENCE ONSET WAS 30-50 BUT GETTING YOUNGER
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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
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JAMISON - UNQUIET MIND DIFFICULTIES OF TREATMENT AMBIVALENCE TOWARD MEDICATION (98) IMPORTANCE OF SOCIAL SUPPORT - INFORMAL AND PROFESSIONAL YAVI ASPECT?
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DEPRESSION MUCH MORE COMMON THAN SCHIZ AND BIPOLAR 10% EACH YEAR; 20% OVER LIFETIME SEEMS TO BE INCREASING
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Depression Articles 1966-2001
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Treatment for Depression Kessler et al. 2003
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Diagnoses in Psychotherapy Olfson et al. 2002
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MOOD EITHER (OR BOTH) PRESENCE OF NEGATIVE MOOD OR ABSENCE OF POSITIVE MOOD
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PHYSICAL SYMPTOMS LOW ENERGY, FATIGUE SLEEP DISTURBANCES APPETITE DISTURBANCES VULNERABILITY TO MANY PHYSICAL ILLNESSES
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PSYCHOLOGICAL SYMPTOMS EMOTIONAL - SADNESS, APATHY, LACK OF PLEASURE COGNITIVE - HOPELESSNESS AND HELPLESSNESS, LOW SELF-ESTEEM BEHAVIORAL - WITHDRAWAL, SUICIDE ATTEMPTS
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TYPES MAJOR DEPRESSION - ABOVE PSYCHOTIC - MORE SEVERE, IMMOBILE, SUICIDAL DYSTHYMIC - LONGER LASTING (TWO YEARS) FEWER SYMPTOMS DISTRESS - REACTIVE TO LIFE EVENT, NOT A DISORDER
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CAUSES VARIED SOME GENETIC EARLY LOSS EVENTS AND ABUSE CURRENT LOSSES AND TRAUMAS
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CHARACTERISTICS GREAT VARIANCE ACROSS SOCIETIES (3% - 30%) 2/3 WOMEN INVERSE WITH SOCIAL CLASS MOST AMONG YOUNG, ELDERLY
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PROGNOSIS (COURSE) COURSE HIGHLY VARIABLE OFTEN FREQUENT AND CHRONIC OFTEN ENDS WITH FRESH START EVENTS
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TREATMENT TREATED WITH SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRI) - PROZAC, PAXIL, XOLOFT
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TREATMENT COGNITIVE THERAPY PSYCHOTHERAPY COMBINATION OF THERAPIES
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