Mental Health Conditions and Disorders

Mood Disorders

 

Mood disorders are characterized by the presence of one or more mood episodes, which represent a combination of symptoms representing a predominant mood state or syndrome. There is a paucity of biological markers. Specifiers can also be used to further qualify mood disorders.

 

Mood disorders are characterized by the presence of one or more mood episodes, which represent a combination of symptoms representing a predominant mood state. Mood episodes are not diagnoses per se - serve as means of developing diagnosis of mood disorders. Specifiers can also be used to further qualify mood disorders.

 

Mood Disorders major depressive disorder bipolar disorder

Mood episodes

 

 

 

 

 

 

Mixed episode: Symptoms of both manic and depressive episodes nearly every day for at least one week.

Also could be called dysphoric mania.

 

A manic episode is a period of abnormally and persistently elevated, expansive, or irritable mood lasting at least one week, or requiring hospitalization.

 

Cyclothymia

• presence of numerous periods of hypomanic and depressive episodes, without being major depressive episodes, lasting at least two years
• never without symptoms for longer than two months
• clinically signficant distress or impairment in social, occupational, or other areas of functioning
• may be treated with anticinvulsants and psychotherapy

 

 

Dysthymia

Dysthymia has a point prevelance of 3% and a lifetime prevalence of 6%.

Females are 3x more likely affected than males.

Up to 75% of people with dysthymia will also develop a major depressive disorder within 5 years.

COmmon comorbidities include personality disorders (especially borderline, histrionic, narcissistic, avoidant, and dependent), substance abuse, and major depressive disorders

 

Dysthymia is not substance-induced, with no MDE within the first two years. It is diagnosed with:

 

depressed mood for most of the day, for more days than not, either subjectively or objectively, for at least two years

-and-

presence of at least two of the following:

• poor Concentration or difficulty making decisions
• Hopelessness
• low self-Esteem
• low Energy or fatigue
• Sleep increased or decreased
• Eating increased or decreased

During this time, the person cannot have been without symptoms for more than 2 months at a time.

• primarily psychogical - individual, group, and family
• SSRIs and SNRI may be useful

Anxiety Disorders

 

Anxiety and fear are normal and healthy, anxiety disorders are the most frequent disorders in the general population.

 

Anxiety becomes a problem when it makes decision for you, interferes with your life, or causes distress. It comes in two main forms: misinterpreting threats, or extreme response.

 

Broad categories include:

 

low grade, persistent distress. Resembles heightened state of alertness, with constant vigilance to threats

• generalized anxiety disorder
• obsessive-compulsive disorder

acute, severe, brief wave with cognitive, physiologic, and behavioural component. Resembles acute fear or harm

• panic disorder
• phobias
• post-traumatic stress disorder
• separation anxiety disorder
• PANDAS

Other anxiety disorders include:

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections)

Controversial; due to the antibodies

can be so severe kids can land in hospital

• OCD and/or Tic disorder
• onset from 3 years to puberty
• can be episodic, abrupt onset or dramatic exacerbations
• exacerbations associated with GABHS infection
• presence of neurological abnormalities

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Treatment for anxiety includes psychotherapy and medications. The latter is often a first-line treatment, as it can be started, cheaply, within 30 minutes. Short-term is often benzodiaepines, while longer term can include SSRIs, SNRIs, or TCAs. Psychotherapy is often unavailable and very expensive.

 

Psychotherapy, especially involving exposure to stimuli. People need to stay in an anxiety-provoking situation until their feelings start to decrease. This will retrain whatever it is that induces the anxiety. If they get exposed and then leave (avoidance), then next time their anxiety might be heightened. Don't do this. (SHOW GRAPH HERE)

 

 

Psychotic Disorders

 

Psychosis is characterized by a significant loss of contact with reality affecting the ability to think, feel, perceive, and act. Psychosis typically involves a) delusions or hallucinations, with or without insight, and b) disorganized behaviour. Further information can be found under 'what is psychosis?' and 'assessing psychotic episodes'.

 

Primary psychotic disorders:

• schizophrenia - signs of illness for over 6 months, and psychotic symptoms for over one month, with functional impairment
• schizophreniform disorder - similar to schizophrenia, but with duration of less than 6 months
• schizoaffective disorder - concurrent symptoms of schizophrenia and mood disorder, with at least two weeks of psychotic symptoms alone
• brief psychotic disorder - psychotic symptoms for between one day and one month, potentially realted to life stressor; full recovery may follow
• delusional disorder - nonbizzare delusions for at least one month, not meeting criteria for schizophrenia

Other causes of psychosis:

• mood disorders (ie psychotic depression or bipolar disorder)
• personality disorders
• general medical conditions (tumours, trauma, dementia, delerium, metabolic)
• substance-induced psychosis (intoxication or withdrawal)

Mnemonic:

• General medical condition
• Affective Disorders
• Substance Induced
• Personality Disorders
• Pyschotic Disorders

Cognitive Disorders

 

• delerium
• dementia
  • Alzheimer's Disease

 

 

personality disorders

 

Childhood Something Disorders

Disruptive behaviour disorders

• attention deficit hyperactivity disorder (ADHD)
• conduct disorder
• separation anxiety disorder
• pervasive developmental disorders

• autism spectrum disorder
• Asperger's sydrome
• Rett's Syndrome
• childhood disintegrative disorder
• pervasive developmental disorder NOS

 

Anxiety disorders

 

oppositional defiant disorder

Negativistic, hostile, defiant behaviours for at least 6 months

Have particular problems with authority figures.

Annoying to other children, teachers, parents.

Often blame others for how things are, with much anger, resentment, spite, and vindictiveness

 

Behaviour Management

Behaviour management is what this is all about.

Pick your battles; don't worry about the small behaviours.

Manage yourself; stay neutral, firm, and cool.

Negotiation is very important; don't be authoritarian.

Rewards can be beneficial

 

Involvement of family, teachers, etc

Psycho-social education of parents is very important

Other Disorders

 

substance abuse disorders

adjustment disorder

somatiform disorders

• conversion disorder
• somatization disorder
• pain disorder
• hypochondriasis
• body dysmorphic disorder

 

Dissociative disorders (amnesia, fugue, identity disorder) result from a dissociation so severe that usual integration of consciousness and perception of self break down. It can come on suddenly or gradually, and can be transient or chronic.

Understandably, symptoms cause distress or impaired functioning.

 

Amnesia is the inability to recall important personal information, usually of a traumatic or stressful nature. Amnesia can be localized, selective, or generalized.

 

Fugue is the sudden, unexpected travel away from home or workplace, with the inability to recall some or all of one's past; a new identity may be taken.

 

Identitiy disorder, aka multiple personality disorder, is the rpesence of two or more distinct personalities who take control of an individual's behaviour.

 

eating disorders

sleep disorders

• nocturnal myoclonus
• narcolepsy

sexuality and gender disorders