Mood Disorders & Schizophrenia 

Mood Disorders

    Mood disorders are prolonged & disturbed emotional state that affects almost all of a person’s 
thoughts, feelings, and behaviors.

Three common mood disorders

1. Major depression disorder is marked by at least two weeks of continually being in a bad mood, 
having no interest in anything, and getting no pleasure from activities. in addition, a person 
must have at least four of the following symptoms; problems with eating, sleeping, thinking, 
concentrating, or making decisions, lacking energy, thinking about suicide, feeling worthless 
or guilty.
 
2. Bipolar I disorder is marked by fluctuations between episodes of depression and mania. A 
manic episode goes on for at least a week during which a person is unusually euphoric, cheerful, 
and high and also has three of the following symptoms: great self esteem, has little need for sleep, 
speaks rapidly and frequently, has racing thoughts, is easily distracted, and pursues 
pleasurable activities.
 
3. Dysthymic disorder is characterized by being chronically but not continually depressed for a 
period of two years. While depressed, a person experiences at least two of the following: poor 
appetite, insomnia, fatigue, low self-esteem, poor concentration, feelings of hopelessness.

Causes of mood disorders

1. Biological factors underlying depression include genetic, neurological, chemical, and 
physiological components that may predispose or put someone at risk for developing 
a mood disorder.
 
2. Psychosocial factors underlying depression include personality traits, cognitive styles, social 
supports, and the ability to deal with stressors, that interact with predisposing biological factors 
to put one at risk for developing mood disorders
Treatment of mood disorders

• For major depression & dysthymic disorder
 
     - antidepressant drugs act by increasing the levels of a specific group of neurotransmitters 
(monoamines-serotonin, norepinephrine, and dopamine) that are involved in the regulation 
of emotions and moods.
 
     - psychotherapy
 
• For Bipolar I disorder
 
     - past drug of choice was lithium (mood stabilizer)
 
     - antipsychotics & antidepressants are often combined with lithium
 
• For Mania - lithium

Electroconvulsive Therapy

     In 30% of depressions antidepressant drugs fail, the only other available treatment is ECT.
 
 • Electroconvulsive therapy or ECT involves placing electrodes on the skull and administering 
a mild electric current that passes through the brain and causes a seizure.
 
 Treatment consists of 10 to 12 sessions at about three per week.
 
 A serious side effect of ECT is memory loss.

Personality Disorders

    A personality disorder consists of inflexible, long-standing, maladaptive traits that cause 
significantly impaired functioning or great distress in one’s personal & social life.

Six Common Types of Personality Disorders

1. Paranoid personality disorder is a pattern of distrust and suspiciousness and perceiving others 
as having evil motives. (0.5 - 2.5% of population)

2. Schizotypical personality disorder is characterized by an acute discomfort in close relationships, 
distortions in thinking, & eccentric behavior. (3 - 5% of population)
 
    Schizotypal personality disorder, or simply schizotypal disorder, is a less common personality 
disorder that is characterized by a need for social isolation, odd behavior & thinking, & often 
unconventional beliefs such as being convinced of having extra sensory abilities. Some people 
believe that schizotypal personality disorder is a mild form of schizophrenia.

3. Histrionic personality disorder is characterized by excessive emotionality and attention seeking, 
(2% of population)

4. Obsessive-Compulsive personality Disorder or OCD is an intense interest in being orderly, achieving 
perfection, and having control. (4% of population)

5. Dependent personality disorder refers to a pattern of being submissive & clingy because of an 
excessive need to be taken care of. (2% of population)

6. Antisocial personality disorder refers to a pattern of disregarding or violating the rights of others 
without feeling guilt or remorse. (3% of population)

Schizophrenia

    Schizophrenia is a serious mental disorder that lasts for at least six months and includes at least 
two of the following symptoms: delusions, hallucinations, disorganized speech, disorganized behavior, 
& decreased emotional expression.

Subcategories of Schizophrenia

1. Paranoid schizophrenia is characterized by auditory hallucinations or delusions, such as thoughts 
of being persecuted by others or thoughts of grandeur.

2. Disorganized schizophrenia is marked by bizarre ideas, often about one’s body (bones melting), 
confused speech, childish behavior, great emotional swings, and often extreme neglect of personal 
appearance and hygiene.

3. Catatonic schizophrenia is characterized by periods of wild excitement or periods of rigid, prolonged 
immobility. Sometimes the person assumes the same frozen posture for hours on end.

Chance of Recovery by type

    Type I schizophrenia includes having positive symptoms, such as hallucinations and delusions. There 
is distortion of normal function with no intellectual impairment & a good reaction to medication 
- good chance of recovery -

    Type II schizophrenia includes having negative symptoms, such as dulled emotions and little inclination 
to speak, which are a loss of normal functions. There is intellectual impairment & poor reaction to medication 
- poor chance for recovery -

Symptoms of Schizophrenia

1. disorders of thought - delusions
2. disorders of attention
3. disorders of perception - hallucinations
4. motor disorders
5. emotional (affective) disorders

Causes of Schizophrenia

    Biological causes; Schizophrenia seems to have a genetic predisposition & researchers are seeking the 
genetic markers involved with schizophrenia.

    A genetic marker refers to an identifiable gene or number of genes or a specific segment of a chromosome 
that is directly linked to some behavioral, physiological, or neurological trait or disease.

     Neurological causes; Two reliable differences: larger ventricles & decreased activity in the prefrontal cortex

     Environmental causes; The diathesis stress theory says that biological & neurological factors create a 
genetic predisposition that interacts with life stressors in the environment to produce schizophrenia.

Treatment

     Neuroleptic drugs (also called antipsychotic drugs) are used to treat serious mental disorders, such as 
schizophrenia, by changing the levels of neurotransmitters in the brain.

     Typical neuroleptics primarily reduce levels of the neurotransmitter dopamine.

    The Dopamine Theory says that in schizophrenia the dopamine neurotransmitter system is somehow 
overactive and gives rise to a wide range of symptoms.

     Atypical neuroleptics such as clozapine, risperidone, lower levels of dopamine and also reduce levels 
of other neurotransmitters, especially serotonin. Atypical neuroleptics reduce positive symptoms, may improve 
negative symptoms, and reduce relapse.

Treatment - Evaluation of neuroleptic drugs
 
    Phenothiazines (a group of typical neuroleptic drugs) can produce unwanted motor movements in a side 
effect called Tardive dyskinesia which involves the appearance of slow, involuntary, and uncontrollable rhythmic 
movements and rapid twitching of the mouth and lips, as well as unusual movements of the limbs.
 
    Atypical neuroleptics such as risperidone & olanzapine produce a very low rate of tardive dyskinesia; but can 
cause increased levels of glucose or blood sugar (hyperglycemia), excessive weight gain, & onset of, or 
worsening of, diabetes.

Dissociative Disorders
 
   A Dissociative Disorder is characterized by a person having a disruption, split, or breakdown in his or her normal 
   integrated self, consciousness, memory, or sense of identity.
   
   Types
   
   1. Dissociative Amnesia (DSM-IV: 300.12)  Patients with this Dissociative Disorder experience marked but 
   reversible impairment of recall of important personal information or experience, usually involving emotional trauma.
   
   2. Dissociative Fugue (DSM-IV: 300.13)  Patients with this Dissociative Disorder suddenly & unexpectedly travel 
   away from their home geographic location, experience impaired recall of their past. They may be confused about 
   their former identity and may assume a new identity.
   
   3. Dissociative Identity Disorder - DID (DSM-IV: 300.14)  was formerly called multiple personality disorder. 
   Patients with this Dissociative Disorder suffer from alternation of two or more distinct personality states with 
   impaired recall among personality states of important information.
   
   4. Depersonalization Disorder (DSM-IV: 300.6)  Patients with this Dissociative Disorder experience episodes 
   during which they feel detached from themselves. They may experience themselves or their surroundings as unreal. 
   They may feel outside or lacking control of themselves. They retain awareness that this is only a feeling. 
   (less common type)
   
   5. Dissociative Disorder NOS (DSM-IV: 300.15)  (less common type)
    
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                 Topics in Psychology
                      Robert C. Gates