Transcript January 27, Types of Mental Illness

TYPES OF MENTAL ILLNESS
A BEAUTIFUL MIND
• JOHN NASH
CAUSES
• USED TO THINK BAD FAMILIES WERE
CAUSE (SCHIZOPHRENOGENIC
MOTHER)
• NOW THOUGHT TO BE BRAIN
DISORDER WITH GENETIC OR
BIOLOGICAL CAUSE
• ABOUT 1% PREVALENCE IN WIDE
VARIETY OF TIMES AND PLACES
CORRELATES
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LOW SOCIAL CLASS
CAUSE OR CONSEQUENCE?
NO GENDER DIFFERENCES
NO ETHNIC DIFFERENCES
EARLY ONSET - 16-25 YEARS
ALMOST ALL NOT 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 INTERPERSONALLY
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
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PROBABLE GENETIC CAUSE
RUNS IN FAMILIES
PREVALENCE BETWEEN 1/2% TO 1%
SEEMS TO BE UNIVERSAL
SOCIAL CORRELATES
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NO SOCIAL CLASS DIFFERENCES
NO ETHNIC DIFFERENCES
SMALL GENDER DIFFERENCE
VARIABLE AGE OF ONSET – FROM
LATE TEENS TO MIDDLE AGE
COURSE AND TREATMENT
• HIGHLY VARIABLE COURSE, BUT
USUALLY RECURRENT
• 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?