Chapter 21

1. Chapter 21 Mental Health Diseases and Disorders

2. Common Signs and Symptoms • Typically begin with behavioral changes • Slow-developing and very subtle • May not be noticed early in development of disorder • Forgetfulness, anxiety, and temper tantrums

3. Diagnostic Tests • Physiologic tests • Brain scans, EEGs, and MRIs • Referral to psychiatrist for psychological testing • Aptitude and personality tests

4. Developmental Mental Health Disorders • Intellectual disability • Formerly known as mental retardation • Symptoms: • Decreased intelligence • Decreased ability to learn, socialize, and mature • Known causes: • Genetic • Acquired

5. Developmental Mental Health Disorders • Attention deficit hyperactivity disorder • Symptoms: • Inability to concentrate • Hyperactivity • Impulsiveness • Cause unknown, but seems familial • Treatment: • Amphetamines

6. Developmental Mental Health Disorders • Eating disorders • Compulsion to eat or avoid eating that affects individual’s mental and physical condition • Most common: • Anorexia nervosa • Bulimia

7. Developmental Mental Health Disorders • Tic disorders • Sudden, rapid muscle movement or vocalization • E.g., eye blinking, facial grimacing, neck or shoulder jerking, throat clearing, snorting, grunting • Enuresis • Bedwetting • Urinary incontinence after toilet training

8. Substance-Related Mental Disorders • Diagnosis used • Instead of drug addiction • Common terms: • Addiction • Dependency • Tolerance • Withdrawal

9. Substance-Related Mental Disorders • Alcohol • Alcoholism • Physical and mental dependence on alcohol • Chronic • Progressive • Often fatal

10. Substance-Related Mental Disorders • Marijuana • Also known as pot • Euphoric effect • Cocaine • Accelerant to CNS and anesthetic

11. Substance-Related Mental Disorders • Methamphetamine • Fastest growing abused drug today • Addictive potent CNS stimulant • Caffeine and nicotine • Most common addictive substances • Sedatives or depressants • Anti-anxiety medications

12. Substance-Related Mental Disorders • Amphetamines • Release epinephrine leading to increased heart rate, respiration, and digestion • Hallucinogens • Also known as psychedelic drugs • E.g., lysergic acid diethylamide (LSD), mescaline, phencyclidine (PCP)

13. Substance-Related Mental Disorders • Narcotics • Depressants primarily prescribed as analgesics • E.g., heroin, opium • Inhalants • Abused legal substances • Taken by huffing, snuffing, and bagging • E.g., glue, nail polish, lighter fluid

14. Substance-Related Mental Disorders • Anabolic steroids • Abused by athletes to produce increases in muscle strength, lean body mass, and improved performance • Dangerous long-term effects

15. Organic Mental Disorders • Associated with physical cause • Affect cognition and ability to think, remember, and make judgments • May be temporary or permanent

16. Organic Mental Disorders • Dementia • Deterioration of mental abilities due to physical changes in brain • Delirium • Acute condition from medications, alcohol, fever, or illness • Alzheimer’s disease • Progressive, irreversible form of dementia

17. Psychosis • Disintegration of one’s personality • Impaired communication skills • Inability to deal with life’s demands • Delusions and hallucinations

18. Psychosis • Schizophrenia • Loss of touch with reality • Delusions • Delusional disorders • Belief in delusion in otherwise normally adjusted and balanced personality • Treatment: • Antipsychotic medications

19. Psychosis • Delusional disorders • Types: • Grandiose • Jealous • Erotomanic • Persecutory • Somatic

20. Mood or Affective Disorders • Depression • Prolonged feeling of extreme sadness, unhappiness, despair, or discouragement • Seasonal affective disorder • Depressive condition during winter months

21. Mood or Affective Disorders • Bipolar disorder (manic depressive) • Extreme depression and mania occur • Mood disorder questionnaire (MDQ) aids physician in identifying symptoms

22. Dissociative Disorders • Changes in identity or consciousness • Types: • Psychogenic amnesia • Psychogenic fugue • Depersonalization • Multiple personality

23. Anxiety Disorders • Anxiety • Usual temporary response to stress becomes chronic • May be related to genetic factors, severe stress, biochemical alterations, and in some cases, physical causes • E.g., hyperthyroidism

24. Anxiety Disorders • Types: • Generalized anxiety disorder • Panic disorder • Phobia disorder • Obsessive-compulsive disorder • Post-traumatic stress disorder

25. Somatoform Disorders • Physical symptoms, but no organic cause found • Conversion • Hysterical neurosis • Hypochondriasis • Abnormal anxiety about one’s body and health

26. Somatoform Disorders • Pain disorder • Pain does not have physiologic cause • Malingering • False display of symptoms for financial or personal reward • Munchausen syndrome • Simulation of illness for no other reason than to receive treatment

27. Personality Disorders • Types: • Paranoid • Schizoid • Antisocial • Narcissistic • Histrionic

28. Gender Identity Disorder • Individual uncomfortable or distressed with sexual identity • Adults may seek hormonal or surgical intervention for sex change

29. Sexual Disorders • Types: • Exhibitionism • Fetishism • Transvestic fetishism • Frotteurism

30. Sexual Disorders • Types: • Pedophilia • Sexual sadism • Sexual masochism • Voyeurism

31. Sleep Disorders • Types: • Insomnia • Narcolepsy • Sleep apnea • Nightmare disorder • Sleep terror • Sleepwalking

32. Trauma • Grief • Natural process of coping with loss • Suicide • Major concern with teenagers

33. The Older Adult • Disorders may occur in early childhood or later in life • Important to distinguish if actual mental health problem or physiologic or system-specific disorder • Some symptoms due to aging process or side effects of medications