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TYPES OF MENTAL ILLNESS

TYPES OF MENTAL ILLNESS. SCHIZOPHRENIA. CAUSES. ABOUT 1% PREVALENCE IN WIDE VARIETY OF TIMES AND PLACES USED TO THINK BAD FAMILIES WERE CAUSE (SCHIZOPHRENOGENIC MOTHER) NOW THOUGHT TO BE BRAIN DISORDER WITH GENETIC OR BIOLOGICAL CAUSE. CORRELATES. LOW SOCIAL CLASS CAUSE OR CONSEQUENCE?

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TYPES OF MENTAL ILLNESS

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  1. TYPES OF MENTAL ILLNESS

  2. SCHIZOPHRENIA

  3. CAUSES • ABOUT 1% PREVALENCE IN WIDE VARIETY OF TIMES AND PLACES • USED TO THINK BAD FAMILIES WERE CAUSE (SCHIZOPHRENOGENIC MOTHER) • NOW THOUGHT TO BE BRAIN DISORDER WITH GENETIC OR BIOLOGICAL CAUSE

  4. CORRELATES • LOW SOCIAL CLASS • CAUSE OR CONSEQUENCE? • NO GENDER DIFFERENCES • NO ETHNIC DIFFERENCES • EARLY ONSET - 16-25 YEARS • “BURN OUT” • ALMOST ALL NOT MARRIED

  5. 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%

  6. 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

  7. 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)

  8. 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

  9. BI-POLAR DISORDER

  10. DYSREGULATION OF MOOD • ALTERATIONS OF WILD ELATION AND DEEP DEPRESSION • CAN BE ACCOMPANIED BY DELUSIONS AND HALLUCINATIONS • VERY DIFFERENT INTERPERSONALLY THAN SCHIZOPHRENIA - CONNECTEDNESS

  11. 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

  12. DEPRESSIVE PHASE • TOTAL BLEAKNESS WHEN DEPRESSED (111) • HIGH RATE OF SUICIDE

  13. CAUSE • PROBABLE GENETIC CAUSE • RUNS IN FAMILIES • PREVALENCE BETWEEN 1/2% TO 1% • SEEMS TO BE UNIVERSAL

  14. SOCIAL CORRELATES • NO SOCIAL CLASS DIFFERENCES • NO ETHNIC DIFFERENCES • SMALL GENDER DIFFERENCE • VARIABLE AGE OF ONSET – FROM LATE TEENS TO MIDDLE AGE • MORE DIAGNOSIS LATELY

  15. 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

  16. JAMISON - UNQUIET MIND • DIFFICULTIES OF TREATMENT • AMBIVALENCE TOWARD MEDICATION (98) • IMPORTANCE OF SOCIAL SUPPORT - INFORMAL AND PROFESSIONAL • YAVI ASPECT?

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