MENTAL DISOIDER - SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC DISORDERS

WHAT ARE MENTAL DISORDERS?

Mental disorders (or mental illnesses) are conditions that affect your thinking, feeling, mood, and behavior. They may be occasional or long-lasting (chronic). They can affect your ability to relate to others and function each day.

WHO DEFINES -  KEY FACTS   

  • There are many different mental disorders, with different presentations. They are generally characterized by a combination of abnormal thoughts, perceptions, emotions, behavior and relationships with others.
  • Mental disorders include: depression, bipolar disorder, schizophrenia and other psychoses, dementia, and developmental disorders including autism nd etc.
  • There are effective strategies for preventing mental disorders such as depression.
  • There are effective treatments for mental disorders and ways to alleviate the suffering caused by them.
  • Access to health care and social services capable of providing treatment and social support is key.


    DIAGNOSTIC STATISTICAL MANUAL OF MENTAL DISORDERS(DSM5)


THE Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health care professionals in the United States and much of the world as the authoritative guide to the diagnosis of mental disorders. DSM contains descriptions, symptoms, and other criteria for diagnosing mental disorders. It provides a common language for clinicians to communicate about their patients and establishes consistent and reliable diagnoses that can be used in the research of mental disorders. It also provides a common language for researchers to study the criteria for potential future revisions and to aid in the development of medications and other interventions.
THE DSM -5 MANUAL IS PREPARED BY APA (AMERICAN PSYCHATRIST ASSOCIATION)


SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC DISORDERS

schizophrenia, are characterized by distortions in thinking, perception, emotions, language, sense of self and behaviour. Common psychotic experiences include hallucinations (hearing, seeing or feeling things that are not there) and delusions (fixed false beliefs or suspicions that are firmly held even when there is evidence to the contrary). The disorder can make it difficult for people affected to work or study normally.

Schizophrenia is a type of mental illness known as a "psychosis." A psychosis is a mental illness in which a person cannot tell what is real from what is imagined. At times, people with psychotic illnesses lose touch with reality. The world may seem like a jumble of confusing thoughts, images, and sounds.

How common is schizophrenia?

Schizophrenia is more common than most people think. About 1 in 200 of the people in the United States will develop schizophrenia over the course of their lives. It's also important to know that schizophrenia has many different symptoms and can show up in many different ways.

Schizophrenia is not the same as a "split personality." A split personality is another type of mental illness. Split personality is much less common than schizophrenia.


CRITERIA IN DSM -5 

The DSM-5 has added the word, “spectrum” to the title. The same basic diagnoses are still available in the DSM-5. Some symptom criteria were changed to make diagnosis more accurate and precise. Additionally, catatonia has been deconceptualized as a separate diagnostic feature that cuts across several broad categories of disorders. The distinction between bizarre and non-bizarre delusions is no longer diagnostically significant.

Symptom criteria changes:


Criterion A lists the five key symptoms of psychotic disorders: 
OUT OF THIS, 2 OF THE SYMPTOM SHOULD BE PRESENT, AND at least one symptom must be one of the first three (delusions, hallucinations, disorganized speech).

In DSM-IV 2 of these 5 symptoms were required. However, only 1 of the 5 symptoms was required if delusions were bizarre or if hallucinations included a running commentary on a person's thoughts/behavior, and/or two or more voices conversing.
BUT THE CRITERIA GETS CHANGED IN DSM-5 👇


1 MONTH - PROMINENT SYMPTOMS , 6 MONTH PERSISTENT SYMPTOM

1) Delusions,

2) Hallucinations, 

3) Disorganized speech,

4) Disorganized or catatonic behavior
5) Grossly disorganized or abnormal motor behavior(including catatonia) 

5) Negative symptoms.

NEGATIVE SYMPTOMS:- 

Negative symptoms account for a substantial portion of the morbidity associated with schizophrenia but are less prominent in other psychotic disorders.
it includes:-

  • Diminished emotional expression 
  • Intonation of speech (PROSODY)
  • Avoilation - Decrease in purposeful activity
  • Alogia- Diminished speech 
  • Anhedonia -Decreased activity to experience pleasure.
  • Asociality -Lack of interest in social interactions

DISORDERS COME UNDER SCHIZOPHRENIA :-

  • Schizotypal personality disorder. A person with schizotypal personality disorder has a difficult time developing close relationships with other people and may hold beliefs not shared by other people in his or her same culture. The person may also have unusual behaviors and learning difficulties.
  • Schizoid personality disorder. A person with schizoid personality disorder is aloof from other people and does not show many emotions.
  • Delusional disorder. People with delusional disorder believe things that could happen but are unlikely to happen. For example, a person with delusional disorder may believe he or she has cancer despite several negative test results. The person has no other psychotic symptoms, except those related to the delusion. But he or she is able to function in daily life.
  • Schizoaffective disorder. People with schizoaffective disorder have the same symptoms as people with schizophrenia. But they also have episodes of depression and times when they feel extremely happy or have lots of energy (mania). For more information, see the topics Depression and Bipolar Disorder.
  • Schizophreniform disorder. People with schizophreniform disorder have the same symptoms as people with schizophrenia. But their illness episodes do not last as long (from 1 to 6 months), and they may not have as many problems getting along with other people.

CAUSES OF SCHIZOPHRENIA 




1) GENETIC AND PHYSIOLOGICAL

One of the most significant risk factors for schizophrenia may be genes. This disorder tends to run in families.

If you have a parent, sibling, or other close relative with the condition, you may have a higher likelihood of developing it, too.

However, researchers don’t believe a single gene is responsible for this disorder. Instead, they suspect a combination of genes can make someone more susceptible.

Other factors, such as stressors, may be needed to “trigger” the disorder in people who are at a higher risk.

If you’ve been diagnosed with schizophrenia, you may have subtle physical differences in your brain. But these changes aren’t seen in everyone with this disorder.

They may also occur in people who don’t have a diagnosed mental health disorder.

Still, the findings suggest that even minor differences in brain structure may play a role in this psychiatric disorder

A series of complex interrelated chemicals in the brain, called neurotransmitters, are responsible for sending signals between brain cells.

Low levels or imbalances of these chemicals are believed to play a role in the development of schizophrenia and other mental health conditions.

DOPAMINE AND SEROTONIN in particular, seems to play a role in the development of schizophrenia.

RESEARCHERS have found evidence that dopamine causes an overstimulation of the brain in people with schizophrenia. It may account for some of the symptoms of the condition.

Glutamate is another chemical that’s been LINKED TO SCHIZOPHRENIA Evidence has pointed toward its involvement. However, there are a number of limitations to this research.

ENVIORNMENTAL FACTORS

Complications before and during birth may increase the likelihood a person will develop mental health disorders, including schizophrenia.
1 LOW BIRTH WEIGHT

2INFECTION DURING PREGENANCY

3 lack of oxygen during delivery

Because of the ethics involved in studying pregnant women, many of the

 studies that have looked at the connection between prenatal complications and schizophrenia have been on animals.

Women with schizophrenia are at an increased risk for complications during pregnancy.

It’s unclear if their children are at an increased likelihood for developing the condition because of genetics, pregnancy complications, or a combination of the two.

SOME RESEARCHES ALSO SUGGEST THAT USE OF DRUG. MARIJUNA ALSO LEAD TO SCHIZOPHRENIA.

Childhood trauma is also thought to be a contributing factor in developing schizophrenia. Some people with schizophrenia experience hallucinations related to abuse or neglect they experienced as children.

People are also more likely to develop schizophrenia if as children they experienced the death or permanent separation of one or both parents.

TREATMENT



1) MEDICATION:- ANTIPSYCHOTIC DRUGS  These medications affect brain chemistry. They help decrease symptoms by affecting the level of chemicals believed to be involved with the disorder.

THAT LOCK CERTAIN NEUROTRANSMITTER.

PSYCHOLOGICAL TREATMENT-FAMILY THERAPY WHICH MEANS FAMILY PROVIDING CARE TO THAT PARTICULAR PATIENT.
PSYCHOEDUCATION - EDUCATIOM OF ALL THESE MENTAL DISORDERS TO THE FAMILIES WHICH HELPS THEM TO RECOGNIZE ABOUT THAT,

Coordinated specialty care. This approach to treatment combines medication and psychosocial therapy. It also adds family integration, education, and employment counseling. This type of care aims to reduce symptoms, manage periods of high activity, and improve quality of life.

Psychosocial therapy. You can learn coping skills to help you manage some of the challenges this disorder causes. These skills can help to complete school, hold a job, and maintain quality of life.


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