Mental Disorders - AB Psych

Bipolar Disorders

• Bipolar disorder may be a more severe variant of mood disorders
• Depression and mania are the world's first documented mental illnesses
• Aretaeus of Cappadocia combined depression and mania into bipolar disorder
• Theophile Bonet used the term "melancholicus mania" in 1679
• Willis described "Melancholia" and "Mania" as distempers of raving
• Emil Kraeplin categorized mood disorders, including bipolar disorder, as "manic-depressive insanity"

Diagnostic Considerations for Depressive Disorder due to Another Medical Condition

• No depressive episodes prior to the medical condition
• Probability that the medical condition causes a depressive disorder

Bipolar I (Manic)

• At least one manic episode (elation and euphoria)
• Children's behavior judged against their own baseline
• First episode usually a major depressive episode (MDE)
• Factors to consider: family history, onset, medical history, psychotic symptoms, and treatment response

Children and Bipolar Disorder

• Changes in behavior represent a clear change from the child's typical behavior
• Symptoms of mood lability and impulsivity must be a distinct episode
• Youths who meet DSM-5 criteria for BP display significant impairment in functioning

Bipolar II (Hypomanic)

• One or more hypomanic episodes and one or more MDE
• Often begins with depressive episodes
• Highly recurrent
• Once hypomanic episode occurs, it never reverts to MDD
• Co-occurring disorders common (e.g., anxiety disorders, ADHD)

Mood, Bipolar, and Cyclothymic Disorders

• Cyclothymic disorder: mood disorder with hypomanic and depressive episodes
• Comorbid disorders: substance-related disorders, sleep disorders
• Emotion regulation difficulties in children with bipolar disorder
• Emotion reactivity: individual differences in emotional experience
• Emotion regulation: enhancing, maintaining, or inhibiting emotional arousal

Eating Disorders

• Pica: eating non-nutritive substances for at least 1 month
• Rumination disorder: repeated regurgitation of food for at least 1 month
• Avoidant/Restrictive Food Intake Disorder: eating or feeding disturbance
• Anorexia Nervosa: fear of gaining weight, subtypes: binge-eating/purging type and restricting type
• Bulimia Nervosa: recurrent episodes of binge eating and purging
• Binge Eating Disorder: recurrent episodes of binge eating

Elimination Disorders

• Enuresis: repeated voiding of urine in bed or clothes
• Encopresis: repeated passage of feces into inappropriate places

Sleeping Disorders

• Insomnia: difficulty initiating or maintaining sleep
• Sleep Disorders: Dyssomnias (e.g., insomnia, sleep apnea) and Parasomnias (e.g., sleepwalking, sleep terrors)
• Sleep continuity: overall balance of sleep and wakefulness
• Sleep latency: amount of time required to fall asleep
• Wake after sleep onset: amount of awake time between sleep onset and final awakening

Somatic Symptom Disorders

• Somatic Symptom Disorder: excessive thoughts, feelings, or behavior related to somatic symptoms
• Illness Anxiety Disorder: preoccupation with having or acquiring serious illness
• Conversion Disorder: altered voluntary motor or sensory function
• Factitious Disorder: falsification of physical or psychological symptoms
• Psychological Factors Affecting Other Medical Conditions: psychological or behavioral factors affect a medical condition

Dissociative Disorders

• Depersonalization-Derealization Disorder: detachment from self or the world
• Dissociative Amnesia: inability to recall important autobiographical information
• Dissociative Fugue: sudden, unexpected travel away from home
• Dissociative Identity Disorder: disruption of identity characterized by two or more distinct personality states### Depressive Disorders
• A diagnosis of "other specified depressive disorder" or "unspecified depressive disorder" may be given in certain cases
• A separate diagnosis of PDD (Persistent Depressive Disorder) is not made if symptoms occur only during a psychotic disorder
• Double Depression: a condition in which an individual suffers from both MDE (Major Depressive Episode) and PDD with fewer symptoms

Premenstrual Dysphoric Disorder

• At least 5 symptoms must be present for most menstrual cycles
• Delusions and hallucinations can occur in the late luteal phase of the menstrual cycle, but are rare

Seasonal Affective Disorder

• Episodes must have occurred for at least 2 years with no evidence of nonseasonal MDE during that time
• Also known as "Cabin Fever"

Grief

• Integrated Grief: acute grief where the finality of death and its consequences are acknowledged, and the individual adjusts to the loss
• Complicated Grief: a reaction that can develop without a preexisting depressed state

Dissociative Identity Disorder (DID)

• Characterized by switching between personalities
• Considered an extreme subtype of PTSD (Post-Traumatic Stress Disorder)
• Individuals with DID have the highest hypnotic capacity among all clinical groups
• Often presents with comorbid depression, anxiety, substance abuse, self-injury, or other symptoms
• Early life trauma is a risk factor for developing DID
• Several brain regions are implicated in the pathophysiology of DID, including the orbitofrontal cortex, hippocampus, parahippocampal gyrus, and amygdala
• DOES NOT have a classic bipolar sleep disturbance
• Often comorbid with PTSD, depressive disorders, and substance abuse