Mental Illness

Schizophrenia

Mood Disorders (Depression)

References

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MENTAL ILLNESS

The purpose of this page is to provide information on two types of mental illness: Schizophrenia and Mood Disorders. Search links at bottom of page for additional resources.

SCHIZOPHRENIA

Schizophrenia is characterized by:

At least 1 month of positive symptoms (hallucinations, delusions, disorganized speech, and severe behavioral changes)

A 6-month period of continuous disturbance involving deficit or negative symptoms and which may include positive symptoms in either full-scale or attenuated form

Biological Features

Genetic Risk - MZ twins 40%; both parents 25%; one parent 15%;
DZ twins/one sibling 10%; general risk 1%

Biological Treatment

First episode psychosis should be investigated and managed on an inpatient basis; it is crucial to rule out substance use and general medical conditions that can cause psychosis
Antipsychotic medication is the cornerstone of treatment
Traditional antipsychotic medications work well for positive symptoms. Newer antipsychotics treat negative symptoms.

Psychosocial Treatment

Community care involves a case manager, vocational rehabilitation, social skills training, and ongoing supportive therapy
Family Education is important
Housing in a group home or residence may need to be arranged

Prognosis

Overall, the prognosis remains discouraging: only 25% lead relatively normal lives; over 50% require repeated hospitalizations

MOOD DISORDERS

Major Depressive Disorder

A Major Depressive Disorder (MDD) is one of two main mood disorders, the other being bipolar disorder. While a transient decline in mood is a universal human experience, depression is characterized by hopelessness, a sense of losing control, and a loss of enjoyment.

Biological Features

Genetic factors are becoming increasingly evident; adoption and twin studies also support this finding (chromosomes 5, 11, 18, X)
Serotonin and norepinephrine are the neurotransmitters involved in mood disorders; antidepressant medications increase their levels
There are several biological changes in depression, e.g. sleep & circadian rhythm changes; endocrine & immune system changes

Biological Treatment

Antidepressants from different chemical classes appear to have similar efficacy, but vary widely in their side effect profile
Specific treatments may be indicated for subtypes of depression
Onset of action takes at least 2 weeks and appears to be related to down-regulation of post-synaptic beta noradrenergic receptors and type-2 serotonergic (5HT2) receptors

Psychosocial Treatment

Many effective psychotherapies exist for depression: cognitive, interpersonal, and psychodynamic are the most common
Combining psychotherapy with medication may produce the best outcome, though this issue is still debated

Prognosis

The prognosis for MDD is generally favorable; at least 80% of patients fully recover; relapses are common with up to 25% occurring in the first year, 50% within 2 years, and 75% within 5 years

Robinson, D. (2001). Mnemonics & More. Port Huron, MI:Rapid Psychler Press.

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