Depression/Schizophrenia Flashcards
Major Depression - Epidemiology
Lifetime prevalence: 15%
2x more common for women
Family history possibly
Mean age is 40, but occurs at any age
Increased risk of occurrence after losing close relationship
Occurs in all socioeconomic classes and races
Greater cause of suffering than cancer
Major Depression - Course
Untreated - Can last for 6-12 mos
Treated - Can often resolve within 2 mos.
Risk for recurrence - Rule of thirds
Major Depression - Symptoms
Feelings of worthlessness Helplessness Excessive guilt Irritability/tearfulness Psychosis 5 or more symptoms for 2 weeks duration
Differential Diagnosis
Bipolar depression Dysthymia Grief Adjustment disorder Hypothyroidism Substance induced or w/d CHF Hypoxia Parkinsons HIV Adrenal disorders
Etiology
Genetic (Runs in different families than bipolar generally)
Catecholamines/serotonin
Psychoanalytic
Production of Serotonin
Tryptophan to 5-Hydroxytryptophan via Tryptophan hydroxylase
5-Hydroxytryptophan to Serotonin (5-HT) via amino acid decarboxylase
Metabolism of Serotonin
Metabolized by monoamine oxidase and aldehyde dehydrogenase to form 5-hydroxyindole acetic acid
Major Depression - Suicide Risk
10-15% life time risk
Single episode of MDD: 66% consider suicide
Suicide > MVA as a cause of death
Major Depression - Treatment
SSRIs
SNRIs
Tricyclics
MAOIs
Schizophrenia - Epidemiology
Lifetime prevalence: 1-2% Equal prevalence between males and females Age of onse: M: Late teens; F: Early 20s No racial difference in prevalence Socioeconomic class correlation?
Schizophrenia - Positive symptoms
Delusions
Paranoia
Hallucinations - Auditory/Visual
Disorganized thought process
Schizophrenia - Negative symptoms
Blunted affect Alogia Social isolation Lack of motivation Anhedonia Poor hygiene
Schizophrenia - DSM V
No longer categorizes previous subtypes
Catatonia associated with another mental illness is now a separate category
Schizophrenia - Course
Lifelong illness
Psychotic exacerbations
Negative symptoms tend to be chronic and longstanding
Schizophrenia - Differential
Psychosis (Manic, Substance Induced, Depressive) Shizoidal PD Shiczotypal PD Delirium Schizoaffective Disorder
Schizophrenia - Etiology
Dopamine theory: Mesolimbic, mesocortical
Genetic
Double-bind, psychosocial theories
Schizophrenia - Suicide Risk
10% Lifetime Risk
Schizophrenia - Treatment
Typical antpsychotics: D2 blockers
Atypicals: D2/4 blockers - 5HT2 blockers
