Schizophrenia
Psychosis or psychotic disorders are mental and behavioral disorders that cause major disruption and organizational disorders in the mental capacity which allows cognizance of reality and response. It is a severe mental illness presenting typical delusions, hallucinations, impaired talk or catatonic behavior characterized by a significantly impaired assessment of reality in patients. Schizophrenia is the most typical example of psychotic disorder.
Schizophrenia is a clinical syndrome including an inconsistent yet significantly destructive psychopathology that affects thought, perception, emotion, movement and behavior. Although the manifestation of symptoms vary among individuals in the course of time, the total impact of the disease is always severe and permanent.
Prevalence of schizophrenia in society is around 1%. It usually starts at a young age (15-25 years). Schizophrenia takes up 25% of hospital beds, causes great costs due to loss of productivity by patients and treatment, results in 20% reduced life expectancy and a rate suicide of 10-15%.
Symptoms of Schizophrenia
Delusion
Delusions are fixed beliefs that cannot be changed even in light of true evidence. The content of these beliefs can be very varied. Persecuted Delusions: Belief that a person, organization or group may give harm. Delusions of Grandeur: Erotomanic delusions. Nihilistic delusion is the belief that a large-scale destruction is imminent. Somatic delusions are delusions on health and organ functions.
Hallucination
Hallucination is a perception-like experience occurring without an external stimulus. These perceptions are vivid and clear, they are impactful and affect the person just like normal perceptions. These are uncontrollable. The most widespread perceptions in schizophrenia are hearing-related hallucinations. These are familiar or non-familiar sounds.
Disorganized Thinking and Speech
Disorganized thoughts typically impact patients' speech. Patients are indifferent to questions and they quickly jump from one thought to the other.
Grossly Disorganized or Abnormal Motor Behaviors
These are juvenile-like irresponsible, unexpected, agitated and angry, nervous behaviors. These challenge everyday life.
Catatonic Behaviors
These are characterized by a marked loss of sensitivity towards the environment. This can be characterized by pronounced negative behavior to freezing rigidly in very different positions. The patient can live in a vegetative state without responding to their surroundings.
Negative Symptoms
Emotion expression, reduction of mimics and expressions on the face and the body are reduced. Involuntariness, alogia, inability to speak, jadedness, unsociability.
Of the symptoms given above:
- At least 2 must be present (many patients show more),
- At least one symptom of delusion, hallucination or disorganized thoughts must be present and be ongoing for at least 1 month.
- Symptoms must be present for at least 6 months.
For schizophrenia diagnosis.
Bipolar Disorder
Bipolar Disorder is a mood disorder. Pathological mood swings progress with mania and depressive episodes. Depression and its polar opposite mania profiles manifest in episodes or successively, or sometimes even together (mixed type).
Mania episodes are characterized by joy, depression episodes are characterized by hopelessness and collapse. The person turns to normal during interim periods. While symptoms of mania and depression are seen together in some patients, in some others, symptoms are mild (hypomania).
If first degree relatives (mother, father and sibling) carry the disorder, risk increases by 20-25%. It has been determined that 50% of bipolar patients have parents with mood disorders.
Manic Episode
Is an abnormal and permanent, progressing and irritating mood disorder. Goal-directed activities and energy are significantly increased. The disorder is present every day and manifests throughout the day. It continues for at least 1 week. Treatment generally includes hospitalization. The manic episode occurs with increased energy and activity during the mood disorder.
Hypomanic Episode
Goal-oriented activities and energy are significantly increased. The disorder is present every day throughout the day. It continues for at least 4 days. Other symptoms are similar to manic episodes but are milder. Hospitalization is generally not necessary.
Major Depressive Episode
If at least 5 of the following symptoms are present for a period of two weeks, major depression episode is diagnosed. Among those symptoms, depressive mood and anhedonia must be present. Findings such a depressive mood (feeling angry, empty and hopeless) in the most part of the day, decrease in interest and pleasure towards all things, significant weight change (a 5% weight change in one month), nearly constant insomnia or hypersomnia, psychomotor retardation or agitation, constant fatigue, feeling worthless and guilty, loss of concentration during activities, recurring thoughts of death cause severe social maladaptive issues. These findings are not caused by drug or substance use or any other disease.
Anxiety
Anxiety is a feeling creating tension, avoidance, aggression etc. in the face of any identifiable or unidentifiable dangerous situation for the organism. Its most important feature is it being an unpleasant feeling for the person.
Fear
Fear is an emotional response felt towards urgent real or perceived threats.
Anxiety Disorders
Anxiety disorders are characterized by the expectation of a future threat.
Anxiety is determined as a mental illness symptom when a response to a stimulus is inappropriate in terms of severity or duration, when it is recurrent and when it damages professional or social functioning.
Anxiety disorder is frequent but seldom noticed and treated. The individual does not dissociate from reality. They are aware of their disorder and find their thoughts and fears to be absurd (they have insight). Social adaptation is not affected too much.
Physical symptoms: palpitations, tremor, sweating, blushing, hot flashes, shortness of breath, nausea, stomachache, vertigo, dizziness, feeling like falling or fainting.
Mental symptoms include fear of loss of control due to a misinterpretation of physical symptoms, fear of not being able to cope, fear of physical damage or death, fear of losing sanity, fear of being misevaluate by others.
Depression
Depressive disorders are disorders where the body is affected as a whole including the person's physiology, biochemistry, mood, thoughts and behaviors. It may affect eating and sleep habits, thoughts and feelings about the self, others and the external world. It causes significant clinical problems and causes a severe loss of function in social, professional and other important areas.
Although prevalence of depression varies between cultures, it is one of the most frequent psychiatric disorders. Among disorders that cause weakening and that result in death (15% of untreated clinical depression result in suicide), depression is the most frequently diagnosed. According to the studies of the American National Institute of Mental Health, lifelong incidence rate of major depression has been determined at 5.8%, and for dysthymia, a milder form of major depression, it has been determined at 3.3%. It has also been indicated that more than 50% of depression patients experience recurrent depression episodes throughout their lives.
Symptoms of Depression
If at least 5 of the following symptoms are present for a period of two weeks, major depression episode is diagnosed. Among those symptoms, depressive mood and anhedonia must be present. Findings such a depressive mood (feeling angry, empty and hopeless) in the most part of the day, decrease of interest and pleasure towards all things, significant weight change (a 5% weight change in one month), nearly constant insomnia or hypersomnia, psychomotor retardation or agitation, constant fatigue, feeling worthless and guilty, loss of concentration during activities, recurring thoughts of death cause severe social maladaptive issues. These findings are not caused by drug or substance use or any other disease.
Attention Deficit and Hyperactivity Disorder
Attention Deficit and Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder classified as a mental disease in children and adolescents.
Attention deficit presents with impulsive behaviors, auto-control disorders and hyperactivity. Its incidence in society has been determined at 8% in children and 6% in adolescents. Although it is generally identified as a childhood illness, its prevalence in adults is of 4%.
Although hyperactivity is an important part of this syndrome, attention deficit is frequently observed on its own. While diagnosis is easier in the presence of hyperactivity in children, patients who only suffer from attention deficit may be diagnosed tardily.
