PSYCHOLOGICAL DISORDERS

Pervasive developmental disorder (PDD):

Autism, Asperger syndrome and ASD

Autism is a life-long condition that affects the way a person communicates and relates to people around them. As part of the spectrum of Pervasive Developmental Disorder (PDD) it also includes the condition known as Asperger Syndrome, which describes people who show the characteristics of autism, but are of average or above average intelligence and may also have good communication skills [see reference]. The estimated prevalence rate of autistic spectrum disorders (ASD), including Asperger syndrome, is approximately 1 per 100 children in the United Kingdom [see reference]. Autism also affects four times as many boys as girls. Though it describes a state with wide ranging degrees of severity, all those affected have a triad of impairments, which will include all or some of the following characteristics:

Difficulty with developing imagination

People with autism are usually unable to play imaginatively with objects or toys or with other children or adults. They tend to focus on minor or trivial things around them, for example an earring rather then the person wearing it, or a wheel instead of the whole toy train.

Difficulty with verbal and non-verbal communication

People with autism may be unable to appreciate the social uses and the pleasure of communication. Even if the person with autism has a lot of speech they would probably use this to talk "at" you rather than with you. The person with autism may be able to ask for their own needs but find it hard to talk about feelings or thoughts and will not understand the emotions, ideas and beliefs of other people. They do not really understand the meaning of gestures, facial expression or tone of voice, although higher functioning people with autism do use gestures but these tend to be odd and inappropriate. People with autism understand and use language very literally, with an idiosyncratic, sometimes pompous choice of words and phrases and limited content of speech.

Difficulty with social relationships

People with autism may often appear aloof and indifferent to other people. The more able people with autism will passively accept social contact and even show some signs of pleasure in this, but will rarely make spontaneous approaches. They can occasionally approach other people but in an odd, inappropriate, repetitive way, paying little or no attention to the responses of those they approach.

What causes it?

The exact causes of autism have not yet been fully established [see reference]. It is however evident from research that autism can be caused by a variety of physical conditions affecting brain development that may occur before, during or after birth. They include: maternal rubella, tuberous sclerosis, lack of oxygen at birth (hypoxia) and various complications arising from childhood illnesses such as whooping cough and measles. In many instances, genetic traits also appear to be important, although the sites of the relevant genes have not yet been identified. Autism is not due to emotional problems or emotional deprivation.

Is there a cure?

As yet there is no cure for autism, but specialised education and structured support may help maximise a child's skills and minimise any behaviour problems [see reference]. The right kind of education and care programmes are essential. They can make a real difference to the child's life enabling each individual, whatever their level of ability, to achieve as great a degree of independence as possible. Apart from education and management programmes a variety of therapies have also been tried. Sometimes parents have found that one particular therapy has helped - but no single approach has been found to be successful for everybody.

http://osiris.sunderland.ac.uk/autism/what.htm

Schizophrenia

WHAT IS IT?

Schizophrenia is a chronic, severe, and disabling brain disease. Approximately 1 percent of the population develops schizophrenia during their lifetime – more than 2 million Americans suffer from the illness in a given year. Although schizophrenia affects men and women with equal frequency, the disorder often appears earlier in men, usually in the late teens or early twenties, than in women, who are generally affected in the twenties to early thirties. People with schizophrenia often suffer terrifying symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. These symptoms may leave them fearful and withdrawn. Their speech and behavior can be so disorganized that they may be incomprehensible or frightening to others. Available treatments can relieve many symptoms, but most people with schizophrenia continue to suffer some symptoms throughout their lives; it has been estimated that no more than one in five individuals recovers completely.

Schizophrenia As An Illness

Schizophrenia is found all over the world. The severity of the symptoms and long-lasting, chronic pattern of schizophrenia often cause a high degree of disability. Medications and other treatments for schizophrenia, when used regularly and as prescribed, can help reduce and control the distressing symptoms of the illness. However, some people are not greatly helped by available treatments or may prematurely discontinue treatment because of unpleasant side effects or other reasons. Even when treatment is effective, persisting consequences of the illness – lost opportunities, stigma, residual symptoms, and medication side effects – may be very troubling.

The first signs of schizophrenia often appear as confusing, or even shocking, changes in behavior. Coping with the symptoms of schizophrenia can be especially difficult for family members who remember how involved or vivacious a person was before they became ill. The sudden onset of severe psychotic symptoms is referred to as an “acute” phase of schizophrenia. “Psychosis,” a common condition in schizophrenia, is a state of mental impairment marked by hallucinations, which are disturbances of sensory perception, and/or delusions, which are false yet strongly held personal beliefs that result from an inability to separate real from unreal experiences. Less obvious symptoms, such as social isolation or withdrawal, or unusual speech, thinking, or behavior, may precede, be seen along with, or follow the psychotic symptoms.

Some people have only one such psychotic episode; others have many episodes during a lifetime, but lead relatively normal lives during the interim periods. However, the individual with “chronic” schizophrenia, or a continuous or recurring pattern of illness, often does not fully recover normal functioning and typically requires long-term treatment, generally including medication, to control the symptoms.

The World of People With Schizophrenia

Distorted Perceptions of Reality

People with schizophrenia may have perceptions of reality that are strikingly different from the reality seen and shared by others around them. Living in a world distorted by hallucinations and delusions, individuals with schizophrenia may feel frightened, anxious, and confused.

In part because of the unusual realities they experience, people with schizophrenia may behave very differently at various times. Sometimes they may seem distant, detached, or preoccupied and may even sit as rigidly as a stone, not moving for hours or uttering a sound. Other times they may move about constantly – always occupied, appearing wide-awake, vigilant, and alert.

Hallucinations and Illusions

Hallucinations and illusions are disturbances of perception that are common in people suffering from schizophrenia. Hallucinations are perceptions that occur without connection to an appropriate source. Although hallucinations can occur in any sensory form – auditory (sound), visual (sight), tactile (touch), gustatory (taste), and olfactory (smell) – hearing voices that other people do not hear is the most common type of hallucination in schizophrenia. Voices may describe the patient’s activities, carry on a conversation, warn of impending dangers, or even issue orders to the individual. Illusions, on the other hand, occur when a sensory stimulus is present but is incorrectly interpreted by the individual.

Delusions

Delusions are false personal beliefs that are not subject to reason or contradictory evidence and are not explained by a person’s usual cultural concepts. Delusions may take on different themes. For example, patients suffering from paranoid-type symptoms – roughly one-third of people with schizophrenia – often have delusions of persecution, or false and irrational beliefs that they are being cheated, harassed, poisoned, or conspired against. These patients may believe that they, or a member of the family or someone close to them, are the focus of this persecution. In addition, delusions of grandeur, in which a person may believe he or she is a famous or important figure, may occur in schizophrenia. Sometimes the delusions experienced by people with schizophrenia are quite bizarre; for instance, believing that a neighbor is controlling their behavior with magnetic waves; that people on television are directing special messages to them; or that their thoughts are being broadcast aloud to others.

Disordered Thinking

Schizophrenia often affects a person’s ability to “think straight.” Thoughts may come and go rapidly; the person may not be able to concentrate on one thought for very long and may be easily distracted, unable to focus attention.

People with schizophrenia may not be able to sort out what is relevant and what is not relevant to a situation. The person may be unable to connect thoughts into logical sequences, with thoughts becoming disorganized and fragmented. This lack of logical continuity of thought, termed “thought disorder,” can make conversation very difficult and may contribute to social isolation. If people cannot make sense of what an individual is saying, they are likely to become uncomfortable and tend to leave that person alone.

Emotional Expression

People with schizophrenia often show “blunted” or “flat” affect. This refers to a severe reduction in emotional expressiveness. A person with schizophrenia may not show the signs of normal emotion, perhaps may speak in a monotonous voice, have diminished facial expressions, and appear extremely apathetic. The person may withdraw socially, avoiding contact with others; and when forced to interact, he or she may have nothing to say, reflecting “impoverished thought.” Motivation can be greatly decreased, as can interest in or enjoyment of life. In some severe cases, a person can spend entire days doing nothing at all, even neglecting basic hygiene. These problems with emotional expression and motivation, which may be extremely troubling to family members and friends, are symptoms of schizophrenia – not character flaws or personal weaknesses.

Normal Versus Abnormal

At times, normal individuals may feel, think, or act in ways that resemble schizophrenia. Normal people may sometimes be unable to “think straight.” They may become extremely anxious, for example, when speaking in front of groups and may feel confused, be unable to pull their thoughts together, and forget what they had intended to say. This is not schizophrenia. At the same time, people with schizophrenia do not always act abnormally. Indeed, some people with the illness can appear completely normal and be perfectly responsible, even while they experience hallucinations or delusions. An individual’s behavior may change over time, becoming bizarre if medication is stopped and returning closer to normal when receiving appropriate treatment.

http://www.schizophrenia.com/family/sz.overview.htm

Eating Disorders

Anorexia Nervosa

Anorexia nervosa is a mental illness. You have a preoccupation with food and body image to the extreme: You don’t eat. Despite being underweight, you continue to try to lose weight. The syndrome is more common in women than in men, and most often begins between the ages of 13-30 years. The medical complications brought about by this psychiatric disorder can be severe. You may die.

Bulimia

Bulimia is an eating disorder. Someone with bulimia might binge on food and then vomit (also called purge) in a cycle of binging and purging. Binge eating refers to quickly eating large amounts of food over short periods of time. Purging involves forced vomiting, laxative use, excessive exercise, or fasting in an attempt to lose weight that might be gained from eating food or binging.

The strict medical definition used by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) requires 2 binge-eating episodes a week for at least 3 months to make the diagnosis, but it's likely that some people with symptoms of bulimia may not fit these exact criteria.

A person with bulimia often feels a loss of control over their eating as well as guilt over their behavior. They are usually aware that their behavior is abnormal. Bulimia is most common in adolescent and young adult women. People with bulimia are often of normal or near-normal weight, which makes them different from people with anorexia (another eating disorder in which the person does not eat).