Increase in neurotransmitter

- Increase in norepinephrine

Positive Symptoms:
Conventional and Typical (Chlorpromazine, haloperidol) (s/e: EPS,
pseudo parkinsonism, akathisia
Atypical antipsychotic drugs (S/e: Sedative: watch for orthostatic
hypotension)

Negative Symptoms (Absence or difficulty) – Atypical (Clozapine)

AFFECTIVE DISORDERS
Affect- Emotions, mood “Manic depressive disorder”/ Bipolar
Mania- Affective disorder
Maniac- Psychoneurotic disorder

Bipolar- Opposite tone, alteration between extreme happiness and

extreme happiness. (PERVASIVE ALTERATION OF EMOTION)

- Bipolar I – manic type

- Bipolar II- depressed type
- Mixed type – mood swing
BIPOLAR 1 (Manic type)
- Chief characteristics:
- rapid shift of emotional responses: labile mood
- Flight of ideas
- Increase in psychomotor
- Expansive
C
Inflated concept of self-esteem (delusions of grandiosity)
Expansive- uses many accessories in the body. Use of
heavy make-up, use of inappropriate dress psychedelic
color (neon/bright)
Labile mood- Rapid shift of emotional responses
Manipulative-
Extravagant-
Pressured Speech
Enthusiastic shifts to irritable
Lasts about 1 week
Increased psychomotor activities
4E’s in Manic (Euphoria, Elation, Ecstasy, exaltation)
Bipolar II (Major depressive disorder)
- Lasts at least 2 weeks during the person experiences
depression

Classical Sx: 4 or 5 sx
- Changes in appetite or weight
- Disturbed sleeping pattern (insomnia, hypo insomnia)
- Decreased motor activity (Akinesia) – typical/conventional
Bradykinesia (slowness of movement)
Anergia (lack of energy) – facing in the wall
- Feeling of unworthiness, hopelessness helplessness, guilt,
remorse (self-reproach)
- Difficulty in concentration, thinking and decision making
- Recurrent thoughts of death

Characteristic SCHIZO Manic Depressive

Mood Social Withdrawal Labile Mood/Mood Sadness/ loneliness

Swings
Speech Verbigeration, Pressured Speech Alogia (Poverty of
echolalia, Speech)
tangentiality,
circumstantiality,
neologism,
perseveration, clang
association
Delusion Delusion of Infidelity, Delusion of Persecution,
Delusion of grandiosity, inflated unworthiness,
persecutory, Delusion self-concept
of poison, Delusion of
religiosity, Delusion of
politics
Food Served food that are Served food that rich Foods that rich in
sealed, open in front in calories (finger fiber,
of the client or eat food: fried chicken,
together w/ client milk in glass
Thinking Ideas of reference Flight of ideas Poor decision
making, judgment,
 concentration and
attention
Personality Traits Asthenic type (tall, Cyclothymic (cheerful Dysthymic (sad,
thin, unhappy, sad) – enthusiastic, irritable) lonely)
Introvert type
Tendency to become
depress
Chief 4 A’s (Ambivalence, Euphoria, Elation, Anergia,
Characteristics autistic, apathy and Ecstasy, and Exaltation
associative)
Plus 1
Auditory
Hallucination

Classic sx Waxy flexibility, Self-inflated Anergia

paranoid (Delusion of Anhedonia
grandiosity, sexually Pacing
provocative) Poverty of speech
Manipulative, Feeling of
impulsive, self- helplessness,
reproach) pressured hopelessness,
speech unworthiness

Seasonal Affective Disorder (S.A.D)

1. Winter depression – Increase in appetite. Sleeping pattern, crave of
carbohydrates.
2. Interpersonal Conflict- Feeling of sensitivity and irritation and partners
3. Spring onset- opposite of winter (decrease of appetite, weight loss)
4. April-June- Financial crisis

Postpartum or maternity blues

- Mild and predictable mood disturbances, occurs first several days after delivery
- Labile Mood, frequent crying and anxiety
Postpartum Depression
- Very consistent with those of depression.
Sx of Major depressive disorder - Postpartum psychosis
Additional 2 sx: delusion and hallucination
 CAUSES:
1. Genetics- 1st degree relative, twice at risk.
2. 15-20% sibling
3. Neurochemical- Neurotransmitter
Mania (Increase) Dopamine and Norepinephrine
Depression (Decrease) serotonin, epinephrine
KINDLING – It is the process by which seizures activity in the specific area of the
brain is initially by reaching a threshold of accumulative effect of stress.\
Neuroendocrine influences – Hormonal fluctuation (thyroid, adrenal, pituitary
and parathyroid hormones – prone to depression) also alters mood.
4. Psychodynamic theory by Sigmund Freud- pertains the psychic forces (Id, ego,
superego
5.
6. Environmental factor-

NURSING INTERVETIONS
1. Watch out the client regarding suicidal
2. I feel as if I am no longer in myself.
3. Allow your client to cry
4. Teach the client of coping mechanism.
 EATING DISORDERS
- Abnormal eating habits.
1. Anorexia Nervosa- Doesn’t like to eat
2. Bulimia- Bingeing and purging (large amount of meals and then use
of compensatory behavior.
Other types:
Pica
Orthorexia
Night eating syndrome

OVERVIEW
In the late 1,800 in England and France they describe women “self-
starvation” to avoid obesity
1960- Anorexia Nervosa was established as a mental disorder.
1979-
1993- 1st description of binge eating disorder as

Fewer men than woman suffer from eating disorder.

COMORBIDITY- Underlying/ associated illnesses

1. Obsessive compulsive personality disorder (OCPD)
2. Borderline personality disorder
3. Depression
4. Anxiety
5. Body Dysmorphic
6. Narcissistic personality disorder
7. Addiction and Substance abuse
8. Abuse or victim of trauma
1982- Two description of Anorexia Nervosa
1. Restricting Type- Fasting, excessive exercise, loss of weight due to
dieting
2. Bingeing and Purging

CAUSES-
1. Unknown
2. Biologic factor (Chromosome 1)
3. Personality type (OCD and sensitive avoidant)