Chapter 8:

(Psychological Disorders)

classification and diagnosis of psychological disorders:

The classification and diagnosis of psychological disorders involve systematic
approaches to categorizing and identifying mental health conditions. Two widely used
systems for classification are the Diagnostic and Statistical Manual of Mental Disorders
(DSM) and the International Classification of Diseases (ICD).
1. Diagnostic and Statistical Manual of Mental Disorders (DSM):
• The DSM is published by the American Psychiatric Association and is one of the most widely
used systems for classifying mental disorders.
• It provides a common language and standard criteria for the classification of mental
disorders, facilitating communication among clinicians, researchers, and other mental
health professionals.
• The DSM categorizes disorders into different classes, such as mood disorders, anxiety
disorders, psychotic disorders, and more.
• Each disorder is defined by specific criteria that must be met for a diagnosis to be made.
2. International Classification of Diseases (ICD):
• The ICD is a global system of diagnostic codes used for various health conditions, including
mental disorders.
• It is published by the World Health Organization (WHO) and is used by healthcare
providers and researchers worldwide.
• The ICD provides a comprehensive framework for classifying diseases and health
conditions, including psychological disorders.
The diagnostic process typically involves the following steps:
 1. Clinical Assessment:
• Gathering information about the individual's symptoms, behaviors, and history through
interviews, observations, and standardized assessment tools.
2. Diagnostic Criteria:
• Referring to the criteria outlined in the DSM or ICD to determine if the individual's
symptoms meet the criteria for a specific disorder.
3. Differential Diagnosis:
• Differentiating between various disorders with similar symptoms to ensure an accurate and
precise diagnosis.
4. Collaborative Approach:
• Involving input from multiple sources, such as the individual, family members, and other
healthcare professionals, to provide a comprehensive understanding of the situation.
5. Cultural Considerations:
• Taking into account cultural factors that may influence the expression of symptoms and the
understanding of mental health.
6. Holistic Assessment:
• Considering biological, psychological, and social factors that may contribute to the
development and maintenance of psychological disorders.
It is important to note that the diagnosis of psychological disorders should only be
made by a qualified mental health professional after a thorough evaluation of the
patient’s symptoms and history . If you or someone you know is experiencing symptoms
of a psychological disorder, it is recommended to seek professional help from a licensed
mental health provider .

Anxiety disorder:
Definition:
An anxiety disorder is a mental health condition characterized by excessive and
persistent worry, fear, or apprehension about future events or situations. These feelings can
be so intense that they interfere with a person's daily life, relationships, and overall well-
being.
Symptoms:
It is characterized by symptoms such as restlessness, sudden feelings of panic and
fear, uneasiness, nausea, cramps, sleep-related problems, cold or sweaty hands or feet,
numbness in the hands or feet, shortness of breath, increased heart rate, chest pain, dry
mouth, hot flashes or chills, sudden trembling, dizziness, avoidance of situations that
may cause fear, obsessions, and compulsions.
Causes:
 The exact cause of anxiety disorder is not known, but it could be the result of a
combination of factors including changes in brain chemicals and its functioning,
environmental stress, family history, traumatic life events, other medical conditions, and
drug or alcohol abuse .
Types of Anxiety order:
There are several types of anxiety disorders, including:
•
Generalized anxiety disorder: persistent and excessive worry .
•
Panic disorder: sudden and intense attacks .
•
Social anxiety disorder: fear of judgment and embarrassment .
•
Agoraphobia: fear of being trapped or helpless .

•
Separation anxiety disorder: fear of being away from parents .
•
Phobias: irrational and specific fears .

It is important to note that the diagnosis of psychological disorders should only be

made by a qualified mental health professional after a thorough evaluation of the
patient’s symptoms and history . If you or someone you know is experiencing symptoms
of a psychological disorder, it is recommended to seek professional help from a licensed
mental health provider .

Mood disorders:

Mood disorders are a category of mental health conditions characterized by

significant disturbances in a person's mood. These disturbances can manifest as
intense, prolonged emotional states that interfere with a person's ability to function
in daily life. The two main types of mood disorders are depressive disorders and
bipolar disorders.
1. Depressive Disorders:
• Major Depressive Disorder (MDD): This is characterized by persistent feelings of
sadness, hopelessness, and a lack of interest or pleasure in activities. Other
symptoms may include changes in appetite, sleep disturbances, fatigue, and
difficulty concentrating.
• Persistent Depressive Disorder (Dysthymia): Dysthymia involves a chronic, low-
grade depression that lasts for at least two years. While less severe than MDD, it can
still significantly impact daily functioning.
• Seasonal Affective Disorder (SAD): SAD is a type of depression that occurs at
specific times of the year, usually during the fall and winter months when there is
less sunlight.
2. Bipolar Disorders:
• Bipolar I Disorder: Characterized by manic episodes that last at least seven days or
are severe enough to require hospitalization. Depressive episodes may also occur.
• Bipolar II Disorder: Involves a pattern of depressive episodes and hypomanic
episodes (less severe than full manic episodes).
• Cyclothymic Disorder: This is a milder form of bipolar disorder involving mood
swings that range from mild depression to mild mania. The symptoms are less
severe and persistent compared to bipolar I and II disorders.
• Other Specified and Unspecified Bipolar and Related Disorders: This category
includes conditions that don't fit the criteria for the above disorders but still involve
significant mood disturbances.

Causes of Mood Disorders:

• Biological Factors: Genetics, brain structure and function, and neurotransmitter

imbalances can contribute to mood disorders.
• Environmental Factors: Stressful life events, trauma, and chronic stress can trigger
or exacerbate mood disorders.
• Psychological Factors: Personality traits, coping styles, and negative thought
patterns can play a role in the development of mood disorders.
Treatment:
• Medication: Antidepressants, mood stabilizers, and antipsychotic medications may
be prescribed.
• Psychotherapy: Cognitive-behavioral therapy (CBT), interpersonal therapy, and
other therapeutic approaches can be beneficial.
• Electroconvulsive Therapy (ECT): Used in severe cases where other treatments
haven't been effective.
• Lifestyle Changes: Regular exercise, healthy sleep patterns, and stress management
can support overall well-being.
It's essential for individuals experiencing symptoms of a mood disorder to seek
professional help for accurate diagnosis and appropriate treatment. If you or
someone you know is struggling with a mood disorder, contacting a mental health
professional or helpline is crucial for support and guidance.
 Schizophrenia:

Definition:
Schizophrenia is a serious mental disorder in which people interpret reality
abnormally. Schizophrenia may result in some combination of hallucinations,
delusions, and extremely disordered thinking and behavior that impairs daily
functioning, and can be disabling.

People with schizophrenia require lifelong treatment. Early treatment may

help get symptoms under control before serious complications develop and may
help improve the long-term outlook

Symptoms:
It's important to note that the symptoms of schizophrenia can vary widely among
individuals, and the severity and duration of symptoms also differ. The Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), outlines the criteria for
diagnosing schizophrenia, and symptoms are typically categorized into positive, negative,
and cognitive symptoms. Here are some common symptoms associated with schizophrenia:
• Positive Symptoms:
• Hallucinations: Perceptions of stimuli that are not present, such as hearing voices,
seeing things, or feeling sensations that others do not.
• Delusions: Strongly held false beliefs that are resistant to reasoning or contrary
evidence. Delusions can be paranoid, grandiose, or bizarre.
• Negative Symptoms:
• Flat affect: Reduced emotional expression, including facial expressions, voice tone,
and gestures.
• Anhedonia: Lack of interest or pleasure in activities that were previously enjoyed.
• Avolition: Decreased motivation to initiate and sustain purposeful activities.
• Cognitive Symptoms:
• Impaired executive function: Difficulty in organizing thoughts, making decisions,
or planning.
• Memory difficulties: Short-term memory deficits and problems with attention and
focus.
• Disorganized Symptoms:
• Disorganized thinking: Fragmented thought patterns, making it difficult to
communicate coherently.
• Disorganized or abnormal motor behavior: Unpredictable and inappropriate
actions or movements.
• Impaired Reality Testing:
• Impaired insight: Difficulty recognizing that their thoughts or beliefs are not
grounded in reality.
It's important to note that these symptoms can vary in intensity and may come and go
over time.

Causes:
COMMON:
The actual causes of schizophrenia are not fully understood. There are many factors
that normally contribute to the onset of schizophrenia
Brain chemistry:
Abnormal functioning of neurotransmitters such as dopamine can cause
schizophrenia.
Heredity:
Schizophrenia tends to run in families. If a parent has the disorder, the offsprings are
susceptible to the disease.
Abnormality in the brain:
Abnormalities such as shrinkage in brain, or circuitry dysfunction can cause
schizophrenia.
Complications during pregnancy and birth:
Chances of a child getting Schizophrenia are increased by infection or malnutrition
during pregnancy and complications during birth such as brain injury.
Drug Use:
Substance abuse, particularly during adolescence, has been linked to an increased risk
of developing schizophrenia.
Stressful Life Events:
Psychosocial stressors, such as traumatic life events, chronic stress, or social isolation,
may contribute to the development or exacerbation of schizophrenia in vulnerable
individuals.
It's important to note that schizophrenia is likely to result from a complex interplay of
these factors, and no single cause can fully explain the onset of the disorder.

Types of schizophrenia:

There are several types of schizophrenia, and they are classified based on the
predominant symptoms and their duration. The fifth edition of the Diagnostic and
Statistical Manual of Mental Disorders (DSM-5) recognizes the following types:
• Paranoid Schizophrenia:
• Hallucinations and delusions are prominent.
• Delusions often involve themes of persecution or conspiracy.
• Cognitive functioning and affect may be relatively preserved.
• Disorganized Schizophrenia:
• Disorganized thinking and speech are the primary features.
• Behavior may be unpredictable and inappropriate.
• Affect may be flat or inappropriate.
• Catatonic Schizophrenia:
• Marked by disturbances in movement and behavior.
• Can include immobility (catatonia), excessive purposeless movement, or peculiar motor
behaviors.
• May also involve mutism or echolalia.
• Undifferentiated Schizophrenia:
• Symptoms do not clearly fit the criteria for paranoid, disorganized, or catatonic types.
• Represents a catch-all category for cases with mixed or atypical symptoms.
• Residual Schizophrenia:
• Refers to individuals who have had at least one episode of schizophrenia but are
currently not experiencing prominent positive symptoms.
• Residual symptoms may include social withdrawal or odd beliefs.
• Schizoaffective Disorder:
• Features a combination of mood disorder symptoms (major depressive or manic
episodes) and schizophrenia symptoms.
• The mood symptoms are present for a substantial portion of the illness.
It's important to note that the classification and understanding of schizophrenia have
evolved over time, and the DSM-5 represents the current diagnostic criteria. Individuals
with schizophrenia may experience a range of symptoms, and their presentation can
vary significantly. Treatment typically involves a combination of antipsychotic
medications, psychotherapy, and support services. It's crucial for individuals with
schizophrenia to receive appropriate and ongoing care from mental health professionals.
Treatments of Schizophrenia:
The treatment of schizophrenia typically involves a combination of medication,
psychotherapy, and support from mental health professionals. It's important to note that
treatment plans may vary based on the individual's specific symptoms, preferences, and
response to different interventions. Here are some key components of the treatment for
schizophrenia:
 1. Antipsychotic Medications:
• Antipsychotic medications are the cornerstone of schizophrenia treatment. They
help manage symptoms such as delusions, hallucinations, and disorganized thinking.
• Both typical (first-generation) and atypical (second-generation) antipsychotics are
used. Atypical antipsychotics are often preferred due to their lower risk of side
effects.
• Examples of atypical antipsychotics include clozapine, risperidone, olanzapine,
quetiapine, aripiprazole, and others.
2. Psychotherapy:
• Individual psychotherapy, such as cognitive-behavioral therapy (CBT), can help
individuals manage and cope with symptoms, improve problem-solving skills, and
enhance social functioning.
• Family therapy involves educating and involving family members to provide
support and improve communication within the family.
3. Supportive Therapy:
• Supportive therapy focuses on practical aspects of daily living, such as social and
vocational skills, and helps individuals integrate into their communities.
• Supported employment and education programs can assist in reintegrating
individuals with schizophrenia into the workforce or educational settings.
4. Hospitalization:
• In severe cases or during acute episodes, hospitalization may be necessary to ensure
the safety of the individual and provide intensive treatment.
5. Community Support and Rehabilitation:
• Community-based programs and services, such as vocational rehabilitation, housing
support, and social skills training, can help individuals with schizophrenia
reintegrate into the community.
6. Self-Help and Coping Strategies:
• Encouraging individuals to learn and implement self-help strategies, such as stress
management, relaxation techniques, and maintaining a healthy lifestyle, can
complement other forms of treatment.
7. Medication Adherence:
• It is crucial for individuals with schizophrenia to adhere to their medication
regimen. Regular follow-up appointments with a psychiatrist are essential to
monitor the effectiveness of medications and manage potential side effects.
8. Peer Support:
• Engaging in peer support groups and connecting with others who have experienced
similar challenges can provide valuable understanding, encouragement, and a sense
of community.
It's important to recognize that treatment plans should be individualized, and ongoing
collaboration between the individual, their family, and a multidisciplinary mental health
team is crucial for effective management of schizophrenia. Regular monitoring, adjustment
of treatment plans, and addressing side effects are essential aspects of long-term care.
 Personality Disorders:

Definition:
Personality disorders are a group of mental health conditions that are characterized
by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited
across many contexts and deviating from those accepted by the individual’s culture .
Types of personality disorders:
There are several recognized types of personality disorders, grouped into three clusters
in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is commonly
used by mental health professionals for diagnosis:
Cluster A: Odd or Eccentric Behavior
1. Paranoid Personality Disorder: Characterized by pervasive distrust and suspicion
of others.
2. Schizoid Personality Disorder: Involves detachment from social relationships and
limited emotional expression.
3. Schizotypal Personality Disorder: Features peculiar thoughts, behaviors,
appearance, and difficulty forming close relationships.
Cluster B: Dramatic, Emotional, or Erratic Behavior
1. Antisocial Personality Disorder: Involves a pervasive pattern of disregard for the
rights of others.
2. Borderline Personality Disorder: Characterized by instability in interpersonal
relationships, self-image, and affects, along with impulsivity.
3. Histrionic Personality Disorder: Involves excessive emotionality and attention-
seeking behavior.
4. Narcissistic Personality Disorder: Features a grandiose sense of self-importance,
a lack of empathy, and a need for excessive admiration.
Cluster C: Anxious or Fearful Behavior
1. Avoidant Personality Disorder: Characterized by social inhibition, feelings of
inadequacy, and hypersensitivity to negative evaluation.
2. Dependent Personality Disorder: Involves an excessive need to be taken care of,
leading to submissive and clinging behavior.
3. Obsessive-Compulsive Personality Disorder: Features preoccupation with
orderliness, perfectionism, and control.
Treatments of personality disorders:

If you suspect that you or someone you know has a personality disorder, it is
important to seek professional help. A diagnosis of personality disorder may involve a
physical exam, a mental health evaluation, and neuropsychological testing .

The treatment for personality disorders depends on the severity of the disorder and
the individual’s life situation. A team approach is often needed to meet the mental,
medical, and social needs of the individual. The treatment team may include a
psychiatrist, psychologist, psychiatric nurse, pharmacist, and social worker .
1. Dialectical behavioral therapy (DBT):
Dialectical behavioral therapy (DBT) is a form of psychotherapy that is used to treat
personality disorders. DBT focuses on treating dangerous behavior, including behavior
that can lead to suicide, as well as behavior that can get in the way of treatment or
affect quality of life. DBT consists of weekly one-on-one sessions with a therapist and
can last for about a year .
Medications :
Medications may also be used during treatment, although the Food and Drug
Administration (FDA) has not approved any medicines to treat personality disorders 3. In
some cases, hospitalization and residential treatment programs may be necessary.
2. Psychotherapy (Talk Therapy):
• Cognitive-Behavioral Therapy (CBT): Helps individuals identify and change
negative thought patterns and behaviors.
• Psychodynamic Psychotherapy: Focuses on exploring unconscious thoughts and
feelings that may contribute to maladaptive behaviors.

3. Group Therapy:
• Provides individuals with a supportive environment where they can share their
experiences, learn from others, and develop social skills.
4. Skills Training:
• Teaches individuals practical skills to cope with stress, regulate emotions, and
improve interpersonal relationships.
5. Hospitalization or Intensive Outpatient Programs:
• In severe cases or during crises, individuals with personality disorders may require
hospitalization or participation in intensive outpatient programs to ensure their
safety and provide more intensive treatment.
6. Family Therapy:
• Involves family members in the therapeutic process to improve communication,
address conflicts, and provide support.
7. Mindfulness and Relaxation Techniques:
• Techniques such as mindfulness meditation and relaxation exercises can help
individuals manage stress and regulate emotions.
8. Case Management and Support Services:
• Providing practical assistance with daily living tasks and connecting individuals
with community resources can be crucial for long-term stability.
9. Rehabilitation Programs:
• Focus on helping individuals with personality disorders reintegrate into society,
develop vocational skills, and achieve independence.
It's important to emphasize that treatment plans should be individualized based on the
specific needs and circumstances of each person. Additionally, individuals with
 personality disorders may face challenges in engaging with treatment due to the nature
of their conditions, such as difficulties in forming and maintaining therapeutic
relationships. A collaborative and patient-centered approach is essential for the best
outcomes.

THE END

Written By:

Zainab Bibi