Saturday, August 31, 2013

An Interesting Introduction to Psychology - Delusion and Depression

A person who presents with delusions that are theoretically plausible (non-bizarre), appropriate behavior, and no marked impairment in functioning would receive a diagnosis of Delusional Disorder. Erotomanic Type Delusional Disorder is characterized by the delusion that a person, typically of higher status, is in love with the patient. Grandiose Type is characterized by the delusion that one has made a truly meaningful discovery and/or has a remarkable talent. Jealous Type is a Delusional Disorder that fits a man who is convinced his wife is cheating, based on the fact she came home from work with a wrinkled shirt.

A person with Delusional Disorder who believes they, or someone they know, is being malevolently mistreated best qualify for Persecutory Type. Somatic Type is a type of Delusional Disorder is characterized by the irrational conviction that one has a physical defect, disorder, or disease. When a client's delusional belief cannot be clearly determined or is not described by the specific types, they would receive a diagnosis of Delusional Disorder Unspecified Type. A person can present with more than one type of Delusional Disorder. This is referred to as Mixed Type. A person experiences the sudden onset of at least one psychotic symptom (delusion, hallucination, etc) that lasts from several hours up to a month, and then returns to premorbid level of functioning, the most appropriate diagnosis is Brief Psychotic Disorder.

If a Brief Psychotic Disorder is in response to a very stressful event, it is sometimes referred to a Brief Reactive Psychosis and the diagnosis would include the specifier With Marked Stressor(s). The French term Folie a Deux (aka Shared Psychotic Disorder) often refers to when a person in close relation to another person who has a psychotic disorder begins experiencing similar delusions. A Manic Episode involves impaired functionality as a result of abnormally elevated, expansive, or irritable mood for a period of at least 1 week, in addition to symptoms such as grandiosity, flight of ideas, and increased verbosity; a Hypomanic Episode is similar, however the duration must be 4 days, no psychotic features or functional impairment is present, and hospitalization is not needed. A person who reports experiencing both mania and major depression in a single day, for at least 1 week, is experiencing A Mixed Episode.

Major Depressive Episode is characterized by a change in prior functioning due to the experience of depressed mood or loss of pleasure, in addition to at least 5 other symptoms of depression, during a two-week period. Bipolar I involves the presence of at least 1 manic or mixed episode at some time, and the person may or may not have experienced 1 or more major depressive episodes; the diagnosis of Bipolar II is given when 1 or more major depressive episodes and at least one hypomanic episode are present. Considered a Bipolar Disorder, Cyclothymic Disorder involves a mood disturbance of at least 2 years where the person alternates between hypomania and mild to moderate depressive states; functioning is often unimpaired. According to the DSM, approximately 15% of people with Major Depressive Disorder die by suicide. A person experiencing their first (and perhaps only) depressive episode would be diagnose Major Depressive Disorder, single episode, while one who has experienced more than one episode in a 2 year period would receive the indicator recurrent.

Research has shown that women appear to experience depression at a higher rate than men. Come of the possible reasons for this are that men are likely underrepresented due to underreporting; coping styles differ- men employ action and mastery strategies, women tend to brood and dwell on problems; women tend to express more extreme levels of well-being than men. The appropriate diagnosis for a woman who, within 4 weeks after giving birth, experiences mood swings, tearfulness, and other depressive symptoms suggestive of a Mood Disorder is Postpartum Depression A 24 y/o client reports he has felt "pretty down" for most his life, stating he experiences difficulty falling asleep, low self-image, decreased energy, feelings of hopelessness, and difficulty concentrating and making decisions. He explains, however, that it rarely affected his functional capacities. The likely diagnosis in this situation is Dysthymic Disorder. A person who has both Major Depressive Disorder and Dysthymic Disorder is best characterized by the condition known as Double Depression.

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