Mood disorders, suicide and schizophrenia

Mood disorders:

• Major depressive disorder: a depressed mood or loss of interest in almost everything, along with changes in sleep and weight, slowed thinking, feelings of guilt and worthlessness, and thoughts of death. Risk factors include genes, age, gender (women are more often diagnosed) and stressful life events.
• Bipolar disorders (earlier called manic-depressive disorder): Bipolar I has full episodes of mania (extreme excitement, overactivity, grand ideas) alternating with depression. Bipolar II has milder highs. Cyclothymic disorder has long-lasting, milder ups and downs.

Suicide is a major cause of death among young people, and it is preventable. The strongest risk factor is a previous attempt. Warning signs include withdrawal, talk of death, and sudden changes in behaviour or school performance. The WHO recommends measures such as limiting access to means and responsible media reporting. Parents and teachers should watch for changes in students and help build their self-esteem.

Schizophrenia is a severe disorder of thought, perception and emotion. Its symptoms fall into three groups:

Positive symptoms (excesses: things added to normal behaviour):

• Delusions: false beliefs held firmly. The most common is the delusion of persecution ('people are plotting against me'); others are delusions of reference (everything refers to me), grandeur (I am great or special) and control (my thoughts are controlled by others).
• Thought disorders: illogical thinking; neologisms (inventing new words).
• Hallucinations: perceiving things that are not there, usually hearing voices.
• Inappropriate affect: emotions that do not fit the situation.

Negative symptoms (deficits: things missing): alogia (poverty of speech), blunted or flat affect (little emotion), avolition (no drive to act), and social withdrawal.

Psychomotor symptoms: unusual movements, or catatonia: staying motionless in odd postures for long periods.