Whither Psychiatric Diagnosis

1999 ◽  
Vol 33 (2) ◽  
pp. 161-165 ◽  
Author(s):  
Allen J. Frances ◽  
Helen Link Egger
Keyword(s):  
Psychiatric Disorders ◽  
Psychiatric Illness ◽  
Biological Effects ◽  
Genetic Research ◽  
Explanatory Models ◽  
Psychiatric Research ◽  
Diagnostic And Statistical Manual ◽  
Current State ◽  
System Method ◽  
Dsm Iv

Objective: The aim of this paper is to describe the development of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), its purposes and limitations, and the psychiatric nosologies which may emerge from advances in psychiatric research and which may supersede the current classification system. Method: A review of the methodology used to develop DSM-IV, considered in the context of current and future psychiatric, neurobiological, and genetic research, was undertaken. Results: The DSM-IV is a descriptive nosology that has shaped psychiatric research and clinical practice by providing agreed-upon definitions of psychiatric disorders based on the current state of empirical data. Despite the critical importance of the DSM system of classification, this complex yet limited nosology will eventually be replaced by simpler, more incisive explanatory models of psychiatric illness that reflect the interplay of biological, psychological, environmental and social variables affecting the expression and treatment of psychiatric disorders. Conclusions: As we continue to understand the pathophysiology of brain disorders, as well as the biological effects of psychiatric interventions, we will be able to move from a descriptive model to an integrative, explanatory model of psychiatric illness.

Toward the Content Validity of Premenstrual Dysphoric Disorder: Do Anger and Irritability More than Depressed Mood Represent Treatment-Seekers' Experiences?

2002 ◽  
Vol 90 (1) ◽  
pp. 189-202 ◽  
Author(s):  
Shirley Ann Hartlage ◽  
Kelly E. Arduino
Keyword(s):  
Psychiatric Disorders ◽  
Depressed Mood ◽  
Content Validity ◽  
Premenstrual Dysphoric Disorder ◽  
Premenstrual Symptoms ◽  
Text Revision ◽  
Diagnostic And Statistical Manual ◽  
Functional Interference ◽  
Dsm Iv ◽  
Treatment Seekers

The content validity of Premenstrual Dysphoric Disorder in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV–TR) has been questioned in the literature. We tested whether mood-related symptoms reported by 26 women seeking treatment for premenstrual disorders were among the proposed criteria. These women were asked to list their premenstrual symptoms and rate the severities of listed symptoms daily for two menstrual cycles before treatment. They completed semistructured interviews to differentiate symptoms of Premenstrual Dysphoric Disorder from those of other psychiatric disorders in women who had other disorders. All participants reported functional interference due to the symptoms. 19 symptoms of or similar to those of Premenstrual Dysphoric Disorder were among the 22 most frequent premenstrual symptoms experienced. Premenstrual depressed mood was less frequent than premenstrual irritability or anger when other psychiatric disorders such as major depression were taken into account. Results suggest that the DSM-IV–TR criteria have generally good content validity but may need revision to represent treatment-seekers' experiences more accurately.

Undiagnosed Psychiatric Patients

1972 ◽  
Vol 121 (565) ◽  
pp. 647-651 ◽  
Author(s):  
Jay L. Liss ◽  
Amos Welner ◽  
Eli Robins
Keyword(s):  
Psychiatric Disorder ◽  
Psychiatric Disorders ◽  
Psychiatric Illness ◽  
Chart Review ◽  
Psychiatric Patients ◽  
Psychiatric Research ◽  
Hospital Records ◽  
Follow Up Study ◽  
Narrative Interview

In a previous report records were studied of 256 in-patients who were discharged as undiagnosed, i.e. in-patients who at the time of discharge did not have a definable psychiatric illness (Welner, Liss, Robins and Richardson, 1972). In that study it was shown that when rigorous criteria for psychiatric research (Feighner, Robins, Guze, Woodruff, Winokur and Munoz, 1972) were used 68 per cent of these patients met the criteria for an established psychiatric disorder. It was concluded that: (1) The chart review diagnoses for a population of undiagnosed patients consisted of a variety of established psychiatric disorders and the population was not homogeneous. (The chart review diagnosis is a diagnosis obtained by review of the patients' hospital records and evaluating the information by using diagnostic criteria for psychiatric disorders.) (2) The most efficient way to arrive at a diagnosis was by structured rather than conventional narrative interview. This study is a follow-up study of these patients and attempts to evaluate the validity of the chart review diagnosis. A concordance between the chart review diagnosis and follow-up diagnosis supports the above conclusions. The follow-up study also served to establish diagnosis in patients who had too few symptoms initially to meet the criteria for a diagnosis.

Hospital Admission in Adolescents with acute Psychiatric Disorder: How Long should it be?

2005 ◽  
Vol 13 (2) ◽  
pp. 165-168 ◽  
Author(s):  
Harith Swadi ◽  
Candace Bobier
Keyword(s):  
Length Of Stay ◽  
Clinical Outcome ◽  
Psychiatric Illness ◽  
Diagnostic Category ◽  
Adjustment Disorder ◽  
Outcome Data ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Health Gains ◽  
Dsm Iv

Objective: To determine the length of stay in hospital for youth with acute psychiatric illness, and the treatment outcome. Methods: Diagnostic and Statistical Manual of Mental Disorders(4th edn;DSM-IV) psychiatric diagnosis, clinical outcome and the length of stay were sys-tematically gathered for admissions over an 18month period at the Christchurch Youth Inpatient Unit (YIU). Clinical outcome data were collected at admission,3 weeks after admission and at discharge, using the Health of the Nation Out-come Scale for Children and Adolescents (HoNOSCA). The length of stay was determined retrospectively. Discharge was decided on clinical grounds. Results: During the 18 months of the investigation, 72 subjects were admitted for the treatment of acute mental illness. The most common diagnostic category was mood disorder (n = 39, 54%), followed by anxiety or adjustment disorder (n = 18, 25%), and major psychosis (n = 15, 21%). The mean length of admission for the whole population was 27.3 days, 23.7 days for mood disorders, 18.9 days for anxiety disorders and 46.9 days for the major psychosis diagnostic groups. According to HoNOSCA clinician ratings, the major portion of the improvement occurred during the first 3 weeks of admission. Conclusions: For the majority of youth with acute psychiatric illness, a relatively short stay in hospital is feasible, because most health gains tend to occur early during an admission.

scholarly journals Diagnostic classification of psychiatric disorders and familial-genetic research

1999 ◽  
Vol 1 (3) ◽  
pp. 191-196
Keyword(s):  
Psychiatric Disorders ◽  
Genetic Research ◽  
International Classification Of Diseases ◽  
Epidemiological Studies ◽  
Classification Systems ◽  
Detailed Knowledge ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases ◽  
Icd 10

The validity of diagnostic definitions in psychiatry is directly related to the extent to which their etiology can be specified. However, since detailed knowledge of causal or susceptibility factors is lacking for most psychiatric disorders with a known or suspected familial-genetic origin, the current widely accepted classification systems largely fail to achieve this ideal. To illustrate this problem, this paper looks at the difficulties posed by the criteria for schizophrenia as laid down in the International Classification of Diseases, 10th revision (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R), and highlights the discrepancies between the majority of diagnostic boundaries and the various phenotype aggregation patterns observed in family studies. Progress in our understanding of psychiatric disorders requires to be firmly based on the findings of epidemiological studies as well as on a clear appreciation of the limitations of classification tools.

Behavioral Genetics: Concepts for Research and Practice in Language Development and Disorders

1995 ◽  
Vol 38 (5) ◽  
pp. 1126-1142 ◽  
Author(s):  
Jeffrey W. Gilger
Keyword(s):  
Language Development ◽  
Behavioral Genetics ◽  
State Of The Art ◽  
Genetic Research ◽  
Great Promise ◽  
Behavioral Genetic ◽  
Fine Grained ◽  
Future Goals ◽  
Current State ◽  
Research Designs

This paper is an introduction to behavioral genetics for researchers and practioners in language development and disorders. The specific aims are to illustrate some essential concepts and to show how behavioral genetic research can be applied to the language sciences. Past genetic research on language-related traits has tended to focus on simple etiology (i.e., the heritability or familiality of language skills). The current state of the art, however, suggests that great promise lies in addressing more complex questions through behavioral genetic paradigms. In terms of future goals it is suggested that: (a) more behavioral genetic work of all types should be done—including replications and expansions of preliminary studies already in print; (b) work should focus on fine-grained, theory-based phenotypes with research designs that can address complex questions in language development; and (c) work in this area should utilize a variety of samples and methods (e.g., twin and family samples, heritability and segregation analyses, linkage and association tests, etc.).

Comparison of Three Questionnaires to Screen for Borderline Personality Disorder in Adolescents and Young Adults

2017 ◽  
Vol 33 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Anne van Alebeek ◽  
Paul T. van der Heijden ◽  
Christel Hessels ◽  
Melissa S.Y. Thong ◽  
Marcel van Aken
Keyword(s):  
Young Adults ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Adolescents And Young Adults ◽  
Patient Questionnaire ◽  
Statistical Manual ◽  
Axis Ii ◽  
Diagnostic And Statistical Manual ◽  
Dsm Iv

Abstract. One of the most common personality disorders among adolescents and young adults is the Borderline Personality Disorder (BPD). The objective of current study was to assess three questionnaires that can reliably screen for BPD in adolescents and young adults (N = 53): the McLean Screening Instrument for BPD (MSI-BPD; Zanarini et al., 2003 ), the Personality Diagnostic Questionnaire 4th edition – BPD scale (PDQ-4 BPD; Hyler, 1994 ), and the SCID-II Patient Questionnaire – BPD scale (SCID-II-PQ BPD). The nine criteria of BPD according to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV; APA, 1994 ) were measured with the Structural Clinical Interview for DSM-IV Axis II disorders – BPD scale (SCID-II; First, Spitzer, Gibbon, Williams, & Benjamin, 1995 ). Correlations between the questionnaires and the SCID-II were calculated. In addition, the sensitivity and specificity of the questionnaires were tested. All instruments predicted the BPD diagnosis equally well.

The Classification of Eating Disorders

2010 ◽  
pp. 7-24 ◽  
Author(s):  
Kathryn H. Gordon ◽  
Jill M. Holm-Denoma ◽  
Ross D. Crosby ◽  
Stephen A. Wonderlich
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Latent Class ◽  
Minority Groups ◽  
Statistical Manual ◽  
Text Revision ◽  
Diagnostic And Statistical Manual ◽  
Key Issues ◽  
Dsm Iv

The purpose of the chapter is to elucidate the key issues regarding the classification of eating disorders. To this end, a review of nosological research in the area of eating disorders is presented, with a particular focus on empirically based techniques such as taxometric and latent class analysis. This is followed by a section outlining areas of overlap between the current Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) eating disorder categories and their symptoms. Next, eating disorder classification models that are alternatives to the DSM-IV-TR are described and critically examined in light of available empirical data. Finally, areas of controversy and considerations for change in next version of the DSM (i.e., the applicability of DSM criteria to minority groups, children, males; the question of whether clinical categories should be differentiated from research categories) are discussed.

scholarly journals Psychiatric disorders in China: strengths and challenges of contemporary research and clinical services

2021 ◽  
pp. 1-14
Author(s):  
Xiao Chang ◽  
Qiyong Gong ◽  
Chunbo Li ◽  
Weihua Yue ◽  
Xin Yu ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Disease Burden ◽  
Large Scale ◽  
Well Being ◽  
Research Quality ◽  
Psychiatric Research ◽  
Clinical Services ◽  
Contributing Factors ◽  
Brain Functions ◽  
Neuroscience Research

Abstract China accounts for 17% of the global disease burden attributable to mental, neurological and substance use disorders. As a country undergoing profound societal change, China faces growing challenges to reduce the disease burden caused by psychiatric disorders. In this review, we aim to present an overview of progress in neuroscience research and clinical services for psychiatric disorders in China during the past three decades, analysing contributing factors and potential challenges to the field development. We first review studies in the epidemiological, genetic and neuroimaging fields as examples to illustrate a growing contribution of studies from China to the neuroscience research. Next, we introduce large-scale, open-access imaging genetic cohorts and recently initiated brain banks in China as platforms to study healthy brain functions and brain disorders. Then, we show progress in clinical services, including an integration of hospital and community-based healthcare systems and early intervention schemes. We finally discuss opportunities and existing challenges: achievements in research and clinical services are indispensable to the growing funding investment and continued engagement in international collaborations. The unique aspect of traditional Chinese medicine may provide insights to develop a novel treatment for psychiatric disorders. Yet obstacles still remain to promote research quality and to provide ubiquitous clinical services to vulnerable populations. Taken together, we expect to see a sustained advancement in psychiatric research and healthcare system in China. These achievements will contribute to the global efforts to realize good physical, mental and social well-being for all individuals.

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