Overdiagnosis in Psychiatry

2015 ◽  
Author(s):  
Joel Paris
Keyword(s):  
Mental Disorders ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Best Practice ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Critical Problem ◽  
Hyperactivity Disorder ◽  
Post Traumatic

As one of the few resources to thoroughly examine the critical problem of over-diagnosis in psychiatry today, this title covers how over-diagnosis in psychiatric practice may lead to over-treatment. It considers the complications of the DSM-5 classification system, with particular reference to major depression, bipolar disorder, Post-traumatic Stress Disorder (PTSD), and Attention-Deficit Hyperactivity Disorder (ADHD). While each of these conditions have given rise to diagnostic fads and epidemics, the classification of mental disorders remains provisional without any biomarkers for mental disorders. It then covers the importance of conservative diagnoses, recognizing that normal variants are not necessarily disorder, and that in many cases, under-, rather than over-diagnosing may be best practice.

scholarly journals Caesar in Vietnam: Did Roman Soldiers Suffer from Post-Traumatic Stress Disorder?

2011 ◽  
Vol 58 (2) ◽  
pp. 209-223 ◽  
Author(s):  
AISLINN MELCHIOR
Keyword(s):  
Mental Disorders ◽  
Vietnam War ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Ancient World ◽  
Post Traumatic Stress ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Post Traumatic

Post-traumatic stress disorder (PTSD) made its first appearance in the Diagnostic and Statistical Manual of Mental Disorders in 1980, partly as a result of the ongoing treatment of veterans from the Vietnam War. Although PTSD is not only or even primarily a disorder caused by combat, combat is a regular trigger and my chief concern in what follows. Therefore I will not be examining such evidence as exists for the psychological traumas of civilians in the ancient world who were exposed to violence, rape, enslavement, or the execution of family members in the context of conquest. My focus is on the soldier.

scholarly journals ‘Military Munchausen's’: assessment of factitious claims of military service in psychiatric patients

1998 ◽  
Vol 22 (3) ◽  
pp. 153-154 ◽  
Author(s):  
Martin Baggaley
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Military Service ◽  
Stress Disorder ◽  
Psychiatric Patients ◽  
Post Traumatic Stress ◽  
Military Experience ◽  
Simple Classification ◽  
Post Traumatic

Thirteen per cent of referrals of ex-servicemen to a military psychiatric centre for the treatment of combat-related post-traumatic stress disorder (PTSD) in a 12-month period have proved to be factitious. A simple classification of factitious combat-related PTSD into those with no military service and those with military service but with false claims of combat is described. The possible causes of this behaviour are discussed and a guide to the detection of factitious claims for psychiatrists without military experience is given.

Prevention of Post-Traumatic Stress Disorder

2018 ◽  
Author(s):  
Arieh Y. Shalev ◽  
Anna C. Barbano ◽  
Wei Qi ◽  
Charles R. Marmar
Keyword(s):  
Mental Disorders ◽  
Early Development ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Events ◽  
Trauma Exposure ◽  
Post Traumatic Stress ◽  
Post Traumatic

Post-traumatic stress disorder (PTSD) follows an exposure to traumatic events and as such its onset and early development are better charted then those of most other mental disorders. It is not surprising, therefore, that major efforts have been dedicated to preventing its occurrence before, during and after trauma exposure. This chapter discusses the rationale, desirability, feasibility and outcome of interventions designed to prevent PTSD. Several efficient interventions have been documented. Barriers to their early implementations, however, greatly reduce their effectiveness and require urgent attention.

scholarly journals Differentiating ICD-11 complex post-traumatic stress disorder from other common mental disorders based on levels of exposure to childhood adversities, the traumas of persecution and postmigration living difficulties among refugees from West Papua

BJPsych Open ◽  
2018 ◽  
Vol 4 (5) ◽  
pp. 361-367
Author(s):  
Derrick Silove ◽  
Susan Rees ◽  
Mohammed Mohsin ◽  
Natalino Tam ◽  
Moses Kareth ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Common Mental Disorders ◽  
Interpersonal Trauma ◽  
Post Traumatic Stress ◽  
Childhood Adversities ◽  
Cultural Validity ◽  
Post Traumatic

BackgroundFollowing years of controversy, a category of complex post-traumatic stress disorder (CPTSD) will be included in the forthcoming ICD-11.AimsTo test whether refugees with CPTSD differ from those with other common mental disorders (CMDs) in the degree of exposure to childhood adversities, adult interpersonal trauma and post-traumatic hardship.MethodSurvey of 487 West Papuan refugees (response rate 85.5%) in Papua New Guinea.ResultsRefugees with CPTSD had higher exposure to childhood adversities (CPTSD: mean 2.6, 95% CI 2.5–2.7 versus CMD: mean 1.15, 95% CI 1.10–1.20), interpersonal trauma (CPTSD: mean 9, 95% CI 8.6–9.4 versus CMD: mean 5.4, 95% CI 5.4–5.5) and postmigration living difficulties (CPTSD: mean 2.3, 95% CI 2–2.5 versus CMD mean 1.85, 95% CI 1.84–1.86), compared with those with CMDs who in turn exceeded those with no mental disorder on all these indices.ConclusionsThe findings support the cross-cultural validity of CPTSD as a reaction to high levels of exposure to recurrent interpersonal trauma and associated adversities.Declaration of interestNone.

Hurricane Katrina experience and the risk of post-traumatic stress disorder and depression among pregnant women

2010 ◽  
Vol 5 (3) ◽  
pp. 181-187 ◽  
Author(s):  
Xu Xiong, MD, DrPH ◽  
Emily W. Harville, PhD ◽  
Donald R. Mattison, MD ◽  
Karen Elkind-Hirsch, PhD ◽  
Gabriella Pridjian, MD ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Pregnant Women ◽  
Hurricane Katrina ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Increased Risk ◽  
Post Traumatic ◽  
Hurricane Exposure

Objective: Little is known about the effects of disaster exposure and intensity on the development of mental disorders among pregnant women. The aim of this study was to examine the effect of exposure to Hurricane Katrina on mental health in pregnant women.Design: Prospective cohort epidemiological study.Setting: Tertiary hospitals in New Orleans and Baton Rouge, USA.Participants: Women who were pregnant during Hurricane Katrina or became pregnant immediately after the hurricane.Main outcome measures: Post-traumatic stress disorder (PTSD) and depression.Results: The frequency of PTSD was higher in women with high hurricane exposure (13.8 percent) than women without high hurricane exposure (1.3 percent), with an adjusted odds ratio (aOR) of 16.8 (95% confidence interval: 2.6-106.6) after adjustment for maternal race, age, education, smoking and alcohol use, family income, parity, and other confounders. The frequency of depression was higher in women with high hurricane exposure (32.3 percent) than women without high hurricane exposure (12.3 percent), with an aOR of 3.3 (1.6-7.1). Moreover, the risk of PTSD and depression increased with an increasing number of severe experiences of the hurricane.Conclusions: Pregnant women who had severe hurricane experiences were at a significantly increased risk for PTSD and depression. This information should be useful for screening pregnant women who are at higher risk of developing mental disorders after disaster.

scholarly journals Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys

2016 ◽  
Vol 47 (2) ◽  
pp. 227-241 ◽  
Author(s):  
E. J. Bromet ◽  
L. Atwoli ◽  
N. Kawakami ◽  
F. Navarro-Mateu ◽  
P. Piotrowski ◽  
...  
Keyword(s):  
Mental Health ◽  
General Population ◽  
Mental Disorders ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
The World ◽  
Post Traumatic ◽  
Ptsd Prevalence

BackgroundResearch on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20–40% range in disaster-focused studies but considerably lower (3–5%) in the few general population epidemiological surveys that evaluated disaster-related PTSD as part of a broader clinical assessment. The World Mental Health (WMH) Surveys provide an opportunity to examine disaster-related PTSD in representative general population surveys across a much wider range of sites than in previous studies.MethodAlthough disaster-related PTSD was evaluated in 18 WMH surveys, only six in high-income countries had enough respondents for a risk factor analysis. Predictors considered were socio-demographics, disaster characteristics, and pre-disaster vulnerability factors (childhood family adversities, prior traumatic experiences, and prior mental disorders).ResultsDisaster-related PTSD prevalence was 0.0–3.8% among adult (ages 18+) WMH respondents and was significantly related to high education, serious injury or death of someone close, forced displacement from home, and pre-existing vulnerabilities (prior childhood family adversities, other traumas, and mental disorders). Of PTSD cases 44.5% were among the 5% of respondents classified by the model as having highest PTSD risk.ConclusionDisaster-related PTSD is uncommon in high-income WMH countries. Risk factors are consistent with prior research: severity of exposure, history of prior stress exposure, and pre-existing mental disorders. The high concentration of PTSD among respondents with high predicted risk in our model supports the focus of screening assessments that identify disaster survivors most in need of preventive interventions.

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