Science, Philosophy, and Diagnosis

2015 ◽  
pp. 55-64
Author(s):  
Joel Paris
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Gold Standard ◽  
Psychiatric Epidemiology ◽  
Medical Diagnoses ◽  
Dsm 5 ◽  
Science Philosophy

Mental disorders need not be seen as “real” in the same way as medical diagnoses. Current categories of mental disorder are not well validated, and can best be considered as heuristics. Overdiagnosis ignores these limitations, sometimes leading to diagnostic epidemics in which many different phenomena are seen as belonging to the same category. The use of DSM-5 as a gold standard has also distorted psychiatric epidemiology, which has been based on syndromal definitions rather than empirically validated categories. These concepts have made it all too easy to diagnose almost everyone with some form of mental disorder.

Types of Mental Disorders in People with Intellectual Disability

2020 ◽  
pp. 55-60
Author(s):  
Sally-Ann Cooper
Keyword(s):  
Intellectual Disability ◽  
General Population ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Bipolar Affective Disorder ◽  
Hyperactivity Disorder ◽  
Dsm 5 ◽  
Icd 10 ◽  
Physical Disorders ◽  
Challenging Behaviours

Mental disorders are common in people with intellectual disability, with a reported point prevalence of 36% in children and young people (including challenging behaviours), and 40.9% in adults (or 28.3% excluding challenging behaviours). People with intellectual disability experience all types of mental disorders, some more commonly than the general population, e.g. autism, attention-deficit hyperactivity disorder, schizophrenia, bipolar affective disorder, and dementia. Challenging behaviours are also common, and have no clear general population equivalent. Multi-morbidity of mental and physical disorders is typical. Mental disorder assessments are complex due to multi-morbidity and polypharmacy, in addition to impairments in communication, understanding, vision, and hearing, and the need to work with family and paid carers as well as the person with intellectual disability. Mental disorder classificatory systems have been developed for people with intellectual disability, in view of under-reporting when using general population manuals: DC-LD was designed to complement ICD-10, and DM-ID 2 to interpret DSM-5.

scholarly journals Commonly diagnosed mental disorders in a general hospital system

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
George Scott ◽  
Alessandra M. Beauchamp-Lebrón ◽  
Ashley A. Rosa-Jiménez ◽  
Javier G. Hernández-Justiniano ◽  
Axel Ramos-Lucca ◽  
...  
Keyword(s):  
Health Psychology ◽  
Puerto Rico ◽  
Mental Disorders ◽  
Mental Disorder ◽  
General Hospital ◽  
Medical Patients ◽  
Hospital System ◽  
Clinical Health Psychology ◽  
Dsm 5 ◽  
A Current

Abstract Background Considering many patients receive care from general hospitals, these healthcare institutions are uniquely situated to address mental and physical health needs. Little is documented, however, on the common current mental disorders diagnosed in patients receiving care in general hospital settings, especially in Puerto Rico. The objective of this study was to characterize the five most common current DSM-5 mental disorder diagnoses made in patients receiving non-psychiatric medical and surgical care from a general hospital system in southern Puerto Rico between January 2015 and December 2019. Methods Our clinical health psychology team provides integrated psychology consultation-liaison services to select clinical units in general hospitals across the southwestern region of Puerto Rico. The clinical team conducted routine standardized psychological evaluations at patients' bedside, arrived at a current DSM-5 diagnosis if warranted, and documented the diagnosis and other select variables. A retrospective study of cross-sectional data generated from the clinical team’s standardized evaluations of 5494 medical patients was implemented. Multinomial logistic regression analyses were used to assess the odds of being diagnosed with a current DSM-5 mental disorder during hospitalization. Results Overall, 53% of the entire sample was diagnosed with a mental disorder during hospitalization. Major depressive, neurocognitive, anxiety, substance-related and schizophrenia-spectrum disorders were the most frequently diagnosed. Interestingly, females were 23% less likely to have been diagnosed with major depressive disorder than males (aOR: 0.769, CI [0.650, 0.909], p = 0.002). This is to say males evidenced 1.30 higher odds of being diagnosed with depression compared to their female counterpart. Age, biological sex, civil status, employment status, monthly household income, previous mental disorder and history substance use/abuse history was differentially associated with receiving a current DSM-5 disorder. Conclusion The integration of clinical health psychology services within a general hospital facilitated our team’s work of identifying and treating co-occurring mental disorders among hospitalized patients receiving medical and surgical care. Future studies examining the opportunities and barriers of integrating clinical health psychology services within a general hospital’s administrative and clinical infrastructure for rapid identification and treatment of co-occurring mental disorders among medical patients is encouraged.

Biology and Genetics in DSM-5

2013 ◽  
Vol 15 (3) ◽  
pp. 195-198 ◽  
Author(s):  
Colin A. Ross
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
American Psychiatric Association ◽  
History Of Psychiatry ◽  
X Rays ◽  
Risk Genes ◽  
Dsm 5 ◽  
History Of ◽  
Genetic Specificity ◽  
Porous Boundaries

DSM-5 includes a number of statements concerning the biology and genetics of mental disorders, and these represent a significant landmark in the history of psychiatry. According to DSM-5, there are no laboratory tests, x-rays, or other biological markers for any mental disorder; there is no physiological specificity to any mental disorder; there is no genetic specificity to any mental disorder; and there is no symptom specificity to DSM-5 disorders. DSM-5 disorders, according to the manual, have porous boundaries with each other, have high rates of comorbidity, and fluctuate a great deal over time. The risk genes for mental disorders number in the hundreds, each contributes perhaps 1%–2% to the overall risk, and the same genes confer risk for multiple DSM-5 categories of disorder. The idea that DSM disorders are separate diseases with distinct pathophysiologies has been disconfirmed by the DSM-5, and therefore by the American Psychiatric Association, as it has by the National Institutes of Mental Health.

Angststörungen – von der ICD-10 zur ICD-11

2020 ◽  
pp. 1-5
Author(s):  
Timo D. Vloet ◽  
Marcel Romanos
Keyword(s):  
Mental Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.

Primary Health Care and the ICD-11

2013 ◽  
Vol 10 (01) ◽  
pp. 33-37 ◽  
Author(s):  
M. Klinkman ◽  
D. Goldberg
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Medical Care ◽  
Special Needs ◽  
Field Trials ◽  
Primary Medical Care ◽  
Dsm 5 ◽  
Primary Health ◽  
Icd 10

SummaryThis paper describes the necessity of adapting the major classifications of mental disorders exemplified by the ICD-11 and the DSM-5 for the special needs of primary medical care. An earlier version of the classification – the ICD-10-PHC – is described, and the process of adapting it is described in detail. The new 28 item version of the classification is described, and the procedures to be adopted in the Field Trials to be held during 2013 are set out, together with the specific problems these field trials will address.

Evidence-Based Practice in School Mental Health

2019 ◽  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Health Problems ◽  
Common Mental Disorders ◽  
Adolescent Psychopathology ◽  
Real Life ◽  
Childhood And Adolescence ◽  
Dsm 5 ◽  
School Based ◽  
K 12

Schools have become the default mental health providers for children and adolescents, but they are often poorly equipped to meet the mental health needs of their students. The introduction tackles how to make students eligible for school-based services using the Individuals with Disabilities Education Act or Section 504 of the Rehabilitation Act. Using the new DSM-5 as an organizing principle, this book then addresses the 12 most common mental disorders of childhood and adolescence, ages 3–18. While there are many books that address child and adolescent psychopathology, this book focuses on how to help students with mental disorders in pre-K–12 schools. Each chapter addresses the prevalence of a disorder in school-age populations, appropriate diagnostic criteria, differential diagnosis, comorbid disorders, rapid assessment instruments available, school-based interventions using multitiered systems of support, and easy-to-follow suggestions for progress monitoring. Unique to this book, each chapter has detailed suggestions for how school-based clinicians can collaborate with teachers, parents, and community providers to address the needs of youth with mental health problems so that school, home, and community work together. Each chapter ends with a list of extensive web resources and a real-life case example drawn from the clinical practice of the authors. The final chapter addresses two newly proposed diagnoses for self-harm in the DSM-5 and brings a cautious and sensible approach to assessing and helping students who may be at risk for serious self-injury or suicide.

Diagnoses, Dimensions, and DSM-5

2010 ◽  
pp. 254-279
Author(s):  
Thomas A. Widiger ◽  
Maryanne Edmundson
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Paradigm Shift ◽  
Empirical Support ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Dimensional Classification ◽  
Diagnosis And Classification

The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) is often said to have provided a significant paradigm shift in how psychopathology is diagnosed. The authors of DSM-5 have the empirical support and the opportunity to lead the field of psychiatry to a comparably bold new future in diagnosis and classification. The purpose of this chapter is to address the validity of the categorical and dimensional models for the classification and diagnosis of psychopathology. Considered in particular will be research concerning substance use disorders, mood disorders, and personality disorders. Limitations and concerns with respect to a dimensional classification of psychopathology are also considered. The chapter concludes with a recommendation for a conversion to a more quantitative, dimensional classification of psychopathology.

scholarly journals Impact of arthritis on the perceived need and use of mental healthcare among Canadians with mental disorders: nationally representative cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041371
Author(s):  
Alyssa Howren ◽  
J Antonio Aviña-Zubieta ◽  
Deborah Da Costa ◽  
Joseph H Puyat ◽  
Hui Xie ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Clinical Care ◽  
Mental Healthcare ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Perceived Need ◽  
Mental Health Support ◽  
Health Support

ObjectiveTo evaluate the association between having arthritis and the perceived need for mental healthcare and use of mental health support among individuals with mental disorders.DesignA cross-sectional analysis using data from Canadian Community Health Survey—Mental Health (2012).SettingThe survey was administered across Canada’s 10 provinces using multistage cluster sampling.ParticipantsThe study sample consisted of individuals reporting depression, anxiety or bipolar disorder.Study variables and analysisThe explanatory variable was self-reported doctor-diagnosed arthritis, and outcomes were perceived need for mental healthcare and use of mental health support. We computed overall and gender-stratified multivariable binomial logistic regression models adjusted for age, gender, race/ethnicity, income and geographical region.ResultsAmong 1774 individuals with a mental disorder in the study sample, 436 (20.4%) reported having arthritis. Arthritis was associated with increased odds of having a perceived need for mental healthcare (adjusted OR (aOR) 1.71, 95% CI 1.06 to 2.77). In the gender-stratified models, this association was increased among men (aOR 2.69, 95% CI 1.32 to 5.49) but not women (aOR 1.48, 95% CI 0.78 to 2.82). Evaluation of the association between arthritis and use of mental health support resulted in an aOR of 1.50 (95% CI 0.89 to 2.51). Individuals with arthritis tended to use medications and professional services as opposed to non-professional support.ConclusionComorbid arthritis among individuals with a mental disorder was associated with an increased perceived need for mental healthcare, especially in men, underscoring the importance of understanding the role of masculinity in health seeking. Assessing the mental health of patients with arthritis continues to be essential for clinical care.

Tobacco smoking and mental disorders in Australian adolescents

2021 ◽  
pp. 000486742110096
Author(s):  
David Lawrence ◽  
Sarah E Johnson ◽  
Francis Mitrou ◽  
Sharon Lawn ◽  
Michael Sawyer
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Tobacco Smoking ◽  
Mental Health Problems ◽  
Health Problems ◽  
Major Depressive ◽  
Current Smoking ◽  
Self Harm ◽  
Current Tobacco

Objectives: This study aimed to (1) examine the strength of the association between mental disorders/mental health problems, risk behaviours and tobacco smoking among Australian adolescents, (2) compare rates of tobacco smoking among Australian adolescents with major depressive disorder, attention-deficit/hyperactivity disorder and/or conduct disorder in 2013/14 vs 1998, and (3) identify the extent to which an association between tobacco smoking and mental health problems among adolescents can be attributed to non-mental health risk factors. Methods: The study utilised data from the first (1998) and second (2013/14) child and adolescent components of the National Surveys of Mental Health and Wellbeing. Both surveys identified nationally representative samples of Australian young people aged 4–17 years, living in private dwellings. Information was collected from parents and 13- to 17-year-olds about mental disorders, mental health problems, risk behaviours and tobacco smoking. Results: In the 2013/14 survey, the rate of current tobacco smoking among those with a mental disorder was 20% compared to 5% in those without a mental disorder. Rates were highest for young people with conduct disorder (50%), major depressive disorder (24%) and anxiety disorders (19%). In 2013/14, 38% of current tobacco smokers had a mental disorder and 32% reported self-harm and/or suicidal ideation vs 10% and 5%, respectively, among adolescents who had never smoked. Females with mental disorders or reporting self-harm or suicidal ideation had higher rates of current smoking than males. Other significant factors associated with current smoking included school-related problems, binge eating and having had more than one sexual partner. Conclusion: While smoking rates in 13- to 17-year-olds with mental disorders had declined since 1998, the strength of the association between mental disorders and smoking had increased, especially among females. Our findings highlight the need to address the tobacco smoking among adolescents with mental disorders, particularly females.

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