Seeing sense in psychiatric diagnoses

Author(s):  
Paul R. McHugh
2013 ◽  
Author(s):  
Carl-Goran Goran Svedin ◽  
Malin Gren-Landell ◽  
Maria Zetterkvist ◽  
Nikolas Aho

1952 ◽  
Vol 47 (2, Suppl) ◽  
pp. 577-578 ◽  
Author(s):  
Benjamin Mehlman

2020 ◽  
Author(s):  
Tom Joseph Barry ◽  
David John Hallford ◽  
Keisuke Takano

Decades of research has examined the difficulty that people with psychiatric diagnoses, such as Major Depressive Disorder, Schizophrenia Spectrum Disorders, and Posttraumatic Stress Disorder, have in recalling specific autobiographical memories from events that lasted less than a day. Instead, they seem to retrieve general events that have occurred many times or which occurred over longer periods of time, termed overgeneral memory. We present the first transdiagnostic meta-analysis of memory specificity/overgenerality, and the first meta-regression of proposed causal mechanisms. A keyword search of Embase, PsycARTICLES and PsycINFO databases yielded 74 studies that compared people with and without psychiatric diagnoses on the retrieval of specific (k = 85) or general memories (k = 56). Multi-level meta-analysis confirmed that people with psychiatric diagnoses typically recall fewer specific (g = -0.864, 95% CI[-1.030, -0.698]) and more general (g = .712, 95% CI[0.524, 0.900]) memories than diagnoses-free people. The size of these effects did not differ between diagnostic groups. There were no consistent moderators; effect sizes were not explained by methodological factors such as cue valence, or demographic variables such as participants’ age. There was also no support for the contribution of underlying processes that are thought to be involved in specific/general memory retrieval (e.g., rumination). Our findings confirm that deficits in autobiographical memory retrieval are a transdiagnostic factor associated with a broad range of psychiatric problems, but future research should explore novel causal mechanisms such as encoding deficits and the social processes involved in memory sharing and rehearsal.


2018 ◽  
Author(s):  
Jordan Stevens ◽  
Douglas Steinley ◽  
Cassandra L. Boness ◽  
Timothy J Trull ◽  
...  

Using complete enumeration (e.g., generating all possible subsets of item combinations) to evaluate clustering problems has the benefit of locating globally optimal solutions automatically without the concern of sampling variability. The proposed method is meant to combine clustering variables in such a way as to create groups that are maximally different on a theoretically sound derivation variable(s). After the population of all unique sets is permuted, optimization on some predefined, user-specific function can occur. We apply this technique to optimizing the diagnosis of Alcohol Use Disorder. This is a unique application, from a clustering point of view, in that the decision rule for clustering observations into the diagnosis group relies on both the set of items being considered and a predefined threshold on the number of items required to be endorsed for the diagnosis to occur. In optimizing diagnostic rules, criteria set sizes can be reduced without a loss of significant information when compared to current and proposed, alternative, diagnostic schemes.


2021 ◽  
pp. 002076402110255
Author(s):  
Chao-Ying Tu ◽  
Wei-Shih Liu ◽  
Yen-Fu Chen ◽  
Wei-Lieh Huang

Background: Somatic symptom disorder (SSD) is common in medical settings but has been underdiagnosed. Stigma related to psychiatric illness was one of the barriers to making the diagnosis. More and more SSD patients who visited psychiatric clinics with physical complaints identify themselves as having ‘autonomic dysregulation’ in Taiwan. Aims: This study aimed to investigate the characteristics of patients with a subjective diagnosis of ‘autonomic dysregulation’. Method: We assessed the sociodemographic profile, medical/psychiatric diagnoses, subjective psychiatric diagnoses, perceived psychiatric stigma, help-seeking attitude, and healthcare utilization of 122 participants with SSD. Participants who identified themselves as having ‘autonomic dysregulation’ ( n = 84) were compared to those who did not (n=38). Results: Participants with a subjective diagnosis of ‘autonomic dysregulation’ were younger and had a higher education level than those who did not have such a subjective diagnosis. They also had higher scores on the Patient Health Questionnaire-15 (PHQ-15) and Health Anxiety Questionnaire (HAQ), whereas comorbid psychiatric diagnoses were similar in the two groups. Participants with and without a subjective diagnosis of ‘autonomic dysregulation’ did not have a significant difference in perceived psychiatric stigma and help-seeking attitude/behaviors. In a multiple logistic regression model, only age was associated with having a subjective diagnosis of ‘autonomic dysregulation’. Conclusion: Among SSD patients, those who identify themselves as having ‘autonomic dysregulation’ tend to have higher somatic distress and health anxiety than those who do not. ‘Autonomic dysregulation’ is not associated with perceived psychiatric stigma.


Author(s):  
Bianca Reis ◽  
Jenny Hsin-Chun Tsai

OBJECTIVE This practice improvement project sought to determine the prevalence of psychiatric diagnoses among patients admitted to a community hospital’s inpatient medical units and which diagnoses were serviced by the hospital’s psychiatric consultation service. METHOD Electronic medical record data on adult patients of five medical units admitted with a psychiatric condition between October 1, 2019, and December 31, 2019, were used. Psychiatric ICD-10 ( International Classification of Diseases, 10th Revision) codes and diagnosis names extracted were categorized into seven major diagnostic groups. A total of 687 adult patients with 82 psychiatric ICD-10 codes were analyzed using descriptive statistics. RESULTS Substance-related and addictive disorders were the most prevalent psychiatric diagnoses. Ninety-six percent ( n = 658) of patients residing on medical floors with psychiatric disorders were hospitalized for a principal medical problem. Seventy-three cases received psychiatric consultations during their stay. Sixty percent ( n = 44) of those cases had psychiatric disorders from two or more diagnostic categories. CONCLUSIONS Multidisciplinary, team-based health care delivery models that include a psychiatric nurse can provide an effective approach to treat patients in community hospitals with multiple psychiatric and medical comorbidities. Hospitals could take a significant role in providing substance use disorder treatment and equipping medical nurses with training to competently care for patients with psychiatric disorders on medical units. Further research into the prevalence and impact of patients with co-occurring and multiple psychiatric diagnoses in community hospitals is needed to implement effective health care delivery models and provide appropriate treatment options in the community.


2021 ◽  
pp. 1-8
Author(s):  
Michael Wainberg ◽  
Peter Zhukovsky ◽  
Sean L. Hill ◽  
Daniel Felsky ◽  
Aristotle Voineskos ◽  
...  

Abstract Background Our understanding of major depression is complicated by substantial heterogeneity in disease presentation, which can be disentangled by data-driven analyses of depressive symptom dimensions. We aimed to determine the clinical portrait of such symptom dimensions among individuals in the community. Methods This cross-sectional study consisted of 25 261 self-reported White UK Biobank participants with major depression. Nine questions from the UK Biobank Mental Health Questionnaire encompassing depressive symptoms were decomposed into underlying factors or ‘symptom dimensions’ via factor analysis, which were then tested for association with psychiatric diagnoses and polygenic risk scores for major depressive disorder (MDD), bipolar disorder and schizophrenia. Replication was performed among 655 self-reported non-White participants, across sexes, and among 7190 individuals with an ICD-10 code for MDD from linked inpatient or primary care records. Results Four broad symptom dimensions were identified, encompassing negative cognition, functional impairment, insomnia and atypical symptoms. These dimensions replicated across ancestries, sexes and individuals with inpatient or primary care MDD diagnoses, and were also consistent among 43 090 self-reported White participants with undiagnosed self-reported depression. Every dimension was associated with increased risk of nearly every psychiatric diagnosis and polygenic risk score. However, while certain psychiatric diagnoses were disproportionately associated with specific symptom dimensions, the three polygenic risk scores did not show the same specificity of associations. Conclusions An analysis of questionnaire data from a large community-based cohort reveals four replicable symptom dimensions of depression with distinct clinical, but not genetic, correlates.


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