Psychotic States Arising in Late Life (Late Paraphrenia)

1995 ◽  
Vol 166 (2) ◽  
pp. 205-214 ◽  
Author(s):  
Osvaldo P. Almeida ◽  
Robert J. Howard ◽  
Raymond Levy ◽  
Anthony S. David
Keyword(s):  
Psychiatric Symptoms ◽  
Current Trend ◽  
Late Life ◽  
Signs And Symptoms ◽  
Diagnostic Systems ◽  
Formal Thought Disorder ◽  
Wide Range ◽  
Icd 10 ◽  
Dsm Iv ◽  
State Examination

BackgroundThis study explored the psychopathological state of a sample of ‘late paraphrenic’ patients and the reliability of their diagnosis according to the most widely used systems of classification of mental disorders.MethodThe presence and severity of psychiatric symptoms were assessed with the Present State Examination (PSE), the Scale for the Assessment of Positive Symptoms (SAPS), and the High Royds Evaluation of Negativity (HEN) scale. Patient signs and symptoms were classified according to the PSE9–CATEGO4, DSM–III–R, DSM–IV, and ICD–10 diagnostic systems. Agreement among the 11 most widely used criteria for the diagnosis of schizophrenia was assessed for these patients. These included DSM–III–R, DSM–IV, ICD–10, Schneider, Langfeldt, New Haven Schizophrenia Index, Carpenter, Research Diagnostic Criteria (RDC), Feighner, Taylor & Abrams, and PSE9–CATEGO4. The study assessed 47 patients, including in-patients, out-patients, day-patients, and those in the community. Thirty-three elderly controls were recruited from luncheon clubs in Southwark and Lambeth (London, UK).ResultsPatients showed a wide range of delusional ideas, most frequently involving persecution (83.0%) and reference (31.9%). Eighty-three per cent of patients reported some sort of hallucination, most frequently auditory (78.7%). Formal thought disorder was very rare, only one patient showing mild signs of circumstantial speech. No patients exhibited catatonic symptoms or inappropriate affect. Shallow, withdrawn, or constricted affect was found in only 8.5% of patients. The various systems of classification indicated that most patients displayed typical schizophrenic symptoms, although up to one-third of them did not meet criteria for the diagnosis of schizophrenia. There was poor agreement among the different diagnostic schedules as to whether to classify patients as schizophrenic (0.02 < k < 0.45).ConclusionPsychotic states arising in late life are accompanied by various psychiatric symptoms that are not entirely typical of early-onset schizophrenia. The current trend to include ‘late paraphrenia’ into the diagnosis of schizophrenia or delusional disorder has poor empirical and theoretical bases.

Symptoms of Psychiatric Illness

2014 ◽  
Author(s):  
Peter Sloan ◽  
Joy Bell
Keyword(s):  
Mental Disorder ◽  
Mental State ◽  
Psychiatric Illness ◽  
Signs And Symptoms ◽  
Symptom Clusters ◽  
Scientific Study ◽  
Diagnostic Systems ◽  
Vital Importance ◽  
Icd 10 ◽  
Dsm Iv

Few physical signs or investigative tools are available to psychiatrists to aid them in making their diagnosis. An ability to understand the patient’s mental state is therefore of vital importance in categorizing and precisely communicating their mental disorder. The MSE is the psychiatrist’s most used and useful resource. It elicits psychopathology in particular pat­terns, enabling diagnoses to be made. Psychopathology can therefore be defined as the scientific study of abnormal experience, cognition, and behaviour (Sims, 2002) and was first described by Karl Jaspers in the early 900s. More specifically, descriptive psychopathology is the subjective description of abnormal experience as related by patients and the objective observation of their behaviour. It has facilitated the creation of diagnostic systems, for example ICD-10 and DSM-IV, grouping symptom clusters and classifying which signs and symptoms indicate a particular diagnosis. In this chapter, you will be presented with a number of clinical sce­narios, which will enable you to familiarize yourself with some of the important phenomenological terms used by clinicians to help classify experience and illness. We have attempted to incorporate signs encoun­tered in all elements of the MSE and have used clinical examples from the main diagnostic groups.

A Qualitative Analysis on What Brazilian Psychiatrists Want from Current Diagnostic Classifications

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
A. Santos Júnior ◽  
L.F.A.L. Silva ◽  
C.E.M. Banzato ◽  
M.E.C. Pereira
Keyword(s):  
Daily Practice ◽  
Diagnostic Systems ◽  
Diagnostic Categories ◽  
Frequent Use ◽  
Open Questions ◽  
Dsm V ◽  
The Everyday ◽  
Icd 10 ◽  
Axis I ◽  
Dsm Iv

Aims:To analyze the qualitative answers profile of an anonymous standardized survey, with qualitative and quantitative questions, about the Brazilian psychiatrists' perceptions on their use of the multiaxial diagnostic systems ICD 10 and DSM-IV and on their expectations about future revisions of these classifications (ICD-11 and DSM-V).Method:the questionnaire, elaborated by Graham Mellsop (New Zealand), was translated into Portuguese and sent through mail to 1050 psychiatrists affiliated to the Brazilian Psychiatry Association. The quantitative analysis is presented elsewhere.Results:One hundred and sixty questionaries returned (15,2%). From these, 71,1% of the open questions where answered. The most needed and/or desirable qualities in a psychiatric classification were found to be: simplicity, criteria clarity, objectivity, comprehensibility, reliability and ease to use. The axis I of the ICD-10 was reported to be the most used due to its instrumental character in addition to being the official classification, including for legal and bureaucratic purposes. The DSM-IV was also used in the everyday practice, mostly for education and research purposes, by psychiatrists with academic affiliations. The less frequent use of the multiaxial systems was justified by the lack of training and familiarity, the overload of information and by the fact they are not mandatory. It was evaluated that some diagnostic categories must be reviewed, like: mental retardation, eating disorders, personality disorders, sleeping disorders, child and adolescence disorders, affective and schizoaffective disorders.Conclusion:This material offers a systematic panorama about the psychiatrists' opinions and expectations concerning the diagnostic instruments used in the daily practice.

scholarly journals Late-life depression in Peru, Mexico and Venezuela: the 10/66 population-based study

2009 ◽  
Vol 195 (6) ◽  
pp. 510-515 ◽  
Author(s):  
Mariella Guerra ◽  
Cleusa P. Ferri ◽  
Ana Luisa Sosa ◽  
Aquiles Salas ◽  
Ciro Gaona ◽  
...  
Keyword(s):  
Latin America ◽  
Latin American ◽  
Depressive Episode ◽  
Local Treatment ◽  
Late Life ◽  
Urban Site ◽  
Computer Assisted ◽  
Late Life Depression ◽  
Icd 10 ◽  
Dsm Iv

BackgroundThe proportion of the global population aged 60 and over is increasing, more so in Latin America than any other region. Depression is common among elderly people and an important cause of disability worldwide.AimsTo estimate the prevalence and correlates of late-life depression, associated disability and access to treatment in five locations in Latin America.MethodA one-phase cross-sectional survey of 5886 people aged 65 and over from urban and rural locations in Peru and Mexico and an urban site in Venezuela. Depression was identified according to DSM–IV and ICD–10 criteria, Geriatric Mental State–Automated Geriatric Examination for Computer Assisted Taxonomy (GMS–AGECAT) algorithm and EURO–D cut-off point. Poisson regression was used to estimate the independent associations of sociodemographic characteristics, economic circumstances and health status with ICD–10 depression.ResultsFor DSM–IV major depression overall prevalence varied between 1.3% and 2.8% by site, for ICD–10 depressive episode between 4.5% and 5.1%, for GMS–AGECAT depression between 30.0% and 35.9% and for EURO–D depression between 26.1% and 31.2%; therefore, there was a considerable prevalence of clinically significant depression beyond that identified by ICD–10 and DSM–IV diagnostic criteria. Most older people with depression had never received treatment. Limiting physical impairments and a past history of depression were the two most consistent correlates of the ICD–10 depressive episode.ConclusionsThe treatment gap poses a significant challenge for Latin American health systems, with their relatively weak primary care services and reliance on private specialists; local treatment trials could establish the cost-effectiveness of mental health investment in the government sector.

scholarly journals THE BIPOLAR AFFECTIVE DISORDER TYPE II

2018 ◽  
Vol 24 (3) ◽  
pp. 157-162
Author(s):  
Leonid M. Bardenshteyn ◽  
N. N Osipova ◽  
Ya. M Slavgorodsky ◽  
N. I Beglyankin ◽  
G. A Aleshkina ◽  
...  
Keyword(s):  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
International Studies ◽  
Type Ii ◽  
Diagnostic Systems ◽  
Course Of Disease ◽  
Dsm V ◽  
Icd 10 ◽  
Dsm Iv ◽  
Disorder Type

The article presents review of modern publications concerning studies of bipolar affective disorder type II. The materials are summing up concerning national and international studies of characteristics of clinical course of depressions and hypo-maniacal states within the framework of bipolar affective disorder type II, problems of differential diagnostic of bipolar affective disorder within spectrum of affective pathology. The significance of studying of pre-morbid background in case of bipolar affective disorder type II, co-morbid states for prognosis of course of disease is demonstrated. The screening, diagnostic and estimated scales and questionnaires are considered including principles of their application as an add-on to actual international diagnostic systems ICD-10, DSM-IV-TR, DSM-V.

Assessing Behavioral Symptoms of Dementia of the Alzheimer Type: Categorical and Quantitative Approaches

1996 ◽  
Vol 8 (S2) ◽  
pp. 183-200 ◽  
Author(s):  
Michael Zaudig
Keyword(s):  
Rating Scales ◽  
Psychiatric Symptoms ◽  
International Classification Of Diseases ◽  
Assessment Procedure ◽  
Alzheimer Type ◽  
Behavioral Disturbances ◽  
Psychiatric Disturbances ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Dsm Iv

Behavioral disturbances are a prevalent and important aspect of dementia of the Alzheimer type, but they have been relatively neglected by researchers. To characterize patients as having dementia, at least two goals should be addressed: first, determining a reliable definition and categorical diagnosis of dementia using such criteria as the Diagnostic and Statistical Manual of Mental Disorders (DSM)–IV and the International Classification of Diseases (ICD)–10; second, establishing a reliable and valid measurement of the severity of cognitive and noncognitive impairment by means of rating scales. DSM-IV and ICD-10 do not provide definitions of behavioral disturbance, whereas more than 100 geriatric rating scales exist that include some measurement of behavioral disturbances of dementia. There is a need for consensus on the term for these noncognitive symptoms. Some authors prefer the subdivisions of (a) psychiatric and noncognitive symptomatology into psychiatric symptoms, or syndromes and behavioral distrubances; and (b) cognitive syndromes. Given the frequency and clinical significance of behavioral and psychiatric disturbances in dementia, a standardized assessment procedure is needed for reliably and comprehensively describing psychiatric phenomena and behavioral disturbances in patients with dementia.

Anorexia nervosa or otherwise? The usefulness of adult diagnostic systems in child and adolescent eating disorders

2006 ◽  
Vol 23 (4) ◽  
pp. 156-158
Author(s):  
Alma Lydon ◽  
Onome Agbahovbe ◽  
Brendan Doody
Keyword(s):  
Anorexia Nervosa ◽  
Paediatric Population ◽  
Classification Systems ◽  
Childhood And Adolescence ◽  
Diagnostic Systems ◽  
Young Males ◽  
Icd 10 ◽  
Inpatient Management ◽  
Dsm Iv ◽  
Adolescent Eating Disorders

AbstractWe report on the case of a 15-year-old boy referred to Warrenstown inpatient unit for management of what appeared to be a typical case of anorexia nervosa. Over the course of his admission however, this diagnosis was no longer considered appropriate and substituted for a food avoidance emotional disorder. This is one of a number of cases of young males who have recently been referred for inpatient management of anorexia nervosa but which emerged into something quite atypical. The limited usefulness of the ICD-10/DSM-IV criteria in the diagnosis of an eating disorder in childhood and adolescence in this case reflects a broader level of discontent with the application of such diagnostic classification systems in a paediatric population.

The Munich 15-year follow-up study (MUFUSSAD) on first-hospitalized patients with schizophrenic or affective disorders: Assessing courses, types and time stability of diagnostic classification

2011 ◽  
Vol 26 (4) ◽  
pp. 231-243 ◽  
Author(s):  
H.J. Möller ◽  
M. Jäger ◽  
M. Riedel ◽  
M. Obermeier ◽  
A. Strauss ◽  
...  
Keyword(s):  
Affective Disorders ◽  
Time Stability ◽  
Diagnostic Systems ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Icd 10 ◽  
Dsm Iv ◽  
Chronic Course

AbstractObjectiveIn the context of the development of DSM-V and ICD-11 it appears to be useful to get further data on the validity of the diagnostic differentiation between schizophrenic and affective disorders. This study investigated the relevance of the main diagnostic groups schizophrenia, schizoaffective psychosis and affective disorder in the context of different diagnostic systems (ICD-9, ICD-10, DSM –IV), assessing their time stability, long-term courses, types and functional outcome.MethodsA total of 323 first hospitalized inpatients of the Psychiatric Department of the University Munich were recruited at index time. The full follow-up evaluation including standardized assessment procedures could be performed in 197 patients.ResultsThe re-diagnosis of the patients’ disorders shows that with the transition from ICD-9 to ICD-10 or DSM-IV, the group of affective disorders increased numerically while the diagnostic groups of schizophrenia and schizoaffective disorders decreased in size. The structured clinical interview for DSM-IV (SCID) analysis showed that altogether ICD-10 and DSM-IV had a relatively high diagnostic stability. Of the patients with an ICD-10 diagnosis of schizophrenia, 57% had a chronic course; 61% of the patients with a DSM-IV diagnosis of schizophrenia. Patients with affective disorders, according either to ICD-10 or DSM-IV, had in more than 90% of the cases an episodic-remitting course. In terms of prediction of long-term outcome regarding the differentiation between chronic and non-chronic course, the ICD-10 diagnoses did give a slightly better predictive result than a dimensional approach based on the key psychopathological syndrome scores.ConclusionsThe differentiation between schizophrenic and affective disorders seems meaningful especially under predictive aspects. A dimensional syndromatological description does not exceed the predictive power of the investigated main diagnostic categories, but might increase the clinically relevant information.

The ICD-10 and DSM-IV diagnostic criteria and the prevalence of schizophrenia

1997 ◽  
Vol 12 (5) ◽  
pp. 217-223 ◽  
Author(s):  
E Lindström ◽  
B Widerlöv ◽  
L von Knorring
Keyword(s):  
Diagnostic Criteria ◽  
Schizoaffective Disorder ◽  
Delusional Disorder ◽  
Diagnostic Systems ◽  
Residual Symptoms ◽  
Number Of Patients ◽  
Icd 10 ◽  
International Statistical Classification ◽  
Dsm Iv ◽  
Narrow Concept

SummaryIn the present study, all patients who met the diagnostic criteria for a long-term functional psychosis (LFP) were identified within a defined uptake area in the northern part of the county of Uppsala, Sweden. LFP includes patients 1) with productive psychotic symptomatology, not caused by organic disease, for 1 week or more, at least once during the course of the illness; 2) having been affected by a psychosis for a continuous period of at least 6 months on the same occasion; 3) having shown psychotic features or residual symptoms during the index year; and 4) older than 18 years of age. Primarily, all diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III-R. The prevalence of schizophrenia was 4.2 per 1,000 inhabitants. The prevalence of schizoaffective disorder was 0.7 per 1,000 inhabitants and for delusional disorder, 0.1 per 1,000 inhabitants. When the patients were rediagnosed according to DSM-III, DSM-IV and International Statistical Classification of Disease (ICD)-10, it was found that the prevalence of schizophrenia, schizoaffective disorder and delusional disorder was somewhat lower according to the DSM-III criteria, while the same number of patients fulfilled the criteria according to DSM-IV. If ICD-10 was used, it resulted in a broader concept of schizophrenia and a somewhat more narrow concept of schizoaffective disorder. Thus, the introduction of the new parallel diagnostic systems, ICD-10 and DSM-IV, will result in different, but comparable, prevalence estimates concerning schizophrenia, schizoaffective disorder and delusional disorder.

Subjectivity and Intersubjectivity in Psychiatric Diagnosis

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
T. Fuchs
Keyword(s):  
Psychiatric Diagnosis ◽  
Subjective Experience ◽  
Self Concept ◽  
List Type ◽  
Type Number ◽  
Diagnostic Systems ◽  
Theoretical Level ◽  
Behavioural Symptoms ◽  
Icd 10 ◽  
Dsm Iv

The establishment of criteriological and manualized systems of diagnosis since the 1980ies has lead to a valuable increase in the precision and reliability of psychiatric diagnosis. On the other hand, the limits of this approach for clinicians and researchers are increasingly becoming apparent. In particular, the assessment of subjective experience is nearly excluded on the theoretical level and downplayed on the pragmatic level, with serious consequences for the validity of psychiatric diagnosis, for empirical research and, above all, for therapeutic purposes.In my paper, I will argue that a thorough assessment and inclusion of subjective experience in our diagnostic systems will be indispensable for clinical, therapeutic as well as research purposes. To this purpose, I will distinguish three major approaches to the assessment of mental illness: 1.The positivistic, objectifying or 3rd person approach as endorsed by DSM IV and ICD 10, focusing mainly on observable behavioural symptoms.2.The phenomenological, subject-oriented or 1st person approach, focusing on the patient's self-experience and exploring its basic, often implicit structures.3.The hermeneutic, intersubjective or 2nd person approach, mainly aiming at the co-construction of shared narratives or interpretations regarding the patient's self-concept, conflicts and relationships, as e.g. in psychodynamic approaches.These three approaches will be compared regarding their respective values for psychopathological description, diagnosis, research and therapeutic purposes.

Gender differences in the prevalence of DSM-IV and ICD-10 PTSD

2005 ◽  
Vol 36 (1) ◽  
pp. 81-89 ◽  
Author(s):  
LORNA PETERS ◽  
CATHY ISSAKIDIS ◽  
TIM SLADE ◽  
GAVIN ANDREWS
Keyword(s):  
Gender Differences ◽  
Gender Difference ◽  
Well Being ◽  
Diagnostic Systems ◽  
Post Traumatic Stress ◽  
Symptom Level ◽  
Icd 10 ◽  
Post Traumatic ◽  
Dsm Iv ◽  
Diagnostic Criterion

Background. Gender differences in the prevalence of post-traumatic stress disorder were examined by analysing discrepancies between the DSM-IV and ICD-10 diagnostic systems.Method. Data from the Australian National Survey of Mental Health and Well-Being (n=10641) were analysed at the diagnostic, criterion and symptom level for DSM-IV and ICD-10 PTSD for males versus females.Results. While there was a significant gender difference in the prevalence of PTSD for ICD-10, no such difference was found for DSM-IV. The pattern of gender difference at the diagnostic level was mirrored in the pattern of gender differences at the criterion level for both DSM-IV and ICD-10. Females only endorsed three symptoms at a significantly higher rate than males. For all other symptoms, endorsement was equal. This apparently small gender difference at the symptom level was sufficient to cause the gender difference at the diagnostic level for ICD-10, but not DSM-IV because of the different manner in which symptoms are configured into criteria in each of the diagnostic systems.Conclusions. Gender differences in ICD-10 PTSD but not in DSM PTSD diagnoses are attributable in this study to different patterns of endorsement of symptoms by males and females. Possible reasons for the differential endorsement of symptoms and implications for the use of epidemiological instruments are discussed.

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