It Is Time to Rename the DSM

2006 ◽  
Vol 8 (1) ◽  
pp. 61-67 ◽  
Author(s):  
Bruce A. Thyer
Keyword(s):  
Mental Disorders ◽  
Conduct Disorder ◽  
Mental Disorder ◽  
Psychosocial Factors ◽  
Human Behavior ◽  
Natural Science ◽  
A Priori ◽  
Dysfunctional Behavior ◽  
Mental Disturbance ◽  
Dsm Iv

Although the DSM purports to be a theoretical with respect to the etiology of mental disorders, its fundamental assumption that aberrant patterns of thought, emotion or behavior reflect mental disturbance is itself an unjustifiable a priori position. Within the DSM-IV-TR, the existence of compelling dysfunctional psychosocial etiological influences precludes the diagnosis of conduct disorder. Consistent with this precedent, the following principle needs to be expanded to virtually all the conditions found in the DSM: “Conditions reasonably attributable to psychosocial factors or medical conditions should not be considered mental disorders.” Following this principle could cause the very concept of mental disorder to evaporate, in favor of a nondualist perspective on explaining human behavior in favor of a consistently physicalistic one. This would promote the study of dysfunctional behavior as a legitimate field of natural science and not one of metaphysical enquiry.

scholarly journals Proportion of patients without mental disorders being treated in mental health services worldwide

2015 ◽  
Vol 206 (2) ◽  
pp. 101-109 ◽  
Author(s):  
Ronny Bruffaerts ◽  
Jose Posada-Villa ◽  
Ali Obaid Al-Hamzawi ◽  
Oye Gureje ◽  
Yueqin Huang ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Dose Response ◽  
Mental Health Treatment ◽  
World Health ◽  
Health Treatment ◽  
The Past ◽  
The World ◽  
Dsm Iv

BackgroundPrevious research suggests that many people receiving mental health treatment do not meet criteria for a mental disorder but are rather ‘the worried well’.AimsTo examine the association of past-year mental health treatment with DSM-IV disorders.MethodThe World Health Organization's World Mental Health (WMH) Surveys interviewed community samples of adults in 23 countries (n = 62 305) about DSM-IV disorders and treatment in the past 12 months for problems with emotions, alcohol or drugs.ResultsRoughly half (52%) of people who received treatment met criteria for a past-year DSM-IV disorder, an additional 18% for a lifetime disorder and an additional 13% for other indicators of need (multiple subthreshold disorders, recent stressors or suicidal behaviours). Dose–response associations were found between number of indicators of need and treatment.ConclusionsThe vast majority of treatment in the WMH countries goes to patients with mental disorders or other problems expected to benefit from treatment.

Neuropsychiatry

1993 ◽  
Vol 1 (3) ◽  
pp. 108-110 ◽  
Author(s):  
Perminder Sachdev
Keyword(s):  
Mental Disorders ◽  
Psychiatric Disorder ◽  
Mental Disorder ◽  
19Th Century ◽  
General Paresis ◽  
Ancient Greek ◽  
General Psychiatry ◽  
Mental Disturbance ◽  
Physical Disorders ◽  
The 19Th Century

The relative emphasis on “biological” or “psychological” formulations in our understanding of “mental” disorders has varied at different periods in history. The early traditions of Western medicine, as represented by ancient Greek and Roman physicians, recognised that mental disturbance could be produced by physical disorders. The famous 17th century neurologist Thomas Willis, who coined the term “neurology”, believed in a neurological basis of psychiatric disorder. This opinion was explicitly stated in the mid-19th century text on mental disorders by Griesinger [1]. In fact, in die latter half of the 19th century, neuropsychiatry was synonymous with general psychiatry. A number of developments led to this situation. The study of aphasia had resulted in a burgeoning interest in brain structure-function relationships. The recognition of general paresis as an acquired disease with an identifiable aetiology had resulted in therapeutic optimism. Further, neurologists of this period were interested in retaining the territory of mental disorder as a source of patients.

scholarly journals Lifetime and 12-month prevalence, severity and unmet need for treatment of common mental disorders in Japan: results from the final dataset of World Mental Health Japan Survey

2015 ◽  
Vol 25 (3) ◽  
pp. 217-229 ◽  
Author(s):  
H. Ishikawa ◽  
N. Kawakami ◽  
R. C. Kessler ◽  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Common Mental Disorders ◽  
Unmet Need ◽  
Diagnostic Interview ◽  
Need For Treatment ◽  
World Mental Health ◽  
The World ◽  
Dsm Iv

Background.The aim of this study is to estimate the lifetime and 12-month prevalence, severity and treatment of Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) mental disorders in Japan based on the final data set of the World Mental Health Japan Survey conducted in 2002–2006.Methods.Face-to-face household interviews of 4130 respondents who were randomly selected from Japanese-speaking residents aged 20 years or older were conducted from 2002 to 2006 in 11 community populations in Japan (overall response rate, 56%). The World Mental Health version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI), a fully structured, lay administered psychiatric diagnostic interview, was used for diagnostic assessment.Results.Lifetime/12-month prevalence of any DSM-IV common mental disorders in Japan was estimated to be 20.3/7.6%. Rank-order of four classes of mental disorders was anxiety disorders (8.1/4.9%), substance disorders (7.4/1.0%), mood disorders (6.5/2.3%) and impulse control disorders (2.0/0.7%). The most common individual disorders were alcohol abuse/dependence (7.3/0.9%), major depressive disorder (6.1/2.2%), specific phobia (3.4/2.3%) and generalized anxiety disorder (2.6/1.3%). While the lifetime prevalence of any mental disorder was greater for males and the middle-aged, the persistence (proportion of 12-month cases among lifetime cases) of any mental disorder was greater for females and younger respondents. Among those with any 12-month disorder, 15.3% were classified as severe, 44.1% moderate and 40.6% mild. Although a strong association between severity and service use was found, only 21.9% of respondents with any 12-month disorder sought treatment within the last 12 months; only 37.0% of severe cases received medical care. The mental health specialty sector was the most common resource used in Japan. Although the prevalence of mental disorders were quite low, mental disorders were the second most prevalent cause of severe role impairment among chronic physical and mental disorders.Conclusions.These results suggest lower prevalence of mental disorders in Japan than that in Western countries, although the general pattern of disorders, risk factors and unmet need for treatment were similar to those in other countries. Greater lifetime prevalence for males and greater persistence for females seems a unique feature of Japan, suggesting a cultural difference in gender-related etiology and course of disorders. The treatment rate in Japan was lower than that in most other high-income countries in WMH surveys.

Resolving the paradox of common, harmful, heritable mental disorders: Which evolutionary genetic models work best?

2006 ◽  
Vol 29 (4) ◽  
pp. 385-404 ◽  
Author(s):  
Matthew C. Keller ◽  
Geoffrey Miller
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Human Behavior ◽  
Behavior Genetics ◽  
Balancing Selection ◽  
Paternal Age ◽  
Heterozygote Advantage ◽  
Psychiatric Genetics ◽  
Apparent Paradox ◽  
Evolutionary Genetic

Given that natural selection is so powerful at optimizing complex adaptations, why does it seem unable to eliminate genes (susceptibility alleles) that predispose to common, harmful, heritable mental disorders, such as schizophrenia or bipolar disorder? We assess three leading explanations for this apparent paradox from evolutionary genetic theory: (1) ancestral neutrality (susceptibility alleles were not harmful among ancestors), (2) balancing selection (susceptibility alleles sometimes increased fitness), and (3) polygenic mutation-selection balance (mental disorders reflect the inevitable mutational load on the thousands of genes underlying human behavior). The first two explanations are commonly assumed in psychiatric genetics and Darwinian psychiatry, while mutation-selection has often been discounted. All three models can explain persistent genetic variance in some traits under some conditions, but the first two have serious problems in explaining human mental disorders. Ancestral neutrality fails to explain low mental disorder frequencies and requires implausibly small selection coefficients against mental disorders given the data on the reproductive costs and impairment of mental disorders. Balancing selection (including spatio-temporal variation in selection, heterozygote advantage, antagonistic pleiotropy, and frequency-dependent selection) tends to favor environmentally contingent adaptations (which would show no heritability) or high-frequency alleles (which psychiatric genetics would have already found). Only polygenic mutation-selection balance seems consistent with the data on mental disorder prevalence rates, fitness costs, the likely rarity of susceptibility alleles, and the increased risks of mental disorders with brain trauma, inbreeding, and paternal age. This evolutionary genetic framework for mental disorders has wide-ranging implications for psychology, psychiatry, behavior genetics, molecular genetics, and evolutionary approaches to studying human behavior.

scholarly journals The Lay Concept of Conduct Disorder: Do Nonprofessionals Use Syndromal Symptoms or Internal Dysfunction to Distinguish Disorder from Delinquency?

2006 ◽  
Vol 51 (4) ◽  
pp. 210-217 ◽  
Author(s):  
Jerome C Wakefield ◽  
Stuart A Kirk ◽  
Kathleen J Pottick ◽  
Derek K Hsieh ◽  
Xin Tian
Keyword(s):  
Conduct Disorder ◽  
Mental Disorder ◽  
Social Workers ◽  
Diagnostic Criteria ◽  
False Positives ◽  
Shared Understanding ◽  
Clinical Vignettes ◽  
Dsm Iv ◽  
Definition Of ◽  
Professional Judgments

Background: Conduct disorder (CD) must be distinguished from nondisordered delinquent behaviour to avoid false positives, especially when diagnosing youth from difficult environments. However, the nature of this distinction remains controversial. The DSM-IV observes that its own syndromal CD diagnostic criteria conflict with its definition of mental disorder, which requires that symptoms be considered a manifestation of internal dysfunction to warrant disorder diagnosis. Previous research indicates that professional judgments tend to be guided by the dysfunction requirement, not syndromal symptoms alone. However, there are almost no data on lay conceptualizations. Thus it remains unknown whether judgments about CD are anchored in a broadly shared understanding of mental disorder that provides a basis for professional–lay consensus. Objective: The present study tests which conception of CD, syndromal-symptoms or dysfunction-requirement, corresponds most closely to lay judgments of disorder or nondisorder and compares lay and professional judgments. We hypothesized that lay disorder judgments, like professional judgments, tend to presuppose the dysfunction requirement. Method: Three lay samples (nonclinical social workers, nonpsychiatric nurses, and undergraduates) rated their agreement that youths described in clinical vignettes have a mental disorder. All vignettes satisfied DSM-IV CD diagnostic criteria. Vignettes were varied to present syndromal symptoms only, symptoms suggesting internal dysfunction, and symptoms resulting from reactions to negative circumstances, without dysfunction. Results: All lay samples attributed disorder more often to youths whose symptoms suggested internal dysfunction than to youths with similar symptoms but without a likely dysfunction. Conclusions: The dysfunction requirement appears to reflect a widely shared lay and professional concept of disorder.

Evolutionary Concepts of Mental Disorders—A Unifying Framework?

2017 ◽  
Author(s):  
Andreas Heinz
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Human Behavior ◽  
Learning Mechanisms ◽  
Evolutionary Theories ◽  
Evolutionary Concepts ◽  
Basic Learning

Dysfunction of basic learning mechanisms my best be understood within an evolutionary framework of human behavior. In this chapter, traditional evolutionary accounts of mental disorders are described and criticized, because they often have been based on a rather prejudiced view of non-European cultures and their supposed “primitiveness”. Such existing evolutionary theories and their pitfalls have to be kept in mind when developing a new understanding of mental disorder.

scholarly journals Prevalence of Mental Health Patient Hospitalized in Medical Wards in Beheshti Hospital in 2007

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
G. Akasheh ◽  
M. Sedighi
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Somatoform Disorder ◽  
List Type ◽  
Hospital Data ◽  
Mental Health Patient ◽  
Descriptive Research ◽  
Duke University ◽  
Dsm Iv ◽  
Medical Wards

Mental disorders are one of the most problems in the world and influence on medical disease thus this study investigated the prevalence of mental disorders in medical wards of Beheshti hospital.Method and materials:This study was a descriptive research in 260 patients hospitalized in medical wards of Beheshti hospital. Data was collected in two groups:1.Identification data includes: name, age, gender, maritial status, resident place and previous mental disorder and type of medical ward.2.G.H.Q. Those who scores were higher than the cut of point in GHQ, were psychiatrically interviewed based on DSM-IV TR criteria.The results were analyzed by descriptive statistic.Result:54.2% suffered from mental disorder include: mood disorder (34.2%), anxiety disorder (9.6%), somatoform disorder (1.5%) and psychosis (0.4%). The rate of illness in female was 56.9% versus 42.7% in male. Prevalence of psychotic disorder is more than findings of Higashi and Yashiro (27 to 39%) and Koeng in Duke university (36.5% MDD).Conclusion:Mental disorders are common in general hospital and consult with psychiatrist and liasion psychiatry is very important.

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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