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Psychiatric News

Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


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Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Linkage between Personality Traits & Longevity.


Depression Linked to Increase in Harmful Type of Body Fat


Leaving Las Vegas May Reduce Odds of Suicide


Researchers \'Astonished\' by Anorexia Death Rates


More


Disorders
 
 
Psychiatric Disorders: Diagnosis and Classification

Psychiatric Disorders are classified and categorized by the Diagnostic and Statistical Manual of Mental Disorders, more commonly known as the DSM, currently in its 4th edition hence DSM-IV. It is published by the American Psychiatric Association and categorizes mental disorders for both children and adults. It also lists known causes of these disorders, statistics in terms of gender, age at onset, and prognosis as well as some research concerning the treatment options and most appropriate approaches.

It has become a standard for mental health professionals to use the DSM-IV on a routine basis in their daily practice. It’s use help to have a better and common understand of mental illnesses and potential treatments as well as communicating with others such as insurance companies. Many refer to it as the ‘bible’ for any professional who makes psychiatric diagnoses in the United States.

Only a trained and licensed clinician such as a psychologist or psychiatrist can accurately diagnose psychiatric disorders since this requires a thorough understanding of the oft complex and overlapping psychiatric symptoms.

Psychiatric disorders are classified according to their predominant symptom . For example, depression, dysthymic disorder and bipolar disorder all have a disturbed mood pattern as their main feature and therefore all of these are classified under Mood Disorders.


Major Diagnostic Categories (in the DSM-IV)

Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence

The DSM-IV makes it clear that this categorization is "for convenience only" since many disorders included in other sections have their onset during childhood and adolescence whereas many conditions classified under this category are not diagnosed until an individual reaches adulthood. The following disorders are included in this section: Mental Retardation, Learning Disorders (also commonly known as "Learning Disability), Motor Skills Disorders, Communication Disorders, Pervasive Developmental Disorders such as Autistic Disorder or "Autism" and Asperger’s Disorder, Attention Deficit Hyperactivity Disorder and Disruptive Behavior Disorders including Oppositional Defiant Disorder and Conduct Disorder, Tic Disorders, Elimination Disorders, Separation Anxiety Disorder, Selective Mutism, Reactive Attachment Disorder and Others.

Delirium, Dementia and other Cognitive Disorders

According to the DSM-IV, the main feature of various disorders in this category is "a clinically significant deficit in cognition or memory that represents a significant change from a previous level of functioning." Examples include Delirium ("characterized by a disturbance of consciousness and a change in cognition that develop over a short period of time") and Dementia ("characterized by multiple cognitive deficits that include impairment in memory"); a well-known condition in this category is Dementia of the Alzheimer’s Type or "Alzheimer’s Disease".

Mental Disorders Due to a General Medical Condition

This category pertains to the mental symptoms that are considered to be the direct physiological consequence of a general medical condition; examples would be a Personality Change due to general medical condition or Anxiety Disorder due to a general medical condition. The main purpose of distinguishing medical conditions from mental disorders, according to the DSM-IV, is to encourage thoroughness in evaluation and to enhance communication among healthcare providers.

Substance-Related Disorders

This section is about the disorders that are related to taking the drugs of abuse, including alcohol, as well as sue to the side effects of medications and exposure to toxins. Such substances are grouped into 11 classes including alcohol, amphetamines and similar drugs, caffeine, cannabis, cocaine, hallucinogens, inhalants, nicotine, opioids, PCP and similar drugs, and sedatives, hypnotics or anxiolytics. This section also deals with Polysubstance Dependence and Other or Unknown Substance-Related Disorders (this entails most disorders related to medications or toxins).

Schizophrenia and Other Psychotic Disorders

All the disorders included in this section are characterized by the presence of psychotic symptoms such as delusions and hallucinations. A broader definition would also include other symptoms such as disorganized thought process and/or speech. The most well known example from this category would be Schizophrenia; others include: Schizoaffective Disorder, Delusional Disorder, Brief Psychotic Disorder and Psychotic Disorder Not Otherwise Specified.

Mood Disorders

Disturbance in mood is the defining feature of various disorders in this category. The disorders are divided into:

Depressive Disorders (Major Depressive Disorder or "Clinical Depression", Dysthymic Disorder and Depressive Disorder Not Otherwise Specified); these are distinguished from the Bipolar Disorders by the fact that there is no history of a Manic, Hypomanic or Mixed Episode.

Bipolar Disorders (Bipolar I Disorder, Bipolar II Disorder, Cyclothymic Disorder and Bipolar Disorder Not Otherwise Specified); these disorders involve the presence (or history) of Manic, Hypomanic or Mixed Episodes.

Mood Disorder Due to a General Medical Condition, Substance-Induced Mood Disorder, and Mood Disorder Not otherwise Specified.

Anxiety Disorders

The disorders contained in this category include: Panic Disorder (with and without Agoraphobia), Agoraphobia (without history of Panic Disorder), Specific Phobias; Social Phobia, Obsessive-Compulsive Disorder; "OCD"), Post-Traumatic Stress Disorder ("PTSD"), Acute Stress Disorder, Generalized Anxiety Disorder, Anxiety Disorder Due to to a General Medical Condition; Substance-Induced Anxiety Disorder and Anxiety Disorder Not Otherwise Specified. As the name suggests, the predominant feature of all of these disorders is the presence of anxiety-related symptoms, both physical and psychological.

Somatoform Disorders

According to the DSM-IV, the common feature of Somatoform Disorders is the presence of physical symptoms suggesting the presence of a general medical condition but the symptoms are not fully explained either by the general medical condition or by the effects of a substance, or by another mental disorder. The production of such physical symptoms (unlike those in Factitious Disorder and Malingering) is not intentional, and there is no diagnosable medical condition to fully account for these physical symptoms. This category includes: Somatization Disorder, Undifferentiated Somatoform Disorder, Conversion Disorder, Pain Disorder, Hypochondriasis, Body Dysmorphic Disorder, and Somatoform Disorder Not Otherwise Specified.

Factitious Disorders

These disorders are characterized by intentionally produced or feigned physical or psychological symptoms in order to assume the sick role. In Malingering, the symptoms are also feigned or produced intentionally but in this instance there is a tangible motive for doing so and such goal is obvious when the person’s circumstances are known. On the other hand, in Factitious Disorder the motivation is purely psychological to assume the role of being sick.

Dissociative Disorders

The DSM-IV notes that the essential feature of Dissociative Disorders is a "disruption in the usually integrated functions of consciousness, memory, identity or perception of the environment". Various disorders in this category are: Dissociative Amnesia, Dissociative Fugue, Dissociative Identity Disorder (previously known as "Multiple Personality Disorder"), Depersonalization Disorder and Dissociative Disorder Not Otherwise Specified.

Sexual and Gender Identity Disorders

This category contains Sexual Dysfunctions, Paraphilias, and the Gender Identity Disorders. The former include Sexual Desire Disorders, Sexual Arousal Disorders, Orgasmic Disorders, Sexual Pain Disorders, Sexual Dysfunction Due to a General Medical Condition, Substance Induced Sexual Dysfunction, and Sexual Dysfunction Not Otherwise Specified). The Paraphilias are characterized by "recurrent, intense sexual urges, fantasies, or behaviors that involve unusual objects, activities and situations and cause clinically significant distress or impairment in social, occupational, or other important areas of functioning". These include Exhibitionism, Fetishism, Frotteurism, Pedophilia, Sexual Masochism, Sexual Sadism, Transvestic Fetishism, Voyeurism, and Paraphilia Not Otherwise Specified. The Gender Identity Disorders are characterized by "strong and persistent cross-gender identification accompanied by persistent discomfort with one’s assigned sex", according to the DSM-IV.

Eating Disorders

The predominant feature of these disorders is a severe disturbance in eating behavior. The two specific diagnoses noted in the DSM-IV are Anorexia Nervosa (characterized by refusal to maintain a minimally normal body weight) and Bulimia Nervosa (characterized by repeated episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting or excessive exercise). An essential feature of both disorders is a distortion in one’s perception of body shape and weight. Eating Disorder Not Otherwise Specified is diagnosed when there is a clinically significant disturbance in a person’s eating behavior but the individual does not meet the criteria for a specific eating disorder.

Sleep Disorders

In DSM-IV, Sleep Disorders are sub-divided according to their presumed etiology. No specific etiology can be identified in Primary Sleep Disorders and they consist of Dyssomnias (characterized by the abnormality in the amount, quality or timing of sleep) and Parasomnias (characterized by abnormal behaviors or physiological events occurring in association with sleep, specific sleep stages or sleep-wake transitions). In Sleep Disorder Related to Another Mental Disorder there is prominent sleep disturbance resulting from another diagnosable mental disorder but of sufficient severity to warrant independent clinical attention. The other two categories in this section are Sleep Disorders due to a General Medical Condition and Substance Induced Sleep Disorder.

Impulse Control Disorders

The DSM-IV includes the following disorders in this category: Intermittent Explosive Disorder (characterized by discrete episodes of failure to resist aggressive impulses resulting in serious assaults or destruction of property), Kleptomania (characterized by recurrent failure to resist impulses to steal objects not needed for personal use or monetary value), Pyromania (characterized by a pattern of fire setting for pleasure, gratification or relief of tension), Pathological Gambling (characterized by recurrent or persistent, maladaptive gambling behavior), Trichotillomania (characterized by recurrent pulling out of one’s hair for pleasure, gratification or relief of tension that results in noticeable hair loss), and Impulse Control Disorder Not Otherwise Specified.

Adjustment Disorders

The DSM-IV notes the essential feature of these disorders as the onset of clinically significant emotional or behavioral symptoms in response to identifiable psychosocial stressor(s). The symptoms must develop within three months after the onset of the stressor(s). Adjustment Disorders are sub-typed according to the predominant symptoms such as with Depressed Mood, with Anxiety, with Mixed Anxiety and Depressed Mood, with Disturbance of Conduct, with Mixed Disturbance of Emotions and Conduct, and Unspecified. The duration of the symptoms of Adjustment Disorders can be indicated by one of the specifiers as Acute (persistence of symptoms for less than six months) and Chronic (persistence of symptoms for six months or longer); the latter requires presence of chronic stressor(s) since by definition the symptoms cannot persist for more than six months after termination of stressor(s).

Personality Disorders

The DSM-IV defines a personality disorder as "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive, and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment". The manual identifies and describes diagnostic criteria for 10 specific personality disorders. These are listed as below:

Paranoid Personality Disorder: characterized by a pervasive pattern of distrust and suspiciousness. 

Schizoid Personality Disorder: characterized by a pervasive pattern of detachment from social relationship 

Schizotypal Personality Disorder: characterized by a pervasive pattern of acute discomfort in close relationships, cognitive and perceptual distortions and eccentricities of behavior 

Antisocial Personality Disorder: characterized by a pervasive pattern of disregard for and violation of the rights of others. 

Borderline Personality Disorder: characterized by a pervasive pattern of instability in interpersonal relationships, self-image, and affects and marked impulsivity. 

Histrionic Personality Disorder: characterized by a pervasive pattern of excessive emotionality and attention seeking. 

Narcissistic Personality Disorder: characterized by a pervasive pattern of grandiosity, need for admiration and lack of empathy.

Avoidant Personality Disorder: characterized by a pervasive pattern of social inhibition, feeling of inadequacy, and hypersensitivity to negative evaluation. 

Dependent Personality Disorder: characterized by a pervasive pattern of submissive and clingy behavior related to an excessive need to be taken care of. 

Obsessive Compulsive Personality Disorder: characterized by a pervasive pattern of preoccupation with orderliness, perfectionism, and control. 

 

 

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