MENTAL HEALTH DISORDERS

WHAT IS HEALTH?

WHO, “Health is a state of complete physical, mental and social well being, and not merely the absence of any disease or infirmity in an individual”

WHAT IS MENTAL HEALTH?

MENTAL HEALTH WHO, “The capacity of an individual to

form harmonious relationship with others and to participate in and contribute constructively to changes in the social environment”.

Meninger defines, “The adjustment of human beings to the world and to each other with the maximum of effectiveness and happiness”.

MENTAL ILLNESS Mental illness can occur when the brain

is not working well. One or more of its 6 main functions will

be disrupted. Thinking Perception Emotion Behavior Physical Signaling

REFERENCE WORK Find out the difference between mental

illness and mental retardation.

NEUROSIS & PSYCHOSIS

NEUROSIS Neurosis also known as Psychoneurosis It refers to minor mental disorders They are characterized by inner struggles

and certain mental and physical disturbances

Clinically, Psychoneurosis implies a bodily disturbance without ant structural or organic defect.

The patient is unable to understand but nevertheless, he realizes that something is wrong with him/her.

Ex: Phobia, Stress related disorders

PSYCHOSIS Psychosis refer to insanity or madness. Psychosis are major personality

disorders marked by gross emotional and mental disruptions.

These diseases make the individual incapable of adequate self management and adjustment to society.

Ex: Personality disorders, mood disorders, and so on.

REFERENCE WORK Prepare a chart on the differences

between Neurosis and Psychosis and bring it to next class.

CLASSIFICATION OF MENTAL DISORDERS Psychiatric disorders are classified

mostly on the basis of symptoms. Sometimes on the basis of etiology.

WHY CLASSIFICATION? To make generally acceptable diagnosis To facilitate communication between

psychiatrists, other doctors and other professionals

Leading to better treatment planning To make framework for research in

psychiatry.

SOME TERMS USED CLASSIFICATION – placing a clinical

condition into a category based on shared characteristics.

MULTIAXIAL SYSTEM – A classification system that has multiple dimensions.

DIAGNOSIS – the conclusion reached concerning the nature of a patient’s problem, based on clinical observations.

ETIOLOGY – the cause(s) or Origin(s) of a condition.

IMPORTANT TERMS SYNDROME – a group of signs and

symptoms that together indicate or describe a disorder.

DISEASE –A definite pathological process having a characteristic set of signs and symptoms.

DISORDER – a derangement or abnormality of function; a morbid physical or mental state.

ILLNESS –refers to the feelings that might come with having a disease.

SYMPTOMS – refers to an observable behavior or state.

MILESTONES IN THE HISTORY OF CLASSIFICATION 1796 – Edinburgh physician William Cullen attempts to

classify mental disorders using an approach based on biologists’ systems for classifying plants and animals.

1879 – English psychiatrist William Maudsley suggests classifying mental disorders in terms of identifiable symptoms.

1883- German psychiatrist Emil Kreapelin published the first edition of an influential textbook that describes and classifies several mental disorders.

6th edition of the International Classification of Diseases, injuries and causes of death is published and includes for the first time a section devoted to mental disorders.

1980 – the 3rd edition of the APA’s Diagnostic and Statiscal Manual is published.

ICD - 10 International Statiscal Classification of

Disease and Related health problems – 1992

Developed by the World Health Organization

Mostly used in Europe, Africa and Asia The chapter ‘F’ classifies psychiatric

disorder as a mental and behavioral disorders and codes them on an alphanumeric system from F00 to F99.

ICD -10 CLASSIFICATIONCode number

Mental disorders

F00-F09 Organic, including symptomatic mental disorders

F10-F19 Mental and behavioral disorders due to psychoactive substance use

F20-F29 Schizophrenia, schizotypal & Delusional disorders

F30-F39 Mood (Affective) disorders

F40-F49 Neurotic, stress - rapid & somato-form disorders

F50-F59 Behavioral syndromes associated with physiological disturbances & physical factors

F60-F69 Disorders of adult personality & behavior

F70-F79 Mental Retardation

F80-F89 Disorders of physiological development

F90-F98 Behavioral & emotional disorders with onset usually occuring in childhood and adolescence

F99 Unspecified mental disorders

THE MULTIAXIAL APPROACH Emil Kraepelin (1856-1926) – two

symptom patterns that seemed to hang together and recur.

Ex: Dementia praecox (Schizophrenia) and manic depressive insanity (Bipolar)

The APA’s multiaxial classification system (DSM) is currently so widely accepted .

DSM-IV-TR Published in 2000 by American

Psychiatric Association, US 5 axes Provide information about the biological,

psychological and social aspects of a person’s condition.

It is used worldwide and mostly used for research purposes.

DSM-IV-TR (AXES) Axis I – Clinical Psychiatric Diagnosis Axis II – Personality disorders and MR Axis III – General medical conditions

relevant to a case Axis IV – Psycho-social and environmental

problems Axis V – Global assessment of functioning

(GAF) rating scale from 1 to 100. 100 – no symptoms – superior functioning 60 – moderate symptoms or moderate difficulty

in social, occupational or social functioning. 10 – persistent danger of severely hurting self

or others

REFERENCE WORK Find out the differences between ICD

and DSM