2 Classification and diagnosis 1

Question 1

What are Wakefield’s two criteria for mental disorder?

Answer 1

1) Must be an internal dysfunction

2) Symptoms must not be socially accepted/seen as harmful

Question 2

How does the DSM apply its own definition of mental illness to specific categories?

Answer 2

It doesn’t, actually.

Question 3

What may be a cause of overdiagnosis of mental illness?

Answer 3

Looking only at symptoms, not at cause/dysfunctionality, which may be absent.

Question 4

When was first edition of DSM published?

Answer 4

In 1952.

Question 5

Name some inconsistencies in diagnostical categories between the ICD and the DSM

Answer 5

GAD in ICD makes no mention of worry.

Binge eating disorder only in DSM (move to Europe and you’re cured!)

Mixed anxiety/depression only in ICD.

Question 6

What are the four assumptions about illnesses in the medical model of health?

Answer 6

Different illnesses are:

1) clearly distinguishable from each other (cancer/broken leg)
2) occur independently
3) have specific, identifiable causal agents
4) respond to specific treatments

Question 7

What is a syndrome?

Answer 7

A cluster of symptoms whose cause is unknown

Question 8

When does a syndrome become a disease?

Answer 8

When its cause/aetiology is known

Question 9

Who is credited as the first person to attribute disease to physical causes?

Answer 9

Hippocrates (c460-377 BC)

Question 10

What were the three categories of mental illness described by Paracelsus?

Answer 10

Vesania –caused by toxins
Lunacy – by the phases of the moon
Insanity –inherited

Question 11

This is a description of which disorder proposed by Henry Maudsley (1867)?

“Extreme perversion of feeling and derangement of thought, failure of intelligence,
nocturnal hallucinations, and suicidal and homicidal propensities.”

Answer 11

Masturbatory insanity

Question 12

What did Hippocrates believe to be the cause of hysteria?

Answer 12

Uterus dries up through lack of sexual intercourse. Detaches and moves around body interfering with other organs.

Question 13

What would Emil Kraepelin advise you to do if you observed symptoms of a disorder but didn’t know the cause?

Answer 13

Stay on the level of description of symptoms –don’t try to treat the cause, because you’ll just be guessing.

Question 14

What is the Kraepelian method of describing a mental disorder?

Answer 14

1) Clearly describe symptoms
2) Identify syndromes
3) Describe onset, course, epidemiology

Question 15

How was General Paresis of the Insane re-categorised when its cause was found?

Answer 15

As the final stage of syphilis.

Question 16

How were illnesses categorised in Kraepelin’s final Compendium of Psychiatry (1915)?

Answer 16

Either categorised according to known cause or remained at level of description.

Question 17

What 4 causes for mental illness were proposed by Kraepelin?

Answer 17

1) Bacterial or viral infections
2) Localised brain damage
3) Toxins
4) Heredity

Question 18

What was Henry Cotton’s ‘focal sepsis’ hypothesis and what treatments did it generate (from 1907-1930)?

Answer 18

Insanity caused by chronic inflammation of organ, much like delusions in fever are caused by infection.

Treatment: remove possibly infected organs one by one until cured. 45% death rate!

Question 19

How many categories in the DSM-5 are diseases?

Answer 19

None, as cause is unknown. All at syndrome level.

Question 20

Who was the first person to attribute disease to physical causes?

Answer 20

Hippocrates (c460-377)

Question 21

What was the crisis in the medical/biological model of mental illness in the early of the 20th century, leading to the rise of psychoanalysis?

Answer 21

Knowledge of biological causes was need for successful classification of diseases, and for their treatment. These could not be found, and treatments on hypothesised causes – e.g. focal sepsis – only did harm.