2 Classification and diagnosis 1 Flashcards
What are Wakefield’s two criteria for mental disorder?
1) Must be an internal dysfunction
2) Symptoms must not be socially accepted/seen as harmful
How does the DSM apply its own definition of mental illness to specific categories?
It doesn’t, actually.
What may be a cause of overdiagnosis of mental illness?
Looking only at symptoms, not at cause/dysfunctionality, which may be absent.
When was first edition of DSM published?
In 1952.
Name some inconsistencies in diagnostical categories between the ICD and the DSM
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.
What are the four assumptions about illnesses in the medical model of health?
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
What is a syndrome?
A cluster of symptoms whose cause is unknown
When does a syndrome become a disease?
When its cause/aetiology is known
Who is credited as the first person to attribute disease to physical causes?
Hippocrates (c460-377 BC)
What were the three categories of mental illness described by Paracelsus?
Vesania –caused by toxins
Lunacy – by the phases of the moon
Insanity –inherited
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.”
Masturbatory insanity
What did Hippocrates believe to be the cause of hysteria?
Uterus dries up through lack of sexual intercourse. Detaches and moves around body interfering with other organs.
What would Emil Kraepelin advise you to do if you observed symptoms of a disorder but didn’t know the cause?
Stay on the level of description of symptoms –don’t try to treat the cause, because you’ll just be guessing.
What is the Kraepelian method of describing a mental disorder?
1) Clearly describe symptoms
2) Identify syndromes
3) Describe onset, course, epidemiology
How was General Paresis of the Insane re-categorised when its cause was found?
As the final stage of syphilis.
How were illnesses categorised in Kraepelin’s final Compendium of Psychiatry (1915)?
Either categorised according to known cause or remained at level of description.
What 4 causes for mental illness were proposed by Kraepelin?
1) Bacterial or viral infections
2) Localised brain damage
3) Toxins
4) Heredity
What was Henry Cotton’s ‘focal sepsis’ hypothesis and what treatments did it generate (from 1907-1930)?
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!
How many categories in the DSM-5 are diseases?
None, as cause is unknown. All at syndrome level.
Who was the first person to attribute disease to physical causes?
Hippocrates (c460-377)
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?
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.
