Week 1: Diagnosis in Psychiatry Pt. 1 Flashcards
The identification and classification of a medical condition.
Diagnosis
Examples of Paradigmatic Diseases
1) Infectious diseases: These are diseases caused by pathogens like bacteria, viruses, fungi, or parasites. Examples: Smallpox, Polio, Measles
2) Genetic disorders: These are diseases caused by inherited genetic mutations. Examples: Cystic fibrosis, Sickle cell anemia, Huntington’s disease
Classifying disorders based on a group of symptoms.
Syndromal Approach
The classification of diseases, injuries, and disorders.
Nosology
The development and progression of a disease.
Biological mechanism underlying the disorder (i.e., infections, cancers)
Pathogenesis
Classifying disorders based on their cause.
Etiological Approach
The tendency or predisposition to develop a disease.
Susceptibility
A disease that serves as a model or example for other diseases.
Paradigmatic Disease
Means decided or chosen without any particular reason or rule.
It suggests something is random or based on personal preference rather than logic or objective criteria.
Arbitrary
A prediction of the course of a disease.
Prognosis
The treatment of diseases.
Therapeutics
The study of the distribution and determinants of health and disease in populations.
Epidemiology
What is the purpose of a diagnosis?
1) Predictions: prognosis
2) Treatment: therapeutics
3) Research: an analytic tool for increasing understanding of the causes of disease
4) Epidemiology: distribution of diseases within populations
A classification system proposed by Emil Kraepelin that divided mental disorders into two main categories: dementia praecox (schizophrenia) and manic-depressive illness.
Kraepelinian Dichotomy
Distinguished between lunacy (you could get better) and idiocy (you would not get better).
14th Century Common Law
Identified different mental disorders such as mania, melancholia, and hysteria.
Ancient Greece
- Writing on clay tablets
- Accurate descriptions of mental and neurological disorders
- Descriptions only, no systematization
Babylonian c 3500 (History of Psychiatry)
What are the two main categories under the Kraepelinian Dichotomy?
1) Dementia praecox (schizophrenia)
2) Manic-depressive illness
A mental disorder characterized by alternating periods of mania and depression. It is now more commonly known as bipolar disorder.
Manic-depressive Illness
A term coined by Emil Kraepelin to describe a group of mental disorders characterized by delusions, hallucinations, disorganized speech and behavior, and negative symptoms.
Dementia Praecox (schizophrenia)
A state of excessive excitement, energy, enthusiasm, and a decreased need for sleep.
Mania
A state of sadness, despair, and hopelessness.
Melancholia
A term used to describe a variety of symptoms, often affecting women, including fainting, paralysis, and convulsions.
Hysteria
A term used to describe a condition that was believed to be caused by the moon. It was often associated with periods of madness or irrational behavior.
Lunacy
The cause or origin of a disease.
Aetiology
A term used to describe a condition that was believed to be congenital or incurable. It was often associated with intellectual disability.
Idiocy
Mental disorders caused by physical damage to the brain. Examples: General paralysis of the insane, Alzheimer’s Disease, Korsakoff’s Psychosis
Organic Mental Disorder
A term used to describe a condition characterized by antisocial behavior and lack of moral conscience.
It was introduced to describe personality disorders or socially abnormal behavior without insanity or mental deficiency.
Moral Insanity (Psychopathy)
A progressive neurological disorder caused by syphilis, characterized by dementia, delusions, and physical symptoms such as tremors and slurred speech.
General Paralysis of the Insane
Deterioration of cognitive function, including memory, thinking, and judgment.
Dementia
False beliefs, such as believing you are being monitored by the government.
Delusions
Perceiving things that are not real, such as hearing voices.
Hallucinations
Speaking in a way that is difficult to understand, such as jumping from one topic to another.
Disorganized Speech
Acting in a way that is inappropriate or unusual, such as hoarding objects or taking off one’s clothes in public.
Disorganized Behavior
A lack of motivation, pleasure, or emotion.
Negative Symptoms
A progressive neurodegenerative disorder characterized by memory loss, cognitive decline, and changes in behavior.
It is the most common cause of dementia and remains a major public health challenge.
Alzheimer’s Disease
Problems with thinking, reasoning, and problem-solving.
Cognitive Decline
Difficulty remembering recent events or information.
Memory Loss
A neurological disorder caused by thiamine deficiency, often associated with chronic alcoholism. It is characterized by memory loss, confabulation (making up false memories), and other cognitive impairments.
Korsakoff’s Psychosis
Making up false memories to fill in gaps in memory.
Confabulation
Severe mental disorders characterized by delusions, hallucinations, and disorganized thinking. Examples include schizophrenia and bipolar disorder.
Psychoses
A personality disorder characterized by a lack of empathy, remorse, and conscience. They may engage in manipulative, impulsive, and aggressive behavior.
Psychopathy
Less severe mental disorders characterized by anxiety, depression, and other symptoms. Examples include anxiety disorders and phobias.
Neuroses
Definitions that specify observable behaviors or operations that define a concept.
Operational Definition
A mood disorder, such as depression or bipolar disorder.
Affective Disorder
Structured interviews that use specific questions and procedures to assess psychiatric symptoms.
Structured Interviewing Techniques
Focuses on understanding mental disorders from the patient’s perspective (first-person perspective) by exploring their subjective experiences, thoughts, feelings, and behaviors.
Phenomenological Approach
Operational definitions provide concrete and measurable ways to study variables, while theoretical concepts represent abstract ideas that may be more difficult to define and measure directly.
Operational Definition VS Theoretical Concepts
refers to a system used in earlier versions of the DSM (DSM-III and DSM-IV) to assess various aspects of an individual’s functioning. It involved rating the individual on five axes.
Multiaxial Diagnostic Assessment System
Introduced important innovations:
- Explicit diagnostic criteria
- Multiaxial diagnostic assessment system (diagnosis, personality, social)
- Neutral with respect to the causes of mental disorders
DSM-III
DSM-IV
Focuses on observable symptoms and behaviors.
Aims to provide a detailed and objective description of a disorder.
Less concerned with underlying causes or theoretical explanations.
Descriptive Approach
Was based on a comprehensive review of the literature to ensure an empirical foundation.
Worked closely with ICD-10 to minimize differences between the two systems.
DSM-IV
A more modern approach that incorporates elements of Kraepelin’s classification system, such as a focus on observable symptoms and behaviors, but also includes advancements in diagnostic criteria and methodology.
Neo-Kraepelian
Biological markers that can be used to diagnose or monitor a disease.
Biomarkers
Variations in a single nucleotide in the DNA sequence.
Single Nucleotide Polymorphisms (SNP)
initially had grand ambitions (biomarkers, functional imaging, genomic research)
DSM-V
