Mental disorders syndromes

First, we are going to briefly review some of the terms used to refer to ethnic differences and to describe the processes that take place when two or more cultural groups come into contact with each other. Second, we will outline some studies that illustrate how cultural aspects can affect, for example, the prevalence of certain disorders, the different ways symptoms are manifested, how therapeutic aid is sought or the efficacy of different forms of treatment. Cultural aspects can determine the appearance of syndromes that are specific to each culture (culture-bound syndromes) or can affect the manifestation of the symptoms that make up the different mental disorders. We will then show how cultural variations have been incorporated into the different systems of classification. Last, we will also detail the current recommendations on including cultural aspects in the diagnoses of mental disorders. 

Definitions of mental illness tend to contain two aspects a normative element and a functional element. Normative definitions delimit abnormal behavior in light of what is typical, usual, or the norm. Some degree of deviance from the norm is necessary for a behavior to be considered abnormal. Deviance alone, however, is never sufficient for a label of abnormality. High IQ is just as deviant as low IQ, but only mental retardation is labeled abnormal. This leads us to the functional element of the definition. Typically, the label of abnormality requires deviance plus maladaptation. Maladaptation suggests some diminished capacity to function relative to an average. For example, the DSM defines mental disorder as a syndrome that is associated with distress or impairment in functioning (American Psychiatric Association, 1994, pp- xxi-xxii). 

Essentially this is a four-component definition. First, the person has to have panic attacks. Second, these attacks should not be caused by a substance or general medical condition, or be accounted for by another mental disorder. Third, at least two of these panic attacks have to be unexpected. Fourth, they should lead to a clinical syndrome that includes concern about additional attacks, worry about the consequences of panic, or significant behavioral change as a result of fear of panicking. This syndrome is the heart of panic disorder, and taxometric analyses would focus on it. However, an investigator should deal with the other components first. 

Mental disorders, for example, multiple subtypes of anxiety, chronic fatigue syndrome, depression, sometimes together with chronic pain, posttraumatic stress disorders (PTSD), and schizophrenia... 

The Diagnostic Statistical Manual, of Mental Disorders, 4th ed. (DSM-FV American Psychiatric Association, 1994), describes this syndrome as discrete episodes of a failure to resist aggressive impulses, resulting in serious assault or destruction in the face of limited provocation. These attacks are accompanied by remorse afterwards. This syndrome usually occurs in males with childhood histories of violence, a family history of arrest, poor occupational records, and low socioeconomic status (SES). 

The prototypes of modem psychopharmaceuticals were discovered between 1952 and 1958. Since that time the effective treatment of schizophrenic psychoses, depressions, anxiety syndromes and other mental disorders has become possible and a new, multidisciplinary science biological psychiatry has developed. Clinical psychiatry has changed dramatically in the past 50 years fewer patients are hospitalized long term, psychiatric care and treatment have largely shifted to outpatient departments and private practices, and new models of combined pharmacological and non-drug-based prophylactic and therapeutic interventions have been developed. 

According to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV)(8), mixed episodes occur when full manic and full depressive syndromes occur together. 

Caplan, Paula J. Pathologizing Your Period Classification of Premenstrual Syndrome in Diagnostic and Statistical Manual of Mental Disorders. Ms. 18, no. 3 (Summer 2008) 63-64. Feminists criticize psychiatrists for... 

Hypertension, hepatitis, cirrhosis, peptic ulcer, glaucoma, mental disorders, menopausal syndrome and Parkinson s disease. 

Obsessive-compulsive disorder (OCD) is a syndrome characterized by obsessions and/ or compulsions, which together last at least an hour per day and are sufficiently bothersome that they interfere with one s normal social or occupational functioning. Obsessions are experienced internally and subjectively by the patient as thoughts, impulses, or images. According to standard definitions in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), obsessions are intrusive and inappropriate and cause marked anxiety and distress. Common obsessions are listed in Table 9—1. 

The Diagnostic and Statistical Manual of Mental Disorders lists several distinct criteria necessary for a diagnosis of schizophrenia.5 These criteria include a marked disturbance in the thought process, which may include bizarre delusions and auditory hallucinations (i.e., hearing voices ). Also, a decreased level of function in work, social relations, and self-care may be present. Other factors include the duration of these and additional symptoms (at least 6 months) and a differential diagnosis from other forms of mental illness (such as affective disorders and organic brain syndrome). 

List of Abbreviations Ach, acetylcholine AMPA, a-amino-3-hydroxy-5-methylisoxazole-4-propionic acid CNS, central nervous system COMT, catechol-O-methyltransferase DA, dopamine DRP-2, dihy-dropyrimidinase-related protein 2 DSM, diagnostic and statistical manual of mental disorders GNAS1, guanine nucleotide-binding protein (G-protein) alpha stimulating activity polypeptide 1 5-HIAA, 5-hydroxyindole acetic acid 5-FIT, serotonin (5-hydroxytryptamine) MAO, monoamine oxidase MHPG, 3-methoxy-4-hydroxyphenylglycol NE, norepinephrine NMDA, N-methyl-D-aspartate PCP, phencyclidine SSRI, selective serotonin reuptake inhibitor SDS, schedule for the deficit syndrome... 

Also falling within the scope of modern psychiatric diagnostic systems are organic mental disorders (e.g. dementia in Alzheimer s disease), disorders due to substance misuse (e.g. alcohol and opiate dependence—see Chapter 10), personality disorders, disorders of childhood and adolescence (e.g. attention deficit/hyperactivity disorder, Tourette s syndrome) and mental retardation (learning disabilities). 

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