Mental functions, determination

The therapeutic effects of psychopharmaceuticals are expressed as changes in well-being and behavior. The clinical testing of new substances therefore involves the reliable determination of these modifications in a form that can subsequently undergo statistical analysis. Three basic types of methods are available for this purpose questioning of the patients themselves (or other procedures to determine subjective effects) behavioral observations of various degrees of complexity and test procedures for specific mental functions. 

Assessment methods that determine mental functioning (attention, orientation, memory, speech, understanding of speech, psychomotor functions) in a simple, practical way are recommended for a rough estimation of the severity of dementia. The best-known instrument is the Mini-Mental State Examination (MMSE. Folstein et al.. 1975), which allows the grading of dementia on a 30-point scale on the basis of a simple 5 10-min examination. Other, rather more involved procedures include the Dementia Rating Scale (DRS) of Mattis (1976) and the Alzheimer Disease Assessment Scale (ADAS) of Rosen et al. (1984). The... 

Pauling recently introduced the concept of orthomolecular psychiatry in an attempt to redefine the basis of mental disease and the treatment thereof. He suggests that aberrant mental function and behavior may be due to inadequate brain levels of essential nutrients (e.g., vitamins, amino acids, fatty acids, etc.). Orthomolecular psychiatric therapy, therefore, would provide optimum concentrations of these vital substances in order to correct alleged cerebral deficiencies. Diagnostic methods for determining optimum levels of a pertinent nutrient for individual patients are not yet available. One critic has already taken issue with these views. Other investigators have independently considered the possibility that abnormal plasma levels of free fatty acids may influence the erratic dietary intake of schizophrenic children. 

The HF method determines the best one-determinant trial wave function (within the given basis set). It is therefore clear that in order to improve on HF results, the starting point must be a trial wave function which contains more than one Slater Determinant (SD). This also means that the mental picture of electrons residing in orbitals has to be abandoned, and the more fundamental property, the electron density, should be considered. As the HF solution usually gives 99% of the correct answer, electron correlation methods normally use the HF wave function as a starting point for improvements. 

The lADC Drill Bits Subcommittee began work on a new classification method in 1985. It was determined from the outset that (1) a completely new approach was required, (2) the method must be simple enough to gain widespread acceptance and uniform application, yet provide sufficient detail to be useful, (3) emphasis should be placed on describing the form of the bit, i.e., paint a mental picture of the design , (4) no attempt should be made to describe the function of the bit, i.e., do not link the bit to a particular formation type or drilling technique since relatively little is certain yet about such factors for fixed cutter bits, (5) every bit should have a unique lADC code, and (6) the classification system should be so versatile that it will not be readily obsolete. 

Depressed patients should have a medication review, physical examination, mental status examination, a complete blood count with differential, thyroid function tests, and electrolyte determinations. 

Evaluation of diagnostic endeavors reveals two principal and interrelated functions of a classification system. First, diagnostic systems are used to determine what constitutes a disorder (psychiatric condition or not) second, diagnostic systems are used to discriminate among the identified psychiatric conditions. Therefore, in discussing classification, we must first ask what a mental disorder is (i.e., should x be considered a psychiatric condition ). If we answer affirmatively, we must then consider whether this disorder is unique from other disorders within the classification system. We briefly consider each of these issues next. 

The DSM is careful to recognize that culture also determines definitions of mental illness. In the DSM, unusual and distressing behaviors such as culturally sanctioned responses to the death of a loved one are excluded from diagnosis. Most current conceptualizations of mental illness recognize that societal values play an important role in establishing whether something is a mental disorder (Lilienfeld Marino, 1995 Wakefield, 1992). The result is that the boundaries of mental illness are believed to shift as a function of culture, both across cultures and within cultures, over time. One important implication of cultural relativism is that definitions of mental illness will necessarily vary. 

The data Include protocols of military experloience declassified for this review, reports published in the scientific literature on animals and man, and my own studies. Between 1956 and 1966, experiments were undertaken in my laboratories in New York and St. Louis to define the effects of anticholinergic drugs on brain function and behavior. He sought to determine whether ai of the substances had persistent behavioral effects chat could be useful in treating the severely mentally ill (1-7). 

Most people taking lithium have no complaints about its effects on mental processes they feel normal and function normally. Mild cognitive effects can occur, although it is sometimes difficult to determine whether they are due to the lithium, the resolution of manic euphoria, the presence of mild depression or hypothyroidism, or the effects of other medications. Complaints can include reduced reactivity, lack of spontaneity, loss of emotional tone, and patchy memory impairment. Lithium reportedly has adverse effects on memory, speed of information processing, and reaction time (155,156). It has been suggested that the risk of driving accidents may be increased in patients taking lithium, but there is no evidence that this... 

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