Mental illness diagnosis

Mental illness—Classification. 2. Mental illness—Diagnosis. I. Kotov, Roman. II. Joiner, Thomas E. III. Title. 

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. 

Many expressed the feeling that a diagnosis of mental illness and the suggestion that they take medications made them feel defective ... 

A group of clinical researchers in New Hampshire, USA, who are highly experienced in the treatment of substance abuse in the severely mentally ill have identified certain key principles of management (Drake et al. 1993, 2001), which are shown in Table 7.4. They consider that a special approach is necessary because the severely mentally ill do not identify problems in the same way, they typically have difficulty with addiction treatment approaches such as group therapy, and there is an ever-present danger that this group fall between two sets of services. Their work is in a unit specifically for dual diagnosis patients. 

Drake RE, Essock SM Shaner A (2001). Implementing dual diagnosis services for clients with severe mental illness. Psychiatric Services, 57, 469-76... 

Johnson S (1997). Dual diagnosis of severe mental illness and substance misuse a case for specialist services. British Journal of Psychiatry, 171, 205-8... 

Important demographic information relevant to the pharmacotherapy of patients with a dual diagnosis can be gleaned from several studies. For example, in their report of chronic mentally ill patients, with or without addictions, Drake and Wallach ( 403) found that the dually diagnosed were... 

Search for abnormalities in receptors, enzymes, neurotransmitters, genes, or gene products that correlate with the diagnosis of a particular mental illness... 

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). 

Compared with persons without a psychiatric diagnosis, the one year prevalence of violence is five to six times higher in patients with serious mental illness in the community (Swanson et al., 1990). The risk for aggression is increased further in patients with severe mental illness who are hospitalized (Tardiff et al., 1997 Owen et al., 1999 Barlow et al., 2000) and in patients with comorbid schizophrenia and substance abuse (Steadman et al., 1998 Elbogen Johnson, 2009). Thus, patients with schizophrenia represent a group at elevated risk for violence. 

Kendell RE (1975) The role of diagnosis in psychiatry. Blackwell, London, See also Kendell RE (2002) The distinction between personality disorder and mental illness. Br J Psychiat 180 110-115... 

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