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Psychiatry
Published in Roy Palmer, Diana Wetherill, Medicine for Lawyers, 2020
Without utilizing a mutually agreed classification system, each psychiatrist would employ their own idiosyncratic classification. This would make it impossible to communicate, render research impossible, and every clinician would have to write their own textbook! For legal purposes, requiring each expert to employ the same set of diagnostic rules allows for a common language that both sides can understand. It gives both sides in court the opportunity to refer to standard textbooks2,3 for descriptions of the condition and allows for focussed cross-examination. The two most important diagnostic systems employed in psychiatry are: the International Classification of Diseases, now in its 10th edition, abbreviated as ICD-10.4the diagnostic and statistical manual of the American Psychiatric Association, edition 4, abbreviated as DSM-IV.5
Functional GI Disorders
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
It is also important to standardize the selection of patients for clinical trials. In previous studies with IBS, mixed patient samples (e.g., combining those with predominant diarrhea with those having predominant constipation) increased the likelihood that a medication (e.g., to control diarrhea) would not be effective (9). Symptom-based criteria allow patient groups to be targeted to the predicted effects of the treatment (i.e., to treat diarrhea or constipation). Within psychiatry, there is evidence that panic disorder is clinically distinct from generalized anxiety, and is more closely linked to depression, even though anxiety is common to both disorders. Therefore, these disorders are classified separately in DSM-IV. Using these criteria, it was found that patients with panic disorder respond better to antidepressants than patients with generalized anxiety.
Psychiatry, the drug industry′s paradise
Published in Peter C. Gøtzsche, Richard Smith, Drummond Rennie, Deadly Medicines and Organised Crime, 2019
Peter C. Gøtzsche, Richard Smith, Drummond Rennie
According to Frances, new diagnoses are as dangerous as new drugs: ‘We have remarkably casual procedures for defining the nature of conditions, yet they can lead to tens of millions being treated with drugs they may not need, and that may harm them.’4 Drug regulatory agencies should therefore not only evaluate new drugs but should also oversee how new ‘diseases’ are being created. The confusion and incompetence is so great that the DSM-IV cannot even define what a mental disorder is.2 I have highlighted in italics some of the wishy-washy bits of the definition: A clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (e.g., a painful symptom) or disability (i.e., impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom. In addition, this syndrome or pattern must not be merely an expectable and culturally sanctioned response to a particular event, for example, the death of a loved one. Whatever its original cause, it must currently be considered a manifestation of a behavioral, psychological, or biological dysfunction in the individual. Neither deviant behavior … nor conflicts that are primarily between the individual and society are mental disorders unless the deviance or conflict is a symptom of a dysfunction in the individual.
Mental health service-seeking behavior in post-Soviet Ukraine
Published in International Journal of Mental Health, 2023
Amanda Jiang, Rachel Ulrich, Kristin Van De Griend, Nathan Tintle, Mark McCarthy, Daniela A. Beckelhymer
Not trivially, this data was collected in 2002, and now describes the state of Ukraine almost twenty years ago. Much has transpired both politically and economically, most notably the War in Donbass and Russia’s seizure of Crimea. In a 2011 study on barriers to health care access (also in collaboration with KIIS), researchers maintained that although data was collected before these events, due to a paucity of existing new health care data, historical baseline measures remain relevant (Cockerham et al., 2017). Although the current medical reformation is gradually changing the healthcare system in Ukraine, health-seeking determinants may be lasting and can potentially inform the implementation of a new healthcare system. Moreover, our study survey uses DSM-IV diagnostic criteria, as opposed to the state of the science, the DSM-V. For various reasons, the survey did not attempt to diagnose certain types of mental health disorders, including, but not limited to, personality and learning disorders. Although not accounted for, these disorders could represent concurrent and possibly confounding diagnoses, which might influence results. Finally, due to the cross-sectional nature of the data, we are not able to draw any causal conclusions.
A Crosswalk Study of DSM-IV and DSM-5 Criteria for PTSD from the DSM-5 Field Trials
Published in Psychiatry, 2022
Carol S. North, Alina M. Surís, Diana Clarke, Jayme M. Palka, Lamyaa Yousif, Darrel A. Regier
The above-mentioned studies suggest the need to further examine effects of each of the diagnostic criteria for PTSD in a crosswalk study designed for this purpose. The DSM-5 Field Trials were conducted to measure the reliability of clinical assessments of the same patient by two different clinical raters using the new diagnostic criteria in real-world clinical settings (Clarke et al., 2013; Regier et al., 2013). For PTSD, the test-retest reliability was very good (κ = .67; Regier et al., 2013). The Field Trials did not originally include a crosswalk study to compare the DSM-IV and DSM-5 criteria. A crosswalk study provides a point-by-point comparison of separate diagnostic criteria sets, examining both overall prevalence rates and agreement/disagreement at the individual level for each element of the criteria as well as overall diagnosis. Therefore, the purpose of the current study was to conduct a subsequent crosswalk comparison to examine the extent of agreement in the individual symptom criteria and overall diagnostic criteria for PTSD based on DSM-IV and DSM-5 criteria in samples of military veteran psychiatric patients. This allowed examination of contributions of specific changes in the criteria between DSM-IV and DSM-5 to differences in diagnostic prevalence.
Association analysis of potentially functional variants within 8p12 with schizophrenia in the Han Chinese population
Published in The World Journal of Biological Psychiatry, 2021
Ruirui Chen, Jianhua Chen, Chengwen Gao, Chuanhong Wu, Dun Pan, Jinmai Zhang, Juan Zhou, Ke Wang, Qian Zhang, Qiangzhen Yang, Xuemin Jian, Yalin Zhao, Yanqin Wen, Zhuo Wang, Yongyong Shi, Zhiqiang Li
We selected inpatients or outpatients from various mental health centres in China who had a two-year history and were interviewed independently by two psychiatrists (Li et al. 2017). In addition, we uniformly used the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV as our criteria for inclusion in the study. Participants consisted of 2403 patients with SCZ (1309 males and 1094 females) and 2594 control subjects (1376 males and 1218 females). They are a subset of the sample used in our previous study (Li et al. 2017). All selected cases have two characteristics: frequent auditory hallucinations and preoccupation with one or more delusions. Beyond that, they also carry varying degrees of disorganised speech, flat or inappropriate affect, disorganised or catatonic behaviour. For the control group, we randomly selected Han Chinese volunteers from hospital and community surveys. All of these people had been asked to rule out major mental illness. We obtained informed consent from all volunteers. Our research was approved by the local Human Genetic Resources Ethics Committee.