Diagnosis 2.0 Are Mental Illnesses Diseases, Disorders, or Syndromes? A Major Challenge for the DSM-V Committees as They Revise the Diagnostic "Bible" of Psychiatric Disorders Is to Determine Whether Mental Illnesses Are Diseases, Disorders, or Syndromes

By Nasrallah, Henry A. | Current Psychiatry, January 2009 | Go to article overview
Save to active project

Diagnosis 2.0 Are Mental Illnesses Diseases, Disorders, or Syndromes? A Major Challenge for the DSM-V Committees as They Revise the Diagnostic "Bible" of Psychiatric Disorders Is to Determine Whether Mental Illnesses Are Diseases, Disorders, or Syndromes


Nasrallah, Henry A., Current Psychiatry


Here's how my version of Webster's dictionary defines these terms:

* Disease: A particular distinctive process in the body with a specific cause and characteristic symptoms.

* Disorder: Irregularity, disturbance, or interruption of normal functions.

* Syndrome: A number of symptoms occurring together and characterizing a specific disease.

Let's consider 4 facts that may be relevant for this decision.

[ILLUSTRATION OMITTED]

Probably not 'diseases'

No objective laboratory test can differentiate 1 psychiatric malady from another, and this lack of specificity casts doubt on the disease model. However, many documented perturbations of normal brain functions are consistent with a disorder paradigm.

Symptom overlap

The signs and symptoms of psychiatric ailments overlap considerably. Depression and anxiety share many symptoms and frequently co-occur. Bipolar mania and schizophrenia share psychotic features, cognitive deficits, agitation, suicidality, aggressive behavior, etc. The obsessions of obsessive-compulsive disorder (OCD) resemble and sometimes morph into the fixed false beliefs (delusions) of psychosis, and OCD's compulsions often characterize the behaviors of other psychiatric disorders, such as anorexia or bulimia nervosa.

Personality disorder features essentially are attenuated but enduring forms of Axis I conditions. Nearly all psychiatric illnesses have some degree of suicidality, insomnia, and addictive behavior. Posttraumatic stress disorder's symptoms recapitulate those of numerous diagnostic categories, such as anxiety, depression, psychosis, negative symptoms, mania, OCD, impulsive behavior, and personality changes.

Common neurobiology

Most diagnostic categories in psychiatry share some neurobiologic features, such as:

* neurotransmitter pathways (serotonin, dopamine, norepinephrine, or glutamate)

* structural abnormalities on neuroimaging (cortical atrophy, ventriculomegaly, gray and/or white matter abnormalities) or

* genetic predispositions.

Medical and psychiatric comorbidities (migraine, chronic pain, diabetes, obesity, alcohol abuse, anxiety, eating disorders, and Axis II features) occur across all major psychiatric diagnoses.

Nonspecific medications

Psychotropics approved for treating 1 condition are frequently useful for others:

* Selective serotonin reuptake inhibitors initially were indicated for depression but soon were found to have efficacy for panic attacks, social phobia, OCD, bulimia, impulse dyscontrol, and fibromyalgia.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Diagnosis 2.0 Are Mental Illnesses Diseases, Disorders, or Syndromes? A Major Challenge for the DSM-V Committees as They Revise the Diagnostic "Bible" of Psychiatric Disorders Is to Determine Whether Mental Illnesses Are Diseases, Disorders, or Syndromes
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?