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Consideration is given to the extent to which the DSM and ICD approach to psychiatric case definition and treatment supports clinical activity. Their validity as a way of defining ‘mental illness’ is found wanting and they do not, in themselves, usefully guide treatment. These conclusions are set in a critical realist approach to ‘mental illness’, which draws attention to the legitimacy of several differing perspectives, each reflecting their own sets of interests and allegiances. DSM‐V and ICD‐11 are due to be published in 2012 and 2014 respectively, and their architects are called upon to be clear about which of these constituencies they are representing.

Research objects, such as datasets and classification standards, are difficult to be incorporated into a document-centric framework of citations, which relies on unique citable works. The Diagnostic and Statistical Manual for Mental Disorder (DSM)—a dominant classification scheme used for mental disorder diagnosis—however provides a unique lens on examining citations to a research object, given that it straddles the boundaries as a single research object with changing manifestations.

Using over 180,000 citations received by the DSM, this paper analyzes how the citation history of DSM is represented by its various versions, and how it is cited in different knowledge domains as an important boundary object.

It shows that all recent DSM versions exhibit a similar citation cascading pattern, which is characterized by a strong replacement effect between two successive versions. Moreover, the shift of the disciplinary contexts of DSM citations can be largely explained by different DSM versions as distinct epistemic objects.

Based on these results, the authors argue that all DSM versions should be treated as a series of connected but distinct citable objects. The work closes with a discussion of the ways in which the existing scholarly infrastructure can be reconfigured to acknowledge and trace a broader array of research objects.

This paper connects quantitative methods and an important sociological concept, i.e. boundary object, to offer deeper insights into the scholarly communication system. Moreover, this work also evaluates how versioning, as a significant yet overlooked attribute of information resources, influenced the citation patterns of citable objects, which will contribute to more material-oriented scientific infrastructures.

We sought to evaluate the capacity of the Edinburgh Postnatal Depression Scale (EPDS) in discriminating mental disorders other than depression in pregnant women in northern Mexico. Three hundred pregnant women attending prenatal consultations in a public hospital in Durango City, Mexico submitted a validated EPDS and were examined for mental disorders other than depression using the Diagnostic and Statistical Manual of Mental Disorders - 4th Ed. (DSM-IV) criteria. Sensitivity and specificity of cut-off points of the EPDS, and positive and negative predictive values were calculated. Of the 300 pregnant women studied, 21 had mental disorders other than depression by the DSM-IV criteria. The best EPDS score for screening mental disorders other than depression was 8/9. This threshold showed a sensitivity of 52.4%, a specificity of 67.0%, a positive predictive value of 11.5%, a negative predictive value of 95.4%, and an area under the curve of 0.643 (95% confidence interval: 0.52-0.76). The EPDS can be considered for screening mental disorders other than depression in Mexican pregnant women whenever a cut-off score of 8/9 is used. However, the tool showed small power to separate pregnant women with and without mental disorders other than depression.

The purpose of this paper is to determine: the extent to which an intellectual disability diagnosis meets current diagnostic and statistical manual of mental disorders (DSM) diagnostic criteria; the prevalence of reported autism spectrum disorders (ASD); and the extent to which assessment of developmental issues is central to the diagnosis of psychotic disorder, in patients discharged with a diagnosis of psychotic disorder and intellectual disabilities.

Of all patients discharged with psychotic disorder during a four‐year period (n=3339), chart reviews were completed on those also diagnosed with intellectual disability or borderline IQ.

The findings if this paper are threefold: only 39 percent of the 41 individuals discharged with a diagnosis of psychotic disorder and intellectual disability met documented DSM criteria for intellectual disability; the prevalence of reported ASD was much lower than expected; and the average number of different discharge diagnoses per individual over time was 4.8. Schizophrenia diagnoses were made early in the diagnostic process and tended to persist even when ASD concerns were documented.

The results support the need to systematically assess the developmental issues of patients with intellectual disability as part of the psychiatric diagnostic formulation. Differential diagnoses of psychotic‐like behaviours seen in people with intellectual disability, and alternative frameworks for understanding these behaviours, which in turn should guide more effective interventions and treatment, are discussed.

The purpose of this paper is to identify symptoms that constitute a shared cultural model of depression among African Americans and to compare these accounts with criteria for major depressive disorder (MDD) in the 5th edition of the Diagnostic Statistical Manual of mental disorders (DSM-V).

Data were collected in a disproportionately Black urban neighborhood in the USA and analyzed using cultural consensus analysis (CCA). In total, 34 African Americans participated in a free-listing exercise to elicit common indicators of depression in the same community. Another 40 key informants completed a survey to rate how common each indicator was in the same community. Factor analysis was performed, factor loadings were used to weight the responses of each informant in the survey and then aggregated to determine the most significant indicators or components of the shared model depression.

Indicators of depression included classic symptoms in the DSM-V such as sadness and lack of motivation. However, other indicators that are inconsistent with symptoms of MDD in the DSM-V such as paranoia and rage were common and constituted a shared model of depression in the sample.

Some symptoms common among African Americans that are not in the DSM-V or on research instruments developed based on the DSM could be overlooked in epidemiological surveys and in clinical assessments of depression.

The provision of mental health care might benefit from a better understanding of how contextual factors shape expressions of distress among African Americans.

This study identify culturally salient symptoms of depression among African Americans independent of clinically defined criteria.

The aim of this paper is to assess highly toxic leaders and dysfunctional organizations as presented via management consulting and executive coaching assignments.

The paper employs an action research approach via two participant observer case studies incorporating the DSM IV‐TR: Diagnostic and Statistical Manual of Mental Disorders.

The paper finds that the nexus of dysfunctional organizational systems may be located in “pre‐existing” leadership pathologies.

First, additional research will be needed to confirm and extend the findings of individual pathologies in leaders to dysfunctional organizational systems; second, a closer look is necessary at the applicability of the DSM IV‐TR to pathologies at the organizational level; third, due to the action research, case study approach utilized, there is somewhat limited generalizability; fourth, there are limitations re: the applicability of DSM IV‐TR as an assessment tool for management researchers due to the necessity of training in clinical psychology.

The importance of distinguishing personality disorders in leaders from toxic behaviors falling within a range of “normal pathology,” and the ability to assess individual leadership pathology within organizational systems via the clinically trained usage of the DSM IV‐TR; providing clinical assessment tools for reducing the number of misdiagnoses of leadership pathology in the workplace; encouraging collaboration between management and psychology researchers and practitioners.

This paper fills a gap in the toxic organizations research by identifying personality disorders in leaders and providing an action research agenda for incorporating the DSM IV‐TR as a means of extending the repertoire of assessment tools;

The 11th revision of the International Classification of diseases which sets global standards for defining, reporting and managing health conditions is under way. The International Classification of Diseases (ICD) underpinning principle of clinical utility is currently poor for persons with Disorders of Intellectual Development (DID) and mental disorders. This impedes access to healthcare resources; services and social inclusion thereby further aggravating their vulnerability. The purpose of this paper is to present a critical overview and evidence informed recommendations within the context of an international collaborative programme, undertaken by the Faculty of Psychiatry of Intellectual Disability, Royal College of Psychiatrists, UK with support from the World Health Organisation (WHO).

The authors carried out: first, a systematic review (SR) of literature, using PRISMA guidelines regarding the reliability, validity and utility of the ICD-10/Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria in people with DID (PWDID); second, a national and international consultation exercise with partners, stakeholders and experts; third, a multicentric survey of problem behaviours in PWDID; and finally, information dissemination/dialogues including presentations and workshops at key scientific events, consultation networking, data gathering and consensus building.

The SR revealed a dearth of robust studies – most consisting of weak research methodologies. Significant difficulties were highlighted regarding the application of diagnostic criteria in the current classificatory systems – particularly in people with severe/moderate DID. Recommendations supported the introduction WHERE APPROPRIATE of modifications based on observed phenomena (signs) in PWDID in lieu of reported symptoms to facilitate DIAGNOSIS AND better access to healthcare and the community. Heterogeneity precluded quantitative pooling and meta-analysis. The consensus building exercise globally revealed that problem behaviours were the commonest reasons for referral to healthcare services with significant numbers without a diagnosed mental disorder being prescribed psychoactive medication.

The consensus gathering exercise WAS SELECTIVE AND did not cover all of the 194 member states of WHO due to resource and time constraints and this constitutes the main limitation of our study. Based on the SR and expert consensus, the authors submitted evidence informed pragmatic proposals to the WHO aimed at addressing the shortcomings of the ICD-10. The key recommendations focused on improving clinical utility within the context of epistemic iteration which would consolidate and strengthen the future evidence base. It was also recommended that self-injurious behaviour should form a standalone sub category in view of its relevance for healthcare services and resources which underpin clinical utility.

The ICD-11 is a global, multidisciplinary and multilingual development for public health benefit with 70 per cent of the world's health expenditures assigned using this system for resource allocation. Currently mental disorders in PWDID can be misinterpreted, unrecognised and under reported resulting in barriers to access to treatment and healthcare resources. Conversely disorders may be over diagnosed when the inherent discrepancies between the chronological age and the developmental level of functioning are not considered. Conclusions and recommendations from this study will result in better diagnosis of mental disorders and healthcare resources in this population.

PWDID are a vulnerable sector of the population with an increased prevalence of mental health problems who are marginalised and discriminated by society. Early detection, treatment and management of these conditions will prevent further decompensation and stigmatisation.

To the best of the authors knowledge this is the first comprehensive, large-scale study which evaluates the ICD classificatory system within the context of clinical utility for PWDID, including experts and stakeholders from both lower/middle- and high-income countries. The international consultation/consensus building process culminating in the formulation of evidence informed recommendations, aimed at improving the clinical utility of the ICD-11 for this population, has the potential to improve access to appropriate healthcare and treatment and consequent enhancement of their quality of life.

Professionals working with community populations are often presented with complicated cases where it is difficult to determine which diagnosis or diagnoses are appropriate. Differentiating among neurodevelopmental disorders such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder and intellectual disability can be a complex process, especially, as these disorders have some overlapping symptoms and often co-occur in young children. This series of case studies aims to present commonly overlapping symptoms in children who present to clinics with developmental concerns.

This paper presents three case studies that were completed at a free community ASD screening clinic in Southern California.

The case studies have common presenting behaviors and symptoms (e.g. social communication difficulties) that often co-occur across diagnoses; explanations for the final diagnoses are given in each case.

Conclusions from these three cases cannot generalize to all children being seen in clinics for neurodevelopmental concerns.

This series of case studies highlights commonly overlapping symptoms in children who present for differential diagnosis with social and/or behavioral concerns. Implications for educational placement and intervention are discussed.

These cases highlight the challenges involved in the differential and dual diagnostic process for young children with developmental concerns. Diagnostic considerations can affect later educational placement and opportunities for socialization.

This series of case studies provide practical information for clinicians about how to effectively differentiate between commonly occurring neurodevelopmental disorders, particularly given recent changes to the Diagnostic and Statistical Manual, 5th edition (DSM-5).

Widely varying rates for the prevalence of psychiatric disorder have been reported in the previous published literature. The aims of this study were to describe the prevalence of psychiatric disorders in a random sample of adults with moderate to profound learning disabilities living in the community, and to explore the socio‐clinical factors associated with psychiatric disorders.A process of active case finding was undertaken to identify adults with learning disabilities. A random sample of 240 was taken of whom 121 were found to have moderate to profound learning disabilities at interview. Information was collected on socio‐demographics, service use, physical health, medication use, and life events. Standardised instruments were used to assess psychiatric symptoms, problem behaviour, and severity of learning disabilities. Diagnoses were generated using four diagnostic systems: clinical, DC‐LD, DCR‐10 and DSM‐IV.Higher rates of psychiatric disorder are reported than in previous published studies in the general population and in studies with people with learning disabilities living in the community. Further investigation of the effect of diagnostic system on prevalence rates, and associations of psychiatric disorder are warranted.

This article explores the nature of the classifications of learning disabilities as promulgated in the diagnostic manuals. By leaving aside all doubts and controversies that surround the concept and measurement of intellectual functioning, weaknesses are exposed from within those manuals' own frames of reference. The difficulties arising from using the international sub‐classifications of learning disabilities when the national classifications should apply are discussed.