Mental Health Conditions and Disorders

 

Everyone experiences a range of emotions throughout their lives, and these result in thoughts or behaviours considered negative by people or those around them. However, symptoms alone do not signify illness. Accordingly, mental health conditions and disorders are defined by syndrome - their central features and associated symptoms, their duration, and resulting disability and distress. More information can be found under making a diagnosis.

However, a diagnosis label can be harmful.

 

The burden of mental health describes incidence and prevalence, populations at risk, and impact of these conditions and disorders on individuals, communities, and populations. Mental health is of tremendous significance, with five of the top ten worldwide causes of disability being associated with the mind, will, and emotions.

 

Twelve-month prevalence estimates were anxiety, 18.1%; mood, 9.5%; impulse control, 8.9%; substance, 3.8%; and any disorder, 26.2%. Of 12-month cases, 22.3% were classified as serious; 37.3%, moderate; and 40.4%, mild. Fifty-five percent carried only a single diagnosis; 22%, 2 diagnoses; and 23%, 3 or more diagnoses (Kessler et al, 2005b).

Lifetime prevalence estimates are as follows: anxiety disorders, 28.8%; mood disorders, 20.8%; impulse-control disorders, 24.8%; substance use disorders, 14.6%; any disorder, 46.4%. Half of all lifetime cases start by age 14 years and three fourths by age 24 years (Kessler et al, 2005a).

 

  • mood
    disorders
  • anxiety
    disorders
  • psychotic
    disorders
  • cognitive
    disorders
  • personality
    disorders
  • substance use
    disorders
  • childhood
    disorders
  • other
    disorders

Mood Disorders

 

Mood disorders are characterized by the presence of one or more mood episodes, which represent a combination of symptoms representing a predominant mood state or syndrome. There is a paucity of biological markers. Specifiers can also be used to further qualify mood disorders.

 

Mood Disorders

 

Mood episodes

 

 

 

 

 

 

 

 

 

Anxiety Disorders

 

Anxiety is a problem when it makes decision for you, interferes with your life, or causes distress. Problems generally arise when people misinterpret threats or show extreme responses to threats. Anxiety disorder fall into two broad categories:

  • Acute, severe, brief wave with cognitive, physiologic, and behavioural component. Resembles acute fear or harm. Can lead to panic attacks
  • Low grade, persistent distress. Resembles heightened state of alertness, with constant vigilance to threats. Can lead to generalized anxiety disorders

 

Types of Anxiety Disorders

Medical conditions can cause anxiety - rule them out if suspected

 

 

Treatments for Anxiety Disorders

It is often difficult to argue for psychotherapy, given long wait times and lag time in seeing effects. Drugs can be started within 30 minutes. Psychotherapy, especially involving exposure to stimuli

Pharmacotherapy: SSRI's, SNRI's, TCAs.

Psychotic Disorders

 

Psychosis is characterized by a significant loss of contact with reality affecting the ability to think, feel, perceive, and act. Psychosis typically involves a) delusions or hallucinations, with or without insight, and b) disorganized behaviour. Further information can be found under 'what is psychosis?' and 'assessing psychotic episodes'.

 

Primary psychotic disorders:

  • schizophrenia - signs of illness for over 6 months, and psychotic symptoms for over one month, with functional impairment
  • schizophreniform disorder - similar to schizophrenia, but with duration of less than 6 months
  • schizoaffective disorder - concurrent symptoms of schizophrenia and mood disorder, with at least two weeks of psychotic symptoms alone
  • brief psychotic disorder - psychotic symptoms for between one day and one month; full recovery may follow
  • delusional disorder - nonbizzare delusions for at least one month, not meeting criteria for schizophrenia

Other causes of psychosis:

Mnemonic:

  • General medical condition
  • Affective Disorders
  • Substance Induced
  • Personality Disorders
  • Pyschotic Disorders

Cognitive Disorders

 

 

 

Personality Disorders

 

Personality disorders are pervasive and largely inflexible patterns of inner thoughts and behaviours markedly different from others of the individuals's culture and leading to significant impairment in social, occupational, or other settings.Two or more of the following are affected:

  • perception and interpretation of self, others, events
  • affect regulation
  • interpersonal functioning
  • impulse control

For more information, please see assessing personality disorders.

 

Cluster A

 

Paranoid personality disorder

Schiziod personality disorder

Schizotypal personality disorder

 

Cluster B

 

Antisocial personality disorder

Borderline personality disorder

Histrionic personality disorder

Narcissistic personality disorder

Cluster C

 

Avoidant Personality Disorder

Dependent Personality Disorder

Obsessive-compulsive personality disorder

 

 

Impact of Personality Disorders

Quality of life: complete physical, mental, and social well-being, not just the absence of diease and infirmity.

Cluster A, avoidant, dependent and borderline folks may have lower quality of life.

 

 

Helping People with Personality Disorders

By definition these folks can be difficult to work with; counter-transference is common. Often co-morbid with Axis I disorders, or Axis I conditions may be mimic a PD.

For the most part, they do not tend to repsond well to medication, but can often respond to certain types of psychotherapy.

 

 

Resources and References

coming soon

Substance Abuse Disorders

 

 

 

Childhood Something Disorders

Disruptive behaviour disorders

Pervasive developmental disorders

Anxiety disorders

 

Other Disorders

 

adjustment disorder

somatiform disorders

dissociative disorders (amnesia, fugue, identity disorder)

eating disorders

sleep disorders

  • nocturnal myoclonus
  • narcolepsy

sexuality and gender disorders

 

 

Resources and References

Kessler et al. 2005 Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 62(6):593-602.

 

Kessler et al. 2005. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 62(6):617-27.