Mental Disorders: Introduction

Mental Disorders

Mental health is a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with challenges. Mental health is essential to personal well-being, family and interpersonal relationships, and the ability to contribute to community or society.

Mental disorders are health conditions that are characterized by alterations in thinking, mood, and/or behavior that are associated with distress and/or impaired functioning. Mental disorders contribute to a host of problems that may include disability, pain, or death.

Mental illness is the term that refers collectively to all diagnosable mental disorders.

Why Is Mental Health Important?

Mental disorders are among the most common causes of disability. The resulting disease burden of mental illness is among the highest of all diseases. According to the National Institute of Mental Health (NIMH), in any given year, an estimated 13 million American adults (approximately 1 in 17) have a seriously debilitating mental illness. Mental health disorders are the leading cause of disability in the United States and Canada, accounting for 25 percent of all years of life lost to disability and premature mortality. Moreover, suicide is the 11th leading cause of death in the United States, accounting for the deaths of approximately 30,000 Americans each year.

Mental health and physical health are closely connected. Mental health plays a major role in people's ability to maintain good physical health. Mental illnesses, such as depression and anxiety, affect people's ability to participate in health-promoting behaviors. In turn, problems with physical health, such as chronic diseases, can have a serious impact on mental health and decrease a person's ability to participate in treatment and recovery.

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)

Psychiatric Diagnoses are categorized by the Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition. Better known as the DSM-IV, the manual is published by the American Psychiatric Association and covers all mental health disorders for both children and adults. It also lists known causes of these disorders, statistics in terms of gender, age at onset, and prognosis as well as some research concerning the optimal treatment approaches.

Mental Health Professionals use this manual when working with patients in order to better understand their illness and potential treatment and to help 3rd party payers (e.g., insurance) understand the needs of the patient. The book is typically considered the 'bible' for any professional who makes psychiatric diagnoses in the United States and many other countries. Much of the diagnostic information on these pages is gathered from the DSM IV.

The DSM IV is published by the American Psychiatric Association. Much of the information from the Psychiatric Disorders pages is summarized from the pages of this text. Should any questions arise concerning incongruencies or inaccurate information, you should always default to the DSM as the ultimate guide to mental disorders.

The DSM uses a multiaxial or multidimensional approach to diagnosing because rarely do other factors in a person's life not impact their mental health. It assesses five dimensions as described below:

Axis I: Clinical Syndromes

This is what we typically think of as the diagnosis (e.g., depression, schizophrenia, social phobia)

    Schizophrenia

    Schizophrenia

    A common and serious mental disorder characterized by loss of contact with reality (psychosis), hallucinations (false perceptions), delusions (false beliefs), abnormal thinking

    Psychotic Disorders

    Psychotic Disorders

    Psychotic disorders are a collection of disorders in which psychosis ...

    Mood disorders

    Mood disorders

    Mood disorders are among the most common diagnoses in psychiatry ...

    Personality Disorders

    Personality Disorders

    The majority of people with a personality disorder never come ...

    Disorders of Childhood and Adolescence

    Disorders of Childhood and Adolescence

    Many disorders seen in adults can occur in children.

    Substance-Related Disorders

    Substance-Related Disorders

    Substance abuse is as common as it is costly to society...

    Cognitive Disorders

    Cognitive Disorders

    The cognitive disorders are delirium, dementia, and amnestic disorders ...

    Anxiety Disorders

    The term anxiety refers to many states in which the sufferer experiences a sense of impending threat ...

    Miscellaneous Disorders

    Miscellaneous Disorders

    Miscellaneous disorders does not refer to any official...

    Axis II: Developmental Disorders and Personality Disorders

    Developmental disorders include autism and mental retardation, disorders which are typically first evident in childhood

    Personality disorders are clinical syndromes which have a more long lasting symptoms and encompass the individual's way of interacting with the world. They include Paranoid, Antisocial, and Borderline Personality Disorders.

    Axis III: Physical Conditions

    which play a role in the development, continuance, or exacerbation of Axis I and II Disorders

    Physical conditions such as brain injury or HIV/AIDS that can result in symptoms of mental illness are included here.

    Axis IV: Severity of Psychosocial Stressors

    Events in a persons life, such as death of a loved one, starting a new job, college, unemployment, and even marriage can impact the disorders listed in Axis I and II. These events are both listed and rated for this axis.

    Axis V: Highest Level of Functioning

    On the final axis, the clinician rates the person's level of functioning both at the present time and the highest level within the previous year. This helps the clinician understand how the above four axes are affecting the person and what type of changes could be expected.

    Mental Disorders: Introduction


    Mental disorders are common in medical practice and may present either as a primary disorder or as a comorbid condition. The prevalence of mental or substance use disorders in the United States is 18.5%, resulting in an annual cost of $148 billion dollars, only slightly less than the costs of cardiovascular diseases.

    Anxiety Disorders

    Anxiety disorders, the most prevalent psychiatric illnesses in the general community, are present in 15 to 20% of medical clinic patients. Anxiety, defined as a subjective sense of unease, dread, or foreboding, can indicate a primary psychiatric condition or can be a component of, or reaction to, a primary medical disease ... Anxiety Disorders   

    Psychotic Disorders

    Psychotic disorders are a collection of disorders in which psychosis predominates the symptom complex. Psychosis is defined as a gross impairment in reality testing. Specific psychotic symptoms include delusions, hallucinations, ideas of reference, and disorders of thought ... Psychotic Disorders   

    Mood Disorders

    Mood disorders are among the most common diagnoses in psychiatry. Mood is a persistent emotional state (as differentiated from affect, which is the external display of feelings). There are three major categories of mood disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition ... Mood Disorders   

    Personality Disorders

    Personality disorders are coded on Axis II in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). Ten types of personality disorders are grouped into clusters based on similar overall characteristics. There are three recognized personality disorder clusters ... Personality Disorders   

    Substance-Related Disorders

    Substance abuse is as common as it is costly to society. It is etiologic for many medical illnesses and is frequently comorbid with psychiatric illness. The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) defines substance abuse and dependence independent of the substance ... Substance-Related Disorders   

    Disorders of Childhood and Adolescence

    Many disorders seen in adults can occur in children.
    However, there is a group of disorders usually first diagnosed in children. Child psychiatric assessment requires attention to details of a child's stage of development, family structure and dynamics, and normative age-appropriate behavior. ... Disorders of Childhood and Adolescence   

    Cognitive Disorders

    The cognitive disorders are delirium, dementia, and amnestic disorders. Table 8- I lists the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, classification of cognitive disorders. ... Cognitive Disorders    

    Miscellaneous Disorders

    Miscellaneous disorders does not refer to any official Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) classification but rather to psychiatric diagnoses not covered elsewhere in this book ...Miscellaneous Disorders