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Mental Disorders

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are psychological and behavioral syndromes that deviate significantly from those typical of human beings enjoying good mental health. In general, a mental disorder involves present distress or impairment in important areas of functioning. Such deviations in thought, feelings, and behavior have been recognized throughout history in all cultures.
For the greater part of recorded history, mental deviations were considered supernaturally or unnaturally caused, the work of evil spirits or human depravity. After small beginnings in the 16th and 17th centuries, however, the mental science that eventually developed into psychiatry acquired respectability in the 1790s. At that time the Parisian physician Philippe Pinel (1745-1826) abolished physical restraints, introduced moral (psychological) treatment, and began objective clinical studies. Thereafter, in clinical work with large populations of patients in institutions for the mentally ill, the major types of were outlined and methods of management and treatment were developed(3).
Classification.
The division of into classes is still inexact, and classification varies from country to country. For official record-keeping purposes, most countries follow the International Classification of Diseases of the World Health Organization (WHO). For clinical use in the U. S., the American Psychiatric Association in 1980 adopted a third edition of its Diagnostic and Statistical Manual (DSM-III); an extensive revision (DSM-III-R) was issued in 1987.
Most classification systems recognize childhood disorders (including mental retardation) as separate categories from adult disorders. Most distinguish between organic, somatically caused states and non-organic (sometimes referred to as functional) conditions. Psychotic disorders are also commonly separated from neurotic ones. Psychotic means, roughly, a state in which a patient has lost touch with reality, whereas neurotic refers to a relatively less impaired state. Schizophrenia, many organic , and some forms of depression (such as manic-depressive illness) are psychotic conditions. Examples of neurotic disorders are those in which anxiety is the major symptom, hypochondria (morbid concern about health), and multiple personality(1).

Childhood Disorders.

Several mental disorders are first evident in infancy, childhood, and adolescence.
Mental retardation is characterized by the inability to learn normally and to become as independent and socially responsible as others of the same age in the same culture. Persons having an intelligence quotient (IQ) of less than 70 are considered retarded.
Attention-deficit hyperactivity disorder includes conditions marked by inappropriate lack of attention, by impulsiveness, and by hyperactivity, in which the child has difficulty organizing and completing work, is unable to stick to activities or follow instructions, and is excessively restless.
Anxiety disorders include fear of leaving home and parents (separation), excessive shrinking from contact with strangers (avoidance), and excessive, unfocused worrying and fearful behavior.
Pervasive developmental disorders are characterized by distortions in several psychological functions, such as attention, perception, reality testing, and motor movement. An example is infantile autism, a condition marked by unresponsiveness to other people, bizarre responses, and gross inability to communicate.
Among the other childhood disorders are those involving conduct problems, overeating, anorexia nervosa, tics, stuttering, and bed-wetting(4).

Organic Mental Disorders.

This group of disorders is characterized by psychological or behavioral abnormalities associated with transient or permanent impairments in brain function. The disorders have different symptoms, depending on which area of the brain is affected and on the cause, progression, and duration of the disorder. Organic damage to the brain can result from a disease or drug that directly damages the brain, or from a disease that indirectly damages the brain through effects on other bodily systems.
Symptoms associated with organic mental disorders may be a direct result of organic damage or may be the patient's reaction to lost mental abilities. Some disorders have as their primary feature delirium, or a clouded state of consciousness, which is manifested by difficulties in sustaining attention, by sensory misperceptions, and by disordered thought. Another common symptom, especially in organic mental disorders associated with old age, is dementia. Dementia is marked by impairments in memory, thinking, perception, judgment, and attention that are sufficient to interfere with social and occupational functioning. Emotional expression is also often changed, as evidenced by increased apathy, euphoria, or irritability(3).

Schizophrenia.

Schizophrenia is a group of serious disorders beginning usually in adolescence or young adulthood. Symptoms include disturbances in thought, perception, emotion, and interpersonal relationships(2).

Affective Disorders.

The affective disorders are those in which the predominant symptom is a disturbance in mood. One form, depression, is marked by sadness, guilt, and feelings of helplessness and hopelessness. In mania, mood is elevated, expansive, or irritable(5).

Delusional Disorders.

The central feature of the paranoid disorders is a person's delusion (a firmly held false belief), for instance that he or she is being persecuted or conspired against. In another form, the delusion consists of unreasonable jealousy. The person may be resentful, angry, sometimes violent, socially isolated, seclusive, and eccentric. The disorder usually starts in middle or late adult ...

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