Nursing Tutorials

encyclopedia of mental disorders

2008-08-13T14:38:00.000-07:00

Abnormal Involuntary Movement Scale

The Abnormal Involuntary Movement Scale (AIMS) is a rating scale that was designed in the 1970s to measure involuntary movements known as tardive dyskinesia (TD). TD is a disorder that sometimes develops as a side effect of long-term treatment with neuroleptic (antipsychotic) medications.

Abuse

Physical abuse refers to striking or beating another person with the hands or an object, but may include assault with a knife, gun, or other weapon. Physical abuse also includes such behaviors as locking someone in a closet or other small space, depriving someone of sleep, burning, gagging, or tying them up, etc.

Acupuncture

Acupuncture, one of the main forms of therapy in traditional Chinese medicine (TCM), has been practiced for at least 2,500 years. In acupuncture, certain points on the body associated with energy channels or meridians are stimulated by the insertion of fine needles.

Acute stress disorder

Acute stress disorder (ASD) is an anxiety disorder characterized by a cluster of dissociative and anxiety symptoms that occur within a month of a traumatic stressor. It is a relatively new diagnostic category and was added to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in 1994 to distinguish time-limited reactions to trauma from the farther-reaching and longer-lasting post-traumatic stress disorder (PTSD).

Addiction

Most definitions refer to addiction as the compulsive need to use a habit-forming substance, or an irresistible urge to engage in a behavior. Two other important defining features of addiction are tolerance, the increasing need for more of the substance to obtain the same effect, and withdrawal, the unpleasant symptoms that arise when an addict is prevented from using the chosen substance.

Adjustment disorder

An adjustment disorder is a type of mental disorder resulting from maladaptive, or unhealthy, responses to stressful or psychologically distressing life events. This low level of adaptation then leads to the development of emotional or behavioral symptoms.

Advance directives

An advance directive is a written document in which people clearly specify how medical decisions affecting them are to be made if they are unable to make them, or to authorize a specific person to make such decisions for them. These documents are sometimes called "living wills." Psychiatric advance directives serve the same purpose as general medical advance directives, but are written by mental health consumers as a set of directions for others to follow, made in advance of an injury, psychiatric illness, or crisis.

Affect

Affect is a psychological term for an observable expression of emotion.

Agoraphobia

Agoraphobia is an anxiety disorder characterized by intense fear related to being in situations from which escape might be difficult or embarrassing (i.e., being on a bus or train), or in which help might not be available in the event of a panic attack or panic symptoms. Panic is defined as extreme and unreasonable fear and anxiety.

Alcohol and related disorders

Alcoholism is defined as alcohol seeking and consumption behavior that is harmful. Long-term and uncontrollable harmful consumption can cause alcohol-related disorders that include: antisocial personality disorder, mood disorders (bipolar and major depression) and anxiety disorders.

Alprazolam

Alprazolam is a tranquilizer. It belongs to a group of drugs called benzodiazepines.

Alzheimer's disease

Alzheimer's disease, or AD, is a progressive, incurable disease of the brain caused by the degeneration and eventual death of neurons (nerve cells) in several areas of the brain.

Amantadine

Amantadine is a synthetic antiviral agent that also has strong antiparkinsonian properties. It is sold in the United States under the brand name Symmetrel, and is also available under its generic name.

Amitriptyline

Amitriptyline is a medication used to treat various forms of depression, pain associated with the nerves (neuropathic pain), and to prevent migraine headaches. It is sold in the United States under the brand names Elavil and Endep.

Amnesia

Amnesia is a partial or total loss of memory.

Amnestic disorders

The amnestic disorders are a group of disorders that involve loss of memories previously established, loss of the ability to create new memories, or loss of the ability to learn new information. As defined by the mental health professional's handbook, the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (2000), also known as DSM-IV-TR, the amnestic disorders result from two basic causes: general medical conditions that produce memory disturbances; and exposure to a chemical (drug of abuse, medication, or environmental toxin).

Amoxapine

Amoxapine is an oral tricyclic antidepressant. Formerly sold in the United States under the brand name Asendin, it is now manufactured and sold only under its generic name.

Amphetamines

Amphetamines are a group of drugs that stimulate the central nervous system. Some of the brand names of amphetamines sold in the United States are Dexedrine, Biphetamine, Das, Dexampex, Ferndex, Oxydess II, Spancap No 1, Desoxyn, and Methampex.

Amphetamines and related disorders

Amphetamines are a group of powerful and highly addictive substances that dramatically affect the central nervous system. They induce a feeling of well-being and improve alertness, attention, and performance on various cognitive and motor tasks.

Anorexia nervosa

Anorexia nervosa (AN) is an eating disorder characterized by an intense fear of gaining weight and becoming fat. Because of this fear, the affected individual starves herself or himself, and the person's weight falls to about 85% (or less) of the normal weight for age and height.

Anti-anxiety drugs and abuse

Anti-anxiety drugs, or "anxiolytics," are powerful central nervous system (CNS) depressants that can slow normal brain function. They are often prescribed to reduce feelings of tension and anxiety, and/or to bring about sleep.

Antisocial personality disorder

Also known as psychopathy, sociopathy or dyssocial personality disorder, antisocial personality disorder (APD) is a diagnosis applied to persons who routinely behave with little or no regard for the rights, safety or feelings of others. This pattern of behavior is seen in children or young adolescents and persists into adulthood.

Anxiety and anxiety disorders

Anxiety is an unpleasant emotion triggered by anticipation of future events, memories of past events, or ruminations about the self.

Anxiety reduction techniques

Anxiety reduction techniques are skills that are taught by a therapist to help an individual overcome anxiety, stress, and tension. Anxiety can be experienced in a variety of ways including tension, worry, and nervousness, and can occur in thoughts or experienced as bodily senations.

Apathy

Apathy can be defined as an absence or suppression of emotion, feeling, concern or passion. Further, apathy is an indifference to things generally found to be exciting or moving.

Appetite suppressants

Appetite-suppressant medications are drugs that promote weight loss by decreasing appetite or increasing the sensation of fullness.

Aromatherapy

Aromatherapy is a holistic treatment based on the external use of essential aromatic plant oils to maintain and promote physical, physiological, and spiritual wellbeing. The essential oils may be used in massage, added to a warm bath, used to moisten a compress that is applied to the affected part of the body, added to a vaporizer for inhalation, or diffused throughout a room.

Asperger's disorder

Asperger's disorder, which is also called Asperger's syndrome (AS) or autistic psychopathy, belongs to a group of childhood disorders known as pervasive developmental disorders (PDDs) or autistic spectrum disorders. The essential features of Asperger's disorder are severe social interaction impairment and restricted, repetitive patterns of behavior and activities.

Assertiveness training

Assertiveness training is a form of behavior therapy designed to help people stand up for themselves—to empower themselves, in more contemporary terms. Assertiveness is a response that seeks to maintain an appropriate balance between passivity and aggression.

Assessment and diagnosis

The psychological assessment is a structured interview that gathers information from and/or tests a person to evaluate a mental health complaint.

Attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder characterized by distractibility, hyperactivity, impulsive behaviors, and the inability to remain focused on tasks or activities.

Autism

The term "autism" refers to a cluster of conditions appearing early in childhood. All involve severe impairments in social interaction, communication, imaginative abilities, and rigid, repetitive behaviors.

Aversion therapy

Aversion therapy is a form of behavior therapy in which an aversive (causing a strong feeling of dislike or disgust) stimulus is paired with an undesirable behavior in order to reduce or eliminate that behavior.

Avoidant personality disorder

Avoidant personality disorder is one of several personality disorderslisted in the newest edition of the standard reference guide to mental disorders Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM-IV-TR. It is characterized by marked avoidance of both social situations and close interpersonal relationships due to an excessive fear of rejection by others.

Barbiturates

Barbiturates are a large class of drugs, consisting of many different brand name products with generic equivalents, that are used primarily for mild sedation, general anesthesia, and as a treatment for some types of epilepsy. One barbiturate, butalbital, exists only as a component of several headache preparations.

Beck Depression Inventory

The Beck Depression Inventory (BDI) is a series of questions developed to measure the intensity, severity, and depth of depression in patients with psychiatric diagnoses. Its long form is composed of 21 questions, each designed to assess a specific symptom common among people with depression.

Behavior modification

Behavior modification is a treatment approach, based on the principles of operant conditioning, that replaces undesirable behaviors with more desirable ones through positive or negative reinforcement.

Bender Gestalt Test

The Bender Gestalt Test, or the Bender Visual Motor Gestalt Test, is a psychological assessment instrument used to evaluate visual-motor functioning and visual perception skills in both children and adults. Scores on the test are used to identify possible organic braindamage and the degree maturation of the nervous system.

Benztropine

Benztropine is classified as an antiparkinsonian agent. It is sold in the United States under the brand name Cogentin and is also available under its generic name.

Beta blockers

Beta blockers, also known as beta antagonists, are a class of drugs that were first developed for the treatment of certain heart conditions and hypertension. Later, beta blockers were also found to be useful in glaucoma, migraine, and some psychiatric disorders such as performance anxiety, tremors secondary to lithium, and movement disorders that are caused by some drugs used in the treatment of psychosis.

Bibliotherapy

Bibliotherapy is an adjunct to psychological treatment that incorporates appropriate books or other written materials, usually intended to be read outside of psychotherapy sessions, into the treatment regimen.

Binge eating

Binge eating is a form of overeating in which a person ingests a large amount of food during a discrete period of time (within one or two hours, for example) and experiences feelings of being out of control and unable to stop eating during the episode. In practice, the duration of a binge may vary greatly from one event to the next, making it difficult to define the number of binges occurring in a given day.

Biofeedback

Biofeedback is a technique that uses monitoring instruments to measure and feed back information about muscle tension, heart rate, sweat responses, skin temperature, or brainactivity.

Biperiden

Biperiden is classified as an antiparkinsonian agent. It is sold in the United States under the brand name of Akineton.

Bipolar disorder

Bipolar, or manic-depressive, disorder is a mood disorder that causes radical emotional changes and mood swings, from manic highs to depressive lows. The majority of bipolar individuals experience alternating episodes of mania (an elevated or euphoric mood or irritable state) and depression.

Bipolar disorders

Bipolar disorders is the name given to a group of mental disorders characterized by extreme fluctuations in mood. People diagnosed with bipolar disorders experience moods ranging from deepest depression to mania, often with periods of less extreme moods, or even emotional stability, in between.

Body dysmorphic disorder

Body dysmorphic disorder (BDD) is defined by the DSM-IV-TR(a handbook for mental health professionals) as a condition marked by excessive preoccupation with an imaginary or minor defect in a facial feature or localized part of the body. The diagnostic criteria specify that the condition must be sufficiently severe to cause a decline in the patient's social, occupational, or educational functioning.

Bodywork therapies

Bodywork therapies is a general term that refers to a group of body-based approaches to treatment that emphasize manipulation and realignment of the body's structure in order to improve its function as well as the client's mental outlook. These therapies typically combine a relatively passive phase, in which the client receives deep-tissue bodywork or postural correction from an experienced instructor or practitioner, and a more active period of movement education, in which the client practices sitting, standing, and moving about with better alignment of the body and greater ease of motion.

Borderline personality disorder

Borderline personality disorder (BPD) is a mental disorder characterized by disturbed and unstable interpersonal relationships and self-image, along with impulsive, reckless, and often self-destructive behavior.

Brain

The brain is the part of the central nervous system located in the skull. It controls the mental processes and physical actions of a human being.

Breathing-related sleep disorder

Breathing-related sleep disorder is marked by sleep disruption caused by abnormal breathing during sleep. The most common complaint of individuals with breathing-related sleep disorder is excessive daytime sleepiness, brought on by frequent interruptions of nocturnal, or nighttime, sleep.

Brief psychotic disorder

Brief psychotic disorder is a short-term, time-limited disorder. An individual with brief psychotic disorder has experienced at least one of the major symptoms of psychosis for less than one month.

Bulimia nervosa

Bulimia nervosa is an eating disorder characterized by binge eatingand engaging in inappropriate ways of counteracting the bingeing (using laxatives, for example) in order to prevent weight gain. The word "bulimia" is the Latin form of the Greek word boulimia, which means "extreme hunger." A binge is consuming a larger amount of food within a limited period of time than most people would eat in similar circumstances.

Bupropion

Bupropion is an antidepressant drug used to elevate mood and promote recovery of a normal range of emotions in patients with depressive disorders. In addition, bupropion is used to as an aid in smoking cessation treatment.

Buspirone

Buspirone is an anti-anxiety (anxiolytic) drug sold in the United States under the brand name of BuSpar. It is also available under its generic name.

Caffeine-related disorders

Caffeine is a white, bitter crystalline alkaloid derived from coffee or tea. It belongs to a class of compounds called xanthines, its chemical formula being 1,3,7-trimethylxanthine.

Cannabis and related disorders

Cannabis, more commonly called marijuana, refers to the several varieties of Cannabis sativa, or Indian hemp plant, that contains the psychoactive drug delta-9-tetrahydrocannabinol (THC). Cannabis-related disorders refer to problems associated with the use of substances derived from this plant.

Carbamazepine

Carbamazepine is an anticonvulsant that is structurally related to tricyclic antidepressants such as amitriptyline and imipramine. In the United States, carbamazepine is sold under the trade names Tegretol and Carbatrol.

Case management

Case management assigns the administration of care for an outpatient individual with a serious mental illness to a single person (or team); this includes coordinating all necessary medical and mental health care, along with associated supportive services.

Catatonia

Catatonia is a disturbance of motor behavior that can have either a psychological or neurological cause. Its most well-known form involves a rigid, immobile position that is held by a person for a considerable length of time— often days, weeks, or longer.

Catatonic disorders

Catatonic disorders are a group of symptoms characterized by disturbances in motor (muscular movement) behavior that may have either a psychological or a physiological basis. The best-known of these symptoms is immobility, which is a rigid positioning of the body held for a considerable length of time.

Chamomile

Chamomile is a plant that has been used since ancient Egypt in a variety of healing applications. Chamomile is a native of the Old World; it is related to the daisy family, having strongly scented foliage and flowers with white petals and yellow centers.

Child Depression Inventory

The Child Depression Inventory (CDI) is a symptom-oriented instrument for assessing depression in children between the ages of seven and 17 years. The basic CDI consists of 27 items, but a 10-item short form is also available for use as a screener.

Childhood disintegrative disorder

Childhood disintegrative disorder (CDD) is a developmental disorder that resembles autism. It is characterized by at least two years of normal development, followed by loss of language, social skills, and motor skills before age ten.

Children's Apperception Test

The Children's Apperception Test, often abbreviated as CAT, is an individually administered projective personality test appropriate for children aged three to 10 years.

Chloral hydrate

Chlordiazepoxide

Chlordiazepoxide is used for the treatment of anxiety. It is a member of the benzodiazepine family of compounds, which slow the central nervous system in order to ease tension or nervousness.

Chlorpromazine

Chlorpromazine is an antipsychotic drug. It is a member of the phenothiazine family of compounds and is used to alleviate the symptoms and signs of psychosis.

Circadian rhythm sleep disorder

Circadian rhythm sleep disorder is a persistent or recurring pattern of sleep disruption resulting either from an altered sleep-wake schedule or an inequality between a person's natural sleep-wake cycle and the sleep-related demands placed on him or her. The term circadian rhythm refers to a person's internal sleep and wake-related rhythms that occur throughout a 24-hour period.

Citalopram

Citalopram is a selective serotonin reuptake inhibitor (SSRI) antidepressant drug that is sold in the United States under brand name Celexa.

Clinical Assessment Scales for the Elderly

The Clinical Assessment Scales for the Elderly, often abbreviated as CASE, is a diagnostic tool used to deter mine the presence of mental disorders and other conditions in elderly adults.

Clomipramine

Clomipramine is an antidepressant drug used primarily to alleviate obsessions and compulsions in patients with obsessive-compulsive disorder. Clomipramine is also used in the treatment of depressive disorders and in a number of other psychiatric and medical conditions.

Clonazepam

Clonazepam belongs to a group of drugs called benzodiazepines. Benzodiazepines are medications that help relieve nervousness, tension, symptoms of anxiety, and some types of seizures by slowing the central nervous system.

Clonidine

Clonidine belongs to a class of drugs called central alpha-adrenergic agonists. In the United States, clonidine tablets are sold under the brand name Catapres and clonidine skin patches are sold under the brand name Catapres-TTS.

Clorazepate

Clorazepate is a medication that belongs to a family of drugs called benzodiazepines—a group of pharmacologically active compounds used to produce a calming effect by relieving anxiety and tension. In the United States, clorazepate is sold under brand names Tranxene and Gen-XENE.

Clozapine

Clozapine is an antipsychotic drug used to alleviate the symptoms and signs of schizophrenia—a form of severe mental illness— which is characterized by loss of contact with reality, hallucinations, delusions, and unusual behavior. In the United States, the drug is also known by the brand name Clozaril.

Cocaine and related disorders

Cocaine is extracted from the coca plant, which grows in Central and South America. The substance is processed into many forms for use as an illegal drug of abuse.

Cognistat

The Cognistat is a standardized neurobehavioral screening test. It is a test that examines neurological (brain and central nervous system) health in relation to a person's behavior.

Cognitive problem-solving skills training

Cognitive problem-solving skills training (CPSST) attempts to decrease a child's inappropriate or disruptive behaviors by teaching the child new skills for approaching situations that previously provoked negative behavior. Using both cognitive and behavioral techniques and focusing on the child more than on the parents or the family unit, CPSST helps the child gain the ability to self-manage thoughts and feelings and interact appropriately with others by developing new perspectives and solutions.

Cognitive remediation

Cognitive remediation is a teaching process that targets areas of neuropsychological functioning involved in learning and basic day-to-day functioning.

Cognitive retraining

Cognitive retraining is a therapeutic strategy that seeks to improve or restore a person's skills in the areas of paying attention, remembering, organizing, reasoning and understanding, problem-solving, decision making, and higher level cognitive abilities. These skills are all interrelated.

Cognitive-behavioral therapy

Cognitive therapy is a psychosocial (both psychological and social) therapy that assumes that faulty thought patterns (called cognitive patterns) cause maladaptive behavior and emotional responses. The treatment focuses on changing thoughts in order to solve psychological and personality problems.

Communication skills and disorders

Communication skills are the skills needed to use language (spoken, written, signed, or otherwise communicated) to interact with others, and communication disorders are problems related to the development of these skills.

Community mental health

Community mental health is a decentralized pattern of mental health, mental health care, or other services for people with mental illnesses. Community-based care is designed to supplement and decrease the need for more costly inpatient mental health care delivered in hospitals.

Compliance

Compliance with appropriate, recommended, and prescribed mental health treatments simply means that a person is following a doctor's orders. Compliance is more likely when there is agreement and confidence regarding the medical diagnosis and prognosis.

Compulsion

A compulsion is a repetitive, excessive, meaningless activity or mental exercise that a person performs in an attempt to avoid distress or worry.

Computed tomography

Computed tomography scanning, also called CT scan, CAT scan, or computerized axial tomography, is a diagnostic tool that provides views of internal body structures using x rays. In the field of mental health, a CT scan may be used when a patient seeks medical help for symptoms that could possibly be caused by a brain tumor.

Conduct disorder

Conduct disorder is a childhood behavior disorder characterized by aggressive and destructive activities that cause disruptions in the child's natural environments such as home, school, church, or the neighborhood. The overriding feature of conduct disorder is the repetitive and persistent pattern of behaviors that violate societal norms and the rights of other people.

Conners' Rating Scales-Revised

Developed by C. Keith Conners, Ph.D., the Conners' Rating Scales-Revised (CRS-R) are paper and pencil screening questionnaires designed to be completed by parents and teachers to assist in evaluating children for attention-deficit/hyperactivity disorder (ADHD).

Conversion disorder

Conversion disorder is defined by Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as the DSM-IV-TR,as a mental disorder whose central feature is the appearance of symptoms affecting the patient's senses or voluntary movements that suggest a neurological or general medical disease or condition. Somatoform disorders are marked by persistent physical symptoms that cannot be fully explained by a medical condition, substance abuse, or other mental disorder, and seem to stem from psychological issues or conflicts.

Couples therapy

Couples therapy is a form of psychological therapy used to treat relationship distress for both individuals and couples.

Covert sensitization

Covert sensitization is a form of behavior therapy in which an undesirable behavior is paired with an unpleasant image in order to eliminate that behavior.

Creative therapies

Creative therapy refers to a group of techniques that are expressive and creative in nature. The aim of creative therapies is to help clients find a form of expression beyond words or traditional therapy, such as cognitive or psychotherapy.

Crisis housing

Crisis housing (or crisis residential services) are supervised short-term residential alternatives to hospitalization for adults with serious mental illnesses or children with serious emotional or behavioral disturbances.

Crisis intervention

Crisis intervention refers to the methods used to offer immediate, short-term help to individuals who experience an event that produces emotional, mental, physical, and behavioral distress or problems. A crisis can refer to any situation in which the individual perceives a sudden loss of his or her ability to use effective problem-solving and coping skills.

Cyclothymic disorder

Cyclothymic disorder, also known as cyclothymia, is a relatively mild form of bipolar II disorder characterized by mood swings that may appear to be almost within the normal range of emotions. These mood swings range from mild depression, or dysthymia, to mania of low intensity, or hypomania.

Deinstitutionalization

Deinstitutionalization is a long-term trend wherein fewer people reside as patients in mental hospitals and fewer mental health treatments are delivered in public hospitals. This trend is directly due to the process of closing public hospitals and the ensuing transfers of patients to community-based mental health services in the late twentieth century.

Delirium

Delirium is a medical condition characterized by a vascillating general disorientation, which is accompanied by cognitive impairment, mood shift, self-awareness, and inability to attend (the inability to focus and maintain attention). The change occurs over a short period of time— hours to days— and the disturbance in consciousness fluctuates throughout the day.

Delusional disorder

Delusional disorder is characterized by the presence of recurrent, persistent non-bizarre delusions.

Delusions

A delusion is a belief that is clearly false and that indicates an abnormality in the affected person's content of thought. The false belief is not accounted for by the person's cultural or religious background or his or her level of intelligence.

Dementia

Dementia is not a specific disorder or disease. It is a syndrome (group of symptoms) associated with a progressive loss of memory and other intellectual functions that is serious enough to interfere with performing the tasks of daily life.

Denial

Denial is the refusal to acknowledge the existence or severity of unpleasant external realities or internal thoughts and feelings.

Dependent personality disorder

Dependent personality disorder is characterized by an excessive need to be taken care of or depend upon others. Persons with this disorder are typically submissive and display clinging behavior toward those from whom they fear being separated.

Depersonalization

Depersonalization is a mental state in which a person feels detached or disconnected from his or her personal identity or self. This may include the sense that one is "outside" oneself, or is observing one's own actions, thoughts or body.

Depersonalization disorder

Depersonalization is a state in which the individual ceases to perceive the reality of the self or the environment. The patient feels that his or her body is unreal, is changing, or is dissolving; or that he or she is outside of the body.

Depression and depressive disorders

Depression or depressive disorders (unipolar depression) are mental illnesses characterized by a profound and persistent feeling of sadness or despair and/or a loss of interest in things that were once pleasurable. Disturbance in sleep, appetite, and mental processes are a common accompaniment.

Desipramine

Desipramine is an antidepressant drug used to elevate mood and promote recovery of a normal range of emotions in patients with depressive disorders. In addition, desipramine has uses in a number of other psychiatric and medical conditions.

Detoxification

Detoxification is a process in which the body is allowed to free itself of a drug. During this period, the symptoms of withdrawal are also treated.

Developmental coordination disorder

Developmental coordination disorder is diagnosed when children do not develop normal motor coordination (coordination of movements involving the voluntary muscles).

Diagnosis

Diagnosis can be defined as the identification and labeling of a disease based on its signs and symptoms. Mental health clinicians (psychiatrists, psychologists, and psychiatric nurse practitioners) diagnose mental disorders using the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM, published by the American Psychiatric Association.

Diagnostic and Statistical Manual of Mental Disorders

The Diagnostic and Statistical Manual of Mental Disordersis a reference work consulted by psychiatrists, psychologists, physicians in clinical practice, social workers, medical and nursing students, pastoral counselors, and other professionals in health care and social service fields. The book's title is often shortened to DSM, or an abbreviation that also indicates edition, such as DSM-IV-TR,which indicates fourth edition, text revision of the manual, published in 2000.

Diazepam

Diazepam is a mild tranquilizer in the class of drugs known as benzodiazepines. It is most commonly sold in the United States under the brand name Valium.

Diets

Special diets are designed to help individuals make changes in their usual eating habits or food selection. Some special diets involve changes in the overall diet, such as diets for people needing to gain or lose weight or eat more healthfully.

Diphenhydramine

Diphenhydramine is an antihistamine used in psychiatric medicine to treat phenothiazine drug-induced abnormal muscle movement. It is also used in general medicine to treat allergies, allergic reactions, motion sickness, insomnia, cough, and nausea.

Disease concept of chemical dependency

Disease concept of chemical dependency is the concept that a disorder (such as chemical dependency) is like a disease and has a characteristic set of signs, symptoms, and natural history (clinical course, or outcome).

Disorder of written expression

Disorder of written expression, formerly called developmental expressive writing disorder, is a learning disability in which a person's ability to communicate in writing is substantially below the level normally expected based on the individual's age, intelligence, life experiences, educational background, or physical impairments. This disability affects both the physical reproduction of letters and words and the organization of thoughts and ideas in written compositions.

Dissociation and dissociative disorders

The dissociative disorders are a group of mental disorders that affect consciousness and are defined as causing significant interference with the patient's general functioning, including social relationships and employment.

Dissociative amnesia

Dissociative amnesiais classified by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as the DSM-IV-TR as one of the dissociative disorders, which are mental disorders in which the normally well-integrated functions of memory, identity, perception, or consciousness are separated (dissociated). The dissociative disorders are usually associated with trauma in the recent or distant past, or with an intense internal conflict that forces the mind to separate incompatible or unacceptable knowledge, information, or feelings.

Dissociative fugue

Dissociative fugue is a rare condition in which a person suddenly, without planning or warning, travels far from home or work and leaves behind a past life. Patients show signs of amnesiaand have no conscious understanding or knowledge of the reason for the flight.

Dissociative identity disorder

Previously known as multiple personality disorder, dissociative identity disorder (DID) is a condition in which a person has more than one distinct identity or personality state. At least two of these personalities repeatedly assert themselves to control the affected person's behavior.

Disulfiram

Disulfiram is an aldehyde dehydrogenase inhibitor. It prohibits the activity of aldehyde dehydrogenase, an enzyme found in the liver.

Divalproex sodium

Divalproex sodium is an anticonvulsant (antiseizure) drug. It is also used to treat mania and to help prevent migraine headaches.

Donepezil

Donepezil is a drug used to treat dementia associated with Alzheimer's disease. In the United States, donepezil is sold under the brand name Aricept.

Doxepin

Doxepin is an oral antidepressant. It is sold in the United States under the brand name Sinequan and is also available under its generic name.

Dual diagnosis

Dual diagnosis is a term that refers to patients who have both a mental health disorder and substance use disorder. It may be used interchangeably with "co-occurring disorders" or "comorbidity." According to the U.S.

Dyspareunia

Dyspareunia is painful sexual intercourse. The same term is used whether the pain results from a medical or a psychosocial problem.

Dysthymic disorder

Dysthymic disorder is defined as a mood disorder with chronic (long-term) depressive symptoms that are present most of the day, more days than not, for a period of at least two years.

Electroconvulsive therapy

Electroconvulsive therapy (ECT) is a medical procedure in which a small, carefully controlled amount of electric current is passed through the brainto treat symptoms associated with certain mental disorders. The electric current produces a convulsion for the relief of symptoms associated with such mental illnesses as major depressive disorder, bipolar disorder, acute psychosis, and catatonia.

Electroencephalography

Electroencephalography (EEG) is a neurological diagnostic procedure that records the changes in electrical potentials (brainwaves) in various parts of the brain.

Elimination disorders

Elimination disorders are disorders that concern the elimination of feces or urine from the body. The causes of these disorders may be medical or psychiatric.

Encopresis

Encopresis is an elimination disorder that involves repeatedly having bowel movements in inappropriate places after the age when bowel control is normally expected.

Energy therapies

Energy therapies is a collective term used to refer to a variety of alternative and complementary treatments based on the use, modification, or manipulation of energy fields. Most energy therapies presuppose or accept the theory that matter and energy are not exclusive opposites, but that matter is simply a denser form of energy that is more easily perceived by the senses.

Enuresis

Enuresis, more commonly called bed-wetting, is a disorder of elimination that involves the voluntary or involuntary release of urine into bedding, clothing, or other inappropriate places. In adults, loss of bladder control is often referred to as urinary incontinence rather than enuresis; it is frequently found in patients with late-stage Alzheimer's disease or other forms of dementia.

Erectile dysfunction

Erectile dysfunction (ED) may be defined as the consistent inability to achieve or maintain an erection sufficient to permit satisfactory sexual intercourse. The word "consistent" is included in the definition because most men experience transient episodes of ED that are temporary and usually associated with fatigue, anger, depression or other stressful emotions.

Estazolam

Estazolam is a sedative-hypnotic drug belonging to the class of drugs known as benzodiazepines. It is sold in the United States under the names ProSom and Sedarest.

Evening primrose oil

Evening primrose oil is a dietary supplement derived from the seeds of the evening primrose plant, Oenothera biennis. Its Latin name is derived from the Greek word for wine, reflecting the folk belief that the plant could relieve the symptoms of a hangover.

Executive function

The term executive function describes a set of cognitive abilities that control and regulate other abilities and behaviors. Executive functions are necessary for goal-directed behavior.

Exhibitionism

Exhibitionism is a mental disorder characterized by a compulsion to display one's genitals to an unsuspecting stranger. The Diagnostic and Statistical Manual of Mental Disorders,also known as the DSM-IV-TR,classifies exhibitionism under the heading of the "paraphilias," a subcategory of sexual and gender identity disorders.

Exposure treatment

Exposure treatment is a technique that is widely used in cognitive-behavioral therapy (CBT). Exposure treatment is used for a variety of anxiety disorders, and it has also recently been extended to the treatment of substance-related disorders.

Expressive language disorder

Expressive language disorder occurs when an individual has problems expressing him or herself using spoken language.

Factitious disorder

Factitious disorder (FD) is an umbrella category that covers a group of mental disturbances in which patients intentionally act physically or mentally ill without obvious benefits. According to one estimate, the unnecessary tests and waste of other medical resources caused by FD cost the United States $40 million per year.

Family education

Family education is the ongoing process of educating family members about a serious mental illness in order to improve their coping skills and their ability to help a relative affected by the illness.

Family psychoeducation

Family psychoeducation is a method based on clinical findings for training families to work together with mental health professionals as part of an overall clinical treatment plan for their family members. Family psychoeducation has been shown to improve patient outcomes for persons with schizophreniaand other major mental illnesses.

Family therapy

Family therapy is a form of psychotherapythat involves all the members of a nuclear or extended family. It may be conducted by a pair of therapists—often a man and a woman—to treat gender-related issues or serve as role models for family members.

Fatigue

Fatigue may be defined as a subjective state in which one feels tired or exhausted, and in which the capacity for normal work or activity is reduced. There is, however, no commonly accepted definition of fatigue when it is considered in the context of health and illness.

Feeding disorder of infancy or early childhood

Feeding disorder of infancy or early childhood is characterized by the failure of an infant or child under six years of age to eat enough food to gain weight and grow normally over a period of one month or more. The disorder can also be characterized by the loss of a significant amount of weight over one month.

Female orgasmic disorder

Female orgasmic disorder (FOD) is the persistent or recurrent inability of a woman to have an orgasm (climax or sexual release) after adequate sexual arousal and sexual stimulation. According to the handbook used by mental health professionals to diagnose mental disorders, the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (also known as the DSM-IV-TR), this lack of response can be primary (a woman has never had an orgasm) or secondary (acquired after trauma), and can be either general or situation-specific.

Female sexual arousal disorder

Female sexual arousal disorder (FSAD) refers to the persistent or recurrent inability of a woman to achieve or maintain an adequate lubrication-swelling response during sexual activity. This lack of physical response may be either lifelong or acquired, and either generalized or situation-specific.

Fetishism

Fetishism is a form of paraphilia, a disorder that is characterized by recurrent intense sexual urges and sexually arousing fantasies generally involving non-human objects, the suffering or humiliation of oneself or one's partner (not merely simulated), or children or other non-consenting persons. The essential feature of fetishism is recurrent intense sexual urges and sexually arousing fantasies involving specific objects.

Figure drawings

Figure drawings are projective diagnostic techniques in which an individual is instructed to draw a person, an object, or a situation so that cognitive, interpersonal, or psychological functioning can be assessed.

Fluoxetine

Fluoxetine is an antidepressant of the type known as selective serotonin reuptake inhibitors (SSRI). It is sold in the United States under the brand names Prozac and Sarafem.

Fluphenazine

Fluphenazine is a phenothiazine antipsychotic sold under the brand names Permitil and Prolixin in the United States. It is also available under its generic name.

Flurazepam

Flurazepam is a benzodiazepine hypnotic (sleeping medication) that is given by mouth. It is sold in the United States under the brand name of Dalmane, but is also manufactured and sold by several companies under its generic name.

Fluvoxamine

Fluvoxamine is an antidepressant of the type known as selective serotonin reuptake inhibitors (SSRI). It is marketed in the United States under the brand name Luvox.

Frotteurism

Frotteurism is a disorder in which a person derives sexual pleasure or gratification from rubbing, especially the genitals, against another person, usually in a crowd. The person being rubbed is a victim.

Gabapentin

Gabapentin is an anti-seizure medication. It is sold in the United States under the trade name Neurontin.

Galantamine

Galantamine belongs to a class of drugs called acetylcholinesterase inhibitors. In the United States galantamine is sold under brand name Reminyl.

Ganser's syndrome

Gender identity disorder

Gender identity disorder is a condition characterized by a persistent feeling of discomfort or inappropriateness concerning one's anatomic sex. The disorder typically begins in childhood with gender identity problems and is manifested in adolescence or adulthood by a person dressing in clothing appropriate for the desired gender, as opposed to one's birth gender.

Gender issues in mental health

The term gender is often used to classify the anatomy of a person's reproductive system as either male or female. In the social sciences, however, the concept of gender means much more than biological sex.

Generalized anxiety disorder

Generalized anxiety disorder, or GAD, is a disorder characterized by diffuse and chronic worry. Unlike people with phobias or post-traumatic disorders, people with GAD do not have their worries provoked by specific triggers; they may worry about almost anything having to do with ordinary life.

Genetic factors and mental disorders

In recent years, mental health professionals have become increasingly aware of the importance of genetic factors in the etiology (causes) of mental disorders. Since the Human Genome Project began its mapping of the entire sequence of human DNA in 1990, the implications of its findings for psychiatric diagnosisand treatment have accumulated rapidly.

Geriatric Depression Scale

The Geriatric Depression Scale (GDS) is a 30-item self-report assessment designed specifically to identify depression in the elderly. The items may be answered yes or no, which is thought to be simpler than scales that use a five-category response set.

Gestalt therapy

Gestalt therapy is a complex psychological system that stresses the development of client self-awareness and personal responsibility.

Ginkgo biloba

Ginkgo biloba is an herbal remedy that has been utilized for thousands of years in China and elsewhere. It is obtained from the leaves and seeds of a plant that is commonly known as the maiden hair tree, believed to be the oldest living species of tree.

Ginseng

Ginseng is an herbal preparation derived from the aromatic root of a plant of the genus Panax, which is native to East Asia. Ginseng belongs to the Araliaceae family of plants.

Grief

Grief, which is also known as bereavement, is a term used to describe the intense and painful emotions experienced when someone or something a person cares about either dies or is lost. The emotional pain from losing a loved one, whether it is a spouse, child, parent, sibling, friend, or pet, can be the most severe suffering a person must endure.

Grief counseling

Grief counseling refers to a specific form of therapy, or a focus in general counseling with the goal of helping the individual grieve and address personal loss in a healthy manner. Grief counseling is offered individually by psychologists, clergy, counselors or social workers, in groups led by professionals, as well as informal support groups offered by churches, community groups, or organizations devoted to helping individuals grieve specific losses.

Group homes

Group homes are small, residential facilities located within a community and designed to serve children or adults with chronic disabilities. These homes usually have six or fewer occupants and are staffed 24 hours a day by trained caregivers.

Group therapy

Group therapy is a form of psychotherapyin which a small, carefully selected group of individuals meets regularly with a therapist.

Guided imagery therapy

Guided imagery therapy is a cognitive-behavioral technique in which a client is guided in imagining a relaxing scene or series of experiences.

Hallucinations

A hallucination is a false perception occurring without any identifiable external stimulus and indicates an abnormality in perception. The false perceptions can occur in any of the five sensory modalities.

Hallucinogens and related disorders

Hallucinogens are a chemically diverse group of drugs that cause changes in a person's thought processes, perceptions of the physical world, and sense of time passing. Hallucinogens can be found naturally in some plants, and can be synthesized in the laboratory.

Haloperidol

Haloperidol is a major tranquilizer. It is used to treat psychoses, senile dementia, Tourette's syndrome, and certain serious behavioral disorders in children.

Halstead-Reitan Battery

The Halstead-Reitan Neuropsychological Test Battery is a fixed set of eight tests used to evaluate brainand nervous system functioning in individuals aged 15 years and older. Children's versions are the Halstead Neuropsychological Test Battery for Older Children (ages nine to 14) and the Reitan Indiana Neuropsychological Test Battery (ages five to eight).

Hamilton Anxiety Scale

The Hamilton Anxiety Scale (HAS or HAMA) is a 14-item test measuring the severity of anxiety symptoms. It is also sometimes called the Hamilton Anxiety Rating Scale (HARS).

Hamilton Depression Scale

The Hamilton Depression Scale (HDS or HAMD) is a test measuring the severity of depressive symptoms in individuals, often those who have already been diagnosed as having a depressive disorder. It is sometimes known as the Hamilton Rating Scale for Depression (HRSD) or the Hamilton Depression Rating Scale (HDRS).

Hare Psychopathy Checklist

The Hare Psychopathy Checklist-Revised (PCL-R) is a diagnostic tool used to rate a person's psychopathic or antisocial tendencies. People who are psychopathic prey ruthlessly on others using charm, deceit, violence or other methods that allow them to get with they want.

Historical, Clinical, Risk Management-20

The Historical, Clinical, Risk Management-20 (HCR-20) is an assessment tool that helps mental health professionals estimate a person's probability of violence.

Histrionic personality disorder

Histrionic personality disorder, often abbreviated as HPD, is a type of personality disorder in which the affected individual displays an enduring pattern of attention-seeking and excessively dramatic behaviors beginning in early adulthood and present across a broad range of situations. Individuals with HPD are highly emotional, charming, energetic, manipulative, seductive, impulsive, erratic, and demanding.

Homelessness

In the United States, definitions of homelessness help determine who is able to receive shelter and assistance from certain health and social service providers. The Stewart McKinney Homeless Assistance Act of 1987 defines a homeless person as any individual who lacks housing, including an individual whose primary residence during the night is a supervised public or private facility that provides temporary living accommodations or an individual who is a resident in transitional housing.

Hospitalization

Hospitalization or inpatient care is the most restrictive form of treatment for a psychiatric disorder, addictive disorder, or for someone with more than one diagnosis. Whether it is voluntary or involuntary, the patient relinquishes the freedom to move about and, once admitted, becomes subject to the rules and schedule of a treatment environment.

House-tree-person test

The house-tree-person test (HTP) is a projective personality test, a type of exam in which the test taker responds to or provides ambiguous, abstract, or unstructured stimuli (often in the form of pictures or drawings). In the HTP, the test taker is asked to draw houses, trees, and persons, and these drawings provide a measure of self-perceptions and attitudes.

Hypersomnia

Hypersomnia refers to a set of related disorders that involve excessive daytime sleepiness.

Hypnotherapy

Hypnotherapy is a combination of hypnosis and therapeutic intervention. The therapist leads the patient to positive change while the patient is deeply relaxed in a state of heightened suggestibility called trance.

Hypoactive sexual desire disorder

Hypoactive sexual desire disorder (HSDD) is defined as the persistent or recurrent extreme aversion to, absence of, and avoidance of all, or almost all, genital sexual contact with a sexual partner. Synonyms for HSDD include sexual aversion, inhibited sexual desire, sexual apathy, and sexual anorexia.

Hypochondriasis

The primary feature of hypochondriasis is excessive fear of having a serious disease. These fears are not relieved when a medical examination finds no evidence of disease.

Imaging studies

Imaging studies are tests performed with a variety of techniques that produce pictures of the inside of a patient's body.

Imipramine

Imipramine is a tricyclic antidepressant. It is sold under the brand name Tofranil in the United States.

Impulse-control disorders

Impulse-control disorders are psychological disorders characterized by the repeated inability to refrain from performing a particular action that is harmful either to oneself or others.

Informed consent

Informed consent is a legal document in all 50 states, prepared as an agreement for treatment, non-treatment, or for an invasive procedure that requires physicians to disclose the benefits, risks, and alternatives to the treatment, non-treatment, or procedure. It is the method by which a fully informed, rational patient may be involved in the choices about his or her health.

Inhalants and related disorders

The inhalants are a class of drugs that include a broad range of chemicals found in hundreds of different products, many of which are readily available to the general population. These chemicals include volatile solvents (liquids that vaporize at room temperature) and aerosols (sprays that contain solvents and propellants).

Insomnia

Insomnia is a condition that occurs when a person in unable to get long enough or refreshing enough sleep at night. Insomnia can result from an inability to fall asleep, an inability to stay asleep, or waking too early before having gotten enough sleep.

Intelligence tests

Intelligence tests are psychological tests that are designed to measure a variety of mental functions, such as reasoning, comprehension, and judgment.

Intermittent explosive disorder

Intermittent explosive disorder (IED) is a disorder characterized by impulsive acts of aggression, as contrasted with planned violent or aggressive acts. The aggressive episodes may take the form of "spells" or "attacks," with symptoms beginning minutes to hours before the actual acting-out.

Internet addiction disorder

Internet addictiondisorder refers to the problematic use of the Internet, including the various aspects of its technology, such as electronic mail (e-mail) and the World Wide Web. The reader should note that Internet addiction disorder is not listed in the mental health professional's handbook, the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (2000), which is also called the DSM.

Interpersonal therapy

Interpersonal therapy (IPT) is a short-term supportive psychotherapy that focuses on the connection between interactions between people and the development of a person's psychiatric symptoms.

Intervention

A standard dictionary defines intervention as an influencing force or act that occurs in order to modify a given state of affairs. In the context of behavioral health, an intervention may be any outside process that has the effect of modifying an individual's behavior, cognition, or emotional state.

Involuntary hospitalization

Involuntary hospitalization is a legal procedure used to compel an individual to receive inpatient treatment for a mental health disorder against his or her will. The legal justifications vary somewhat from state to state, but are generally based on a determination that a person is imminently dangerous to self or others; is gravely disabled; or clearly needs immediate care and treatment.

Kaufman Adolescent and Adult Intelligence Test

The Kaufman Adolescent and Adult Intelligence Test (KAIT) is an individually administered general intelligence test appropriate for adolescents and adults, aged 11 to over 85 years.

Kaufman Assessment Battery for Children

The Kaufman Assessment Battery for Children (KABC) is a standardized test that assesses intelligence and achievement in children aged two years, six months to 12 years, six months. The edition published in 1983 by Kaufman and Kaufman was in the process of being revised in 2002 to expand its age range (to cover children ages three to eighteen) and enhance its usefulness.

Kaufman Short Neurological Assessment Procedure

The Kaufman Short Neurological Procedure, often abbreviated as K-SNAP, is a brief test of mental functioning appropriate for adolescents and adults between the ages of 11 and 85 years. It is administered on an individual basis, and measures mental functioning at varying levels of cognitive complexity as well as addressing possible neurological damage.

Kava kava

Kava kava is a dioecious (having male and female reproductive parts of the plant on different individuals) shrub native to the Pacific islands. Its botanical name is Piper methysticum; it is a member of the Piperaceae, or pepper, family.

Kleptomania

Kleptomania is an impulse control disorder characterized by a recurrent failure to resist stealing.

Lamotrigine

Lamotrigine is an anticonvulsant drug commonly used to prevent seizures. It is also used as a mood stabilizer in some people with bipolar (manic-depressive) disorder.

Lavender

Lavender is the shrub-like aromatic plant, Lavandula officinalis, sometimes called Lavandula vera or true lavender.

Learning disorders

Learning disorders, or learning disabilities, are disorders that cause problems in speaking, listening, reading, writing, or mathematical ability.

Light therapy

Light therapy refers to two different categories of treatment, one used in mainstream medical practice and the other in alternative/complementary medicine. Mainstream light therapy (also called phototherapy) includes the use of ultraviolet light to treat psoriasis and other skin disorders, and the use of full-spectrum or bright light to treat seasonal affective disorder(SAD).

Lithium carbonate

Lithium is a naturally occurring element that is classified as an anti-manic drug. It is available in the United States under the brand names Eskalith, Lithonate, Lithane, Lithotabs, and Lithobid.

Lorazepam

Lorazepam, a mild tranquilizer in the class of drugs known as benzodiazepines is a sold in the United States under brand names Alzapam, Ativan, or Loraz. It is also available generically.

Loxapine

Loxapine is a prescription-only drug used to treat serious mental, nervous, and emotional disorders. Loxapine is sold under the brand name Loxitane in the United States.

Luria-Nebraska Neuropsychological Battery

The Luria-Nebraska Neuropsychological Battery, also known as LNNB or Luria-Nebraska Battery, is a standardized test battery used in the screening and evaluation of neuropsychologically impaired individuals.

Magnetic resonance imaging

Magnetic resonance imaging (MRI) is one of the newest diagnostic medical imaging technologies that uses strong magnets and pulses of radio waves to manipulate the natural magnetic properties in the body to generate a visible image. In the field of mental health, an MRI scan may be used when a patient seeks medical help for symptoms that could possibly be caused by a brain tumor.

Major depressive disorder

Major depressive disorder (MDD) is a condition characterized by a long-lasting depressed mood or marked loss of interest or pleasure (anhedonia) in all or nearly all activities. Children and adolescents with MDD may be irritable instead of sad.

Male orgasmic disorder

Male orgasmic disorder may be defined as a persistent or recurrent inability to achieve orgasm despite lengthy sexual contact or while participating in sexual intercourse.

Malingering

The central theme to all definitions of malingering is that the term applies to persons who deliberately pretend to have an illness or disability in order to receive financial or other gain, or to avoid punishment or responsibility.

Managed care

Managed care is a generic term for various health care payment systems that attempt to contain costs by controlling the type and level of services provided. Health maintenance organization (HMO) is a term that is often used synonymously with managed care, but HMOs are actually a particular type of managed care organization.

Manic episode

A discrete period lasting a week or more during which a person experiences mania, an abnormally elevated, cheerful, or euphoric mood.

Maprotiline

Maprotiline is an oral antidepressant. It is a member of the tetracyclic antidepressant family of compounds.

Marital and family therapists

A marriage and family therapist is a person who has received advanced, specialized training and has practiced therapy for an extended period, typically a minimum of 3,000 hours, under the close supervision of a competent, licensed professional. A marital and family counselor must be licensed by passing both written and oral examinations as well as completing continuing education requirements.

Mathematics disorder

Mathematics disorder, formerly called developmental arithmetic disorder, developmental acalculia, or dyscalculia, is a learning disorder in which a person's mathematical ability is substantially below the level normally expected based on his or her age, intelligence, life experiences, educational background, and physical impairments. This disability affects the ability to do calculations as well as the ability to understand word problems and mathematical concepts.

Medication-induced movement disorders

Medication-induced movement disorder occurs due to treatment with antipsychotic medications. Most medication-induced movement disorders are caused by medications that block the action of dopamine, a neurotransmitter that allows communication between two neurons to take place and that is necessary for coordination of movements of different parts of the body.

Meditation

Meditation or contemplation involves focusing the mind upon a sound, phrase, prayer, object, visualized image, the breath, ritualized movements, or consciousness in order to increase awareness of the present moment, promote relaxation, reduce stress, and enhance personal or spiritual growth.

Mental retardation

Mental retardation (MR) is a developmental disability that first appears in children under the age of 18. It is defined as a level of intellectual functioning (as measured by standard intelligence tests) that is well below average and results in significant limitations in the person's daily living skills (adaptive functioning).

Mesoridazine

Mesoridazine is a member of the phenothiazine family of drugs (drugs that reduce the action of the neurotransmitter, dopamine, in the brain) and sold under the brand name Serentil in the United States.

Methadone

Methadone is classified as an opioid (an analgesic that is used for severe pain). In the United States, methadone is also known as dolophine, methenex and methadose.

Methylphenidate

Methylphenidate is a mild, central nervous system stimulant. In the United States, the drug is sold under the brand name Ritalin.

Mini-mental state examination

The mini-mental state examination, which is also known as the MMSE, standardized MMSE, SMMSE, or the Folstein, is a brief examination consisting of eleven questions intended to evaluate an adult patient's level of cognitive functioning. It was introduced in 1975 and designed for use with elderly patients who are able to cooperate at an optimum level with an examiner for only a brief period of time—no more than a few minutes.

Minnesota Multiphasic Personality Inventory

The Minnesota Multiphasic Personality Inventory, known as the MMPI, and its revised second edition (MMPI-2) are psychological assessment instruments completed by the person being evaluated, and scored and interpreted by the examiner. The clinician evaluates the test taker's personal characteristics by comparing the test taker's answers to those given by various psychiatric and nonpsychiatric comparison groups.

Mirtazapine

Mirtazapine is most commonly used to treat depression. Mirtazapine is available in the United States under the trade names of Remeron and Remeron SolTab.

Mixed episode

A mixed episode is a discrete period during which a person experiences nearly daily fluctuations in mood that qualify for diagnoses of manic episode and major depressive episode. Over the course of at least one week, the mood of a person experiencing a mixed episode will rapidly change between abnormal happiness or euphoria and sadness or irritability.

Mixed receptive-expressive language disorder

Mixed receptive-expressive language disorder is diagnosed when a child has problems expressing him-or herself using spoken language, and also has problems understanding what people say to him or her.

Modeling

Modeling, which is also called observational learning or imitation, is a behaviorally based procedure that involves the use of live or symbolic models to demonstrate a particular behavior, thought, or attitude that a client may want to acquire or change. Modeling is sometimes called vicarious learning, because the client need not actually perform the behavior in order to learn it.

Molindone

Molindone is an antipsychotic. It is sold in the United States under the trade name of Moban.

Movement disorders

Movement disorders describe a variety of abnormal movements of the body that have a neurological basis. These abnormal movements are characterized by changes in the coordination and speed of voluntary movement.

Multisystemic therapy

Multisystemic therapy (MST) is an intensive family- and community-based treatment program designed to make positive changes in the various social systems (home, school, community, peer relations) that contribute to the serious antisocial behaviors of children and adolescents who are at risk for out-of-home placement. These out-of-home placements might include foster care, group homes, residential care, correctional facilities, or hospitalization.

Naltrexone

Naltrexone is classified as a pure opiate antagonist. It is sold in the United States under the brand names ReVia and Depade, but is also manufactured and sold under its generic name.

Narcissistic personality disorder

Narcissistic personality disorder (NPD) is defined by the Fourth Edition Text Revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR, a handbook that mental health professionals use to diagnose mental disorders) as one of ten personality disorders. As a group, these disorders are described by DSM-IV-TRas "enduring pattern[s] of inner experience and behavior" that are sufficiently rigid and deep-seated to bring a person into repeated conflicts with his or her social and occupational environment.

Narcolepsy

Narcolepsy is a disorder marked by excessive daytime sleepiness, uncontrollable sleep attacks, and cataplexy (a sudden loss of muscle tone, usually lasting up to half an hour).

Nefazodone

Nefazodone is a prescription antidepressant. Nefazodone is available in the United States under the trade name of Serzone.

Negative symptoms

Negative symptoms are thoughts, feelings, or behaviors normally present that are absent or diminished in a person with a mental disorder.

Neglect

Neglect occurs when a parent or other primary caretaker chooses not to fulfill their obligations to care for, provide for, or adequately supervise and monitor the activities of their child. Parental and caregiving obligations include the physical, emotional, and educational well-being of the child.

Neuropsychological testing

Clinical neuropsychology is a field with historical origins in both psychology and neurology. The primary activity of neuropsychologists is assessment of brain functioning through structured and systematic behavioral observation.

Neurosis

Neurosis is a term generally used to describe a nonpsychotic mental illness which triggers feelings of distress and anxiety and impairs functioning.

Neurotransmitters

Neurotransmitters are chemicals located and released in the brain to allow an impulse from one nerve cell to pass to another nerve cell.

Nicotine and related disorders

Nicotine disorders are caused by the main psychoactive ingredient in tobacco. Nicotine is a physically and psychologically addictive drug.

Nightmare disorder

Nightmare disorder, which is also called dream anxiety disorder, is characterized by the occurrence of repeated dreams during which the sleeper feels threatened and frightened. The sense of fear causes the person to awake.

Nortriptyline

Nortriptyline is a tricyclic antidepressant. It is sold in the United States under the brand names Aventyl and Pamelor, and is also available under its generic name.

Nutrition and mental health

A person's food intake affects mood, behavior, and brain function. A hungry person may feel irritable and restless, whereas a person who has just eaten a meal may feel calm and satisfied.

Nutrition counseling

Nutrition counseling is an ongoing process in which a health professional, usually a registered dietitian, works with an individual to assess his or her usual dietary intake and identify areas where change is needed. The nutrition counselor provides information, educational materials, support, and follow-up to help the individual make and maintain the needed dietary changes.

Obesity

Obesity is the condition of having an excessive accumulation of fat in the body, resulting in a body weight more than 20% above the average for height, age, sex, and body type, and in elevated risk of disability, illness, and death.

Obsession

An obsession is an unwelcome, uncontrollable, and persistent idea, thought, image, or emotion that a person cannot help thinking even though it creates significant distress or anxiety.

Obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is currently classified as an anxiety disorder marked by the recurrence of intrusive or disturbing thoughts, impulses, images or ideas (obsessions) accompanied by repeated attempts to suppress these thoughts through the performance of certain irrational and ritualistic behaviors or mental acts (compulsions). The obsessions and compulsions take up large amounts of the patient's time (an hour or longer every day) and usually cause significant emotional distress for the patient and difficulties in his or her relationships with others.

Obsessive-compulsive personality disorder

Obsessive-compulsive personality disorder (OCPD) is a type of personality disorder marked by rigidity, control, perfectionism, and an overconcern with work at the expense of close interpersonal relationships. Persons with this disorder often have trouble relaxing because they are preoccupied with details, rules, and productivity.

Olanzapine

Olanzapine is classified as an atypical antipsychotic drug. It is available in the United States under the brand names Zyprexa and Zyprexa Zydis.

Opioids and related disorders

Opioids are a class of drugs that include both natural and synthetic substances. The natural opioids (referred to as opiates) include opium and morphine.

Oppositional defiant disorder

Oppositional defiant disorder (ODD) is a disorder found primarily in children and adolescents. It is characterized by negative, disobedient, or defiant behavior that is worse than the normal "testing" behavior most children display from time to time.

Origin of mental illnesses

Over the history of the healing arts, there has been an evolution of theories regarding the root causes of mental illness. Early writings from such ancient civilizations as those of Greece, Rome, India, and Egypt focused on demonic possession as the cause.

Oxazepam

Oxazepam is a member of a family of tranquilizers known as benzodiazepines. It is sold in the United States under the brand name Serax and in Canada under the brand name Ox-Pam.

Pain disorder

Pain disorder is one of several somatoform disorders described in the revised, fourth edition of the mental health professional's handbook, the Diagnostic and Statistical Manual of Mental Disorders(known asDSM-IV-TR). The term "somatoform" means that symptoms are physical but are not entirely understood as a consequence of a general medical condition or as a direct effects of a substance, such as a drug.

Panic attack

Panic attacks, the hallmark of panic disorder, are discrete episodes of intense anxiety. Panic attacks can also be experienced by people with specific phobia, social phobia, or by people who have used or consumed certain substances, such as cocaine.

Panic disorder

Panic disorder is a condition in which the person with the disorder suffers recurrent panic attacks. Panic attacks are sudden attacks that are not caused by a substance (like caffeine), medication, or by a medical condition (like high blood pressure), and during the attack, the sufferer may experience sensations such as accelerated or irregular heartbeats, shortness of breath, dizziness, or a fear of losing control or "going crazy." The sudden attack builds quickly (usually within 10 minutes) and is almost paralyzing in its severity.

Paranoia

Paranoia is a symptom in which an individual feels as if the world is "out to get" him or her. When people are paranoid, they feel as if others are always talking about them behind their backs.

Paranoid personality disorder

People with paranoid personality disorder (PPD) have long-term, widespread and unwarranted suspicions that other people are hostile, threatening or demeaning. These beliefs are steadfastly maintained in the absence of any real supporting evidence.

Paraphilias

Paraphilias are sexual feelings or behaviors that may involve sexual partners that are not human, not consenting, or that involve suffering by one or both partners.

Parent management training

Parent management training (PMT) is an adjunct to treatment that involves educating and coaching parents to change their child's problem behaviors using principles of learning theory and behavior modification.

Paroxetine

Paroxetine is an antidepressant of the type known as selective serotonin reuptake inhibitors (SSRI). It is sold in the United States under the brand name Paxil.

Passionflower

Passionflower (Passiflora incarnata) is a vine whose leaves and flowers are widely used in Europe to make a herbal remedy for anxiety and insomnia. The plant, which is native to the tropical regions of North America, was first used by the Aztecs of Mexico as a folk remedy for these conditions.

Pathological gambling disorder

Pathological gambling disorder occurs when a person gambles compulsively to such an extent that the wagering has a severe negative effect on his or her job, relationships, mental health, or other important aspects of life. The person may continue to gamble even after they have developed social, economic, interpersonal, or legal problems as a result of the gambling.

Pedophilia

Pedophilia is a paraphilia that involves an abnormal interest in children. A paraphilia is a disorder that is characterized by recurrent intense sexual urges and sexually arousing fantasies generally involving: nonhuman objects; the suffering or humiliation of oneself or one's partner (not merely simulated); or animals, children, or other nonconsenting persons.

Peer groups

Peer groups are an important influence throughout one's life, but they are more critical during the developmental years of childhood and adolescence. There is often controversy about the influence of a peer group versus parental influence, particularly during adolescence.

Pemoline

Pemoline is classified as a central nervous system (CNS) stimulant. It is sold in the United States under the brand names Cylert and PemADD and is also available under its generic name.

Perphenazine

Perphenazine is a phenothiazine antipsychotic used to treat serious mental disorders. It has also been used to treat severe nausea and vomiting.

Personality disorders

Long-standing, deeply ingrained patterns of social behavior that are detrimental to those who display them or to others.

Person-centered therapy

Person-centered therapy, which is also known as client-centered, non-directive, or Rogerian therapy, is an approach to counseling and psychotherapy that places much of the responsibility for the treatment process on the client, with the therapist taking a nondirective role.

Pervasive developmental disorders

Pervasive developmental disorders are a group of conditions originating in childhood that involve serious impairment in several areas, including physical, behavioral, cognitive, social, and language development.

Phencyclidine and related disorders

Phencyclidine (PCP) is a street drug known as "angel dust" that causes physiological changes to the nervous and circulatory system, disturbances in thinking and behavior, and can cause hallucinations, psychotic disorder, mood disorder, and anxiety disorder.

Phenelzine

Phenelzine is classified as a monoamine oxidase (MAO) inhibitor. In the United States, phenelzine is sold under the brand name Nardil.

Phonological disorder

Phonological disorder occurs when a child does not develop the ability to produce some or all sounds necessary for speech that are normally used at his or her age.

Pica

Pica is a term that refers to cravings for substances that are not foods. Materials consumed by patients with pica include dirt, ice, clay, glue, sand, chalk, beeswax, chewing gum, laundry starch, and hair.

Pimozide

Pimozide is an atypical antipsychotic drug used to treat serious motor and verbal tics associated with Tourette's syndrome. It is sold under the brand name Orap.

Play therapy

Play therapy refers to a method of psychotherapy with children in which a therapist uses a child's fantasies and the symbolic meanings of his or her play as a medium for understanding and communication with the child.

Polysomnography

Polysomnography is a series of tests performed on patients while they sleep. Polysomnography is a comprehensive overnight procedure that evaluates sleep disorders.

Polysubstance dependence

Polysubstance dependence refers to a type of substance dependence disorder in which an individual uses at least three different classes of substances indiscriminately and does not have a favorite drug that qualifies for dependence on its own.

Positive symptoms

Positive symptoms are thoughts, behaviors, or sensory perceptions present in a person with a mental disorder, but not present in people in the normal population.

Positron emission tomography

Positron emission tomography (PET) is a highly specialized imaging technique using short-lived radiolabeled substances to produce extremely high resolution images of the body's biological function.

Postpartum depression

Postpartum depression is a depression that can range from mild to suicidal and can occur anytime after delivery up to one year later.

Post-traumatic stress disorder

Post-traumatic stress disorder, often abbreviated as PTSD, is a complex disorder in which the affected person's memory, emotional responses, intellectual processes, and nervous system have all been disrupted by one or more traumatic experiences. It is sometimes summarized as "a normal reaction to abnormal events." The DSM-IV-TR(the professional's diagnostic manual) classifies PSTD as an anxiety disorder.

Premature ejaculation

Premature ejaculation (PE) refers to the persistent or recurrent discharge of semen with minimal sexual stimulation before, on, or shortly after penetration, before the person wishes it, and earlier than he expects it. In making the diagnosis of PE, the clinician must take into account factors that affect the length of time that the man feels sexually excited.

Propranolol

Propranolol is classified as a beta blocker. It is sold in the United States under the brand name Inderal.

Protriptyline

Protriptyline is an oral tricyclic antidepressant. It is sold in the United States under the brand name Vivactil and is also available under its generic name.

Pseudocyesis

Pseudocyesis is the medical term for a false pregnancy. Pseudocyesis can cause many of the signs and symptoms of pregnancy, and often resembles the condition in every way except for the presence of a fetus.

Psychiatrist

A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders.

Psychoanalysis

Psychoanalysis, as a form of therapy, is based on the understanding that human beings are largely unaware of the mental processes that determine their thoughts, feelings, and behavior, and that psychological suffering can be alleviated by making those processes known to the individual.

Psychodynamic psychotherapy

Psychodynamic psychotherapy is a method of verbal communication used to help a person find relief from emotional pain. It is based on the theories and techniques of psychoanalysis.

Psychologist

A psychologist is a social scientist who studies behavior and mental processes, generally in a research or clinical setting.

Psychosis

Psychosis is a symptom of mental illness characterized by a radical change in personality and a distorted or diminished sense of objective reality.

Psychosurgery

Psychosurgery is the treatment of a psychiatric disorder using surgical techniques to destroy brain tissue and is now rarely used.

Psychotherapy

The treatment of mental or emotional disorders and adjustment problems through the use of psychological techniques rather than through physical or biological means.

Psychotherapy integration

Psychotherapy integration is defined as an approach to psychotherapythat includes a variety of attempts to look beyond the confines of single-school approaches in order to see what can be learned from other perspectives. It is characterized by an openness to various ways of integrating diverse theories and techniques.

Pyromania

Pyromania is defined as a pattern of deliberate setting of fires for pleasure or satisfaction derived from the relief of tension experienced before the fire-setting. The name of the disorder comes from two Greek words that mean "fire" and "loss of reason" or "madness." The clinician's handbook, the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM, classifies pyromania as a disorder of impulse control, meaning that a person diagnosed with pyromania fails to resist the impulsive desire to set fires—as opposed to the organized planning of an arsonist or terrorist.

Quazepam

Quazepam belongs to a class of drugs called benzodiazepines. These drugs ease anxiety and slow the central nervous system.

Quetiapine

Quetiapine is an atypical antipsychotic drug used to treat symptoms of schizophrenia. It is available with a prescription under the trade name Seroquel.

Rational emotive therapy

Rational emotive therapy (RET) is a psychotherapeutic approach which proposes that unrealistic and irrational beliefs cause many emotional problems.

Reactive attachment disorder of infancy or early childhood

In reactive attachment disorder, the normal bond between infant and parent is not established or is broken. Infants normally "bond" or form an emotional attachment, to a parent or other caregiver by the eighth month of life.

Reading disorder

Reading disorder is a learning disorder that involves significant impairment of reading accuracy, speed, or comprehension to the extent that the impairment interferes with academic achievement or activities of daily life. People with reading disorder perform reading tasks well below the level one would expect on the basis of their general intelligence, educational opportunities, and physical health.

Reinforcement

A reinforcer is a stimulus that follows some behavior and increases the probability that the behavior will occur. For example, when a dog's owner is trying to teach the dog to sit on command, the owner may give the dog a treat every time the dog sits when commanded to do so.

Relapse and relapse prevention

In the course of illness, relapse is a return of symptoms after a period of time when no symptoms are present. Any strategies or treatments applied in advance to prevent future symptoms are known as relapse prevention.

Respite

Respite literally means a period of rest or relief. Respite care provides a caregiver temporary relief from the responsibilities of caring for individuals with chronic physical or mental disabilities.

Rett's disorder

Rett's disorder, which is also known as Rett's syndrome or RS, belongs to a group of childhood disorders known as pervasive developmental disorders(PDDs) or autistic spectrum disorders. It is classified by the mental health professional's handbook (the Diagnostic and Statistical Manual of Mental Disordersor the DSM-IV-TR) as a developmental disorder of childhood.

Risperidone

Risperidone is classified as an atypical antipsychotic drug. It is sold in the United States under the brand name of Risperdal.

Rivastigmine

Rivastigmine is a drug used to treat symptoms of Alzheimer's disease. In the United States, rivastigmine is sold as the brand name drug Exelon.

Rorschach technique

The Rorschach technique, sometimes known as the Rorschach test or the inkblot test, is a projective personality assessment based on the test taker's reactions to a series of 10 inkblot pictures.

Rosemary

Rosemary is an herb derived from an evergreen shrub, Rosmarinus officinalis, related to the mint or Lamiaceae family of plants. Rosemary is a native of the Mediterranean regions of Europe and the Near East; Tunisia is a major modern-day source of the plant.

Rumination disorder

Rumination disorder may be diagnosed when a person deliberately brings food back up into the mouth and either rechews and reswallows it or spits it out.

SAMe

SAMe (or S-adenosyl-L-methionine) is a naturally occurring chemical that is found throughout the entire body. It is involved in many chemical reactions that are necessary for life.

Schizoaffective disorder

One of the most challenging mental disorders to identify accurately and treat appropriately is schizoaffective disorder. This condition involves both psychotic symptoms and conspicuous, long-enduring, severe symptoms of mood disorder.

Schizoid personality disorder

Schizoid personality disorder is characterized by a persistent withdrawal from social relationships and lack of emotional responsiveness in most situations. It is sometimes referred to as a "pleasure deficiency" because of the seeming inability of the person affected to experience joyful or pleasurable responses to life situations.

Schizophrenia

Schizophrenia is the most chronic and disabling of the severe mental disorders, associated with abnormalities of brainstructure and function, disorganized speech and behavior, delusions, and hallucinations. It is sometimes called a psychotic disorder or a psychosis.

Schizophreniform disorder

Schizophreniform disorder (SFD) is a time-limited illness wherein the sufferer has experienced at least two of the major symptoms of psychosisfor longer than one month but fewer than six months. Hallucinations, delusions, and strange bodily movements or lack of movements (catatonic behavior) are all symptoms that may be observed.

Schizotypal personality disorder

Schizotypal personality disorder is characterized by an ongoing pattern in which the affected person distances him- or herself from social and interpersonal relationships. Affected people typically have an acute discomfort when put in circumstances where they must relate to others.

Seasonal affective disorder

Seasonal affective disorder, often abbreviated as SAD, is a type of mood disorder that follows an annual pattern consistent with the seasons. The most common course for SAD includes an onset of depressive symptoms late in the fall, continuation of symptoms throughout winter, and remission of symptoms in the spring.

Sedatives and related disorders

Sedatives are compounds that cause physiological and mental slowing of the body. They have many legitimate medical uses.

Seizures

A seizure is a sudden change in behavior characterized by changes in sensory perception (sense of feeling) or motor activity (movement) due to an abnormal firing of nerve cells in the brain. Epilepsy is a condition characterized by recurrent seizures that may include repetitive muscle jerking called convulsions.

Selective mutism

Selective mutism is a childhood disorder in which a child does not speak in some social situations although he or she is able to talk normally at other times.

Self-control strategies

Self-control strategies are cognitive and behavioral skills used by individuals to maintain self-motivation and achieve personal goals. Initially the skills may be learned from a therapist, text, or self-help book.

Self-help groups

Self-help groups—also called mutual help or mutual aid groups—are composed of peers who share a similar mental, emotional, or physical problem, or who are interested in a focal issue, such as education or parenting. Historically, people banded together to improve their chances for survival by pooling their social and economic resources; however, contemporary groups are more likely to organize around a theme or problem.

Separation anxiety disorder

Like many childhood concerns, separation anxiety is normal at certain developmental stages. For example, when a child between the ages of eight and 14 months is separated from her mother or other primary caretaker, she may experience distress.

Sertraline

Sertraline is an antidepressant that belongs to the class of drugs called selective serotonin reuptake inhibitors (SSRIs). In the in United States it is sold under the brand name Zoloft.

Sexual aversion disorder

Sexual aversion disorder is a disorder characterized by disgust, fear, revulsion, or lack of desire in consensual relationships involving genital contact.

Sexual dysfunctions

Sexual dysfunction disorders are problems that interfere with the initiation, consummation, or satisfaction with sex. They occur in both men and women and are independent of sexual orientation.

Sexual masochism

The essential feature of sexual masochism is the feeling of sexual arousal or excitement resulting from receiving pain, suffering, or humiliation. The pain, suffering, or humiliation is real and not imagined and can be physical or psychological in nature.

Sexual sadism

The essential feature of sexual sadism is a feeling of sexual excitement resulting from administering pain, suffering, or humiliation to another person. The pain, suffering, or humiliation inflicted on the other is real; it is not imagined and may be either physical or psychological in nature.

Sexual Violence Risk-20

The Sexual Violence Risk-20, also called the SVR-20, is an assessment instrument used by mental health professionals.

Shared psychotic disorder

Shared psychotic disorder, a rare and atypical psychotic disorder, occurs when an otherwise healthy person (secondary partner) begins believing the delusions of someone with whom they have a close relationship (primary partner) who is already suffering from a psychotic disorder with prominent delusions.

Single photon emission computed tomography

Single photon emission computed tomography (SPECT) is an imaging study that uses radioactive materials injected through a vein that will pass into the brain generating a high-resolution brain image.

Sleep disorders

Sleep disorders are chronic disturbances in the quantity or quality of sleep that interfere with a person's ability to function normally.

Sleep terror disorder

Sleep terror disorder is defined as repeated temporary arousal from sleep, during which the affected person appears and acts extremely frightened.

Sleepwalking disorder

Sleepwalking disorder, also called somnambulism, is characterized by repeating episodes of motor activity during sleep such as sitting up in bed, rising, and walking around, among others. The person appears to be awake because their eyes are usually open and they can maneuver around objects, but is considered asleep.

Social phobia

Social phobia is defined by DSM-IV-TRas an anxiety disorder characterized by a strong and persistent fear of social or performance situations in which the patient might feel embarrassment or humiliation. Generalized social phobia refers to a fear of most social interactions combined with fear of most performance situations, such as speaking in public or eating in a restaurant.

Social skills training

Social skills training (SST) is a form of behavior therapy used by teachers, therapists, and trainers to help persons who have difficulties relating to other people.

Social workers

A social worker is a helping professional who is distinguished from other human service professionals by a focus on both the individual and his or her environment. Generally, social workers have at least a bachelor's degree from an accredited education program and in most states they must be licensed, certified, or registered.

Somatization and somatoform disorders

Somatization is a term that describes the expression of psychological or mental difficulties through physical symptoms. Somatization takes a number of forms, ranging from preoccupation with potential or genuine but mild physical problems to the development of actual physical pain, discomfort, or dysfunction.

Somatization disorder

Somatization disorder is a psychiatric condition marked by multiple medically unexplained physical, or somatic, symptoms. In order to qualify for the diagnosisof somatization disorder, somatic complaints must be serious enough to interfere significantly with a person's ability to perform important activities, such as work, school or family and social responsibilities, or lead the person experiencing the symptoms to seek medical treatment.

Specific phobias

Specific phobia is a type of disorder in which the affected individual displays a marked and enduring fear of specific situations or objects. Individuals with specific phobias experience extreme fear as soon as they encounter a defined situation or object, a phobic stimulus.

Speech-language pathology

Speech-language pathology is the treatment for the improvement or cure of communication disorders, including speech, language, and swallowing disorders. The term used to describe professionals in this discipline is speech and language pathologist (SLP).

St. John's wort

St. John's wort is a perennial, yellow-flowering plant that grows in the wild throughout Europe and is now found also in North America.

Stanford-Binet Intelligence Scale

The Stanford-Binet Intelligence Scale: Fourth Edition (SB: FE) is a standardized test that measures intelligence and cognitive abilities in children and adults, from age two through mature adulthood.

Stereotypic movement disorder

Stereotypic movement disorder is a disorder characterized by repeated, rhythmic, purposeless movements or activities such as head banging, nail biting, or body rocking. These movements either cause self-injury or severely interfere with normal activities.

Stigma

The 1999 report on mental health by the Surgeon General of the United States was regarded as a landmark document in the United Kingdom, as well as the United States. This was because of its straightforward identification of the stigma associated with mental illness as the chief obstacle to effective treatment of persons with mental disorders.

Stress

Stress is a term that refers to the sum of the physical, mental, and emotional strains or tensions on a person. Feelings of stress in humans result from interactions between persons and their environment that are perceived as straining or exceeding their adaptive capacities and threatening their well-being.

Stroke

A stroke, also called a cerebral vascular accident (CVA), is the sudden death of cells in a specific area of the braindue to inadequate blood flow.

Stuttering

There is no standard definition of stuttering, but most attempt to define stuttering as the blockages, discoordination, or fragmentations of the forward flow of speech (fluency). These stoppages, referred to as disfluencies, are often excessive and characterized by specific types of disfluency.

Substance abuse and related disorders

Substance-related disorders are disorders of intoxication, dependence, abuse, and substance withdrawal caused by various substances, both legal and illegal. These substances include: alcohol, amphetamines, caffeine, inhalants, nicotine, prescription medications that may be abused (such as sedatives), opioids (morphine, heroin), marijuana (cannabis), cocaine, hallucinogens, and phencyclidine (PCP).

Substance Abuse Subtle Screening Inventory

The Substance Abuse Subtle Screening Inventory is also referred to as the SASSI. Dr.

Substance-induced anxiety disorder

Prominent anxiety symptoms (i.e., generalized anxiety, panic attacks, obsessive-compulsive symptoms, or phobia symptoms) determined to be caused by the effects of a psychoactive substance is the primary feature of a substance-induced psychotic disorder. A substance may induce psychotic symptoms during intoxication (i.e., while the individual is under the influence of the drug) or during withdrawal (i.e., after an individual stops using the drug).

Substance-induced psychotic disorder

Prominent psychotic symptoms (i.e., hallucinationsand/or delusions) determined to be caused by the effects of a psychoactive substance is the primary feature of a substance-induced psychotic disorder. A substance may induce psychotic symptoms during intoxication (while the individual is under the influence of the drug) or during withdrawal (after an individual stops using the drug).

Suicide

Suicide is defined as the intentional taking of one's own life. In some European languages, the word for suicide translates into English as "self-murder " Until the end of the twentieth century, approximately, suicide was considered a criminal act; legal terminology used the Latin phrase felo-de-se, which means "a crime against the self." Much of the social stigmathat is still associated with suicide derives from its former connection with legal judgment, as well as with religious condemnation.

Support groups

Support groups are an informal resource that attempts to provide healing components to a variety of problems and challenges. An informal support outside of family, friends, or professionals often provides greater understanding, more similarity (from individuals experiencing similar life events), an opportunity for empathy and altruism, and a sense of identity for participants.

Systematic desensitization

Systematic desensitization is a technique used to treat phobias and other extreme or erroneous fears based on principles of behavior modification.

Tacrine

Tacrine is a drug used to treat dementiaassociated with Alzheimer's disease. In the United States tacrine is sold under the brand name drug Cognex.

Talk therapy

Talk therapy is an alternate name for the various forms of psychotherapy that emphasize the importance of the client or patient speaking to the therapist as the main means of expressing and resolving issues.

Tardive dyskinesia

Tardive dyskinesia is a neurological disorder consisting of abnormal, involuntary body movements caused by certain medicines. It is usually associated with long-term use of medicines for treating schizophreniaand other psychotic disorders.

Temazepam

Temazepam is a drug that belongs to a family of drugs known as benzodiazepines. Temazepam is sold under the brand name Restoril in the United States.

Thematic Apperception Test

The Thematic Apperception Test, or TAT, is a projective measure intended to evaluate a person's patterns of thought, attitudes, observational capacity, and emotional responses to ambiguous test materials. In the case of the TAT, the ambiguous materials consist of a set of cards that portray human figures in a variety of settings and situations.

Thioridazine

Thioridazine is a potent antianxiety and antipsychotic agent. It is a member of the phenothiazine family of compounds.

Thiothixene

Thiothixene is in a class of drugs called antipsychotics. It is available with a prescription under the generic name of thiothixene or the brand name Navane.

Tic disorders

Tic disorders are characterized by the persistent presence of tics, which are abrupt, repetitive involuntary movements and sounds that have been described as caricatures of normal physical acts. The best known of these disorders is Tourette's disorder, or Tourette's syndrome.

Token economy system

A token economy is a form of behavior modificationdesigned to increase desirable behavior and decrease undesirable behavior with the use of tokens. Individuals receive tokens immediately after displaying desirable behavior.

Transvestic fetishism

Transvestic fetishismis defined by the mental health professional's handbook, the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (2000), which is also called DSM-IV-TR, as one of the paraphilias. The paraphilias are a group of mental disorders characterized by obsessionwith unusual sexual practices or with sexual activity involving nonconsenting or inappropriate partners (such as children or animals).

Tranylcypromine

Tranylcypromine is classified as a monoamine oxidase (MAO) inhibitor. It is used to treat serious depression.

Trazodone

Trazodone is an oral antidepressant. It is sold in the United States under the brand name Desyrel and is also available under its generic name.

Triazolam

Triazolam is a hypnotic drug. It is a member of the benzodiazepine family of drugs.

Trichotillomania

Individuals with trichotillomania repetitively pull out their own hair. Trichotillomania as an impulse-control disorder.

Trifluoperazine

Trifluoperazine is a phenothiazine antipsychotic agent. In the United States, this drug is sold under the brand name Stelazine.

Trihexyphenidyl

Trihexyphenidyl is classified as an antiparkinsonian agent. It is sold in the United States under the brand name Artane and is also available under its generic name.

Trimipramine

Trimipramine is an oral tricyclic antidepressant. It is sold in the United States under the brand name Surmontil.

Undifferentiated somatoform disorder

Undifferentiated somatoform disorder occurs when a person has physical complaints for more than six months that cannot be attributed to a medical condition. If there is a medical condition present, the complaints must be far more severe than can be accounted for by the presence of the medical problem.

Urine drug screening

Urine drug screening, or toxicological screening, is a process of chemical analysis designed to test patients for drug abuse, or to insure that a patient is substance-free before undergoing a medical procedure.

Vaginismus

Vaginismus occurs when the muscles around the outer third of the vagina contract involuntarily when vaginal penetration is attempted during sexual intercourse.

Valerian

Valerian is an herbal remedy derived from the dried roots of the valerian plant, Valeriana officinalis. The plant belongs to the Valerianaceae family.

Valproic acid

Valproic acid is an anticonvulsant (anti-seizure) drug. In the United States, valproic acid is also known as valproate, and is sold under the brand name Depakene.

Vascular dementia

Dementia is a decline in a person's mental capacities and intellectual abilities that is great enough to affect the person's normal daily functioning. Vascular dementia is dementia that is caused by disease of the blood vessels of the brain (cerebrovascular disease).

Venlafaxine

Venlafaxine is an antidepressant available in the United States under the trade name of Effexor or Effexor XR.

Vocational rehabilitation

Vocational rehabilitation (VR) is a set of services offered to individuals with mental or physical disabilities. These services are designed to enable participants to attain skills, resources, attitudes, and expectations needed to compete in the interview process, get a job, and keep a job.

Voyeurism

Voyeurism is a psychosexual disorder in which a person derives sexual pleasure and gratification from looking at the naked bodies and genital organs or observing the sexual acts of others. The voyeur is usually hidden from view of others.

Wechsler adult intelligence scale

The Wechsler adult intelligence scale (WAIS) is an individually administered measure of intelligence, intended for adults aged 16–89.

Wechsler Intelligence Scale for Children

The Wechsler Intelligence Scale for Children, often abbreviated as WISC, is an individually administered measure of intelligence intended for children aged six years to 16 years and 11 months.

Wernicke-Korsakoff syndrome

Wernicke-Korsakoff syndrome is a severe memory disorder usually associated with chronic excessive alcohol consumption, although the direct cause is a deficiency in the B vitamin thiamin.

Wide Range Achievement Test

Wide Range Achievement Test, 3rd ed. or WRAT-3 is a screening test that can be administered to determine if a more comprehensive achievement test is needed.

Yoga

Yoga is an ancient system of breathing practices, physical exercises and postures, and meditation intended to integrate the practitioner's body, mind, and spirit. It originated in India several thousand years ago, and its principles were first written down by a scholar named Patanjali in the second century B.C.

Zaleplon

Zaleplon is classified as a hypnotic drug. These drugs help people sleep.

Ziprasidone

Ziprasidone is a drug used to treat schizophrenia. It is available with a prescription under the brand name Geodan.

Zolpidem

Zolpidem is classified as a hypnotic drug. These drugs help people sleep.

mental illness

2008-08-13T14:32:00.000-07:00

Mental disorder or mental illness is a psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as part of normal development or culture. The recognition and understanding of mental disorders has changed over time and across cultures. Definitions, assessments, and classifications of mental disorders can vary, but guideline criterion listed in the ICD, DSM and other manuals are widely accepted by mental health professionals. Categories of diagnoses in these schemes may include dissociative disorders, mood disorders, anxiety disorders, psychotic disorders, eating disorders, developmental disorders, personality disorders, and many other categories. In many cases there is no single accepted or consistent cause of mental disorders, although they are often explained in terms of a diathesis-stress model and biopsychosocial model. Mental disorders have been found to be common, with over a third of people in most countries reporting sufficient criteria at some point in their life. Mental health services may be based in hospitals or in the community. Mental health professionals diagnose individuals using different methodologies, often relying on case history and interview. Psychotherapy and psychiatric medication are two major treatment options, as well as supportive interventions. Treatment may be involuntary where legislation allows. Several movements campaign for changes to mental health services and attitudes, including the Consumer/Survivor Movement. There are widespread problems with stigma and discrimination.

History

Eight women representing prominent mental diagnoses in the nineteenth century.

Main article: History of mental disorders

Ancient civilisations described and treated a number of mental disorders. The Greeks coined terms for melancholy, hysteria and phobia and developed humorism theory. Psychiatric theories and treatments developed in Persia, Arabia and the Muslim Empire, particularly in the medieval Islamic world from the 8th century, where the first psychiatric hospitals were built. Conceptions of madness in the Middle Ages in Christian Europe were a mixture of the divine, diabolical, magical and humoral, as well as more down to earth considerations. In the early modern period, some people with mental disorders may have been victims of the witch-hunts but were increasingly admitted to local workhouses and jails or sometimes to private madhouses. Many terms for mental disorder that found their way into everyday use first became popular the 16th and 17th centuries. By the end of the 17th century and into the enlightenment, madness was increasingly seen as an organic physical phenomenon with no connection to the soul or moral responsibility. Asylum care was often harsh and treated people like wild animals, but towards the end of the 18th century a moral treatment movement gradually developed. Clear descriptions of some syndromes may be relatively rare prior to the 1800s. Industrialization and population growth led to a massive expansion of the number and size of insane asylums in every Western country in the 19th century. Numerous different classification schemes and diagnostic terms were developed by different authorities, and the term psychiatry was coined, though medical superintendents were still known as alienists.

The turn of the 20th century saw the development of psychoanalysis, which would later come to the fore, along with Kraepelin's classification scheme. Asylum "inmates" were increasingly referred to as "patients" and asylums renamed as hospitals. In the United States, a mental hygiene movement aimed to prevent mental disorders. Clinical psychology and social work developed as professions. World War I saw a massive increase of conditions that came to be termed "shell shock". World War II saw the development in the US of a new psychiatric manual for categorizing mental disorders, which along with existing systems for collecting census and hospital statistics led to the first Diagnostic and Statistical Manual of Mental Disorders (DSM). The International Classification of Diseases (ICD) followed suit with a section on mental disorders. The term stress, having emerged out of endocrinology work in the 1930s, was increasingly applied to mental disorders. Electro convulsive therapy, Insulin shock therapy and lobotomies and the "neuroleptic" chlorpromazine came in to use mid-century. An antipsychiatry movement came to the fore in the 1960s. Deinstitutionalization gradually occurred in the West, with isolated psychiatric hospitals being closed down in favor of community mental health services. A consumer/survivor movement gained momentum. Other kinds of psychiatric medication gradually came into use, such as "psychic energizers" and lithium. Benzodiazepines gained widespread use in the 1970s for anxiety and depression, until dependency problems curtailed their popularity. Advances in neuroscience and genetics led to new research agendas. Cognitive behavioral therapy was developed. The DSM and then ICD adopted new criteria-based classifications, and the number of "official" diagnoses saw a large expansion. Through the 1990s, new SSRI antidepressants became some of the most widely prescribed drugs in the world. A recovery model developed.

Classification

Main article: Classification of mental disorders

The definition and classification of mental disorder is a key issue for the mental health professions and for users and providers of mental health services. Most international clinical documents use the term "mental disorder" rather than "mental illness". There is no single definition and the inclusion criteria are said to vary depending on the social, legal and political context. In general, however, a mental disorder has been characterized as a clinically significant behavioral or psychological pattern that occurs in an individual and is usually associated with distress, disability or increased risk of suffering. There is often a criterion that a condition should not be expected to occur as part of a person's usual culture or religion. The term "serious mental illness" (SMI) is sometimes used to refer to more severe and long-lasting disorder. A broad definition can cover mental disorder, mental retardation, personality disorder and substance dependence. The phrase "mental health problems" may be used to refer only to milder or more transient issues.

There are currently two widely established systems that classify mental disorders - Chapter V of the International Classification of Diseases (ICD-10), produced by the World Health Organization (WHO), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) produced by the American Psychiatric Association (APA). Both list categories of disorder and provide standardized criteria for diagnosis. They have deliberately converged their codes in recent revisions so that the manuals are often broadly comparable, although significant differences remain. Other classification schemes may be in use more locally, for example the Chinese Classification of Mental Disorders. Other manuals may be used by those of alternative theoretical persuasions, for example the Psychodynamic Diagnostic Manual.

Some approaches to classification do not employ distinct categories based on cut-offs separating the abnormal from the normal. They are variously referred to as spectrum, continuum or dimensional systems. There is a significant scientific debate about the relative merits of a categorical or a non-categorical system. There is also significant controversy about the role of science and values in classification schemes, and about the professional, legal and social uses to which they are put.

Disorders

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There are many different categories of mental disorder, and many different facets of human behavior and personality that can become disordered.^[1]^[2]^[3]^[4]

The state of anxiety or fear can become disordered, so that it is unusually intense or generalized over a prolonged period of time. Commonly recognized categories of anxiety disorders include specific phobia, Generalized anxiety disorder, Social Anxiety Disorder, Panic Disorder, Agoraphobia, Obsessive-Compulsive Disorder, Post-traumatic stress disorder. Relatively long lasting affective states can also become disordered. Mood disorder involving unusually intense and sustained sadness, melancholia or despair is know as Clinical depression (or Major depression), and may more generally be described as Emotional dysregulation. Milder but prolonged depression can be diagnosed as dysthymia. Bipolar disorder involves abnormally "high" or pressured mood states, known as mania or hypomania, alternating with normal or depressed mood. Whether unipolar and bipolar mood phenomena represent distinct categories of disorder, or whether they usually mix and merge together along a dimension or spectrum of mood, is under debate in the scientific literature.^[5]

Patterns of belief, language use and perception can become disordered. Psychotic disorders centrally involving this domain include Schizophrenia and Delusional disorder. Schizoaffective disorder is a category used for individuals showing aspects of both schizophrenia and affective disorders. Schizotypy is a category used for individuals showing some of the traits associated with schizophrenia but without meeting cut-off criteria.

The fundamental characteristics of a person that influence his or her cognitions, motivations, and behaviors across situations and time - can be seen as disordered due to being abnormally rigid and maladaptive. Categorical schemes list a number of different personality disorders, such as those classed as eccentric (e.g. Paranoid personality disorder, Schizoid personality disorder, Schizotypal personality disorder), those described as dramatic or emotional (Antisocial personality disorder, Borderline personality disorder, Histrionic personality disorder, Narcissistic personality disorder) or those seen as fear-related (Avoidant personality disorder, Dependent personality disorder, Obsessive-compulsive personality disorder).

There may be an emerging consensus that personality disorders, like personality traits in the normal range, incorporate a mixture of more acute dysfunctional behaviors that resolve in relatively short periods, and maladaptive temperamental traits that are relatively more stable.^[6] Non-categorical schemes may rate individuals via a profile across different dimensions of personality that are not seen as cut off from normal personality variation, commonly through schemes based on the Big Five personality traits.^[7]

Other disorders may involve other attributes of human functioning. Eating practices can be disordered, at least in relatively rich industrialized areas, with either compulsive over-eating or under-eating or binging. Categories of disorder in this area include Anorexia nervosa, Bulimia nervosa, Exercise Bulimia or Binge eating disorder. Sleep disorders such as Insomnia also exist and can disrupt normal sleep patterns. Sexual and gender identity disorders, such as Dyspareunia or Gender identity disorder or ego-dystonic homosexuality. People who are abnormally unable to resist urges, or impulses, to perform acts that could be harmful to themselves or others, may be classed as having an impulse control disorder, including various kinds of Tic disorders such as Tourette's Syndrome, and disorders such as Kleptomania (stealing) or Pyromania (fire-setting). Substance-use disorders include Substance abuse disorder. Addictive gambling may be classed as a disorder. Inability to sufficiently adjust to life circumstances may be classed as an Adjustment disorder. The category of adjustment disorder is usually reserved for problems beginning within three months of the event or situation and ending within six months after the stressor stops or is eliminated. People who suffer severe disturbances of their self-identity, memory and general awareness of themselves and their surroundings may be classed as having a Dissociative identity disorder, such as Depersonalization disorder or Dissociative Identify Disorder itself (which has also been called multiple personality disorder, or "split personality".). Factitious disorders, such as Munchausen syndrome, also exist where symptoms are experienced and/or reported for personal gain.

Disorders appearing to originate in the body, but thought to be mental, are known as somatoform disorders, including Somatization disorder. There are also disorders of the perception of the body, including Body dysmorphic disorder. Neurasthenia is a category involving somatic complaints as well as fatigue and low spirits/depression, which is officially recognized by the ICD-10 but not by the DSM-IV.^[8] Memory or cognitive disorders, such as amnesia or Alzheimer's disease exist.

Some disorders are thought to usually first occur in the context of early childhood development, although they may continue into adulthood. The category of Specific developmental disorder may be used to refer to circumscribed patterns of disorder in particular learning skills, motor skills, or communication skills. Disorders which appear more generalized may be classed as pervasive developmental disorders (PDD) also known as autism spectrum disorders (ASD); these include autism, Asperger's, Rett syndrome, childhood disintegrative disorder and other types of PDD whose exact diagnosis may not be specified. Other disorders mainly or first occurring in childhood include Reactive attachment disorder; Separation Anxiety Disorder; Oppositional Defiant Disorder; Attention Deficit Hyperactivity Disorder.

Causes

Main article: Causes of mental disorders

Numerous factors have been linked to the development of mental disorders. In many cases there is no single accepted or consistent cause currently established. A common view held is that disorders often result from genetic vulnerabilities combining with environmental stressors (Diathesis-stress model). An eclectic or pluralistic mix of models may be used to explain particular disorders. The primary paradigm of contemporary mainstream Western psychiatry is said to be the biopsychosocial (BPS) model - incorporating biological, psychological and social factors - although this may not be applied in practice. Biopsychiatry has tended to follow a biomedical model, focusing on "organic" or "hardware" pathology of the brain. Psychoanalytic theories have been popular but are now less so. Evolutionary psychology may be used as an overall explanatory theory. Attachment theory is another kind of evolutionary-psychological approach sometimes applied in the context for mental disorders. A distinction is sometimes made between a "medical model" or a "social model" of disorder and related disability.

Genetic studies have indicated that genes often play an important role in the development of mental disorders, via developmental pathways interacting with environmental factors. The reliable identification of connections between specific genes and specific categories of disorder has proven more difficult.

Environmental events surrounding pregnancy and birth have also been implicated. Traumatic brain injury may increase the risk of developing certain mental disorders. There have been some tentative inconsistent links found to certain viral infections, to substance misuse, and to general physical health.

Abnormal functioning of neurotransmitter systems has been implicated, including serotonin, norepinephrine, dopamine and glutamate systems. Differences have also been found in the size or activity of certain brains regions in some cases. Psychological mechanisms have also been implicated, such as cognitive and emotional processes, personality, temperament and coping style.

Social influences have been found to be important, including abuse, bullying and other negative or stressful life experiences. The specific risks and pathways to particular disorders are less clear, however. Aspects of the wider community have also been implicated, including employment problems, socioeconomic inequality, lack of social cohesion, problems linked to migration, and features of particular societies and cultures.

Diagnosis

Many mental health professionals, particularly psychiatrists, seek to diagnose individuals by ascertaining their particular mental disorder. Some professionals, for example some clinical psychologists, may avoid diagnosis in favor of other assessment methods such as formulation of a client's difficulties and circumstances.^[9] The majority of mental health problems are actually assessed and treated by family physicians during consultations, who may refer on for more specialist diagnosis in acute or chronic cases. Routine diagnostic practice in mental health services typically involves an interview (which may be referred to as a mental status examination), where judgments are made of the interviewee's appearance and behavior, self-reported symptoms, mental health history, and current life circumstances. The views of relatives or other third parties may be taken into account. A physical examination to check for ill health or the effects of medications or other drugs may be conducted. Psychological testing is sometimes used via paper-and-pen or computerized questionnaires, which may include algorithms based on ticking off standardized diagnostic criteria, and in relatively rare specialist cases neuroimaging tests may be requested, but these methods are more commonly found in research studies than routine clinical practice.^[10]^[11] Time and budgetary constraints often limit practicing psychiatrists from conducting more thorough diagnostic evaluations.^[12] It has been found that most clinicians evaluate patients using an unstructured, open-ended approach, with limited training in evidence-based assessment methods, and that inaccurate diagnosis may be common in routine practice.^[13] Comorbidity is very common in psychiatric diagnosis, i.e. the same person given a diagnosis in more than one category of disorder.

Treatment

Main article: Treatment of mental disorders

Treatment and support may be provided in psychiatric hospitals, clinics or any of a diverse range of community mental health services. Often an individual may engage in different treatment modalities. Individuals may be treated against their will in some cases. Services in some countries are increasingly based on a Recovery model that supports an individual's personal journey to regain a meaningful life.

Psychotherapy

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A major option for many mental disorders is psychotherapy. There are several main types. Cognitive behavioral therapy (CBT) is widely used and is based on modifying the patterns of thought and behavior associated with a particular disorder. Psychoanalysis, addressing underlying psychic conflicts and defenses, has been a dominant school of psychotherapy and is still in use. Systemic therapy or family therapy is sometimes used, addressing a network of significant others as well as an individual. Some psychotherapies are based on a humanistic approach. There are a number of specific therapies used for particular disorders, which may be offshoots or hybrids of the above types. Mental health professionals often employ an eclectic or integrative approach. Much may depend on the therapeutic relationship, and there may be problems with trust, confidentiality and engagement.

Medication

A major option for many mental disorders is psychiatric medication. There are several main groups. Antidepressants are used for the treatment of clinical depression as well as often for anxiety and other disorders. There are a number of antidepressants beginning with the tricylics, moving through a wide variety of drugs that modify various facets of the brain chemistry dealing with intercellular communication. Beta-blockers, developed as a heart medication, is also used as an antidepressant. Anxiolytics are used for anxiety disorders and related problems such as insomnia. Mood stabilizers are used primarily in bipolar disorder. Lithium A (a metal) and Lamictal (an epileptic drug) are notable for treating both mania and depression. The others, mainly targeting mania rather than depression, are a wide variety of epilepsy medications and antipsychotics. Antipsychotics are used for psychotic disorders, notably for positive symptoms in schizophrenia. Stimulants are commonly used, notably for ADHD. Despite the different conventional names of the drug groups, there can be considerable overlap in the kinds of disorders for which they are actually indicated. There may also be off-label use. There can be problems with adverse effects and adherence.

Other

Electroconvulsive therapy (ECT) is sometimes used in severe cases when other interventions for severe intractable depression have failed. Psychosurgery is considered experimental but is advocated by certain neurologists in certain rare cases.^[14]^[15]

Psychoeducation may be used to provide people with the information to understand and manage their problems. Creative therapies are sometimes used, including music therapy, art therapy or drama therapy. Lifestyle adjustments and supportive measures are often used, including peer support, self-help groups for mental health and supported housing or supported employment (including social firms). Some advocate dietary supplements.^[16] Many things have been found to help at least some people. A placebo effect may play a role in any intervention.

Prognosis

Please help improve this section by expanding it. Further information might be found on the talk page or at requests for expansion. (June 2008)

There is substantial variation over time between disorders, and between individuals. Functional ability may also vary across different domains. There may be remission of symptoms, but also relapse. Rates of recovery vary. A number of individual and social factors have been linked to prognosis.

Despite often being characterized in purely negative terms, mental disorders can involve above-average creativity, non-conformity, goal-striving, meticulousness, or empathy.^[17] The public perception of the level of disability associated with mental disorders can change.^[18]

Prevalence

Mental disorders have been found to be relatively common, with more than one in three people in most countries reporting sufficient criteria for at least one diagnosis at some point in their life up to the time they were assessed.^[19] A new WHO global survey currently underway[1] indicates that anxiety disorders are the most common in all but 1 country, followed by mood disorders in all but 2 countries, while substance disorders and impulse-control disorders were consistently less prevalent. Rates varied by region.^[20] Such statistics are widely believed to be underestimates, due to poor diagnosis (especially in countries without affordable access to mental health services) and low reporting rates, in part because of the predominant use of self-report data rather than semi-structured instruments.^{[citation needed]} Actual lifetime prevalence rates for mental disorders are estimated to be between 65% and 85%.^{[citation needed]}

A review of anxiety disorder surveys in different countries found average lifetime prevalence estimates of 16.6%, with women having higher rates on average.^[21] A review of mood disorder surveys in different countries found lifetime rates of 6.7% for major depressive disorder (higher in some studies, and in women) and 0.8% for bipolar 1 disorder.^[22]

The updated US National Comorbidity Survey (NCS) reported that nearly half of Americans (46.4%) meet criteria at some point in their life for either an anxiety disorder (28.8%), mood disorder (20.8%), impulse-control disorder (24.8%) or substance use disorder (14.6%).^[23]^[24]^[25]

A 2004 cross-Europe study found that approximately one in four people reported meeting criteria at some point in their life for at least one of the DSM-IV disorders assessed, which included mood disorders (13.9%), anxiety disorders (13.6%) or alcohol disorder (5.2%). Approximately one in ten met criteria within a 12-month period. Women and younger people of either gender showed more cases of disorder.^[26] A 2005 review of surveys in 16 European countries found that 27% of adult Europeans are affected by at least one mental disorder in a 12 month period.^[27]

An international review of studies on the prevalence of schizophrenia found an average (median) figure of 0.4% for lifetime prevalence; it was consistently lower in poorer countries.^[28]

Studies of the prevalence of personality disorders (PDs) have been fewer and smaller-scale, but one broad Norwegian survey found a five-year prevalence of almost 1 in 7 (13.4%). Rates for specific disorders ranged from 0.8% to 2.8%, differing across countries, and by gender, educational level and other factors.^[29] A US survey that incidentally screened for personality disorder found a rate of 14.79%.^[30]

Approximately 7% of a preschool pediatric sample were given a psychiatric diagnosis in one clinical study, and approximately 10% of 1- and 2-year-olds receiving developmental screening have been assessed as having significant emotional/behavioral problems based on parent and pediatrician reports.^[31]

Professions and fields

A number of professions have developed that specialise in the treatment of mental disorders, including the medical speciality of psychiatry (including psychiatric nursing),^[32]^[33]^[34] the division of psychology known as clinical psychology,^[35] Social Work,^[36] as well as Mental Health Counselors, Marriage and Family Therapists, Psychotherapists, Counselors and Public Health professionals. Those with personal experience of using mental health services are also increasingly involved in researching and delivering mental health services and working as mental health professionals.^[37]^[38]^[39]^[40] The different clinical and scientific perspectives draw on diverse fields of research and theory, and different disciplines may favor differing models, explanations and goals.^[17]

Stigma of mental illness

A large proportion of individuals who suffer from the symptoms of a mental illness will avoid seeking treatment for their symptoms because of the social stigma [2] associated with having a mental illness. The US Surgeon General acknowledged this in 1999:

Powerful and pervasive, stigma prevents people from acknowledging their own mental health problems, much less disclosing them to others.^[41]

As a result many people feel the need to keep their mental illness a secret, and will deny the symptoms that they are experiencing. Two thirds of the people who would benefit from treatment for a mental illness do not receive treatment.^[42] As with many physical illnesses, the prognoses of a mental illness can worsen the longer that a mental illness remains untreated. The added anxiety of fearing a mental illness diagnoses can also be detrimental to an individual's mental health, this effect can greatly exacerbate an anxiety disorder or mood disorder. Efforts are being undertaken worldwide to eliminate the stigma of mental illness. ^[43]

Movements

The Consumer/Survivor Movement (also known as user/survivor movement) is made up of individuals (and organizations representing them) who are clients of mental health services or who consider themselves "survivors" of mental health services. The movement campaigns for improved mental health services and for more involvement and empowerment within mental health services, policies and wider society.^[44]^[45]^[46] Patient advocacy organizations have expanded with increasing deinstitutionalization in developed countries, working to challenge the stereotypes, stigma and exclusion associated with psychiatric conditions. An antipsychiatry movement fundamentally challenges mainstream psychiatric theory and practice, including the reality or utility of psychiatric diagnoses of mental illnesses.^[47]^[48] ^[49]

Laws and policies

Three quarters of countries around the world have mental health legislation. Compulsory admission to mental health facilities (also known as Involuntary commitment or sectioning), is a controversial topic. From some points of view it can impinge on personal liberty and the right to choose, and carry the risk of abuse for political, social and other reasons; from other points of view, it can potentially prevent harm to self and others, and assist some people in attaining their right to healthcare when unable to decide in their own interests.^[50]

All human-rights oriented mental health laws require proof of the presence of a mental disorder as defined by internationally accepted standards, but the type and severity of disorder that counts can vary in different jurisdictions. The two most often utilized grounds for involuntary admission are said to be serious likelihood of immediate or imminent danger to self or others, and the need for treatment. Applications for someone to be involuntarily admitted may usually come from a mental health practitioner, a family member, a close relative, or a guardian. Human-rights-oriented laws usually stipulate that independent medical practitioners or other accredited mental health practitioners must examine the patient separately and that there should be regular, time-bound review by an independent review body.^[50] An individual must be shown to lack the capacity to give or withhold informed consent (i.e. to understand treatment information and its implications). Proxy consent (also known as substituted decision-making) may be given to a personal representative, a family member or a legally appointed guardian, or patients may have been able to enact an advance directive as to how they wish to be treated.^[50] The right to supported decision-making may also be included in legislation.^[51] Involuntary treatment laws are increasingly extended to those living in the community, for example outpatient commitment laws (known by different names) are used in New Zealand, Australia, United Kingdom and most of the United States.

The World Health Organization reports that in many instances national mental health legislation takes away the rights of persons with mental disorders rather than protecting rights, and is often outdated.^[50] In 1991, the United Nations adopted the Principles for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care, which established minimum human rights standards of practice in the mental health field. In 2006 the UN formally agreed the Convention on the Rights of Persons with Disabilities to protect and enhance the rights and opportunities of disabled people, including those with psychosocial disabilities^[52]

The term insanity, sometimes used colloquially as a synonym for mental illness, is often used technically as a legal term.

Perception and discrimination

Media

Media coverage of mental illness comprises predominantly negative depictions, for example, of incompetence, violence or criminality, with far less coverage of positive issues such as accomplishments or human rights issues.^[53]^[54]^[55] Such negative depictions, including in children's cartoons, are thought to contribute to stigma and negative attitudes in the public and in those with mental health problems themselves, although more sensitive or serious cinematic portrayals have increased in prevalence.^[56]^[57]

In the United States, The Carter Center has created fellowships for journalists in South Africa, the U.S., and Romania, to enable reporters to research and write stories on mental health topics.^[58] Former U.S. First Lady Rosalynn Carter began the fellowships not only to train reporters in how to sensitively and accurately discuss mental health and mental illness, but also to increase the number of stories on these topics in the news media.^[59] ^[60]

General public

The general public have been found to hold a strong stereotype of dangerousness and desire for social distance from individuals described as mentally ill.^[61]

Violence

People with mental disorders are often afraid of violence against them. Over a quarter of individuals accessing community mental health services in a US inner-city area are victims of at least one violent crime in a given year, a proportion eleven times higher than the inner-city average. The proportion is many times greater in every category of crime, including rape/sexual assault, other violent assaults, and personal and property theft.^[62]^[63] Findings consistently indicate that it is many times more likely that people diagnosed with a serious mental illness living in the community will be the victims rather than the perpetrators of violence.^[64]^[65]

However, fear of unpredictable violent acts by people with mental illness is also common. One US national survey indicated that a far higher percentage of Americans rated individuals described as displaying the characteristics of a mental disorder (for example Schizophrenia or Substance Use Disorder) as "likely to do something violent to others" compared to those described as being 'troubled'.^[66] Research indicates, on balance, a higher than average number of violent acts by some individuals with certain diagnoses, notably antisocial or psychopathic personality disorders, but conflicting findings about specific symptoms (for example links between psychosis and violence in community settings) - but the mediating factors of such acts are most consistently found to be mainly socio-demographic and socio-economic factors such as being young, male, of lower socio-economic status and, in particular, substance abuse (including alcohol).^[64]^[67]^[17] For the most serious crimes, such as homicide, some diagnoses are over-represented in arrests/convictions; however, although high-profile cases have lead to fears that this has increased due to deinstitutionalization, this does not reflect the evidence.^[68]

Violence related to mental disorder typically occurs in the context of complex social interactions, often in a family setting rather than between straingers.^[69] It is also an issue in healthcare settings^[70] and the wider community.^[71]

Employment

Employment discrimination is reported to play a significant part in the high rate of unemployment among those with a diagnosis of mental illness.^[72] Schemes to combat stigma have been prioritized by global and national psychiatric organizations, but their methods and outcomes have been criticized as counterproductive.^[73]

Mental disorders in non-human animals

Psychopathology in non-human primates has been studied since the mid 20th century. Over 20 behavioral patterns in captive chimpanzees have been documented as (statistically) abnormal for their frequency, severity or oddness - some of which have also been observed in the wild. Captive great apes show gross behavioral abnormalities such as stereotypy of movements, self-mutilation, disturbed emotional reactions (mainly fear or aggression) towards companions, lack of species-typical communications, and generalized learned helplessness. In some cases such behaviors are hypothesized to be equivalent to symptoms associated with psychiatric disorders in humans such as depression, anxiety disorders, eating disorders and post-traumatic stress disorder. Concepts of antisocial, borderline and schizoid personality disorders have also been applied to non-human great apes.^[74]

The risk of anthropomorphism is often raised with regard to such comparisons, and assessment of non-human animals cannot incorporate evidence from linguistic communication. However, available evidence may range from nonverbal behaviors - including physiological responses and homologous facial displays and acoustic utterances - to neurochemical studies. It is pointed out that human psychiatric classification is often based on statistical description and judgement of behaviors (especially when speech or language is impaired) and that the use of verbal self-report is itself problematic and unreliable.^[74]^[75]

Psychopathology has generally been traced, at least in captivity, to adverse rearing conditions such as early separation of infants from mothers; early sensory deprivation; and extended periods of social isolation. Studies have also indicated individual variation in temperament, such as sociability or impulsiveness. Particular causes of problems in captivity have included integration of strangers in to existing groups and a lack of individual space, in which context some pathological behaviors have also been seen as coping mechanisms. Remedial interventions have included careful individually-tailored re-socialization programs, behavior therapy, environment enrichment, and on rare occasions psychiatric drugs. Socialization has been found to work 90% of the time in disturbed chimpanzees, although restoration of functional sexuality and care-giving is often not achieved.^[74]^[76]

Laboratory researchers sometimes try to induce symptoms in animals through genetic, neurological or behavioral manipulation,^[77]^[78] although this has been criticized on empirical grounds and opposed on animal rights grounds. The modern city, in connection with the psychological disorders of its residents, has been described as a human zoo.

Metabolic Problems

Adrenoleukodystrophy see Leukodystrophies
Bariatric Surgery see Weight Loss Surgery
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Canavan Disease see Leukodystrophies
Celiac Disease

Childhood Obesity see Obesity in Children
Diabetes
Diabetes Complications
Diabetes Insipidus
Gastric Bypass see Weight Loss Surgery

Gastroplasty see Weight Loss Surgery
Gaucher's Disease
Genetic Brain Disorders
Gluten-sensitive enteropathy see Celiac Disease
Hepatolenticular Degeneration see Wilson Disease

Hypoglycemia
Insulin Resistance see Metabolic Syndrome
Leukodystrophies
Low Blood Sugar see Hypoglycemia
Maple Syrup Urine Disease see Genetic Brain Disorders

Metabolic Disorders
Metabolic Syndrome
Mucolipidoses see Metabolic Disorders
Mucopolysaccharidoses see Metabolic Disorders
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Non-Insulin Dependent Diabetes Mellitus see Diabetes
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Weight Loss Surgery
Wilson Disease

2008-07-26T01:39:00.001-07:00

Respiratory Disease is the term for diseases of the respiratory system. These include diseases of the lung, pleural cavity, bronchial tubes, trachea, upper respiratory tract and of the nerves and muscles of breathing. Respiratory disease ranges from mild and self-limiting such as the common cold to life-threatening such as bacterial pneumonia or pulmonary embolism. They are a common and important cause of illness and death. In the US, Adults average between 2 and 4 colds a year, children between 6 and 10^[1]. One in seven people in the UK is affected by some form of chronic lung disease, most commonly chronic obstructive pulmonary disease and asthma ^[2]. Respiratory disease is responsible for over 10% of hospitalizations and over 16% of deaths in Canada^[3]. The study of respiratory disease is known as pulmonology. A doctor who specializes in respiratory disease is known as a pulmonologist, a chest medicine specialist, a respiratory medicine specialist, a respirologist or a thoracic medicine specialist.

[edit] Symptoms

The symptoms of respiratory disease differ depending on the disease. Common symptoms are:

Shortness of breath or dyspnea which usually occurs with exercise and can interfere with daily activities. In severe cases, shortness of breath occurs while resting.
Cough with or without the production of sputum.
Coughing blood (haemoptysis).
Chest pain. This may or may not be pleuritic chest pain (that is pain that worsens with the movements of breathing).
Noisy breathing, either wheeze or stridor.
Somnolence.
Loss of appetite.
Weight loss.
Cyanosis, a bluish discoloration of the lips, tongue or fingers.

In some cases respiratory disease is diagnosed without symptoms in the investigation of another disease or through a routine check.

[edit] Diagnostic tests

Respiratory diseases may be investigated by performing one or more of the following tests

Chest x-ray
Pulmonary function test
Computed tomography scan
Culture of microorganisms from secretions such as sputum
Bronchoscopy
Biopsy of the lung or pleura
Ventilation - perfusion scan
Ultrasound scanning can be useful to detect fluid such as pleural effusion

[edit] Treatment

Treatment of respiratory disease depends on the particular disease being treated, the severity of disease and the patient. Lifestyle factors such as regular exercise and healthy nutrition are important in preventing and treating respiratory disease. Vaccination can prevent some respiratory diseases. In addition, the following treatments are often used for respiratory diseases:

Medication, often given in an inhaled form
- Corticosteroids
- Bronchodilators
- Antibiotics
- Anticoagulants
- Cancer chemotherapy
- Immune suppressants
Physiotherapy
Oxygen
Mechanical ventilation
Radiotherapy
Surgery
- Removal of a cancer e.g. lobectomy, pneumonectomy
- Pleurodesis
- Lung volume reduction surgery
- Lung transplantation

[edit] Respiratory diseases

Respiratory diseases can be classified in many different ways; by the organ involved, by the pattern of symptoms or by the cause of the disease.

[edit] Obstructive lung diseases

These are diseases of the lung where the bronchial tubes become narrowed making it hard to move air in and especially out of the lung.

[edit] Chronic obstructive pulmonary disease^[4]

Main article: Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive airways disease (COAD) or chronic airflow limitation (CAL), is a group of illnesses characterised by airflow limitation that is not fully reversible. The flow of air into and out of the lungs is impaired. This can be measured with breathing devices such as a peak flow meter or by spirometry. The term COPD includes the conditions emphysema and chronic bronchitis although most patients with COPD have characteristics of both conditions to varying degrees. Asthma being a reversible obstruction of airways is often considered separately, but many COPD patients also have some degree of reversibility in their airways.

In COPD, there is an increase in airway resistance, shown by a decrease in the forced expiratory volume in 1 second (FEV1) measured by spirometry. COPD is defined as a forced expiratory volume in 1 second to forced vital capacity ratio (FEV1/FVC) that is less than 0.7^[5]. The residual volume, the volume of air left in the lungs following full expiration, is often increased in COPD, as is the total lung capacity, while the vital capacity remains relatively normal. The increased total lung capacity (hyperinflation) can result in the clinical feature of a "barrel chest" - a chest with a large front-to-back diameter that occurs in some individuals with COPD. Hyperinflation can also be seen on a chest x-ray as a flattening of the diaphragm.

The most common cause of COPD is cigarette smoking. COPD is a gradually progressive condition and usually only develops after about 20 pack-years of smoking. COPD may also be caused by breathing in other particles and gasses.

The disagnosis of COPD is established through spirometry although other pulmonary function tests can be helpful. A chest x-ray is often ordered to look for hyperinflation and rule out other lung conditions but the lung damage of COPD is not always visible on a chest x-ray. Emphysema, for example can only be seen on CT scan.

The main form of long term management involves the use of inhaled bronchodilators (specifically beta agonists and anticholinergics) and inhaled corticosteroids. Many patients eventually require oxygen supplementation at home. In severe cases that are difficult to control, chronic treatment with oral corticosteroids may be necessary, although this is fraught with significant side-effects.

COPD is generally irreversible although lung function can partially recover if the patient stops smoking. Smoking cessation is an essential aspect of treatment^[6]. Pulmonary rehabilitation programmes involve intensive exercise training combined with education and are effective in improving shortness of breath. Severe emphysema has been treated with lung volume reduction surgery with some success in carefully chosen cases. Lung transplantation is also performed for severe COPD in carefully chosen cases.

Alpha 1-antitrypsin deficiency is a fairly rare genetic condition that results in COPD (particularly emphysema) due to a lack of the antitrypsin protein which protects the fragile alveolar walls from protease enzymes released by inflammatory processes.

[edit] Asthma

Main article: Asthma

Asthma is an obstructive lung disease where the bronchial tubes (airways) are extra sensitive (hyperresponsive). The airways become inflamed and produce excess mucus and the muscles around the airways tighten making the airways narrower. Asthma is usually triggered by breathing in things in the air such as dust or pollen that produce an allergic reaction. It may be triggered by other things such as an upper respiratory tract infection, cold air, exercise or smoke. Asthma is a common condition and affects over 300 million people around the world^[7]. Asthma causes recurring episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning.

Asthma is diagnosed by the characteristic pattern of symptoms. A peak flow meter can record variations in the severity of asthma over time. Spirometry, a measurement of lung function, can provide an assessment of the severity, reversibility, and variability of airflow limitation, and help confirm the diagnosis of asthma^[7].

Asthma is treated by identifying and removing the triggers that set it off, if possible. The main form of long term management involves the use of inhaled corticosteroids. Inhaled bronchodilators, particularly beta agonists are used to relieve and control symptoms by reducing muscle spasm around the airways. An alternative way to control mild asthma is with a leukotriene antagonist tablet.

[edit] Other obstructive lung diseases

Cystic fibrosis is an inherited disorder of the CFTR gene, a chloride ion channel. The lack of this channel causes reduced water content of secretions. This affects the mucus secreted as part of the lung's defence and creates sticky, viscous mucus. This makes the lungs more susceptible to infection, inflammation and mucous plugging.
Bronchiectasis
Bronchiolitis
Allergic bronchopulmonary aspergillosis

In many parts of the world, the most common cause of obstructive lung disease is lung scarring after tuberculosis infection.

[edit] Restrictive lung diseases^[8]

Restrictive lung diseases (also known as interstitial lung diseases) are characterised by a loss of lung compliance, causing incomplete lung expansion and increased lung stiffness. The underlying process is usually pulmonary fibrosis (scarring of the lung). As the disease progresses, the normal lung tissue is gradually replaced by scar tissue interspersed with pockets of air. This can lead to parts of the lung having a honeycomb-like appearance.

The main symptoms are shortness of breath and cough.

In restrictive lung disease, both the FEV1 and FVC are reduced so the FEV1/FVC ratio is normal or even increased in contrast to obstructive lung disease where this ratio is reduced. The values for residual volume and total lung capacity are generally decreased in restrictive lung disease^[9].

Restrictive lung diseases may be due to a specific cause such as:

Asbestosis caused by long-term exposure to asbestos dust.
Radiation fibrosis, usually from the radiation given for cancer treatment.
Certain drugs such as amiodarone, bleomycin and methotrexate.
As a consequence of another disease such as rheumatoid arthritis.
Hypersensitivity pneumonitis due to an allergic reaction to inhaled particles.
Acute respiratory distress syndrome (ARDS), a severe lung condition occurring in response to a critical illness or injury.
Infant respiratory distress syndrome due to a deficiency of surfactant in the lungs of a baby born prematurely.

Many cases of restrictive lung disease are idiopathic (have no known cause). Examples are:

Idiopathic pulmonary fibrosis
Idiopathic interstitial pneumonia, of which there are several types
Sarcoidosis
Eosinophilic pneumonia
Lymphangioleiomyomatosis
Pulmonary Langerhan’s cell histiocytosis
Pulmonary alveolar proteinosis

[edit] Respiratory tract infections

Infections can affect any part of the respiratory system. They are traditionally divided into upper respiratory tract infections and lower respiratory tract infections.

[edit] Upper respiratory tract infection

The most common upper respiratory tract infection is the common cold however infections of specific organs of the upper respiratory tract such as sinusitis, tonsillitis, otitis media, pharyngitis and laryngitis are also considered upper respiratory tract infections.

[edit] Lower respiratory tract infection

The most common lower respiratory tract infection in is pneumonia, a lung infection. Pneumonia is usually caused by bacteria, particularly [[Streptococcus pneumoniae]] in Western countries. Worldwide, tuberculosis is an important cause of pneumonia. Other pathogens such as viruses and fungi can cause pneumonia for example severe acute respiratory syndrome and pneumocystis pneumonia. A pneumonia may develop complications such as a lung abscess, a round cavity in the lung caused by the infection or an empyema, the spread of the infection to the pleural cavity.

[edit] Respiratory tumours

Tumours of the respiratory system are either malignant or benign.

[edit] Malignant tumours

Malignant tumours, or cancers of the respiratory system, particularly lung cancers, are a major health problem responsible for 15% of all cancer diagnoses and 29% of all cancer deaths^[10]. The majority of respiratory system cancers are attributable to smoking tobacco.

The major types of respiratory system cancer are:

Small cell lung cancer
Non-small cell lung cancer
- Adenocarcinoma
- Squamous cell carcinoma
- Large cell undifferentiated carcinoma
Other lung cancers (carcinoid, Kaposi’s sarcoma, melanoma)
Lymphoma
Head and neck cancer
Mesothelioma, usually caused by exposure to asbestos dust.

In addition, since many cancers spread via the bloodstream and the entire cardiac output passes through the lungs, it common for cancer metastases to occur the lung. Breast cancer may invade directly through local spread, and through lymph node metastases. After metastasis to the liver, colon cancer frequently metastasizes to the lung. Prostate cancer, germ cell cancer and renal cell carcinoma may also metastasize to the lung.

Treatment of respiratory system cancer depends on the type of cancer. Surgery (usually removal of part of the lung, a lobectomy or an entire lung, a pneumonectomy), chemotherapy and radiotherapy are all used. The chance of surviving lung cancer depends on the cancer stage at the time the cancer is diagnosed and is only about 14-17% overall^[11]. In the case of metastases to the lung, treatment can occasionally be curative but only in certain, rare circumstances.

[edit] Benign tumours

Benign tumours are relatively rare causes of respiratory disease. Examples of benign tumours are:

Pulmonary hamartoma
Congenital malformations such as pulmonary sequestration and congenital cystic adenomatoid malformation (CCAM).

[edit] Pleural cavity diseases

Pleural cavity diseases include empyema and mesothelioma which are mentioned above.

A collection of fluid in the pleural cavity is known as a pleural effusion. This may be due to fluid shifting from the bloodstream into the pleural cavity due to conditions such as congestive heart failure and cirrhosis. It may also be due to inflammation of the pleura itself as can occur with infection, pulmonary embolus, tuberculosis, mesothelioma and other conditions.

A pneumothorax is a hole in the pleura covering the lung allowing air in the lung to escape into the pleural cavity. The affected lung “collapses” like a deflated balloon. A tension pneumothorax is a particularly severe form of this condition where the air in the pleural cavity cannot escape, so the pneumothorax keeps getting bigger until it compresses the heart and blood vessels, leading to a life threatening situation.

[edit] Pulmonary vascular diseases

Pulmonary vascular diseases are conditions that affect the pulmonary circulation. Examples of these conditions are:

Pulmonary embolism, a blood clot that forms in a vein, breaks free, travels through the heart and lodges in the lungs (thromboembolism). Large pulmonary emboli are fatal, causing sudden death. A number of other substances can also embolise to the lungs but they are much more rare: fat embolism (particularly after bony injury), amniotic fluid embolism (with complications of labour and delivery), air embolism (iatrogenic).
Pulmonary arterial hypertension, elevated pressure in the pulmonary arteries. It can be idiopathic or due to the effects of another disease, particularly COPD. This can lead to strain on the right side of the heart, a condition known as cor pulmonale.
Pulmonary edema, leakage of fluid from capillaries of the lung into the alveoli (or air spaces). It is usually due to congestive heart failure.
Pulmonary hemorrhage, inflammation and damage to capillaries in the lung resulting in blood leaking into the alveoli. This may cause blood to be coughed up. Pulmonary hemorrhage can be due to auto-immune disorders such as Wegener's Granulomatosis and Goodpasture's syndrome.

[edit] Disorders of breathing mechanics

The brain co-ordinates breathing and sends messages via nerves to the muscles of respiration. The muscles produce the movements of breathing. Disorders of the brain’s control of breathing, the nerves or the muscles of respiration can affect the respiratory system. Common disorders of breathing mechanics are:

Obesity is often associated with sleep apnea and can cause either an obstructive or a restrictive pattern on spirometry. Obesity reduces the movement of the chest wall which can, in extreme cases, result in the obesity-hypoventilation syndrome, a cause of respiratory failure.

2008-07-26T01:39:00.000-07:00

[edit] Symptoms

The symptoms of respiratory disease differ depending on the disease. Common symptoms are:

Shortness of breath or dyspnea which usually occurs with exercise and can interfere with daily activities. In severe cases, shortness of breath occurs while resting.
Cough with or without the production of sputum.
Coughing blood (haemoptysis).
Chest pain. This may or may not be pleuritic chest pain (that is pain that worsens with the movements of breathing).
Noisy breathing, either wheeze or stridor.
Somnolence.
Loss of appetite.
Weight loss.
Cyanosis, a bluish discoloration of the lips, tongue or fingers.

In some cases respiratory disease is diagnosed without symptoms in the investigation of another disease or through a routine check.

[edit] Diagnostic tests

Respiratory diseases may be investigated by performing one or more of the following tests

Chest x-ray
Pulmonary function test
Computed tomography scan
Culture of microorganisms from secretions such as sputum
Bronchoscopy
Biopsy of the lung or pleura
Ventilation - perfusion scan
Ultrasound scanning can be useful to detect fluid such as pleural effusion

[edit] Treatment

Medication, often given in an inhaled form
- Corticosteroids
- Bronchodilators
- Antibiotics
- Anticoagulants
- Cancer chemotherapy
- Immune suppressants
Physiotherapy
Oxygen
Mechanical ventilation
Radiotherapy
Surgery
- Removal of a cancer e.g. lobectomy, pneumonectomy
- Pleurodesis
- Lung volume reduction surgery
- Lung transplantation

[edit] Respiratory diseases

Respiratory diseases can be classified in many different ways; by the organ involved, by the pattern of symptoms or by the cause of the disease.

[edit] Obstructive lung diseases

These are diseases of the lung where the bronchial tubes become narrowed making it hard to move air in and especially out of the lung.

[edit] Chronic obstructive pulmonary disease^[4]

Main article: Chronic obstructive pulmonary disease

[edit] Asthma

Main article: Asthma

[edit] Other obstructive lung diseases

Cystic fibrosis is an inherited disorder of the CFTR gene, a chloride ion channel. The lack of this channel causes reduced water content of secretions. This affects the mucus secreted as part of the lung's defence and creates sticky, viscous mucus. This makes the lungs more susceptible to infection, inflammation and mucous plugging.
Bronchiectasis
Bronchiolitis
Allergic bronchopulmonary aspergillosis

In many parts of the world, the most common cause of obstructive lung disease is lung scarring after tuberculosis infection.

[edit] Restrictive lung diseases^[8]

The main symptoms are shortness of breath and cough.

Restrictive lung diseases may be due to a specific cause such as:

Asbestosis caused by long-term exposure to asbestos dust.
Radiation fibrosis, usually from the radiation given for cancer treatment.
Certain drugs such as amiodarone, bleomycin and methotrexate.
As a consequence of another disease such as rheumatoid arthritis.
Hypersensitivity pneumonitis due to an allergic reaction to inhaled particles.
Acute respiratory distress syndrome (ARDS), a severe lung condition occurring in response to a critical illness or injury.
Infant respiratory distress syndrome due to a deficiency of surfactant in the lungs of a baby born prematurely.

Many cases of restrictive lung disease are idiopathic (have no known cause). Examples are:

Idiopathic pulmonary fibrosis
Idiopathic interstitial pneumonia, of which there are several types
Sarcoidosis
Eosinophilic pneumonia
Lymphangioleiomyomatosis
Pulmonary Langerhan’s cell histiocytosis
Pulmonary alveolar proteinosis

[edit] Respiratory tract infections

Infections can affect any part of the respiratory system. They are traditionally divided into upper respiratory tract infections and lower respiratory tract infections.

[edit] Upper respiratory tract infection

[edit] Lower respiratory tract infection

[edit] Respiratory tumours

Tumours of the respiratory system are either malignant or benign.

[edit] Malignant tumours

The major types of respiratory system cancer are:

Small cell lung cancer
Non-small cell lung cancer
- Adenocarcinoma
- Squamous cell carcinoma
- Large cell undifferentiated carcinoma
Other lung cancers (carcinoid, Kaposi’s sarcoma, melanoma)
Lymphoma
Head and neck cancer
Mesothelioma, usually caused by exposure to asbestos dust.

[edit] Benign tumours

Benign tumours are relatively rare causes of respiratory disease. Examples of benign tumours are:

Pulmonary hamartoma
Congenital malformations such as pulmonary sequestration and congenital cystic adenomatoid malformation (CCAM).

[edit] Pleural cavity diseases

Pleural cavity diseases include empyema and mesothelioma which are mentioned above.

[edit] Pulmonary vascular diseases

Pulmonary vascular diseases are conditions that affect the pulmonary circulation. Examples of these conditions are:

Pulmonary embolism, a blood clot that forms in a vein, breaks free, travels through the heart and lodges in the lungs (thromboembolism). Large pulmonary emboli are fatal, causing sudden death. A number of other substances can also embolise to the lungs but they are much more rare: fat embolism (particularly after bony injury), amniotic fluid embolism (with complications of labour and delivery), air embolism (iatrogenic).
Pulmonary arterial hypertension, elevated pressure in the pulmonary arteries. It can be idiopathic or due to the effects of another disease, particularly COPD. This can lead to strain on the right side of the heart, a condition known as cor pulmonale.
Pulmonary edema, leakage of fluid from capillaries of the lung into the alveoli (or air spaces). It is usually due to congestive heart failure.
Pulmonary hemorrhage, inflammation and damage to capillaries in the lung resulting in blood leaking into the alveoli. This may cause blood to be coughed up. Pulmonary hemorrhage can be due to auto-immune disorders such as Wegener's Granulomatosis and Goodpasture's syndrome.

[edit] Disorders of breathing mechanics

2008-07-12T06:41:00.000-07:00

Acne Fact and Fiction! Do Stress, Facials and Concealer's Help to Promote or Reduce Acne Breakouts?
by: Stephen M. Seabrook

What is Acne? People have differing opinions as to what acne really is. So, what exactly is acne? Do a couple of occasional but recurring zits qualify as a case of acne or do you have to have a lot of zits?

Believe it or not, the answer is that occasional pimples or zits do not constitute a true case of acne. Although zits do seem to have the ability to appear almost instantaneously and at the most inopportune times like picture day, prom night, spelling bees, sporting events, dates, and special award ceremonies, they are not a true acne outbreak.

The dictionary defines acne as "an inflammatory disease of the sebaceous glands, characterized by comedones and pimples, especially on the face, back, chest, and, in severe cases, by cysts and nodules resulting in scarring."

The anatomical definition of sebaceous glands is: "small subcutaneous glands usually connected with hair follicles. The follicles secrete an oily semi-fluid matter, composed in great part of fat, which softens and lubricates the hair and skin."

Real acne outbreaks are actually a disease of the skin. However, the great news is that acne is treatable. Although it can be very embarrassing, cause great emotional distress, and lower your personal self-esteem for a period of time, acne is not fatal.

There are new and effective treatments being sought by researchers and great advances have been made in the treatment of acne in the last few years. Years ago, when a person had acne, they were pretty much stuck with the problem. There were very few treatments available and the medical profession didn't even consider acne a disease.

It was long thought that acne was the direct result of a diet that was too high in fat and/or sweets. That is no longer the case. Acne is most often associated with puberty and the onset of pre-teen and teenage years but it can and does develop in adults as well. When acne does finally heal, there can be permanent scars left (from picking and popping) that are unsightly and cause patients to suffer long term emotional distress and low self- esteem.

New and very effective skin resurfacing treatments have been developed over the last several years that have, if not completely removed acne scars, at least diminished their appearance and severity.

Acne Fact or Fiction:

You can hear a lot of tall tales about acne today, so let's take a look at the fact or fiction of acne. It is always better to be well armed with factual information so that you don't get fooled by the fictional facts that surround acne.

Fictional Fact #1: Acne is caused by a lack of sexual activity.

Factual Fact: Acne and sexual activity are two entirely separate issues. One has no bearing on the other. Hormones secreted during puberty and young adulthood does have a bearing on acne. They also have a bearing on sexual arousal and activity. However, acne has no bearing on sexual activity nor does sexual activity have any bearing on acne.

Fictional Fact #2: People have acne because they are dirty.

Factual Fact: Dirt has no part in acne. Dirt is dirt. Acne is acne. One has nothing to do with the other. Acne is a build up of oil, dead skin cells, and bacteria. Dirt isn't involved. Keeping the face clean can and will help to prevent clogged pores but dirt does not cause acne.

Fictional Fact #3: Dermatologists can cure acne.

Factual Fact: Dermatologists can TREAT acne. They can help to alleviate the symptoms and help to clear up the pimples, black-heads, and white heads. They can prescribe antibiotics and topical ointments, lotions, and creams that will help but there is no cure at this time for acne.

Fictional Fact #4: Acne is simply a skin problem.

Factual Fact: It's true that acne affects the skin but it can also affect the way a person sees himself or herself. Acne and the scarring it can leave behind may cause a sufferer to become depressed and develop low self-esteem, both of which can lead to larger and more complex life socialization problems. Acne sufferers need the loving support and reassurance from their family and friends.

Acne and Stress:

Can stress actually cause acne? There is ample evidence available to suggest that stress can most assuredly cause an acne breakout or make an existing breakout worse. Our bodies are highly developed chemical laboratories that produce all sorts of stuff.

At puberty, our body begins to produce an abundance of male hormones and this happens in both boys and girls. This overproduction of male hormones can happen at other times in life besides puberty; for example, when a girl or woman starting or stops taking birth control pills.

These male hormones cause the bodies sebaceous glands to shift into overdrive and begin producing sebum. The sebum then travels up hair follicles, clogs the pores and begins the acne development cycle. However, male hormones are not the only cause for the sebaceous glands to begin producing an overabundance of sebum. When we become extremely stressed or overly emotional, our bodies react by causing the adrenal glands to produce a substance known as Cortisol, which is released directly into the bloodstream. Then the chemical chain reaction continues as the sebaceous glands release sebum, the sebum travels up the same hair follicles, clogs the pores and acne develops.

The physical changes in the body can cause exactly the same chemical chain reaction as the emotional changes in the mind. The mind/body connection is very real. Maybe some of it really IS in your head. If that's the case, there is help available to help people deal with the acne that is caused by stress. Reducing stress will just naturally reduce sebum production by the sebaceous glands and reducing sebum production will help to alleviate an acne breakout. Therefore, when you learn to reduce and control you stress levels, this part of the chemical chain reaction is minimized.

It really it isn't any different than restoring a hormonal balance to your body that reduces sebum production. So, in the final analysis, both factors that cause excessive sebum production should be addressed. Solving one problem might help; however, solving both problems could eliminate acne altogether.

Acne Facials:

If you are part of the 95 of the population who suffer from acne, you have more than likely seen TV or print media advertisements for acne facials. Have you ever wondered if there is anything to the claims that their manufacturers make?

In general, the answer is yes! Most acne facials are very effective, pretty much worth the price, and can be used in conjunction with your usual acne fighting regime. They won't necessarily replace any part of what you are already doing; but, rather enhance the overall effects.

You can find acne facials in most health stores, at many cosmetic counters, and online. As a matter of fact, you can probably complete a better comparison of available products online than you can anywhere else.

Most of these acne facial products provide for a three-step program. The first step is a complete facial cleansing. The next step is a steam massage. The final step is a facial mask. The first two steps are designed to prepare the face. The steam massage softens the black heads and the white heads to remove toxins from your skin. The facial mask serves to remove the dead skin cells from the face and to moisturize it as well. The overall effect of the acne facial is a very relaxing, calming, and cleansing experience. It just plain feels good. Anything that helps to calm and sooth your stress can't be bad because we all know that acne is aggravated by high stress levels. Acne facial masks can be used in addition to other parts of your acne prevention and treatment regime or you may find that the facial can, in fact, actually replace some things that you are currently doing.

Acne Concealer's:

One of Newton's laws of physics laws says that, "For every action, there is an equal and opposite reaction." That law of physics spills over into a lot of our life situations. For example: A young woman gets a zit and wants to cover it up. The cosmetics industry has a multitude of products designed to do just that. Okay, that's a little far out there but you get my point.

The acne pimples, whether they are white heads or black heads should never be picked at or popped. If they are popped or picked, it can and normally does result is a scar that is much harder to get rid of than the actual pimple, black head or white head. Popping a pimple is not going to make it go away. In fact, popping a pimple is only going to make the acne worse.

Still when you get a zit, you have to go out and face the world so you are looking for ways to make your skin look clear. You want to disguise the zit and make it as unnoticeable as possible. Here is where the cosmetic industry can help. There are a multitude of products designed to make a zit less noticeable. You don't want to use a product that just adds to the problem by adding additional oil to already oily skin. So, you do need to remember, that when you use a cover product to make the zit less noticeable, you need to totally clean the product from your skin immediately when you return home.

Some of the better known as well as more effective cosmetic concealer's on the market today are:

1. Dermablend Smooth Indulgence Concealer: This product produces a smooth matte appearance and was designed specifically for covering acne blemishes as well as for covering Rosacea and dark circles under the eyes.

2. Flawless Skin by Prescriptives: This product will not aggravate acne but will supply a medium to full coverage and it contains SPF 25 for protection from the sun.

Don't let acne control you; but rather, become smart and learn how to control the negative influences in your life that create a positive situation for acne to develop!

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