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Comprehensive Overview of Mental Disorders
Three-Fold Classification of Mental Disorders
Category, Specified Syndrome, and Aetiology
The classification of mental disorders can be approached through a three-fold system that includes Category (gross syndrome), Specified Syndrome, and Aetiology (main cause or eliciting factor). This method aims to provide a more nuanced understanding of mental disorders by considering multiple dimensions simultaneously1 2. The International Classification of Diseases (ICD) has made strides in this direction, particularly with the 8th and 9th revisions, but there is still room for further simplification and homogenization1 2.
Genetic Classification of Major Mental Disorders
Genomic Structural Equation Modeling
Recent advancements in genomic research have allowed for the classification of mental disorders based on their genetic underpinnings. Ten major mental disorders, including ADHD, anorexia nervosa, anxiety disorder, autism spectrum disorder, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, posttraumatic stress disorder, schizophrenia, and Tourette syndrome, have been analyzed using genomic structural equation modeling. This approach reveals that these disorders are genetically inter-correlated and can be grouped based on their general psychopathology3. For instance, MDD, ANX, ADHD, ASD, and PTSD form one cluster, while OCD, AN, and TS form another3.
Mental Disorders and Musculoskeletal Diseases
Associations with Depressive and Anxiety Disorders
There is a significant relationship between common musculoskeletal diseases (MSDs) and mental disorders, particularly depressive and anxiety disorders. Studies have shown that major depressive disorder is associated with chronic back pain, while anxiety disorders are linked to cervical or lumbar disc herniation. Additionally, mood and anxiety disorders are associated with lower bone mineral density in men, and life satisfaction can prevent bone loss in postmenopausal women4.
Alcohol Use Disorders in ICD-11
Diagnostic Criteria and Historical Context
The ICD-11 includes a comprehensive section on alcohol use disorders, which encompasses Alcohol Dependence, Harmful Pattern of Use of Alcohol, Alcohol Intoxication, Alcohol Withdrawal, and several alcohol-induced mental disorders. These diagnoses have evolved over time, with significant contributions from the World Health Organization since the 1970s. The ICD-11 aims to provide a more pragmatic and confirmatory approach to diagnosing these disorders, supported by empirical data5.
Immunobiology of Tourette's Disorder and Related Conditions
PANDAS and Immune Dysfunction
Tourette's disorder (TD) and related conditions like obsessive-compulsive disorder (OCD) have been linked to immune dysfunction, particularly involving Group A Streptococcus (GAS). This has led to the identification of pediatric autoimmune neuropsychiatric disorders associated with Streptococcus (PANDAS), where children exhibit sudden onset of neuropsychiatric symptoms following GAS infection. These disorders share common neuroanatomic areas, suggesting a potential immunologic and genetic vulnerability6.
Eating Disorders
Types and Diagnostic Challenges
Eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant-restrictive food intake disorder, pica, and rumination disorder, are severe mental health conditions that impair physical health and psychosocial functioning. These disorders have been increasing over the past 50 years, and changes in the food environment are believed to play a role. Despite their prevalence, eating disorders remain under-researched, leading to uncertainties in their pathophysiology, treatment, and management8.
Shared Heritability in Brain Disorders
Genetic Correlations
Research has shown that psychiatric disorders share a significant amount of genetic risk, particularly among ADHD, bipolar disorder, major depressive disorder, and schizophrenia. In contrast, neurological disorders appear more distinct from one another and from psychiatric disorders, with the exception of migraine, which shows genetic correlations with several psychiatric conditions. This genetic overlap suggests that current clinical boundaries for psychiatric disorders may not reflect distinct underlying pathogenic processes9.
Mnemonics for DSM V Diagnostic Criteria
Aiding Diagnosis
Mnemonics are valuable tools for clinicians to remember the diagnostic criteria for various psychiatric disorders as outlined in the DSM V. These mnemonics serve as narratives or anecdotes that encapsulate the key symptoms of each disorder, thereby aiding in accurate diagnosis and reducing the risk of misdiagnosis10.
Conclusion
The classification and understanding of mental disorders are continually evolving, with significant contributions from genetic research, clinical studies, and diagnostic frameworks like the ICD and DSM. By integrating multiple dimensions such as genetic correlations, clinical symptoms, and aetiology, a more comprehensive and nuanced understanding of mental disorders can be achieved, ultimately improving diagnosis and treatment outcomes.
Sources and full results
Most relevant research papers on this topic
STANDARD LISTS FOR THREE‐FOLD CLASSIFICATION OF MENTAL DISORDERS
The proposed three-fold classification of mental disorders, based on category, main syndrome, and main aetiology, is a step in the right direction.
Gutenberg and the ICD-9 of Mental Disorders
The ICD-9 of Mental Disorders could be further simplified and homogenized by introducing three separate lists for variables, compulsory registration of aetiology, and threefold diagnoses.
Classifying major mental disorders genetically
This study reveals that ten mental disorders are genetically inter-correlated and can be classified hierarchically, potentially improving diagnostic frameworks and treatment regimens for mental disorders.
Observational StudyDepressive disorders, anxiety disorders and subjective mental health in common musculoskeletal diseases: A review.
Common musculoskeletal diseases are associated with mental disorders and poorer subjective mental health in adults aged 45 years or over.
Systematic ReviewAlcohol Use Disorders in ICD-11: past, present and future.
The ICD-11 Alcohol Use Disorders section provides a comprehensive overview of alcohol-related diagnoses, including Alcohol Dependence, Harmful Pattern of Alcohol Use, and related mental disorders.
Literature Review
Very Rigorous Journal
Highly CitedThe immunobiology of Tourette's disorder, pediatric autoimmune neuropsychiatric disorders associated with Streptococcus, and related disorders: a way forward.
Tourette's disorder, pediatric autoimmune neuropsychiatric disorders associated with Streptococcus, and related disorders may share a common immunologic and genetic vulnerability.
Systematic ReviewHighly CitedBROKEN WINDOWS: WHY—AND HOW—WE SHOULD TAKE THEM SERIOUSLY
Broken windows refers to a wide range of social and physical disorders that affect public spaces, often overlooked by criminologists and police.
Eating Disorders
Eating disorders are complex, under-researched mental disorders with varying presentation forms and impact on physical and psychosocial health.
Rigorous JournalHighly CitedAnalysis of shared heritability in common disorders of the brain
Genetic variation overlaps significantly across psychiatric disorders and behavioral traits, but neurological disorders show more distinct genetic risk profiles.
Observational StudyHighly CitedMnemonics for diagnostic criteria of DSM V mental disorders: a scoping review
Mnemonics for DSM diagnostic criteria can help clinicians recall specific symptom criteria, potentially reducing misdiagnosis.
Systematic ReviewRigorous Journal