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This house believes that it is time to end the

distinction between mental and neurological illnesses

Peter White,
Hugh Rickards, Adam Zeman

We have a problem

We have a problem
We regard mental illness as
somehow different from the rest of
medicine with negative
consequences

How do we distinguish between


conditions?

Some ICD10 chapters

Eye
Ear
Circulatory
Respiratory
Digestive
Genito-urinary

ICD10 chapters of the brain


G Nervous system
F Mental and behavioural

ICD10 chapters of the brain


G Nervous system
F Mental and behavioural

The only organ of the body classified in


two separate chapters of ICD-10

Jack has Alzheimers dementia


G30 Alzheimers disease?
F00 Dementia in Alzheimers disease?

Jack has Alzheimers dementia


G30 Alzheimers disease?
F00 Dementia in Alzheimers disease?

Lots of double accounting


Frontotemporal dementia F02, G31
Tension headaches F45.4, G44.2
Chronic fatigue syndrome F48, G93.3

Problems with ICD10


1. Lots of double accounting dodging the
issue.

Problems with ICD10


1. Lots of double accounting dodging the
issue.
2. Mental illnesses what organ involved?

The brain is the organ of mental


illnesses
Both structural and/or functional changes occur
in the brain in all mental conditions
Mental illnesses are conditions of the brain
more than any other organ of the body

Problems with ICD10


1. Lots of double accounting dodging the
issue.
2. Mental illnesses what organ involved?
3. Neurological conditions mental?

Mental illness?
Impairment of thinking, emotion or behaviour
Parkinsons disease thinking?
Pseudobulbar palsy - emotion?
Frontal lobe syndrome - behaviour?

Mental illnesses?
Impairment of thinking, emotion or behaviour
Parkinsons disease thinking?
Pseudobulbar palsy - emotion?
Frontal lobe syndrome - behaviour?
Psychosical factors affect neurological conditions

The false distinction between


mind and brain
The obvious solution
Mental and neurological conditions
should be classified together in one
chapter of the nervous system

Advantages
Change in attitudes - the biopsychosocial
approach
Reduced discrimination against:
Patients, their families
Their mental health professionals

Encourage more cross-discipline training


Bring mental health back into Medicine

Any disadvantages?

Mindless mental healthcare?

Psychosocial interventions
Important in mental healthcare

Psychosocial interventions
Important in mental healthcare
- But also in the rest of medicine

The false distinction between mental and


physical illness
The distinction between mental and physical
illness is ill-founded and incompatible with
contemporary understanding of disease

Robert Kendell, 2001

The nature of the body can only be


understood as a whole, for it is the
great error of our day in the treatment
of the human body that physicians
separate the soul from the body

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