ETIOLOGY OF

MENTAL
DISORDERS
SONNY T. LISAL

Historical
Perspective

Perceived Causes
o movements

of sun or moon
o lunacy--full moon
o evil spirits

Ancient Treatments
o exorcism,

caged like animals,

beaten, burned, castrated,
mutilated, blood replaced with
animals blood

Medical Model

concept that diseases have physical

causes
can be diagnosed, treated, and in most
cases, cured
assumes that these mental illnesses can
be diagnosed on the basis of their
symptoms and cured through therapy,
which may include treatment in a
psychiatric hospital

Somatic factors:

1.

Neuro-anatomy
Neuro-physiology
Neuro-chemistry
Level of development & maturity
Pre & perinatal factors

Psychologic factors

2.

Child-mother interaction
The role of father
Sibling rivalry
Intelligence
Interaction within the family, correlation to
occupation, tipe of play & society
Loss anxiety, depression, self accusation & guilt
Early concept: self identity
Skill, talents & creativity
Adaptation pattern & defense mechanism
Level of emotional development

Socio-cultural Factors

3.

Stability within the family

Nurturing Pattern
Level of economy
Housing: Urban >< suburb/village
Minority issue
Race & Religion influence
Cultural issue

Bio-Psycho-Social
Perspective

Assumes that biological,

sociocultural, and
psychological factors combine
and interact to produce
psychological disorders

Bio-Psycho-Social
Perspective

CLASSIFICTION
OF MENTAL
DISORDERS
SONNY T. LISAL

Psychological Disorders
a harmful dysfunction in which
behavior is judged to be:
atypical--not enough in itself
disturbing--varies with time and
culture
maladaptiveharmful
unjustifiable--sometimes theres a
good reason

Systems of classification for psychiatric

diagnoses have several purposes:
1. to distinguish one psychiatric
diagnosis from another, so that
clinicians can offer the most
effective treatment
2. to provide a common language
among health care professionals
3. to explore the still unknown causes
of many mental disorders

Two most important psychiatric classifications :

1.

DSM-IV

the Diagnostic and Statistical Manual of Mental

Disorders (DSM) developed by the American
Psychiatric Association in collaboration with other
groups of mental health professionals

a widely used system for classifying

psychological disorders
presently distributed as DSM-IV-TR (text
revision)

2.

In Progress: DSM-V (Issues: Internet addiction)

International Classification of Diseases (ICD),

developed by the World Health Organization

ICD-10/PPDGJ III

ICD-10 uses alpha-numeric code, 1

alphabet and 2 numbers 3
characters(A00-Z99). For Mental
Disorders (F.00-F99)
Term Disorder is used for all
classification, and not the term disease
and illness
Disorder is used to describe a cluster of
sings & symptoms or behaviors that
could be found clinically with distress
for most of the cases and could also
cause impairment of functioning

Terms
impairment: a loss or an abnormality of a
structure or function psychological
manifestation of mental function
(memory)
Disability: limitation or decrease of ability
to perform normal daily life activities
(bathing, eating, drinking)
handycap: disadvantage that limit the role
of somebody to function normally

Dichotomy neurotic psychotic is not

used anymore, instead disorders are
grouping according to clinical features

Psychotic is a descriptive term , not

involving psychodynamic formulation ,
point out only hallucinations,
delusions, and certain behaviors
including ecstasy, overactivities, severe
motor retardation and catatonia
All organic origin disorders are
grouped into one section (F00-F09),
and substance related disorders in one
section(F10-F19)
More than one diagnosis can be
concluded, main diagnosis followed by
concomitant diagnosis

Psychiatric Disorders

Neurotic Disorder (term seldom

used now)

usually distressing but that allows

one to think rationally and function
socially

Psychotic Disorder

person loses contact with reality

experiences irrational ideas and
distorted perceptions

Anxiety
Disorders

Anxiety Disorders

distressing, persistent anxiety or

maladaptive behaviors that reduce
anxiety

Generalized Anxiety Disorder

person is tense, apprehensive, and

in a state of autonomic nervous
system arousal

Anxiety
Disorders

Panic Disorder

marked by a minutes-long episode

of intense dread in which a person
experiences terror and
accompanying chest pain,
choking, or other frightening
sensation

Anxiety
Disorders

Phobia

persistent, irrational fear of a specific

object or situation

Obsessive-Compulsive Disorder

unwanted repetitive thoughts

(obsessions) and/or actions
(compulsions)

Anxiety
Disorders
Common and uncommon fears

Anxiety
Disorders

Anxiety
Disorders

PET Scan of brain

of person with
Obsessive/
Compulsive
disorder
High metabolic
activity (red) in
frontal lobe areas
involved with
directing attention

Mood Disorders

Mood Disorders

characterized by emotional extremes

Major Depressive Disorder

a mood disorder in which a person,

for no apparent reason, experiences
two or more weeks of depressed
moods, feelings of worthlessness, and
diminished interest or pleasure in
most activities

Mood Disorders

Manic Episode

a mood disorder marked by a

hyperactive, wildly optimistic state,
flight of ideas

Bipolar Disorder

a mood disorder in which the person

alternates between the hopelessness
and lethargy of depression and the
overexcited state of mania
formerly called manic-depressive
disorder

Mood DisordersDepression

Mood DisordersDepression
Canadian depression
rates

Mood DisordersSuicide

Mood DisordersBipolar

PET scans show that brain energy

consumption rises and falls with
emotional switches

Depressed state

Manic state

Depressed state

Mood DisordersDepression

Altering any
one
component of
the chemistrycognitionmood circuit
can alter the
others

Mood DisordersDepression

The
vicious
cycle of
depressio
n can be
broken at
any point

Dissociative
Disorders

Dissociative Disorders

conscious awareness becomes separated

(dissociated) from previous memories,
thoughts, and feelings

Dissociative Identity Disorder

rare dissociative disorder in which a

person exhibits two or more distinct and
alternating personalities
formerly called multiple personality
disorder

Schizophrenia

Schizophrenia

literal translation split mind

a group of severe disorders
characterized by:

disorganized and delusional thinking

disturbed perceptions
inappropriate emotions and actions

Schizophrenia

Delusions

false beliefs, often of persecution

or grandeur, that may accompany
psychotic disorders, bizarre

Hallucinations

sensory experiences without

sensory stimulation

Schizophrenia

Schizophrenia

Schizophrenia

Personality
Disorders

Personality Disorders

disorders characterized by
inflexible and enduring behavior
patterns that impair social
functioning
usually without anxiety,
depression, or delusions

Personality
Disorders

Antisocial Personality Disorder

disorder in which the person

(usually man) exhibits a lack of
conscience for wrongdoing, even
toward friends and family
members
may be aggressive and ruthless or
a clever con artist

Personality
Disorders

PET scans illustrate reduced activation in

a murderers frontal cortex
Normal

Murderer

Personality
Disorders

Rates of
Psychological
Disorders

ICD-10

F00 F09
Organic, including symptomatic, mental disorders
F10 F11
Mental and behavioral disorders due to psychoactivc substance use
F20 F 29
Schizophrenia and schizotypal and delusional disorders
F30 F 39
Mood (affective) disorders
F40 F48
Neurotic stress-related and somatoform disorders
F50 F59
Behavioral syndromes associated with physiological disturbances
and physical factors
F60 F69
Disorders of adult personality and behavior
F70 F79
Mental retardation
F80 F89
Disorders of psychological development
F90 F 99
Behavioral and emotional disorders with onset usually occurring in
childhood and adolescence