Models for Mental Disorder
Systems approaches are needed to recognise the complexity of the biological bases of psychiatric disease. The bases of mental disorders can best be understood as a complex interplay between biological, psychological, social and lifestyle factors: There are undoubtedly some disorders where a biological model alone is more appropriate — this applies particularly to the psychotic disorders — but even in such cases it must be acknowledged that these illnesses are strongly influenced by psychosocial and lifestyle factors.
What makes a biological understanding of mental illnesses necessary, however, is that it opens the way for the development of rational treatments. This has been the quest since antiquity, with treatments predicated on the putative underlying biological causes: While these models perhaps now seem far-fetched, they were not entirely implausible when one considers contemporary neuro-endocrine and neuro-inflammatory models of mental illness. The full article is accessible to AMA members and paid subscribers. This is the classification system used by the American Psychiatric Association.
The first version DSM 1 was published in The latest version is DSM V published in This is published by The World Health Organisation. Mental disorders were included for the first time in ICD 6.
The current version is ICD 10 published in On the basis of the diagnosis, the psychiatrist will prescribe treatment such as drugs, psychosurgery or electroconvulsive therapy. However, since the s psychiatrists have predominantly treated mental illnesses using drugs. However, studies have shown that diagnosis is not a reliable tool.
Rosenhan conducted an experiment where the aim was to see whether psychiatrists could reliably distinguish between people who were mentally ill and those who were not. The study consists of two conditions from which in one the hospital were informed that patients will be coming that are not actually mentally ill when in fact no patients were sent at all. In this condition the psychiatrists only diagnosed 41 out of patients as being mentally ill when in reality all patients were mentally ill.
In the other conditions, 8 people were told to report at the hospital that they hear noises in their head. As soon as they were administrated, they behaved normally. The doctors in this condition still classified these patients as insane, with a case of dormant schizophrenia.
Diagnostic Criteria
Rosenhan concluded that no psychiatrist can easily diagnose the sane from insane. Though Rosenhan delivered a very accurate report on diagnoses of patients, Rosenhan was criticised for deceiving the hospital for claiming that sane patients were being sent over, though none were actually sent. The main biological explanations of schizophrenia are as follows:. Biochemistry — the dopamine hypothesis argues that elevated levels of dopamine are related to symptoms of schizophrenia.
Neuroanatomy — differences in brain structure abnormalities in the frontal and pre-frontal cortex, enlarged ventricles have been identified in people with schizophrenia. Genetic — there is considerable evidence that the predisposition to develop depression is inherited. Amine hypothesis — low levels of mono amines predominantly noradrenaline and serotonin. Neuroendocrine hormonal factors — the importance of stress hormones e.
Medical Model vs. Psychosocial/Behavioral Model
The main biological explanations of OCD are as follows:. Genetic — there is some evidence of a tendency to inherit OCD, with a gene Sapap3 recently identified. Neuroanatomy — dysfunctions of the orbital frontal cortex OFC over-activity in basal ganglia and caudate-nucleus thalamus have been proposed. The film one flew over the cuckoos nest demonstrates the way in which drugs are handed out like smarties merely to keep the patients subdued.
Antipsychotic drugs can be used to treat schizophrenia by blocking d2 dopamine receptors. They tend to be people who do not have a great track record at tackling problems and overcoming obstacles. By contrast, psychiatrists point to their own illness system, an essential feature of which is the notion that the illness e. I have discussed this issue of blame on previous occasions, but last weekend an incident occurred in our own home that I thought was very illustrative of these dynamics and that warranted sharing. Our older daughter, her husband, and their two sons were visiting. The younger son, Paul, is just over two years old.
One of his favorite toys is a hedgehog named Charlie. At one point I was doing some work in the garage, and Paul came out to see me, and to show me his hedgehog.
A psychological model of mental disorder.
He took Charlie out of his case, and we all had a nice visit. Then Paul decided to go back into the house. When he got to the connecting door, however, he had a problem. Charlie was in his right hand; the case in his left hand — leaving no hand to open the door. My immediate instinct was to go over and open the door for him.
But instead, I paused.