Mental disorder Mental disorder An introductionAn introduction

John CrichtonJohn Crichton

Consultant Forensic Consultant Forensic PsychiatristPsychiatrist

How can Mental Disorder be How can Mental Disorder be understood?understood?

Disease modelDisease model PsychodynamicPsychodynamic BehaviouralBehavioural CognitiveCognitive SocialSocial

Disease ModelDisease Model

Akin to the rest of medicineAkin to the rest of medicine The phenomenological approachThe phenomenological approach description of syndromedescription of syndrome identification of pathological identification of pathological

processesprocesses natural history of the syndromenatural history of the syndrome treatmenttreatment

Standard diagnostic manualsStandard diagnostic manuals

Psychodynamic modelPsychodynamic model

Origins with FreudOrigins with Freud importance of early importance of early

experience and experience and unconscious unconscious processes processes

use of free use of free association in association in therapytherapy

aim for insight and aim for insight and changechange

Behavioural ModelBehavioural Model

Origins in animal Origins in animal experimentsexperiments

rewarded rewarded behaviour behaviour reinforcedreinforced

phobiasphobias

Cognitive modelCognitive model

Automatic Automatic thoughts or ways thoughts or ways of thinking of thinking

hopelessness guilt hopelessness guilt and worthlessnessand worthlessness

catastrophisingcatastrophising

Social ModelSocial Model

Means two Means two different thingsdifferent things

social factors in social factors in diseasedisease

sociology of sociology of deviancedeviance

labelling - labelling - RosenhanRosenhan

antipsychiatryantipsychiatry

DementiaDementia

Global progressive deterioration of Global progressive deterioration of function - memory intellect function - memory intellect personalitypersonality

an organic disorderan organic disorder 5% over 65; 10% over 805% over 65; 10% over 80 F:M 2:1F:M 2:1

SchizophreniaSchizophrenia

Major mental illnessMajor mental illness Characterised by psychotic Characterised by psychotic

symptoms such as hallucinations and symptoms such as hallucinations and delusionsdelusions

Also negative symptomsAlso negative symptoms 1% of the population1% of the population Controlled by antipsychotic Controlled by antipsychotic

medicationmedication

Manic-DepressionManic-Depression

Characterised by periods of elated Characterised by periods of elated mood and depressed mood with mood and depressed mood with psychotic symptomspsychotic symptoms

1% of the population1% of the population Controlled by mood stabilisersControlled by mood stabilisers

DepressionDepression

Can be part of manic depression or Can be part of manic depression or psychotic depression. Most psychotic depression. Most commonly not characterised by commonly not characterised by psychosis.psychosis.

Low mood, biological symptoms, Low mood, biological symptoms, cognitive symptomscognitive symptoms

Prevalence 5-30%Prevalence 5-30% Twice as common in womenTwice as common in women

Personality DisorderPersonality Disorder

An individual’s characteristic way of An individual’s characteristic way of behaving and feeling in a variety of behaving and feeling in a variety of situations consistently through situations consistently through adulthood.adulthood.

May at its extremes cause subjective May at its extremes cause subjective distress and social problems.distress and social problems.

Various typesVarious types

Other conditionsOther conditions

Eating disordersEating disorders Substance misuseSubstance misuse Learning disabilityLearning disability ADHDADHD Autistic spectrum disorderAutistic spectrum disorder Head injuryHead injury Gender dysphoriaGender dysphoria PTSDPTSD