Personal and indirect books films tv experiences in

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Personal and indirect (books, films, TV) experiences in which people are seen to have  unwanted conditions requiring mental health intervention. In training as a mental health professional, through classic case studies or supervised  clinical experiences. Nosology Nosology Science or scheme of disease categorization and classification Diagnosis Diagnosis Act of assigning a nosological category
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Basic Terminology Basic Terminology (from Emil Kraepelin) Etiology = Cause Course = Trajectory Prognosis = Outcome Signs = Observable markers Symptoms = Patient reports Signs + Symptoms = Syndrome Syndrome + Course = Disease Why Diagnose At All? Why Diagnose At All?  Prognosis  Treatment implications Communication among professions Establish prospects for contagion or other   transmission, and possible prevention Legal reasons (e.g., competence, insanity determinations) Financial reasons (compensation to patient and/or treatment provider) Research  Problems Inherent in the Act of Diagnosis Problems Inherent in the Act of Diagnosis Sacrifices the uniqueness of individual patient. Can falsely imply etiology (cause).
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Rigidifies treatment alternatives. Iatrogenic illness. Stigmatization. Secondary gain. Two Kinds of Diagnosis Two Kinds of Diagnosis Phenotypic Signs Symptoms Course Outcome Response to treatment Genotypic Cause Laboratory tests In physical medicine, progress consists of moving from phenotypic to genotypic diagnosis. In mental health, nearly all diagnosis is phenotypic.
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Ingredients of a Diagnosis  Ingredients of a Diagnosis  Symptoms. Signs. Course of illness. Age of onset. Family history. Recent events. Recent behavior. Psychological tests. Laboratory tests (e.g., neuroimaging, hormonal assays, genetic testing). Response to treatment (prior or current). Multifactorial Nature of Diagnosis Multifactorial Nature of Diagnosis No single sign or symptom defines a mental disorder, i.e., is  pathognomonic  of a  mental disorder. Diagnosis is based on a  pattern  of signs and symptoms, i.e., a syndrome. The patterns of syndromes and courses of illness that define mental disorders are  spelled out in the  nosology  of mental disorders. Nosologies for Mental Disorder:  Nosologies for Mental Disorder:   Diagnostic and Statistical Manuals for Mental Disorder   Diagnostic and Statistical Manuals for Mental Disorder  (DSM series) (DSM series) American Psychiatric Association American Psychiatric Association
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1952 DSM – I  (100 disorders in 8 categories) 1968 DSM – II (100 disorders in 10 categories) ------------------------------------------ 1980 DSM – III (230 disorders in 19 categories) 1989
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