Mental and Behavioral Disorders



Mental and Behavioral Disorders



Objectives



image Recognize and use terms related to the pathology of mental and behavioral health.


image Recognize and use terms related to the procedures for mental and behavioral health.





Introduction to Mental and Behavioral Health


Although many body system disorders are described by their abnormal laboratory, physical, or clinical findings, mental and behavioral disorders are not as easily defined. In the United States, the Diagnostic and Statistical Manual of Mental Disorders (DSM), currently a multi-axial classification developed by the American Psychiatric Association (APA), is in its fifth edition (DSM-5). This revision will eventually result in a closer alignment to ICD-10 and its single axis format. Consider the following:



The term behavioral health reflects an integration of the outdated concept of the separate nature of the body (physical health/illness) and the mind (mental health/illness). Advances in research continually acknowledge the roles of culture, environment, and spirituality in influencing physical and behavioral health. The use of the term behavior refers to observable, measurable activities that may be used to evaluate the progress of treatment.


Similar to previous chapters, this chapter examines disorders that result when an individual has a maladaptive response to his or her environment (internal or external). (See Chapter 11 for an explanation of the anatomy and physiology of the brain and nervous system.) However, even though some mental illnesses have organic causes in which neurotransmitters and other known brain functions play a role, there is no mental “anatomy” per se. Instead, behavioral health is a complex interaction among an individual’s emotional, physical, mental, and behavioral processes in an environment that includes cultural and spiritual influences.


Mental health may be defined as a relative state of mind in which a person who is healthy is able to cope with and adjust to the recurrent stresses of everyday living in a culturally acceptable way. Thus mental illness may be generally defined as a functional impairment that substantially interferes with or limits one or more major life activities for a significant duration.



Pathology



image
Fig. 12-1 A, This drawing by a patient with schizophrenia demonstrates thought disorder. B, Drawing by a delusional patient with schizophrenia.

image
Fig. 12-2 The perception of body shape and size can be evaluated with the use of special computer drawing programs that allow a subject to distort (increase or decrease) the width of an actual picture of a person’s body by as much as 20%. Subjects with anorexia consistently adjusted their own body picture to a size 20% larger than its true form, which suggests that they have a major problem with the perception of self-image.


Terms Related to Signs and Symptoms Involving Cognition, Perception, Emotional State, and Behavior and Speech and Voice (R4Ø-R49)








Affect is observable demonstration of emotion that can be described in terms of quality, range, and appropriateness. The following list defines the most significant types of affect encountered in behavioral health:
















































Term Word Origin Definition
amnesia   Inability to remember either isolated parts of the past or one’s entire past; may be caused by brain damage or severe emotional trauma.
anhedonia an- no, not, without
hedon/o pleasure
-ia condition		 Absence of the ability to experience either pleasure or joy, even in the face of causative events.
confabulation   Effort to conceal a gap in memory by fabricating detailed, often believable stories. Associated with alcohol abuse.
dyscalculia dys- difficult
calcul/o stone
-ia condition		 Difficulty with performing mathematical calculations.
dysphoria dys- abnormal
phor/o to carry, to bear
-ia condition		 Generalized negative mood characterized by depression.
echolalia echo- reverberation
-lalia condition of babbling		 Repetition of words or phrases spoken by others.
euphoria eu- good, well
phor/o to carry, to bear
-ia condition		 Exaggerated sense of physical and emotional well-being not based on reality, disproportionate to the cause, or inappropriate to the situation.
hallucination   Any unreal sensory perception that occurs with no external cause.
hyperkinesis hyper- excessive
-kinesis movement		 Excessive movement and activity.
stupor   From the Latin term for “numbness,” a stupor is a state of near unconsciousness.


image



image Exercise 1:


Signs and Symptoms of Mental Illness


Match the term to the definition.



Build the following terms.





Terms Related to Mental and Behavioral Disorders Due to Psychoactive Substance Use (F1Ø-F19)








Substance-related disorders are the most rapidly increasing group of disorders in the mental health chapter. These include abuse of a number of substances, including alcohol, opioids, cannabinoids, sedatives, hypnotics or anxiolytics, cocaine, stimulants (including caffeine), hallucinogens, nicotine, and volatile solvents (inhalants). Classifications for substance abuse include psychotic, amnesiac, and late-onset disorders. It is important to be aware that addiction is not a character flaw. Rather, addiction has a neurological basis; the effects of specific drugs are localized to equally specific areas of the brain.


An individual is considered an “abuser” if he or she uses substances in ways that threaten health or impair social or economic functioning. The term harmful use indicates a pattern of drug use that causes damage to health. If the term tolerance is used to describe someone’s usage, it means a state in which the body becomes accustomed to the substances ingested; hence the user requires greater amounts to create the desired effect. Individuals who exhibit a lessening or disappearance of a disease or disorder are said to be in remission. ICD-10-CM uses “in remission” codes instead of “history” codes.
























Term Word Origin Definition
delirium tremens (DTs)   Acute and sometimes fatal delirium induced by the cessation of ingesting excessive amounts of alcohol over a long period.
dependence   Difficulty in controlling use of a drug.
intoxication in- in
toxic/o poison
-ation process of		 Episode of behavioral disturbance following ingestion of alcohol or psychotropic drugs. ICD-10-CM provides a code for blood alcohol level.
withdrawal state   Group of symptoms that occur during cessation of the use of a regularly taken drug.


image



Terms Related to Schizophrenia, Schizotypal and Delusional, and Other Non-Mood Psychotic Disorders (F2Ø-F29)












































Term Word Origin Definition
catatonia cata- down
ton/o tension
-ia condition		 Paralysis or immobility from psychological or emotional, rather than physical, causes.
catatonic schizophrenia cata- down
ton/o tension
-ic pertaining to
schiz/o split
phren/o mind
-ia condition		 Also called schizophrenic catalepsy. This form of schizophrenia is dominated by prominent psychomotor disturbances that may alternate between extremes, such as hyperkinesis and stupor, and may be accompanied by a dreamlike (oneiric) state and hallucinations.
delirium   Condition of confused, unfocused, irrational agitation. In mental disorders, agitation and confusion may also be accompanied by a more intense disorientation, incoherence, or fear, and illusions, hallucinations, and delusions.
hebephrenia hebe goddess of youth
phren/o mind
-ia condition		 Although more often referred to as disorganized schizophrenia, hebephrenia was named for its original association with initial occurrence at the time of puberty. It is characterized by prominent affective changes, fleeting and fragmentary delusions and hallucinations, and irresponsible and unpredictable behaviors. Shallow, inappropriate mood, flighty thoughts, social isolation, and incoherent speech are also present.
oneirism oneir/o dream
-ism state		 A state of a dreamlike hallucination.
paranoia para- abnormal
-noia condition of the mind		 A type of delusional disorder, paranoia includes the inaccurate perception of suspicious thinking. Also called delusional disorder, or late paraphrenia.
psychosis psych/o mind
-osis abnormal condition		 Disassociation with or impaired perception of reality; may be accompanied by hallucinations, delusions, incoherence, akathisia (the inability to sit still), and/or disorganized behavior.
schizophrenia schiz/o split
phren/o mind
-ia condition		 A group of disorders characterized by fundamental distortions of thinking and perception, coupled with affect that is inappropriate or blunted. The patient exhibits characteristic inability to recognize an appropriate perception of reality, although his/her intellectual capacity is usually intact (Fig. 12-1).
schizotypal disorder   Unlike the other forms of schizophrenia, patient exhibits anhedonia, eccentric behavior, cold affect, and social isolation. Also called borderline schizophrenia, latent schizophrenia and prodromal schizophrenia.



image Exercise 2:


Mental and Behavioral Disorders due to Known Physiological Conditions; Psychoactive Substance Use; Schizophrenia, Schizotypal, Delusional, and Other Non-Mood Psychotic Disorders; and Mood Disorders


Match the terms with their definitions.



Decode the terms.




Terms Related to Anxiety, Dissociative, Stress-Related, Somatoform, and Other Nonpsychotic Mental Disorders (F4Ø-F48)
































































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Jun 16, 2016 | Posted by in ANATOMY | Comments Off on Mental and Behavioral Disorders

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Term Word Origin Definition
acrophobia acro- heights, extremes
-phobia condition of fear, sensitivity		 Fear of heights.
agoraphobia agora- marketplace
-phobia condition of fear, sensitivity		 Fear of leaving home and entering crowded spaces.
androphobia andr/o man, men
-phobia condition of fear, sensitivity		 Fear of men.
anthropophobia anthrop/o man
-phobia condition of fear, sensitivity		 Fear of scrutiny by other people; also called social phobia.
anxiety   Anticipation of impending danger and dread accompanied by restlessness, tension, tachycardia, and breathing difficulty not associated with an apparent stimulus.
claustrophobia claustr/o a closing
-phobia condition of fear, sensitivity		 Fear of enclosed spaces.
delusion   Persistent belief in a demonstrable untruth or a provable, inaccurate perception despite clear evidence to the contrary.
dissociative identity disorder   Maladaptive coping with severe stress by developing one or more separate personalities. A less severe form, dissociative disorder or dissociative reaction, results in identity confusion accompanied by amnesia, oneirism, and somnambulism. Formerly termed multiple personality disorder.
dyslexia dys- difficult
lex/o word
-ia condition		 Inability or difficulty with reading and/or writing.
generalized anxiety disorder (GAD)   Anxiety disorder characterized by excessive, uncontrollable, and often irrational worry about everyday things that is disproportionate to the actual source of worry.
gynephobia gyn/e female, women
-phobia condition of fear, sensitivity		 Fear of women.
illusion   Inaccurate sensory perception based on a real stimulus; examples include mirages and interpreting music or wind as voices.
obsessive-compulsive disorder (OCD)   Disorder characterized by recurrent, distressing, and unavoidable preoccupations or irresistible drives to perform specific rituals (e.g., constantly checking locks, excessive handwashing) that the patient feels will prevent some harmful event.
panic disorder (PD)   Anxiety disorder characterized by recurring, severe panic attacks. Common symptoms of an attack include rapid heartbeat, perspiration, dizziness, dyspnea, uncontrollable fear, and hyperventilation.