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Diagnostic Classification Systems (diagnostic + classification_system)
Selected AbstractsHallucinogen Use Disorders Among Adult Users of MDMA and Other HallucinogensTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 5 2008Li-Tzy Wu ScD We investigated the prevalence, patterns, and correlates of past-year DSM-IV hallucinogen use disorders (HUDs) among past-year users of MDMA and other hallucinogens from a sample of Americans 18 or older (n = 37,227). Users were categorized as MDMA users and other hallucinogen users. Overall, one in five (20%) MDMA users and about one in six (16%) other hallucinogen users reported at least one clinical feature of HUDs. Among MDMA users, prevalence of hallucinogen abuse, subthreshold dependence, and dependence was 4.9%, 11.9%, and 3.6%, respectively. The majority with hallucinogen abuse displayed subthreshold dependence. Most with hallucinogen dependence exhibited abuse. Subthreshold hallucinogen dependence is relatively prevalent and represents a clinically important subgroup that warrants future research and consideration in a major diagnostic classification system. [source] The Validity of a Personality Disorder Diagnosis for People with an Intellectual DisabilityJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 3 2008Jessica Moreland Background, It has long been appreciated that people with intellectual disabilities experience mental health problems. Studies into the prevalence of personality disorder in the population of people with an intellectual disability indicate significant variations, which have no clear explanation. Method, Work on personality disorder and personality is reviewed. Results, This article will outline some of the reasons for the variations in the reported prevalence figures including the impact of diagnostic overshadowing, problems inherent within the diagnostic classification systems and instruments that have a significant impact upon the reliability of a diagnosis. It will also argue that there are some fundamental issues relating to the validity of the construct of personality disorder and its application to the population of people with intellectual disabilities. The article notes that the model of personality, which in itself is not without critics, is derived from research on the general population and has not been integrated with personality research conducted within the population of people with an intellectual disability. Conclusion, It is suggested that the current diagnostic systems need to be reviewed in the context of an existing evidence base from within the field of intellectual disabilities. There are grounds to be cautious with the current diagnostic process and to question its clinical utility. Furthermore, diagnosis may only serve as an intermediate step and as part of a more detailed nomothetic approach. [source] The mood spectrum: improving the diagnosis of bipolar disorderBIPOLAR DISORDERS, Issue 2005Jules Angst Although the distinction between bipolar and unipolar disorders served our field well in the early days of psychopharmacology, in clinical practice it is apparent that their phenotypes are only partially described by current diagnostic classification systems. A substantial body of evidence has accrued suggesting that clinical variability needs to be viewed in terms of a broad conceptualization of mood disorders and their common threshold or subthreshold comorbidity. The spectrum model provides a useful dimensional approach to psychopathology and is based on the assumption that early-onset and enduring symptoms shape the adult personality and establish a vulnerability to the subsequent development of Axis-I disorders. To obtain a clearer understanding of the depressive phenotype, it is pivotal that we increase our detection of hypomanic symptoms so that clinicians can better distinguish bipolar II disorder from unipolar depression. Diagnostic criteria sensitive to hypomanic symptoms have been identified that suggest bipolar II disorder is at least as prevalent as major depression. Moreover, the comorbidities of these illnesses are very different and alcoholism in particular appears to be a greater problem in bipolar II disorder than in unipolar depression. Structured clinical interviews and patient self-report questionnaires have also successfully identified the presence of hypomanic symptoms in patients with unipolar disorder and support the concept of a spectrum of bipolar illness. In conclusion, the importance of subthreshold syndromes should not be underestimated as failure to recognize bipolar spectrum disorder could delay treatment and worsen prognosis. [source] Redefining Affective Disorders: Relevance for Drug DevelopmentCNS: NEUROSCIENCE AND THERAPEUTICS, Issue 1 2008Steven D Targum The evaluation of new drug entities with specific modes of action may be hampered by rigid diagnostic classification systems and patient selection processes that do not focus on the anticipated symptomatic, behavioral, and functional outcomes to be achieved. Patients enrolled in central nervous system (CNS) clinical trials may present with a heterogeneous group of symptoms representing several syndromes or subtypes, subsumed under the same diagnosis in the DSM-IV classification system. As a result, enrolled patients may not have the valid illness characteristics of interest to the particular study. We propose that clinical drug development needs to focus on the primary nosological entity likely to be affected by a new drug entity's mode of action. Ideally, a valid patient will have the acute primary symptoms that the novel drug is supposed to influence. In this article, we propose operational criteria to delineate a more symptom-specific and ecologically valid approach to the identification of the valid patient for clinical trials. [source] | ||||||||||