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The DSM-5’s proposed new categories of sexual disorder: the problem of false positives in sexual diagnosis
- Author:
- WAKEFIELD Jerome C.
- Journal article citation:
- Clinical Social Work Journal, 40(2), 2012, pp.213-223.
- Publisher:
- Springer
- Place of publication:
- New York
The proposals that have emerged from the DSM-5 revision process have triggered considerable controversy, especially regarding potential invalid inflation of diagnostic categories. To illustrate the kinds of issues that have emerged, the author closely examines the proposed new categories of sexual disorder. The DSM-5 Sexual and Gender Identity Disorders Work Group is proposing the addition of three categories of disorder to the DSM-5—hypersexuality, hebephilia (as part of a revised pedophilia category that would become pedohebephilia), and coercive paraphilic disorder (basically a “nonconsent” or rape paraphilia). These proposals are driven by perceived clinical or forensic needs. The author argues, however, that their conceptual soundness remains problematic; each could lead to large numbers of false positive diagnoses (i.e., diagnoses that mistakenly label a normal variant of behavior as a mental disorder), with potential for serious forensic abuse in “sexually violent predator” civil commitment proceedings. (Publisher abstract)
A future state of mind: facing up to the dementia challenge
- Authors:
- BROUGHTON Nida, KEOHANE Nigel, SHORTHOUSE Ryan
- Publisher:
- Social Market Foundation
- Publication year:
- 2012
- Pagination:
- 84p.
- Place of publication:
- London
In the context of forecasts of an increase in the number of people with dementia as the UK population ages, and the launch of the Dementia Challenge by the Prime Minister in 2012, this report looks at diagnosis and early diagnosis of people with dementia. It is based on an extensive literature review, qualitative research involving semi-structured interviews with patients diagnosed with Alzheimer's and their carers or relatives, and quantitative analysis. It notes that evidence suggests that diagnosis is important, and considers the benefits of early diagnosis of dementia, how the UK's diagnosis performance compares internationally and how England performs compared to the devolved administrations. It identifies and discusses patient and professional barriers to early diagnosis. It concludes by proposing policies to improve the early diagnosis rate.
Transparency, hope, and empowerment: a model for partnering with parents of a child with autism spectrum disorder at diagnosis and beyond
- Authors:
- MULLIGAN Janice, et al
- Journal article citation:
- Social Work in Mental Health, 10(4), November 2012, pp.311-330.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
To date, little is known about how a diagnosis of Autism Spectrum Disorder (ASD) is delivered and experienced by families. This study examined the experiences of 10 parents receiving a diagnosis of ASD for their child. Findings revealed a lengthy, complex, and discouraging assessment and diagnostic process that resulted in parents feeling confused, disempowered, and overwhelmed. Identified themes associated with diagnosis comprised: initial recognition that “something is different”; waiting, worry, and uncertainty; preference for diagnostic information in a hopeful tenor; feeling overwhelmed with information and emotion at diagnosis; processes of grief, relief, and making sense of ASD; and becoming an advocate, expert, and case manager. The importance of empowering parents by providing support, information, resources, and tools for navigating the complexity of service/treatments at the time of diagnosis was emphasized within a parent–professional partnership. A protocol for practice, focused on enhanced parental empowerment, is offered including specific clinical guidelines (what to share, how to share, and when to share) for sharing a diagnosis of ASD.
Catatonia in a woman who is profoundly deaf-mute: case report
- Authors:
- AKINTOMIDE Gbolagade, PORTER Stuart Williams, PIERCE Anita
- Journal article citation:
- Psychiatrist (The), 36(11), November 2012, pp.418-421.
- Publisher:
- Royal College of Psychiatrists
... and 2% of these individuals will experience bipolar disorder in their lifetime, emphasising the importance of the accurate diagnosis of catatonia. This paper reports a case of catatonia presenting with dysphagia in a 48 year old profoundly deaf-mute woman with bipolar disorder. The report highlights some modifications of presentation and difficulties of accurate diagnosis and management of catatonia in this patient. She responded poorly to diazepam and was eventually prescribed emergency electroconvulsive therapy with some success. Arrival at a diagnosis required interdisciplinary collaboration among a wide range of professionals. This is believed to be the first case report of catatonia in someone who is profoundly deaf-mute.
Symptomatic remission in psychosis and real-life functioning
- Authors:
- OORSHOT M., et al
- Journal article citation:
- British Journal of Psychiatry, 201(3), September 2012, pp.215-220.
- Publisher:
- Cambridge University Press
It is unclear whether proposed criteria for remission in schizophrenia reflect symptom reduction and improved social functioning. This study investigated whether criteria for symptomatic remission reflect symptom reduction and improved functioning in daily life. It compared patients meeting remission criteria, patients not meeting these criteria and healthy controls. The Experience Sampling Method (ESM), a structured diary technique, was used in 177 patients with (remitted and non-remitted) schizophrenia spectrum disorders and 148 controls. Of 177 patients, 70 met criteria for symptomatic remission. These patients reported significantly fewer positive and negative symptoms and better mood states compared with patients not in remission. Those in remission spent more time in goal-directed activities and had less preference for being alone. However, the patient groups did not differ on time spent in social company and doing nothing, and both the remission and non-remission groups had lower scores on functional outcome measures compared with the control group. The authors conclude that these findings provide an ecological validation for the symptomatic remission criteria, showing that patients who met the criteria reported fewer positive symptoms, better mood states and partial recovery of reward experience compared with those not in remission. However, remission status was not related to functional recovery, suggesting that the current focus on symptomatic remission may reflect an overly restricted goal.
Easily missed? Post-traumatic stress disorder
- Authors:
- REED Ruth V., FAZEL Mina, GOLDRING Lorna
- Journal article citation:
- British Medical Journal, 18.8.12, 2012, pp.44-45.
- Publisher:
- British Medical Association
Post-traumatic stress disorder can be a disabling condition and often goes undiagnosed. This article looks at the causes and symptoms of post-traumatic disorder, why it is often missed in diagnosis, how it is diagnosed and managed. Information boxes summarise the main diagnostic criteria for post-traumatic stress disorder from the International Classification of Diseases and also provide some
Think pathways, not numbers
- Author:
- SCHNEIDER Kate
- Journal article citation:
- Journal of Dementia Care, 20(4), July 2012, pp.23-25.
- Publisher:
- Hawker
The rate of diagnosis of dementia has emerged as a political opportunity for the government, highlighting the “diagnosis gap” in various regions around England. Using an indicator that combines the regional diagnosis gap, current prevalence and its expected rate of increase, the National Audit Office found that the South West and East Midlands are facing the biggest challenge. However, the author contends that socio-economic factors may play a large part of the diagnosis gap, essentially rendering it a meaningless metric. This article questions whether statistics on diagnosis rates are reliable or meaningful at the local level, and instead suggests focusing on the diagnosis pathways and outcomes for people with dementia – using preventative measures to delay onset by equipping key areas
Identification of congenital deafblindness
- Author:
- DAMMEYER Jesper
- Journal article citation:
- British Journal of Visual Impairment, 30(2), 2012, pp.101-107.
- Publisher:
- Sage
The accurate and straightforward identification of congenital deaf blindness can be difficult for many reasons. This article reports on the assessment procedures and experience in Denmark where medical examinations were combined with functional assessments performed through direct observation. The study evaluated the assessment procedure of 190 children and adults found to be congenitally deaf blind. Among the 190 individuals 76 percent were determined using functional assessment in addition to medical examination. A case example involving a 12-year-old child is presented to illustrate the complexity of identifying congenital deaf blindness. The author concludes that determining deaf blindness should not be limited to medical procedures (vision and hearing tests) alone, but may also involve a lengthy process to assess the level of sensory functioning the individual possesses.
Help across the spectrum: a developmental pediatrician's perspective on diagnosing and treating autism spectrum disorders
- Author:
- COPELAND Linda
- Journal article citation:
- Journal of Social Work in Disability and Rehabilitation, 11(1), 2012, pp.1-32.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article explains recent developments in the diagnosis and treatment of autism spectrum disorders (ASD), a group of neurodevelopmental disorders characterised by marked deficits in social interaction and communication with unusually restricted interests ASD has a tremendous impact on society and are increasingly being diagnosed. Increased developmental screening, use of standardised
Phenomenology of depression in older compared with younger adults: meta-analysis
- Authors:
- HEGEMAN J. M., et al
- Journal article citation:
- British Journal of Psychiatry, 200(4), April 2012, pp.275-281.
- Publisher:
- Cambridge University Press
Late-life depression may present differently to early-life depression. Conceptual and methodological limitations and the inherent subjectivity of narrative reviews have made it difficult to draw firm conclusions. This study was designed to investigate the effect of age on the phenomenology of major depression. A systematic search was conducted in PubMed, Embase and PsycINFO for studies examining the relation between age and phenomenology of major depression according to RDC, DSM and ICD criteria. Inclusion criteria required age groups to be compared at the single-item level using the 17-, 21- or 24-item versions of the Hamilton Rating Scale. A meta-analysis was undertaken for each item of the 17-item scale. Eleven papers met the inclusion criteria. When compared with younger depressed adults, older adults demonstrated more agitation, hypochondriasis and general as well as gastrointestinal somatic symptoms, but less guilt and loss of sexual interest. The authors conclude that the experience of late-life depression differs only in part from that of early-life depression. Older people may have a more somatic presentation, whereas feelings of guilt and loss of sexual function may be more prevalent in younger people.