More than 50 million Americans suffer from mental illness or mental disorder. Because most of them are not severe and many go untreated, it may be helpful to understand the science behind what causes mental illness and how it manifests itself in everyday life
Source: The Science of Mental Illness
The Intelligent Clinician’s Guide to the DSM-5: an Interview with Dr Joel Paris from Clinton Power on Vimeo.
I must commend my colleague Clinton Power of Australian Counselling for this most excellent interview with Dr. Joel Parish.
Dr. Joel Paris is a research associate at the Sir Mortimer B. Davis Jewish General Hospital in Montreal. Since 1994 he has been a full professor at McGill University and served as chair of its Department of Psychiatry from 1997 to 2007. He has supervised psychiatric evaluation with residents for over 30 years and has won many awards for his teaching. Dr. Paris is a past president of the Association for Research on Personality Disorders. Over the last 20 years, he has conducted research on the biological and psychological causes and the long-term outcome of borderline personality disorder. Dr. Paris is the author of 183 peer reviewed articles, 40 book chapters and15 books. He’s also editor-in-chief of the Canadian Journal of Psychiatry. Most recently, he’s the author of the book, ‘Treatment of Borderline Personality Disorder: A Guide to Evidence-Based Practice’ amzn.to/14Y7Q22 and his latest book is called ‘The Intelligent Clinician’s Guide to the DSM 5’ amzn.to/YfD8N2
PS~ You can pre-order the new DSM-5 here: amzn.to/161bQPo
The Diagnostic and Statistical Manual of Mental Disorders (DSM), long the master reference work in psychiatry, is seriously flawed and needs radical change from its current “field guide” form, according to an essay by two Johns Hopkins psychiatrists published in the May 17 issue of the New England Journal of Medicine.
“A generation ago it served useful purposes, but now it needs clear alterations,” says Paul R. McHugh, M.D., a professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and co-author of the paper with Phillip R. Slavney, M.D., a professor emeritus in the same department. “They say they can’t do any better. We disagree and can show how.”
The original DSM, published in the 1950s, was intended as a public health service documenting the incidence and prevalence of mental illnesses. By its third edition in 1980 (DSM-III), however, it had evolved into a reference book prescribing how clinicians should identify and classify psychiatric disorders.
Today, the Johns Hopkins psychiatrists say, DSM provides checklists of symptoms, offering few clues to the underlying causes of mental disease and making it difficult to direct treatment or investigate the disorders it details. A new edition, DSM-5, is due out in 2013.
The manual, put together by the American Psychiatric Association, currently identifies hundreds of conditions via lists of diagnostic criteria and symptoms, functioning exactly as does a naturalist’s field guide but for mental illness. It offers no way to make sense of mental disorders and no way to distinguish illnesses that appear to be similar but actually are quite different and require different treatments, the psychiatrists argue.
“If you just name things and don’t explain what the causes are, you do not know how to rationally treat or study the diseases,” says McHugh, former director of Hopkins’ psychiatry department. “The DSM gives everything a name but not a nature.”
Before DSM-III, McHugh and Slavney say, psychiatrists typically used a “bottom-up” method of diagnosis, based on a detailed life history, painstaking examination of mental status and corroboration from third parties. The new emphasis on symptoms, they say, has unfortunately encouraged a cursory “top-down” method that relies on checklists and ignores much of the narrative of the patients’ lives.
The causes of psychiatric disorders derive from four interrelated but separable categories: brain diseases, personality dimensions, motivated behaviors and life encounters, write McHugh and Slavney. The two physicians suggest that organizing mental illnesses based on these four causalities would “promote fruitful thought and, consequently, progress.”
“Psychiatrists would start moving toward the day when they address psychiatric disorders in the same way that internists address physical disorders, explaining the clinical manifestations as products of nature to be comprehended not simply by their outward show but by the causal processes and generative mechanisms that provoke them,” they write. “Only then will psychiatry come of age as a medical discipline and a field guide cease to be its master work.”
Mental health advocate Michael Schratter completed his epic worldwide solo cycling journey in Vancouver today after crossing six continents and 33 countries over 469 days. (CNW Group/Canadian Mental Health Association, BC Division)
His worldwide, 469-day “Ride Don’t Hide” cycling journey has made an indelible impact, raising awareness and helping to overcome the stigma around mental illness for the one in five Canadians who suffer from mental health issues such as depression, anxiety disorders and schizophrenia.
Today, mental health supporters welcomed Michael home as more than 200 cycled along with him from Tsawwassen and Richmond into Vancouver for a celebration event at Rogers Arena, completing his journey. There, Michael shared his adventures from his worldwide trek and personal story with a large crowd of supporters and fans, including Vancouver Canucks owner Francesco Aquilini and General Manager Mike Gillis, who cycled the final leg with Michael.
A Vancouver school teacher diagnosed with bi-polar disorder, Michael began his “Ride Don’t Hide” campaign on August 1, 2010 with the goal of cycling 40,000 km around the globe, and raising $100,000 for the Canadian Mental Health Association’s youth programs.
All he had was a bike, a knapsack and a determination to live out a dream to create awareness and help empower people dealing with mental health challenges. He started out in Vancouver, rode down through the west coast of the United States, Mexico and South America, flew over to the east coast of Australia and cycled up through Asia and then hopped over to Europe. He did all of this by taking a year off from his job as a grade five teacher, using his own funds to finance the journey as he travelled the globe. [continue reading…]
