Tag Archives: mental

Normal or not? When temper tantrums become a disorder

Angry kids who throw excessive, explosive tantrums now have their own disorder: disruptive mood dysregulation disorder. Whereas this new addition to the mental health dictionary, the DSM, has prompted protests that psychiatrists are turning a normal part of childhood into a mental disorder, proponents say it will address the skyrocketing rate of another diagnosis that is leading to the inappropriate use of powerful medications on children. The soaring diagnoses belong to pediatric cases of bipolar disorder. Between 1994-1995 and 2002-2003, the diagnosis of bipolar disorder in children grew by 40-fold, according to research published in 2007 in the journal Archives of General Psychiatry. [11 New Warning Signs Help Spot Mental Illness in Children] Many of these children exhibited a pattern not consistent with a bipolar diagnosis. Specifically, bipolar disorder involves episodes of mania, which can show up in children as irritability. However, many of the children diagnosed did not have clear-cut episodes of irritability, instead, they were constantly irritable. As a result, experts believe many children are being misdiagnosed. Bipolar disorder is often treated with medications that bring worrisome side effects that are worse in children, according to the advocacy group the National Alliance on Mental Illness. These include weight gain that brings increased risk of diabetes or heart problems later in life, movement abnormalities and other problems. When it came time to put together the new edition of the mental health manual, called the DSM-5, officials at the American Psychiatric Association, which publishes the manual, wanted to include a better-fitting diagnosis for kids with persistently angry, irritable dispositions, hence the addition of disruptive mood dysregulation disorder (DMDD). However, the addition is controversial. Allen Frances, who chaired the task force for the previous edition of DSM, charges that this new DMDD diagnosis “will exacerbate, not relieve, the already excessive and inappropriate use of medicationin young children.” The addition of DMDD could prove helpful, because it will enable researchers to study these symptoms in children who have previously been diagnosed with bipolar disorder, but who dont fit the profile for that disorder, said Robin Rosenberg, a clinical psychologist and co-author of the psychology textbook “Abnormal Psychology” (Worth Publishers, 2009). “The concern is that it will lower the threshold for diagnosing kids who are just having a hard time,” Rosenberg said. “There is a gain and there is a risk. If it becomes overly diagnosed, it will prevent us from figuring out what is going on with kids who really have this persistent problem with mood and behavior and, more importantly, needlessly put children on dangerous medications.” Tantrums and bad moods are normal parts of childhood. But to receive a DMDD diagnosis, a child must have rages that are “grossly out of proportion” three or more times per week, on average. The child's mood between outbursts must be “irritable or angry most of the day, nearly every day,” according to the DMDD criteria, which set a threshold of at least 12 months. Kids who might qualify for this new diagnosis may come to the attention of mental health professionals because they have serious behavioral trouble at school or their parents may be unable to control them at home, Rosenberg said. Copyright 2013 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.source : http://www.foxnews.com/health/2013/06/17/normal-or-not-when-temper-tantrums-become-disorder/

Up to 1 in 5 children suffer from a mental disorder, CDC says

Up to 20 percent of children in the United States suffer from a mental disorder, and the number of kids diagnosed with one has been rising for more than a decade, according to a report released on Thursday by the U.S. Center for Disease Control and Prevention. In the agency's first-ever study of mental disorders among children aged 3 to 17, researchers found childhood mental illnesses affect up to one in five kids and cost $247 billion per year in medical bills, special education and juvenile justice. Children with mental disorders - defined as “serious deviations from expected cognitive, social, and emotional development” - often have trouble learning in school, making friends, and building relationships later in life, the report said. They are more likely to have other chronic health problems, such as asthma and diabetes, and are at risk for developing mental illnesses as adults. “This is a deliberate effort by CDC to show mental health is a health issue. As with any health concern, the more attention we give to it, the better. It's parents becoming aware of the facts and talking to a healthcare provider about how their child is learning, behaving, and playing with other kids,” Dr. Ruth Perou, the lead author of the study, said in an interview. “What's concerning is the number of families affected by these issues. But we can do something about this. Mental health problems are diagnosable, treatable and people can recover and lead full healthy lives,” Perou added. The study cited data collected between 1994 and 2011 that showed the number of kids with mental disorders is growing. The study stopped short of concluding why, but suggested improvements in diagnoses as one possible explanation “Changes in estimated prevalence over time might be associated with an actual change in prevalence, changes in case definition, changes in the public perception of mental disorders, or improvements in diagnosis, which might be associated with changes in policies and access to health care,” the study said. Perou said more research was needed to determine the specific causes of mental disorders, and that greater awareness could lead to an uptick in diagnoses. A host of environmental factors, including chemical exposure and poverty, can also affect a child's mental health, she said. Lead, for example, is known to be “one of the biggest toxins to impact behavior and learning,” Perou said. Poor children are at a higher risk for developing certain conditions, according to the study. The most prevalent mental health diagnosis, as reported by parents, was Attention Deficit/Hyperactivity Disorder (ADHD), which affects 6.8 percent of children. Also common were behavioral conduct problems (3.5 percent), anxiety, which consists mostly of fears and phobias (3 percent), depression (2.1 percent) and autism spectrum disorders (1.1 percent). Many of these disorders occur together, the report said. Boys were found more likely to have most of the listed disorders except for depression and alcohol abuse, which affect more girls. The study also noted that suicide, which can be precipitated by an untreated mental illness, was the second leading cause of death (after accidents) among children 12 to 17 years old. The CDC report was based on multiple other studies that collected data and interviewed children and their guardians about their diagnoses, habits, behaviors and other factors.source : http://www.foxnews.com/health/2013/05/17/up-to-1-in-5-children-suffer-from-mental-disorder-cdc-says/

Shrinks, critics face off over psychiatric manual

In the new psychiatric manual of mental disorders, grief soon after a loved one's death can be considered major depression. Extreme childhood temper tantrums get a fancy name. And certain “senior moments” are called “mild neurocognitive disorder.” Those changes are just some of the reasons prominent critics say the American Psychiatric Association is out of control, turning common human problems into mental illnesses in a trend they say will just make the “pop-a-pill” culture worse. Says a former leader of the group: “Normal needs to be saved from powerful forces trying to convince us that we are all sick.” At issue is the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, widely known as the DSM-5. The DSM has long been considered the authoritative source for diagnosing mental problems. The psychiatric association formally introduces the nearly 1,000-page revised version this weekend in San Francisco. It's the manual's first major update in nearly 20 years, and a backlash has taken shape in recent weeks: - Two new books by mental health experts, “Saving Normal” and “The Book of Woe,” say the world's most widely used psychiatric guide has lost credibility. - A British psychologists' group is criticizing the DSM-5, calling for a “paradigm shift” away from viewing mental problems as a disease. An organization of German therapists also attacked the new guide. - Even the head of the U.S. National Institute of Mental Health complained that the book lacks scientific validity. This week, the NIMH director, Dr. Thomas Insel, tried to patch things up as he and the psychiatrists group issued a joint statement saying they have similar goals for improving the diagnosis and treatment of mental illness. The manual's release comes at a time of increased scrutiny of health care costs and concern about drug company influence over doctors. Critics point to a landscape in which TV ads describe symptoms for mental disorders and promote certain drugs to treat them. “Way too much treatment is given to the normal `worried well' who are harmed by it; far too little help is available for those who are really ill and desperately need it,” Dr. Allen Frances writes in “Saving Normal.” He is a retired Duke University professor who headed the psychiatry group's task force that worked on the previous handbook. He says the new version adds new diagnoses “that would turn everyday anxiety, eccentricity, forgetting and bad eating habits into mental disorders.” Previous revisions were also loudly criticized, but the latest one comes at a time of soaring diagnoses of illnesses listed in the manual - including autism, attention deficit disorder and bipolar disorder - and billions of dollars spent each year on psychiatric drugs. The group's 34,000 members are psychiatrists - medical doctors who specialize in treating mental illness. Unlike psychologists and other therapists without medical degrees, they can prescribe medication. While there has long been rivalry between the two groups, the DSM-5 revisions have stoked the tensions. The most contentious changes include: - Diagnosing as major depression the extreme sadness, weight loss, fatigue and trouble sleeping some people experience after a loved one's death. Major depression is typically treated with antidepressants. - Calling frequent, extreme temper tantrums “disruptive mood dysregulation disorder,” a new diagnosis. The psychiatric association says the label is meant to apply to youngsters who in the past might have been misdiagnosed as having bipolar disorder. Critics say it turns normal tantrums into mental illness. - Diagnosing mental decline that goes a bit beyond normal aging as “mild neurocognitive disorder.” Affected people may find it takes more effort to pay bills or manage their medications. Critics of the term say it will stigmatize “senior moments.” - Calling excessive thoughts or feelings about pain or other discomfort “somatic symptom disorder,” something that could affect the healthy as well as cancer patients. Critics say the term turns normal reactions to a disease into mental illness. - Adding binge eating as a new category for overeating that occurs at least once a week for at least three months. It could apply to people who sometimes gulp down a pint of ice cream when they're alone and then feel guilty about it. - Removing Asperger's syndrome as a separate diagnosis and putting it under the umbrella term “autism spectrum disorder.” Dr. David Kupfer, chairman of the task force that oversaw the DSM-5, said the changes are based on solid research and will help make sure people get accurate diagnoses and treatment. Dr. Jeffrey Lieberman, the psychiatry association's incoming president, said challenging the handbook's credibility “is completely unwarranted.” The book establishes diagnoses “so patients can receive the best care,” he said, adding that it takes into account the most up-to-date scientific knowledge. But Insel, the government mental health agency chief, wrote in a recent blog posting that the guidebook is no better than a dictionary-like list of labels and definitions. He said he favors a very different approach to diagnosis that is based more on biological information, similar to how doctors diagnose heart disease or problems with other organs. Yet there's scant hard evidence pinpointing what goes wrong in the brain when someone develops mental illness. Insel's agency two years ago began a research project to create a new way to diagnose mental illness, using brain imaging, genetics and other evolving scientific evidence. That project will take years. The revisions in the new guide were suggested by work groups the psychiatric association assigned to evaluate different mental illnesses and recent research advances. The association's board of trustees decided in December which recommendations to include. Advocacy groups have threatened Occupy-style protests and boycotts at this week's meeting. “The psychiatric industry, allied with Big Pharma, have massively misled the public,” the Occupy Psychiatry group contends. Organizers include Alaska lawyer Jim Gottstein, who has long fought against overuse of psychiatric drugs. The new manual “will drastically expand psychiatric diagnosis, mislabel millions of people as mentally ill, and cause unnecessary treatment with medication,” says the website for the Committee to Boycott the DSM-5, organized by New York social worker Jack Carney. Committee member Courtney Fitzpatrick, whose 9-year-old son died seven years ago while hospitalized for a blood vessel disease, said she has joined support groups for grieving parents “and by no means are we mentally ill because we are sad about our kids that have died.” Gary Greenberg, a Connecticut psychotherapist and author of “The Book of Woe,” says pharmaceutical industry influence in psychiatry has contributed to turning normal conditions into diseases so that drugs can be prescribed to treat them. Many of the 31 task force members involved in developing the revised guidebook have had financial ties to makers of psychiatric drugs, including consulting fees, research grants or stock. Group leaders dismiss that criticism and emphasize they agreed not to collect more than $10,000 in industry money in the calendar year preceding publication of the manual.source : http://www.foxnews.com/health/2013/05/16/shrinks-critics-face-off-over-psychiatric-manual/