Is he mentally ill?

Is he mentally ill?

• Is he mentally ill?

• How do you know?

• What type of mental illness do you think he has?

Incorporates

• Incorporates

• Psychological distress—neither necessary nor sufficient
• Maladaptive—interferes with our well-being, etc.
• Statistical abnormality or deviancy
• Violation of the standards of society
• Social discomfort
• Irrationality and unpredictability—dangerous at times

Nomenclature—a naming system to structure information allows us to study, assess, and treat

• Nomenclature—a naming system to structure information allows us to study, assess, and treat

• Shorthand—like a diagnostic system—leads to a loss of information

• Stigma—people fear what will happen if they reveal a disorder

• Stereotyping—automatic beliefs based on knowing one thing about someone

• Labeling

Definition of mental disorders

• Definition of mental disorders

• A clinically significant behavioral or psychological syndrome or pattern

• Associated with distress or disability

• Not a predictable response to a particular event

• Considered to reflect behavioral, psychological, or biological dysfunction

Epidemiology—study of the distribution of diseases, disorders, etc.

• Epidemiology—study of the distribution of diseases, disorders, etc.

• Prevalence—point, one-year, lifetime

• Any disorder in lifetime—46.6 %

• Incidence

• Comorbidity

1-year Lifetime

• 1-year Lifetime

• MDD 6.7% 16.6%

• Alcohol abuse 3.1 13.2

• Specific phobia 8.7 12.5

Not dysfunctional

• Not dysfunctional
• Thought processes are not seriously disrupted
• Fewer emotional problems than general population
• Characteristics: Nonconformity, creativity, strong curiosity, idealism, happy obsession with hobbies, lifelong awareness of being different, high intelligence, outspokenness, noncompetitiveness, unusual eating and living habits, disinterest in others’ opinions or company, nonmarriage, eldest or only child, poor spelling skills

500,000 yrs ago— trephination

• 500,000 yrs ago— trephination

• Later ancient societies indicate possession

• Babylonians—Idta—spirit who caused insanity

• Greek and Roman views and treatments

• Hippocrates—460-377 BC—denied influence of demons
• Somatogenesis

• Plato—Criminally insane shouldn’t be held responsible like others

• Galen—130-200 AD believed disorders could have either physical causes (injury to the head) or mental causes (stressors)

• After Hippocrates, treatments included pleasant surroundings, giving patients constant activities

Increase in power of the clergy, church rejected scientific forms of investigation.

• Increase in power of the clergy, church rejected scientific forms of investigation.

• Mass madness: group behavior disorders, apparently hysterical. Peak in 14th-15th centuries.

• Tarantism
• Lycanthropy

• Treatment of mental illness was left to clergy. Return of exorcism. Not generally treated as witches, though this did happen.

Agrippa -1486-1588-began to speak out against possession

• Agrippa -1486-1588-began to speak out against possession

• Johan Weyer first physician to specialize in mental illness. 16th cent. On—asylums grew in number

• Gheel, Belgium—first colony of mental patients

• 1547—St. Mary’s of Bethlehem Hospital—bound in chains, popular tourist attractions, mildly mentally ill were forced to beg on the streets

La Bicetre—Philippe Pinel

• La Bicetre—Philippe Pinel

• William Tuke—1732-1822—English Quaker—established York Retreat.

• Moral management—focused on patient’s social, individual, occupational needs—rehabilitation of character. High degree of effectiveness—

• Buffalo Psychiatric Center—originally Buffalo State Hospital for the Insane. Proposed by physician White in 1864, first received patients in 1880. Followed Kirkbride Model of connected buildings.

• Mental hygiene movement—focused on physical well being, not treatment

• Dorothea Dix—1802-1887—champion of the poor and forgotten in mental institutions and prisons.

Two opposing views: somatogenic and psychogenic

• Two opposing views: somatogenic and psychogenic

• Syphilis

• Mental hospitals in the 20th century

• Over 500,000 by 1950s

• Deinstitutionalization

• Thorazine
• Today about 55,000 in state hospitals
• Criminalization of the mentally ill. By some estimates, 300,000 inmates, 500,000 on probation