Browsing by Subject "DSM"
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(2016)Major Depressive Disorder (MDD) is a mental health disorder, which requires a diagnosis or identifying an illness in order to be treated. There are nine criteria symptoms for MDD, and to acquire a diagnosis, an individual must exhibit five to nine of these symptoms (DSM-5). The weight of the criteria symptoms is assumed to be equal and a sum-score is calculated. The sum-score determines whether the MDD in question is mild, moderate or severe. The sum-scores simplify MDD because it is a heterogeneous syndrome. The diagnostic criteria see MDD as a common cause network: criteria symptoms are equally weighted indicators of an illness called MDD. Symptom-based networks are presented as an alternative, more precise way of modeling MDD. In symptom-based networks MDD is seen as consisting of causal connections between symptoms so that a certain existing symptom is likely to result in the manifestation of another symptom. Symptom-based networks are well-suited for explaining the heterogeneity of MDD, the vast spectrum of symptom combinations and the interrelationships of symptoms. In addition, symptom-based networks bypass entirely the problematic assumption that MDD is a latent phenomenon. The heterogeneity hidden in the MDD diagnosis is critically examined through research evaluating the diagnosis and pathogenesis of MDD as well as symptom studies. The results from depression studies and clinical practice strongly indicate that the official view of the scientific community on the etiology of MDD is wrong. A tremendous amount of heterogeneity is hidden behind the MDD diagnosis.
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(2021)The definition of psychosis has evolved over the past few decades to describe a syndrome which includes hallucinations, delusions, and thought disorders. Psychosis is especially associated with psychotic disorders and they cause significant suffering to the individual and a considerable burden to society. In addition, studies have found the syndrome to be associated with other mental disorders such as depression. Milder expressions of psychosis can also be measured in the general population. Disorders that include psychotic symptoms have more similarities than differences: different diagnoses may have similar cognitive deficits and neurobiological abnormalities. The current clinical definition for psychosis does not appear to be comprehensive enough to describe its nature. In this thesis psychosis was initially examined based on the diagnostic system, after which the phenomenon was reviewed transdiagnostically without clinical categorization. The view of the diagnostic system on psychosis was then compared with the transdiagnostic perspective. The purpose of this thesis is to provide a comprehensive, critical, and current overview of the understanding of psychosis. The literature search for this thesis was done on the PubMed database, and current reviews and studies were selected as articles that brought a new perspective to psychosis. The articles examined the DSM-5’s view of psychosis as well as two major dimensional frameworks. In the Hierarchical Taxonomy of Psychopathology (HiTOP) psychosis is viewed through the continuum of psychological processes, whereas in the Research Domain Criteria (RDoC) psychosis is approached through neurobiological mechanisms. The frameworks provided a complementary perspective on psychosis. According to this thesis, psychosis was a syndrome of transdiagnostic nature, of diverse etiology and still partly unclear. The syndrome involved many transdiagnostic processes and mechanisms and could be perceived both dimensionally and hierarchically. Transdiagnostic research may develop biological treatment methods and find ways to improve clinical practice between different diagnoses. Diagnostic systems will lead our understanding of mental health for a long time to come, but the transdiagnostic perspective is gaining significant ground and has the potential to inform future diagnostic systems.
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