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Disorder in sentence

626 examples of Disorder in a sentence

Writing in the fifth century b.c., Hippocrates provided the first known definition of melancholia (what we now call “depression”) as a distinct disorder: “If fear or sadness last for a long time it is melancholia.”
The symptoms that Hippocrates associated with melancholic disorder – “aversion to food, despondency, sleeplessness, irritability, restlessness” – are remarkably similar to those contained in modern definitions of depressive disorder.
Like Hippocrates, physicians throughout history have recognized that the symptoms of normal sadness and depressive disorder were similar.
Traditional psychiatry thus adopted a contextual approach to diagnosing a depressive disorder.
The definition of Major Depressive Disorder (MDD) became purely symptom-based.
The DSM-III’s confusion of normal intense sadness and depressive mental disorder, which persists to the present, emerged inadvertently from psychiatry’s response to challenges to the profession during the 1970’s.
It would not be hard for psychiatry to develop a more adequate definition of depressive disorder that de-medicalizes natural emotions of sadness.
Such a change would acknowledge what humans have always recognized: intense sadness after loss is a painful and perhaps inevitable aspect of the human condition, but it is not necessarily a mental disorder.
A Mania for Diagnosing Bipolar DisorderPROVIDENCE, RI – During the past few years, many experts have suggested that bipolar disorder – a serious illness resulting in significant psychosocial morbidity and excess mortality – is under-recognized, particularly in patients with major depression.
Even patients who are diagnosed with bipolar disorder often wait more than 10 years after initially seeking treatment for the correct diagnosis to be made.
The clinical implications of the failure to recognize bipolar disorder in depressed patients include the under-prescription of mood-stabilizing medications, and an increased risk of rapid “cycling” – swings between manic and depressive phases.
But, perhaps as a consequence of concerted efforts to improve the recognition of bipolar disorder, during the past few years we have observed the emergence of an opposite phenomenon – over-diagnosis.
In my own practice, my colleagues and I have encountered patients who reported that they were previously diagnosed with bipolar disorder, despite lacking a history of manic or hypomanic episodes.
To be sure, we have also seen patients seeking treatment for depression who really did have bipolar disorder.
We therefore conducted a study to examine empirically how often bipolar disorder might be over- and under-diagnosed.
Seven hundred psychiatric outpatients were interviewed with the Structured Clinical Interview for DSM-IV (SCID) and completed a self-administered questionnaire that asked whether they had been previously diagnosed by a health-care professional with bipolar or manic-depressive disorder.
Slightly more than 20% (145 patients) in our sample reported that they had been previously diagnosed as having bipolar disorder, significantly higher than the 12.9% rate based on the SCID.
Less than half of those who reported that they had been previously diagnosed with bipolar disorder were diagnosed with bipolar disorder based on the SCID.
Patients with SCID-diagnosed bipolar disorder had a significantly higher risk of bipolar disorder in their immediate family members than patients who self-reported a previous diagnosis of bipolar disorder that was not confirmed by the SCID.
Patients who self-reported a previous diagnosis of bipolar disorder that was not confirmed by the SCID did not have a significantly higher risk for bipolar disorder than the patients who were negative for bipolar disorder by self-report and the SCID.
Our findings, validated by family history, thus suggest that bipolar disorder was over-diagnosed.
Any study seeking to determine whether a psychiatric disorder is over-diagnosed will find that some patients with the condition do not have it upon re-interview.
Over-diagnosis of bipolar disorder has costs.
Thus, over-diagnosing bipolar disorder can unnecessarily expose patients to serious side-effects of medication.
The impact of marketing efforts by pharmaceutical companies and publicity probably plays a role in the emerging tendency to over-diagnose bipolar disorder.
Direct-to-consumer advertisements that refer individuals to screening questionnaires can result in patients suggesting to their doctors that they have bipolar disorder.
We believe that the increased availability of medications that have been approved for the treatment of bipolar disorder might be influencing clinicians who are unsure whether or not a patient has bipolar disorder or borderline personality disorder to err on the side of diagnosing the disorder that is responsive to medication.
This bias is reinforced by the marketing message of pharmaceutical companies to physicians, which has emphasized research on delayed diagnosis and under-recognition of bipolar disorder, possibly sensitizing clinicians accordingly.
The campaign against under-recognition has probably resulted in some anxious, agitated, and/or irritable depressed patients who complain of insomnia and “racing thoughts” being misdiagnosed with bipolar disorder.
The results of our study are consistent with prior studies suggesting possible problems with the diagnosis of bipolar disorder.
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