1. Mental disorder An introduction John Crichton Consultant Forensic Psychiatrist

2. How can Mental Disorder be understood? Disease model Disease model Psychodynamic Psychodynamic Behavioural Behavioural Cognitive Cognitive Social Social

3. Disease Model Akin to the rest of medicine Akin to the rest of medicine The phenomenological approach The phenomenological approach description of syndrome description of syndrome identification of pathological processes identification of pathological processes natural history of the syndrome natural history of the syndrome treatment treatment

4. Standard diagnostic manuals

5. Psychodynamic model Origins with Freud importance of early experience and unconscious processes use of free association in therapy aim for insight and change

6. Behavioural Model Origins in animal experiments rewarded behaviour reinforced phobias

7. Cognitive model Automatic thoughts or ways of thinking hopelessness guilt and worthlessness catastrophising

8. Social Model Means two different things social factors in disease sociology of deviance labelling - Rosenhan antipsychiatry

9. Dementia Global progressive deterioration of function - memory intellect personality Global progressive deterioration of function - memory intellect personality an organic disorder an organic disorder 5% over 65; 10% over 80 5% over 65; 10% over 80 F:M 2:1 F:M 2:1

10. Schizophrenia Major mental illness Major mental illness Characterised by psychotic symptoms such as hallucinations and delusions Characterised by psychotic symptoms such as hallucinations and delusions Also negative symptoms Also negative symptoms 1% of the population 1% of the population Controlled by antipsychotic medication Controlled by antipsychotic medication

11. Manic-Depression Characterised by periods of elated mood and depressed mood with psychotic symptoms Characterised by periods of elated mood and depressed mood with psychotic symptoms 1% of the population 1% of the population Controlled by mood stabilisers Controlled by mood stabilisers

12. Depression Can be part of manic depression or psychotic depression. Most commonly not characterised by psychosis. Can be part of manic depression or psychotic depression. Most commonly not characterised by psychosis. Low mood, biological symptoms, cognitive symptoms Low mood, biological symptoms, cognitive symptoms Prevalence 5-30% Prevalence 5-30% Twice as common in women Twice as common in women

13. Personality Disorder An individual’s characteristic way of behaving and feeling in a variety of situations consistently through adulthood. An individual’s characteristic way of behaving and feeling in a variety of situations consistently through adulthood. May at its extremes cause subjective distress and social problems. May at its extremes cause subjective distress and social problems. Various types Various types

14. Other conditions Eating disorders Eating disorders Substance misuse Substance misuse Learning disability Learning disability ADHD ADHD Autistic spectrum disorder Autistic spectrum disorder Head injury Head injury Gender dysphoria Gender dysphoria PTSD PTSD