ICD-10 vs DSM-V

At what point should a diagnosis be medical—in the ICD—as opposed to mental—in the DSM?

Psychiatrists are working on the next version of the hefty psychiatric "bible" of diagnoses (DSM-V) to replace the current DSM-IV. In newspapers around the country, an article is circulating about it. Here is a link to one copy of the article, in the New York Times: Psychiatrists Revise the Book of Human Troubles

The debates are passionate, because many “mental” disorders are “medical,” “biological,” “physical.”

Hard-to-Find but Commonly Needed Hypoallergenic Supplements

Many of our children with pediatric-onset symptoms of depression, schizophrenia, schizoaffective, bipolar, OCD, ADHD and autistic-spectrum have biological problems requiring nutritional supplements. But these same children often have food sensitivities to some ingredients commonly found in these supplements.

My younger daughter cannot consume gluten/wheat, dairy (casein), eggs, or soy.  She is also allergic to propylene glycol. Finding some supplements without these ingredients are difficult. We found that even if gluten or soy is not listed as an ingredient, it does not mean there is no gluten or soy in that product!

Plastics & The Brain

It is now common knowledge that ingredients in many plastics (especially when heated) may affect the growth and development of our children's brains. They can even lead to inflammation, increasing risk of diabetes and heart disease.[1] Research is showing these chemicals (Bisphenol A (BPA), phthalates and flame retardants (PBDEs)) can affect mood, cognition, and our endocrine system.[2,3,4]

From our own personal experience, some children are simply more sensitive to some effects than others. Our own daughter was found to be quite sensitive to the endocrine system disrupting effects, and was sent to an endocrinologist about it-- SIXTEEN years ago!

Sleep: A Critical Yet Under-addressed Component of Health

Sleep is critical for human life.

Grossly disrupted or disturbed sleep is often an early indicator that something is going wrong. Many neurological and endocrinological problems have disturbed sleep as a symptom.

Disturbed sleep can cause physical distress as well as mood and psychological issues(*). And physical distress, as well as psychological and emotional issues, can also cause disturbed sleep.

Teasing out what is causing what and, more importantly, addressing the issues that need to be addressed, can be a daunting task.

Nutrition, genes, and brain dysfunctions: Folate

Sometimes eating a healthy diet is not enough. In their search to answer why supplementing with folate helps some people with the brain symptoms of schizophrenia, NARSAD-funded research scientists are studying some people with schizophrenia who may have genetic defects that lower the amount of folate (vitamin B9) available in their bodies for their cells to use. This was found to be true in my daughter's case, as well (see book).

New Doctor Visit: The Medical History

How much should be in a medical history? What details are relevant? What aren’t? Should it be done by age? Or by symptom? There are many ways to create a medical history. Here are some ideas.

The Doctor Went Dumpster-Diving (Medical Records Delivery)

Ever take your child to a new specialist with a sense of happy anticipation that this time will be different—this time the doctor will listen and help—only to be left confused at the end, wondering how everything went so horribly wrong, so fast? Ever wonder how to minimize the chance the same thing will happen with the next specialist you see?

My daughter’s GP keeps meticulous records, keeping not only all the information sent from all the other doctors, but he consolidates lab results into what he calls a “Laboratory Flow Sheet.” It has all the lab test names and normal ranges down the left side, and dates along the top. All abnormal results are printed in red. If your own child’s pediatrician does not do this, I suggest that you create your own spreadsheet. Keep track of all the lab results yourself.

Inflammation of Body and Brain

Many studies have linked inflammation, excessive oxidative stress, and autoimmune disorders with psychiatric and many other medical illnesses. Altered levels of inflammatory markers such as cytokines and immune cells keep cropping up in the literature.

There is increasing evidence that many illnesses categorized diagnostically in the DSM-IV and ICD-10 under “Mental and Behavioral Disorders” are actually systemic (body-wide) disorders. They are physical illnesses affecting the brain—i.e. biological disorders. This systemic effect is well-documented in autism.

Important Links, Books, & Resources to Help Our Children

Perhaps your child is already diagnosed with a non-psychological condition affecting his or her brain (such as clinical depression, pediatric-onset bipolar, autistic-spectrum, hormonal issues, migraines, psychosis-nos, lyme disease, narcolepsy, Kleine-Levin syndrome, thyroid issues, or childhood-onset schizophrenia).

Or, you may still be in the early stages of thinking, “Something is distressing my child. The screaming, horrific nightmares, spacing out, acting like perhaps he/she is hearing voices, not sleeping or sleeping too much, and tantrums indicate that something is wrong.”). In either case, in addition to treating the more salient symptoms of the condition, we need resources to help the child’s underlying biology.

The Stress Connection: Meeting Hormonal, Nutritional, and Metabolic Needs

Many chronic illnesses are affected by stress (see Stress, Immune Response, and Illness). There have been many links between psychiatric symptoms, stress, mitochondrial function, and the endocrine system. A common thread connecting them all is nutrition.

The United States' government organization, NIMH, is currently running studies using nutritional substances to augment treatment of some neurobiological brain disorders such as autism, bipolar and schizophrenia.

Stress and Our Children. How Much is Too Much?

Responding to an acute stressor can boost our immune system. But the impact to our immune system, and the inflammatory response, from some stressors can be quite damaging.

Stress, Immune Response, and Illness

We often hear about the dangers of stress in our lives. We hear about stress contributing to a host of illnesses and also exacerbating existing illnesses.

But what exactly is “stress”?

"Fish Oil": $$ and Favorite Brands of Omega-3 Supplements

Over the years, many of us parents have investigated different brands of omega-3 fatty acid supplements for purity and palatability. How much EPA and/or DHA is needed for the type of symptoms our child has also been an issue. Some health care providers say GLA is important as well for some individuals who might have a problem converting. We've also come up with ideas about affordability. Here are our "secrets."

Omega-3 Fatty Acids (Fish Oil): EPA, DHA, and How Much is Enough?

We've discussed what omega-3 fatty acids are, and how essential they are for our general health (Brain Health: Omega-3 Fatty Acids (Fish Oil)). In order to choose an omega-3 fatty acids (fish oil) supplement, it is helpful to understand what two of the essential fats, EPA and DHA, are.

There are so many of these fish oils supplements on the market, each touting its own ratio of DHA to EPA as "best". It may be more of a matter of "best" for "what?".

Brain Health: Omega-3 Fatty Acids ("Fish Oil")

Most people who have been researching how to help a child’s brain develop healthily, have read a lot about essential fatty acids (EFAs), specifically, Omega-3 fatty acids. They are essential to the proper development and functioning of our nervous system, including brain and vision, as well as the cardiovascular system.

Childhood-Onset Schizophrenia Has High Rates of Comorbid Diagnoses Including Autism and ADHD

Research backs up what some parents of children with childhood-onset schizophrenia (COS) have observed. They have noticed that COS, which is characterized by an onset of psychosis prior to age thirteen, seems to have many overlapping symptoms of autistic-spectrum disorders, sensory issues and attentional problems.

Specific Genes Inherited from Both Parents May Lead to Type of "Schizophrenia"

Some families have noticed a form of schizophrenia that runs in their particular family which seems to "skip" a generation. What that indicates is that there may be recessive genes involved in one parent's "schizophrenia". (That's what happened in my own family, but at least in the younger generation, we were able to beat that "genetic curse").

Genetic Links to “Developmental”, “Mental”, “Auto-Immune” and other Medical Disorders

The United States National Institute of Mental Health (NIMH) refers to Childhood-Onset Schizophrenia as a neurodevelopmental disorder. Extensive genetic research of schizophrenia-spectrum disorders has linked it to many other genetically complex medical and neurodevelopmental disorders.

Viral Infections and Schizophrenia

Even as far back as 100 years ago, scientists perceived a connection between viral infections and "non-affective" psychosis. One of the leading schizophrenia researchers of the time, Kraepelin, proposed that such an infection may be a cause of "dementia praecox" (now called "schizophrenia"). An epidemic of "schizophrenic-syndrome" occurred following the devastating 1918 influenza pandemic.

Sets of Symptoms--Not the Cause–Get Diagnostic Labels

When medical science does not know the specific cause of a set of symptoms, it provides a diagnostic label that encompasses the set of symptoms even if it really says nothing about the cause of the symptoms.

Solving the Puzzle of "Schizophrenia" and "Bipolar Disorder"

I have always thought of all the symptoms my daughter has had as pieces of a "puzzle". It turns out that there were more pieces than I initially thought—I didn’t even recognize small pieces here and there as part of the puzzle.