- Created by Piper Allyn Ranallo, last modified on 2024-Jan-24
Mental and Behavioural Health CRG
Date
22 Nov 2023
Attendees
- Elaine Wooler
- Piper Allyn Ranallo
- Rebecca Berman
- Andrew Wilson
- Ed Cheetham
Discussion items
Item | Description | Owner | Notes | Action |
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0 | Unfinished business: | Unfinished business: mental disorder in pregnancy |
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1 | Phobia (finding) | Are we keeping concept phobia (finding) or is phobia only a disorder? Resolution: both concepts are clinical relevant. A phobia (fear and/or anxiety, phobic avoidance) can exist without the phobia becoming a full blown disorder (i.e, interfering with functioning and/or causing personal distress) |
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2 | First episode psychosis | Verify this is first experience of psychosis by person, not first encounter with health professional for psychosis. Also that a distinct concept would be useful for this. The UK have one in their extension as a finding 1127191000000108 |First episode psychosis (finding)|. If appropriate we could request to promote this to the international release. Resolution: X (Piper Allyn Ranalloand Elaine Wooler to followup) |
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3 | Dissociative neurological disorders | Are psychogenic aphonia and psychogenic dysphonia speech disturbances? Relationship between dissociative muteness and dissociative psychogenic aphonia Relationship between speech and voice. While thoughts often include of internal language (i.e., thinking in sentences) does this qualify as 'speech', or does speech always refer to language spoken by way of voice (v non-vocal means)? Resolution: confirmed that speech is language expressed vocally - it is a child of both voice and language. |
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3.1 | Bodily distress disorders | Illness anxiety disorder v Bodily distress disorder v Hypochondriasis See project summary page here: Somatic Symptoms without Medical Explanation
Review concepts: Appear to be outdated, inactivate as may be a bodily distress disorder?
No references found for this disorder: DSM-5 makes a distinction between somatic symptom disorders and illness anxiety/bodily distress disorders, Should this be inactivated and recreated for clarity? (Currently child of bodily distress disorder) Somatoform pain disorder (disorder) |
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3.2cr | Psychogenic concepts | 275446004 | Gardner-Diamond syndrome (disorder) | (SYN = psychogenic purpura, SYN = factitious purpura) | ||
3.3 | Functional neurological disorders | Value of grouper concept 36480000 | Disturbance of perception associated with conversion and dissociative phenomenon (finding) | Relationship between functional disorder (disorder) and dissociative neurological disorder and psychogenic disorder Psychogenic movement disorder, DEF: A rare neurologic disease with the manifestation of an underlying psychiatric illness that cannot be attributed to any known structural or neurochemical disease. The disease presents typically during adolescence or adulthood. Symptoms may include one or several types of abnormal movements seen in organic movement disorders (tremor, dystonia, chorea, bradykinesia, myoclonus, tics, athetosis, ballism, cerebellar incoordination) and also affect speech and gait. Underlying causes fall into three categories: Conversion disorder, somatic symptom disorders or in rare cases factitious disorder. Functional movement disorder, DEF: The occurrence of abnormal involuntary movements that are incongruent with a known neurologic cause and are significantly improved on neurological exam with distraction or non-physiologic maneuvers. The disorder is defined by its clinical appearance, rather than by any causative speculation. |
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4 | Affect | Review proposed changes to concepts related to affect and expression of emotion | ||
5 | Multiple concepts describing fear and anxiety about body function | Resolve the relationships between the following concepts:
Discussion: Andrew, Becky - use of clinical vignettes in implementation guides (other CRGs: cancer synoptic group, ophthalmology, allergy). Ed - consider reaching out the Nursing CRG for input | Add explicit definitions of fear and anxiety from ICD11 Next step: Keep concepts and add narrative definitions to distinguish between concepts AND/OR seek input for use in implementation guide | |
6 | Complex and social behavior | Review proposed changes to concept and child concepts of Finding relating to complex and social behaviors (finding) |
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Meeting Files
File | Modified | |
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PNG File image-2023-11-21_15-6-31-1.png | 2023-Nov-21 by Piper Allyn Ranallo | |
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PNG File image-2023-11-22_8-35-38.png | 2023-Nov-22 by Piper Allyn Ranallo | |
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Previous Meetings
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2 Comments
Elaine Wooler
Re item 3.2. This has a map to an Orphanet entry 324636.
https://www.orpha.net/consor/cgi-bin/Disease_Search.php?lng=EN&data_id=21796&Disease_Disease_Search_diseaseGroup=-324636&Disease_Disease_Search_diseaseType=ORPHA&Disease(s)/group%20of%20diseases=Autoerythrocyte-sensitization-syndrome&title=Autoerythrocyte%20sensitization%20syndrome&search=Disease_Search_Simple
A rare autoimmune disease with skin involvement characterized by recurrent episodes with isolated or multiple painful edematous inflammatory skin lesions progressing to ecchymoses within 24 hours, due to autosensitization to a stromal component of the patient's own erythrocytes. The development of the lesions is usually preceded by emotional or physical stress, followed by a prodromal stage with fatigue or malaise. Lower limbs and trunk are the most frequently involved sites. Accompanying features may include fever, arthralgia, myalgia, headache, gastrointestinal problems, or hematuria and epistaxis, among others. The disease occurs predominantly in women.
Also in more detail https://rarediseases.info.nih.gov/diseases/6481/index
Piper Allyn Ranallo
Elaine Wooler thank you!
Sounds like we need to remove SYN 'fictitious purpura'.
For discussion: when is concept a subtype of 26112003 | Psychosomatic factor in physical condition (finding) | rather than a subtype of some variation of psychogenic disorder / idiopathic disorder /somatic symptom disorder/bodily distress disorder?
For example, if there is an observable pathophysiological process / biomedical problem do we consider the disorder a subtype of 26112003 | Psychosomatic factor in physical condition (finding) | ?
Piper