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Age and Gender Considerations in Psychiatric Diagnosis

A Research Agenda for DSM-V
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Written to help identify major gaps in our knowledge of how gender and age affect psychiatric diagnoses and to stimulate much-needed research to fill these gaps, Age and Gender Considerations in Psychiatric Diagnosis serves as both a valuable short-term source for the DSM-V Task Force and its disorder-specific workgroups, and a long-term guide for future studies that will contribute to revised psychiatric classifications in these three areas. Here, 47 experts present findings in three areas of psychiatric research that historically have been neglected but rightfully have received increasing attention in recent years and thus are worthy of investigation into their clinical features, etiology, and course: 1. Significant gender differences in prevalence, symptom profiles, and risk factors for mental disorders, including neurodevelopmental, neurophysiological, and environmental factors for men and women that cut across diagnostic categories-for example, the critical importance of gender in how psychiatric illness develops and presents; DSM's approach to gender to date; and relevant research findings and gaps in the epidemiology, etiology, and pathophysiology of disorders and the gender-related expression of psychopathology, including the controversial and complex question of whether DSM should have different diagnostic criteria for men and women. 2. Mental disorders in infancy and early childhood, including diagnosis and measurement of psychopathology; PTSD and social and cognitive factors related to the experience of stress; reactive attachment disorder (unique in part because of its specificity to early childhood); mood and anxiety disorders and difficulties in diagnosis; sleep disorders, including two new disorders, Night-Waking Dysomnia and Sleep-Onset Dysomnia; feeding disorders, including the need to address overeating and overfeeding (especially given the alleged U.S. epidemic of obesity); early childhood manifestations of behavior disorders; and early symptoms and diagnosis of autism. 3. Mental disorders in the elderly, such as dementia and depression, once considered normal consequences of aging but now understood to represent mental disorders, including the need to identify specific brain structure abnormalities, biomarkers, and the many contributing biological, psychosocial, and environmental factors of mental illness in late life and to understand their roles in the elderly to better diagnose and monitor disease progression. Written for clinicians and researchers alike, this thought-provoking compendium contributes critical information that helps enhance our understanding of the causes of mental disorders, develop effective preventive and treatment interventions, and inform future editions of DSM and ICD.
CONTRIBUTORSPREFACEACKNOWLEDGMENTSPART I: Sex/GenderChapter 1. INTRODUCTIONChapter 2. WHY GENDER MATTERSChapter 3. DSM'S APPROACH TO GENDER: History and ControversiesChapter 4. GENDER AND THE PREVALENCE OF PSYCHIATRIC DISORDERSChapter 5. NEUROBIOLOGY AND SEX/GENDERChapter 6. SOCIOCULTURAL FACTORS AND GENDERChapter 7. A DEVELOPMENTAL PERSPECTIVE, WITH A FOCUS ON CHILDHOOD TRAUMAChapter 8. THE LONGITUDINAL LABORATORY OF WOMEN'S REPRODUCTIVE HEALTHChapter 9. CLINICAL VALIDATORS OF DIAGNOSES: Symptom Expression, Course, and TreatmentChapter 10. GENDER AND DIAGNOSTIC CRITERIAChapter 11. CONCLUDING THOUGHTSPART II: Early ChildhoodChapter 12. DIAGNOSIS OF PSYCHOPATHOLOGY IN INFANTS, TODDLERS, AND PRESCHOOL CHILDRENChapter 13. A RESEARCH AGENDA FOR POSTTRAUMATIC STRESS DISORDER IN INFANTS, TODDLERS, AND PRESCHOOL CHILDRENChapter 14. REACTIVE ATTACHMENT DISORDERChapter 15. MEASUREMENT OF PSYCHOPATHOLOGY IN CHILDREN UNDER THE AGE OF SIXChapter 16. NOSOLOGY OF MOOD DISORDERS IN PRESCHOOL CHILDREN: State of Knowledge and Future DirectionsChapter 17. DIAGNOSIS OF ANXIETY DISORDERS IN INFANTS, TODDLERS, AND PRESCHOOL CHILDRENChapter 18. CLASSIFYING SLEEP DISORDERS IN INFANTS AND TODDLERSChapter 19. CLASSIFYING FEEDING DISORDERS OF INFANCY AND EARLY CHILDHOODChapter 20. DISRUPTIVE BEHAVIOR DISORDERS AND ADHD IN PRESCHOOL CHILDREN: Characterizing Heterotypic Continuities for a Developmentally Informed Nosology for DSM-VChapter 21. DIAGNOSIS OF AUTISM AND RELATED DISORDERS IN INFANTS AND VERY YOUNG CHILDREN: Setting a Research Agenda for DSM-VPART III: The ElderlyChapter 22. AGING-RELATED DIAGNOSTIC VARIATIONS: Need for Diagnostic Criteria Appropriate for Elderly Psychiatric PatientsChapter 23. LATE-LIFE DEPRESSION: A Model for Medical ClassificationChapter 24. CHALLENGES OF DIAGNOSING PSYCHIATRIC DISORDERS IN MEDICALLY ILL PATIENTSChapter 25. USE OF BIOMARKERS IN THE ELDERLY: Current and Future ChallengesChapter 26. IMPACT OF PSYCHOSOCIAL FACTORS ON LATE-LIFE DEPRESSIONINDEX
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