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Dr Sacrifice Chirisa Mental Health Matters
This week I have decided to focus on the classification and types of mental disorders. This has been prompted by the fact that our general community thinks there is only one diagnosis in psychiatry. This is expressed in one of the most stigmatic terms (kupenga), which is very unfortunate.

The discourse below is a simplified attempt to let people see the diversity of problems in the world of psychiatry.

Neurodevelopmental disorders

This class covers a wide range of problems that usually begin in infancy or childhood, often before the child begins primary school. Examples include autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD) and learning disorders.

Schizophrenia spectrum and other psychotic disorders

Psychotic disorders cause detachment from reality such as delusions, hallucinations and disorganised thinking and speech. The most notable example is schizophrenia, although other classes of disorders can be associated with detachment from reality at times.

Bipolar and related disorders

This class includes disorders with alternating episodes of mania, periods of excessive activity, energy and excitement and depression.

Depressive disorders

These include disorders that affect how you feel emotionally, such as the level of sadness and happiness, and they can disrupt your ability to function. Examples include major depressive disorder and premenstrual dysphoric disorder.

Anxiety disorders

Anxiety is an emotion characterised by the anticipation of future danger or misfortune, along with excessive worrying. It can include behaviour aimed at avoiding situations that cause anxiety. This class includes generalised anxiety disorder, panic disorder and phobias.

Obsessive-compulsive and related disorders

These disorders involve preoccupations or obsessions and repetitive thoughts and actions. Examples include obsessive-compulsive disorder, hoarding disorder and hair-pulling disorder (trichotillomania).

Trauma- and stressor-related disorders

These are adjustment disorders in which a person has trouble coping during or after a stressful life event. Examples include post-traumatic stress disorder (PTSD) and acute stress disorder.

Dissociative disorders

These are disorders in which your sense of self is disrupted, such as with dissociative identity disorder and dissociative amnesia.

Somatic symptom and related disorders

A person with one of these disorders may have physical symptoms with no clear medical cause, but the disorders are associated with significant distress and impairment. The disorders include somatic symptom disorder and factitious disorder.

Feeding and eating disorders

These disorders include disturbances related to eating, such as anorexia nervosa and binge-eating disorder.

Elimination disorders

These disorders relate to the inappropriate elimination of urine or stool by accident or on purpose. Bedwetting (enuresis) is an example.

Sleep-wake disorders

These are disorders of sleep severe enough to require clinical attention, such as insomnia, sleep apnea and restless legs syndrome.

Sexual dysfunctions

These include disorders of sexual response, such as premature ejaculation and female orgasmic disorder.

Gender dysphoria

This refers to the distress that accompanies a person’s stated desire to be another gender.

Disruptive, impulse-control and conduct disorders

These disorders include problems with emotional and behavioral self-control, such as kleptomania or intermittent explosive dis- order.

Substance-related and addictive disorders

These include problems associated with the excessive use of alcohol, caffeine, tobacco, bronco, cocaine and drugs. This class also includes gambling disorder and social media addiction.

Neurocognitive disorders

Neurocognitive disorders affect your ability to think and reason. These acquired rather than developmental cognitive problems include delirium, as well as neurocognitive disorders due to conditions or diseases such as traumatic brain injury or Alzheimer’s disease.

Personality disorders

A personality disorder involves a lasting pattern of emotional instability and unhealthy behaviour that causes problems in your life and relationships. Examples include borderline, antisocial and narcissistic personality disorders.

Paraphilic disorders

These disorders include sexual interest that causes personal distress or impairment or causes potential or actual harm to another person. Examples are sexual sadism disorder, voyeuristic disorder and pedophilic disorder.

Other mental disorders

This class includes mental disorders that are due to other medical conditions like HIV infection and epilepsy, just to mention a few.

• Dr S. M. Chirisa is a passionate mental health specialist who holds an undergraduate medical degree and postgraduate Master’s degree in psychiatry, both from the University of Zimbabwe. He is currently working as a Senior Registrar in the Department of Psychiatry at Parirenyatwa Group of Hospitals and is also the current national treasurer of the Zimbabwe Medical Association (ZiMA). He can be reached at [email protected]