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In developing an epidemiology of psychiatric illness, we need to be able to disintinguish between the following


(1) syndrome


(2) families of syndromes


(3) Illness


(4) Natural neural mechanisms working in a healthy state.


(5) Signal findings in examination and history


In other words, what may be necessary for human survival, when forced by illness, can lead to subsequent illness.


In addition, because of the similarities of end points to illness, we often see even trained physiicans conflating syndromes and illnesses.


For that reason, this article intends to provide some informative basic examples of families of syndromes seen in psychiatry:

Anxiety

Disturbances of affect

Includes syndromes of depression, mixed affective disturbances, mania, and hypomania

Disturbances of thought

Includes psychosis and many psychologic illnesses.

Disturbances of sensorium

Includes toxicoses and delirium.

Autistic spectrum syndromes.


The important realization to make is that in illnesses, multiple families of syndromes, or syndromes, can present.


For example, all of the above syndromes can occur in dementia. The first three can occur in schizoaffective disorder. For some illnesses, such genetic illnesses, all of these syndromes can appear.


Ideally, only one syndrome would present in a given genetic illness, but because of the pervasive nature of some genetic abnormalities, multple syndromes can be present, and can only be enumerated with careful watching over time and careful examination at each clinic appointment.


A syndrome, then, is a set of findings, rather than a single finding.


Typically, when developmental disabilities are discussed, a syndrome is utilized to help determine the form of the genetic disturbance. In such a case, if we include psychiatric syndromes, then a developmental disability can be inidcated by a set of syndromes. However, usually the indicating syndrome for a genetic disability is fairly obvious - dysmorhology, a motor neuron diease, or a bone or joint feature. An example is cerebral palsy, which can be composed of joint contractures, dysarthrias, spasticity, paraplegias, hemiplegias, quadriplegias, and related rheumatic illness evidences. If we include a depression or anxiety syndrome secondary to the primary syndrome features, we may have appeared to make the diagnosis more complex until we realize that it is the former syndrome that is the primary diagnostic evidence.

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