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In performing their
clinical duties, American psychiatrists are trained to use a specific
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classification
system known as the Diagnostic and Statistical Manual of Mental Disorders
(aka,
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the DSM). According to the most recent editions of
this manaul, the defining feature of
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dementia is the
impairment of memory.
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It is important to
appreciate the fact that other specialists in medicine approach this topic
more
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methodically. To neurologists, for example, dementia is
not a disease, per se. Rather, the
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term dementia refers
to a syndrome of signs and symptoms – such as deficits in thinking,
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perceiving, feeling,
moving, speaking, writing, or planning – which are caused either by toxins,
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by disease processes
outside the brain (e.g., diabetes, hypothyroidism, cancer), or by
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degenerative
conditions which originate in the central nervous system (e.g., Parkinson’s
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disease, Pick’s
disease, Creutzfeld-Jakob disease, multiple sclerosis).
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Key Points:
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Dementia is arguably
under-recognized by psychiatrists in the United States for at least
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three reasons: 1) due to the inordinate emphasis which the
DSM has placed upon the loss of
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memory; 2) due to a
sociocultural expectation that dementia should appear only in old age;
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and 3) due to the
tendency of physicians to attribute dementia-symptoms in psychiatric
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patients to mental
illness, rather than to toxins or somatic (bodily) disease.
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