Kolt, Gregory S and Andersen, Mark B (2004) Recognizing psychopathology. In: Psychology in the physical and manual therapies. Churchill Livingstone, Edinburgh, pp. 81-92.

Abstract

This chapter has covered many of the mental disorders on Axis I of the DSM-IV-TR (American Psychiatic Association 2000). The purpose of the chapter was to describe the disorders in general terms so that physical and manual therapists may recognize the problems easier and earlier. Also included with each disorder were examples of either how the person with the disorder may present in clinical settings, or how the disorder may interfere with the rehabilitation process. The major classes of disorders covered were anxiety disorders, mood disorders, somatoform disorders, adjustment, disorders, and eating disorders. Anxiety disorders, in general, are marked by behavioral and cognitive features that are manifestations of some inner dread, and many of the behaviors of people with anxiety disorders are attempts to compensate for that anxiety and dread. In the area of mood disorders, depression is one of the most common disorders in Western society, and is often called the "common cold" of mental health. Somatoform disorders are particularly difficult to deal with in rehabilitation because there is really no physical underlying problem behind the client's somatic complaints and anxieties. That does not mean that some caring touch will not help. It may help quite a bit, but not for any physical reason. Many people in rehabilititation have adjustment difficulties, and could benefit from some counseling. Often, however, third party payments for psychological treatment will not be made without a DSM-IV-TR diagnosis. The subtypes of adjustment disorder could probably encompass many "normal" people in rehabilitation. Eating disorders are extremely complex and often closeted. The chapter ends with a description of the eating disorders of anorexia nervosa and bulimia nervosa, and a case example of a male diver with bulimia nervosa, and how the interactions with a caring physical therapist helped him seek psychological and nutritional help. Physical and manual therapists should be aware of the signs and symptoms of a variety of psychopathologies so that they can tailor their rehabilitation to suit the needs of the individual. Being aware of such conditions also allows physical and manual therapists to make appropriate referrals to sychologists and other mental health practitioners.

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