MODULE 3- Neurotic disorders

The word neuroses was originally coined in the 18th century to label a range of psychological
disorders that could not usually be linked to a physical cause. It is often confused for
neuroticism, a personality trait. There is no single definition of neurosis. Neurosis was, until
recently, a diagnosable psychological disorder that interferes with quality of life without
disrupting an individual's perception of reality. Some psychologists and psychiatrists use the
term neurosis to refer to anxious symptoms and behaviors. Other doctors use the term to
describe a spectrum of mental illnesses outside of psychotic disorders. Psychoanalysts, such
as Sigmund Freud and Carl Jung, described the thought process itself using the term neurosis.
In 1980, the third publication of the American Psychiatric Association's Diagnostic and
Statistical Manual of Mental Disorders (DSM-III) removed the term neurosis. This article
will discuss how neuroticism differs from neuroses and personality disorders, as well as how
to recognize the signs of an anxiety disorder similar to neuroses. It will also give a few tips
on handling some of the psychological effects of neuroticism.

Neurosis and Psychosis are different types of mental disorders. Neurosis refers to a mild
mental disorder characterised by physical and mental disturbance. Certain mental and
physical disturbances and inner struggles characterize neurosis. Psychosis, on the other hand,
is a major personality disorder marked by mental and emotional disruptions. While neurosis
is a mild mental disorder, psychosis refers to insanity and madness. Neurosis is a set of
mental disorder that involves chronic distress, but they do not include delusions and
hallucinations. Neurosis is also known a neurotic disorder or psychoneurosis and is of
different types:
 Eating disorders
 Impulse control disorder
 Obsessive-compulsive disorder
 Anxiety
 Phobia
 Neurosis involves sadness, depression, irritability, anxiety, anger confusion, and so
on. We can say that neurosis is the inability of a person to change their life pattern and
unable to develop a more complex, satisfying personality.
 Neurosis if generally rooted in ego defence strategies, but both are not the same.
Défense strategies are common way of maintaining a sense of self. The thoughts that
give rise to struggle of difficulties can called as neurosis.
 A person suffering from neurosis faces an unconscious conflict and emotional
distress, which leads to different mental problem. The person might also be neurotic
duo to some natural disaster that he witnessed and cannot overcome the thoughts
leading to emotional instability.
 Neurosis can happen toa person who has been through a traumatic event, and the
thoughts of the events make it difficult for him to forget the incidents and cause
anxiety, which is primary symptoms of neurosis
 1. Generalized Anxiety Disorders

Generalized anxiety disorder was first defined in 1980, in DSM-III, as a disorder of

uncontrollable and diffuse anxiety or worry that is excessive or unrealistic and lasts 1 month
or longer. Previously, these symptoms had been considered part of “anxiety neurosis,” in
which chronic worry and panic attacks lumped together. Generalized anxiety disorder
(GAD), also known as “chronic anxiety neurosis,” is characterized by chronic “free-floating
anxiety,” accompanied by such autonomic symptoms as tremor, tachycardia, and diaphoresis.

1.1. Prevalence

1.2. Age
Prevalence rates of GAD appear to vary somewhat with age. The diagnosis of GAD has only
recently been expanded to include children. Under DSMIII-R criteria, children who had
excessive worry, concern about competence, somatic complaints, self-consciousness,
excessive need for reassurance, and tension that persisted for at least 6 months were given the
diagnosis of overanxious disorder. In DSM-IV, this diagnosis was combined with GAD.
Studies of overanxious disorder in children have found prevalence rates ranging from 2.9% to
4.6% among children aged 11 years and under, and 3.6% to 7.3% among adolescents. In
Germany, Wittchen and colleagues, using the diagnostic criteria for GAD with adolescents
and young adults aged 14 to 24 years, found lower rates. They reported a lifetime prevalence
of 0.8% and a 1-year prevalence of 0.5% . It has been hypothesized that GAD has a later
onset than other anxiety disorders, perhaps because of an accumulation of chronic stressors
over time. GAD also may have an onset in late adulthood. Community-based studies of GAD
have found prevalence rates of about 4% in individuals aged 65 and over .

1.3. Onset

1.4. Clinical Features

1.5. Course
1.6. Etiology
1.7. Comorbidity
1.7.1. Psychiatric comorbidity
Psychiatric comorbidity is common with GAD, which has contributed to the
uncertainty about whether GAD is a distinct diagnosis. In the National Comorbidity
Survey, major depression was present in 62% of subjects with GAD (7). Dysthymia
(40%), alcohol abuse or dependence (38%), social phobia (34%), and simple phobia
(35%) were commonly comorbid with GAD. The overall current psychiatric
comorbidity rate with GAD was 66.3%, and the lifetime comorbidity was 90.4%. It
should be noted, however, that comorbidity rates are high across psychiatric
diagnoses in general, at approximately 50% (18).
1.7.2. Medical comorbidity
GAD may occur more frequently in individuals with certain medical illnesses. There
appears to be a higher rate of GAD among individuals with chronic obstructive
pulmonary disease than in the general population. Similarly, 18 studies of diabetes
mellitus in aggregate suggest that 14% of patients with diabetes also have GAD.
Thyroid disease may also occur at higher rates among patients with GAD than in the
general population, as supported by a study of self-reported thyroid disease in patients
with GAD. In these studies, the order of onset of the disorders is unclear, as is the
etiology of the comorbidity. While the pathophysiology of a general medical disease
and the stress and functional impairment associated with the disease may each serve
as a risk factor for GAD, GAD may also increase the risk of developing some medical
disorders. One study reported that, after adjusting for sociodemographic variables as
well as psychiatric and medical comorbidity, GAD symptoms had a dose-response
relationship, or positive correlation, with the risk of peptic ulcer disease.