If the latest manual in psychiatry is anything to shout about, ladies and gentlemen, we have quite a number of new mental illnesses to worry about. And maybe throw out a couple of outdated ones out of the window..
The Diagnostic and Statistical Manual of Mental Disorders, or DSM for short, lists these changes. The American Psychiatric Association released its revised fifth edition of the manual recently, which serves as the official authority on mental health diagnoses (and related insurance claims).
Among the new entries are:
Compulsive Hoarding– a pattern of behavior that is characterized by the excessive acquisition of and inability or unwillingness to discard large quantities of objects that cover the living areas of the home. Read more here.
Excoriation (Skin-Picking) Disorder– Under the group of obsessive-compulsive disorders, this condition is characterized by chronic picking and scratching of the skin that can cause wounds and scabs. The condition can be associated with other disorders involving compulsive eating, buying and stealing. The problem is often treated with antidepressants, anti-anxiety drugs or other medications.
Caffeine Withdrawal– People who are grumpy before they’ve had their morning coffee may welcome caffeine withdrawal to the manual as a legitimate mental affliction. A controversial addition, the new diagnosis directly reflects our increasing dependence on caffeine, from the proliferation of Starbucks outlets to the growing array of non-coffee energy drinks and caffeine-injected alcoholic beverages.
Social (Pragmatic) Communication Disorder- With this addition to the manual, psychiatrists can now more precisely diagnose speech and written language problems that are unrelated to autism. Indeed, while symptoms of this disorder, which must date back to childhood, include “inappropriate responses in conversation” and difficulty communicating, the diagnosis can only be made after autism spectrum disorders have been ruled out. These problems often hamper people’s social lives, academic careers and job performance.
A few entries in previous editions have been taken out. “Sexual aversion disorder,” for example, has been retracted from legitimate diagnoses because of “rare use and lack of supporting research,” according to the APA. By the way, as an illustration of changing times and how time changes society’s values, until the 1970s, the manual listed homosexuality as a disorder.
Some patients asked recently whether coffee was good for one’s health. Part of the recent upsurge in interest in the health benefits of this beverage has been the shift in marketing strategy by coffee-makers locally in promoting it as a rich source of anti-oxidants.
Yes, coffee is a rich source of anti-oxidants, like chlorogenic acid and melanoidins, the latter being the most important component of roasted coffee. Some of the other beneficial effect of drinking coffee include:
- Reducing the incidence of Parkinson’s Disease and Alzheimer’s. Read “A Cup of Coffee a Day will Keep Alzheimer’s Away”.
- Protecting against diabetes. Moderate consumption may lower the risk of type 2 diabetes in younger and middle aged women.
- Preventing liver disease and the formation of liver and kidney stones.
- The beneficial effects of caffeine in coffee on alertness, attentiveness, and wakefulness.
And the bad news? Among other things:
- Unfiltered coffee (as in Turkish coffee and kahawa) raises blood cholesterol. Filtered coffee, as in instant coffee, does not do so as diterpenes, responsible for raising cholesterol, are removed by filtration.
- Coffee consumption is also associated with an increase of plasma homocysteine, a risk factor for coronary heart disease.
- Caffeine in coffee can increase the risk of elevated blood pressure and hardening of the arteries, as well as palpitations.
- 4 cups or more will hasten osteoporosis, especially in those with low calcium intake in the diet.
- Coffee increases heartburn, aka gastro-eosophageal reflux disease (GERD).
What about heart disease? The verdict’s not in just yet..on one hand, diterpenes cause a rise in cholesterol and homocysteine but this seems balanced by the beneficial anti-oxidant properties.
I ought to clarify here that we are talking about coffee, just coffee. The pendulum swings the other way when we consume coffee with additives like milk and sugar. The latte at the local Starbucks will add on quite a substantial amount of fats, sugars and calories (260 to be precise, see here). Compare that to the ZERO calories of plain black coffee!
Gotten into a heated discussion recently about coffee preventing a proper sleep? Some people find that the mild stimulation of caffeine consumed even hours before bed time delays sleep, while others can consume a cup which will knock them out in no time! This paradox has never been fully explained even in medical circles..
..That’s the advice by the Queensland State government to their doctors who have been working on 30-80 hour non-stop shifts. This advice is contained in a 102-page Queensland Health Fatigue Risk Management System in response to a complaint that public hospital patients were dying because dangerously tired medics were being forced to work up to 80 hours without a break.(see the Reuter’s report)
The document recommends 400 milligrams of coffee (6 cups of coffee) as a fatigue fighter, so that the exhausted doctors can continue their duties. 600 milligrams? That’s enough to cause heart palpitations, raised blood pressure, dizziness, anxiety and hand tremors! Not to mention caffeine dependence and addiction.
The background for this astonishing strategy appears to be mainly due to Australia’s ailing public hospital system which is managed by state governments like Queensland, with federal government support. Gross inefficiencies and the rising cost of healthcare have led to insufficient funding and staff shortages. In a scenario similar to the US, urgent healthcare reform is on the cards and Kevin Rudd is seriously considering a federal government takeover.
Back to coffee..lets not forget its beneficial effects. Its a rich source of anti-oxidants like chlorogenic acid and melanoidins. It also helps to prevent diabetes,Alzheimer’s and Parkinson’s disease. The jury is still out on whether it causes heart disease although it is known to increase blood pressure. Read more about the health effects of coffee in my earlier posting “Losing Sleep Over Coffee”.
Thanks to Fidel for drawing attention to this news report.
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