Spectrum disorder

Spectrum disorder

Spectrum disorder in psychiatry is a term used to describe a mental disorder when there is thought to be "not a unitary disorder but rather a syndrome composed of subgroups" that can range from relatively "severe" to relatively "mild and nonclinical deficits".cite journal |author=Maser JD, Akiskal HS |title=Spectrum concepts in major mental disorders |journal=Psychiatr. Clin. North Am. |volume=25 |issue=4 |pages=xi–xiii |year=2002 |month=December |pmid=12462854 |doi= |url=]

The term spectrum was originally used in physics to indicate an apparent qualitative distinction arising from a quantitative continuum (i.e. a series of colors formed when a beam of white light is dispersed by a prism so that their parts are arranged in the order of their wavelengths). In psychiatry, the concept of spectrum was first used with a slightly different connotation to identify a group of disorders that is qualitatively distinct in appearance (e.g. depression and alcoholism, or different types of mood disorder) but believed to be related from an underlying pathogenic point of view. For different investigators, the hypothetical common pathogenic link has been of a different nature.

"Spectrum", "dimension" and "continuum" are related concepts. Some use them interchangeably while some argue the fine points of difference. The term "continuum" suggests a simple straight line from severe to mild, while the term "spectrum" is used to indicate the fact that although there is a common denominator, a given type of individual may present with a given pattern of symptoms, reminiscent of the spectrum of distinct colors after refraction of light by a prism.

In general, a spectrum approach is contrasted with a categorical approach, which is most associated with the DSM and ICD schemes. A spectrum approach may start with the nuclear, classic DSM diagnostic criteria for a disorder and then include an additional broad range of issues including temperaments or traits, lifestyle, behavioural patterns, and personality characteristics.

It has been noted that for clinicians trained after the publication of DSM-III, the spectrum concept may be relatively new, but that it has a long and distinguished history that dates back to Emil Kraepelin and beyond. It has been argued that within the data used as the basis for the DSM is a large literature leading to an alternative conclusion that a spectrum classification provides a better perspective on phenomenology of psychopathology than a categorical classification. However, it is acknowledged that the term has a varied history, meaning one thing when referring to a schizophrenia spectrum and another when referring to bipolar or obsessive-compulsive disorder spectrum, for example.”

The widely-used DSM and ICD manuals are generally limited to categorical diagnoses but do recognize some subsyndromal subtypes: schizotypal personality disorder, dysthymia and cyclothymia.

Some additional proposed spectra include a bipolar spectrum, a schizophrenia spectrum, an autism spectrum, a post-traumatic stress spectrum, an obsessive-compulsive spectrum, a social anxiety spectrum, and a panic-agoraphobia spectrum. Other higher-level spectra are often proposed, which categorize disorders into even fewer overarching spectra. Different spectrum theories for a given disorder may also user different terminology. For example various spectrum concepts of depression have been called the depression spectrum, the affective spectrum, and the mood spectrum.


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