These are conditions characterized by
Neurodevelopmental disorders are behavioural and cognitive disorders that arise during the developmental period that involve significant difficulties in the acquisition and execution of specific intellectual, motor, or social functions. These are also known as Disorders of psychological development. The presumptive etiology for neurodevelopmental disorders is complex, and in many individual cases is unknown.
Schizophrenia and other primary psychotic disorders are characterized by significant impairments in reality testing and alterations in behavior manifest in positive symptoms such as persistent delusions, persistent hallucinations, disorganized thinking (typically manifest as disorganized speech), grossly disorganized behavior, and experiences of passivity and control, negative symptoms such as blunted or flat affect and avolition, and psychomotor disturbances. The symptoms occur with sufficient frequency and intensity to deviate from expected cultural or subcultural norms.
Catatonia is a marked disturbance in the voluntary control of movements characterized by several of the following: extreme slowing or absence of motor activity, mutism, purposeless motor activity unrelated to external stimuli, assumption and maintenance of rigid, unusual or bizarre postures, resistance to instructions or attempts to be moved, or automatic compliance with instructions. Catatonia may be diagnosed in the context of certain specific mental disorders, including Mood disorders, Schizophrenia, and Autism spectrum disorder. Catatonia may also be caused by physical disorders.Catatonia
Mood Disorders refers to a super ordinate grouping of Bipolar and Depressive Disorders. Mood disorders are defined according to particular types of mood episodes and their pattern over time. The primary types of mood episodes are Depressive episode, Manic episode, Mixed episode, and Hypomanic episode. Mood episodes are not independently diagnosable entities, and therefore do not have their own diagnostic codes. Rather, mood episodes make up the primary components of most of the Depressive and Bipolar Disorders.Bipolar or related disorders
Bipolar and related disorders are episodic mood disorders defined by the occurrence of Manic, Mixed or Hypomanic episodes or symptoms. These episodes typically alternate over the course of these disorders with Depressive episodes or periods of depressive symptoms.Depressive disorders Symptomatic and course presentations for mood episodes in mood disorders
( Source: International Classification of Diseases - 11th Edition(ICD-11), 2022 Release. )
Anxiety and fear-related disorders are characterized by excessive fear and anxiety and related behavioural disturbances, with symptoms that are severe enough to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. A key differentiating feature among the Anxiety and fear-related disorders are disorder-specific foci of apprehension, that is, the stimulus or situation that triggers the fear or anxiety. The clinical presentation of Anxiety and fear-related disorders typically includes specific associated cognitions that can assist in differentiating among the disorders by clarifying the focus of apprehension.Anxiety or fear-related disorders
Obsessive-compulsive and related disorders is a group of disorders characterized by repetitive thoughts and behaviours that are believed to share similarities in etiology and key diagnostic validators. Cognitive phenomena such as obsessions, intrusive thoughts and preoccupations are central to a subset of these conditions (i.e., obsessive-compulsive disorder, body dysmorphic disorder, hypochondriasis, and olfactory reference disorder) and are accompanied by related repetitive behaviours. Hoarding Disorder is not associated with intrusive unwanted thoughts but rather is characterized by a compulsive need to accumulate possessions and distress related to discarding them. Also included in the grouping are body- focused repetitive behaviour disorders, which are primarily characterized by recurrent and habitual actions directed at the integument (e.g., hair-pulling, skin-picking) and lack a prominent cognitive aspect. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.Obsessive-compulsive and related disorders are
Disorders specifically associated with stress are directly related to exposure to a stressful or traumatic event, or a series of such events or adverse experiences. For each of the disorders in this grouping, an identifiable stressor is a necessary, though not sufficient, causal factor. Although not all individuals exposed to an identified stressor will develop a disorder, the disorders in this grouping would not have occurred without experiencing the stressor. Stressful events for some disorders in this grouping are within the normal range of life experiences (e.g., divorce, socio-economic problems, bereavement). Other disorders require the experience of a stressor of an extremely threatening or horrific nature (i.e., potentially traumatic events). With all disorders in this grouping, it is the nature, pattern, and duration of the symptoms that arise in response to the stressful events—together with associated functional impairment—that distinguishes the disorders.Disorders specifically associated with stress
Dissociative disorders are characterized by involuntary disruption or discontinuity in the normal integration of one or more of the following: identity, sensations, perceptions, affects, thoughts, memories, control over bodily movements, or behaviour. Disruption or discontinuity may be complete, but is more commonly partial, and can vary from day to day or even from hour to hour. The symptoms of dissociative disorders are not due the direct effects of a medication or substance, including withdrawal effects, are not better explained by another mental and behavioural disorder, a sleep-wake disorder, a disease of the nervous system or other health condition, and are not part of an accepted cultural, religious, or spiritual practice. Dissociative symptoms in dissociative disorders are sufficiently severe to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning.Dissociative disorders are
Feeding and Eating Disorders involve abnormal eating or feeding behaviours that are not explained by another health condition and are not developmentally appropriate or culturally sanctioned. Feeding disorders involve behavioural disturbances that are not related to body weight and shape concerns, such as eating of non-edible substances or voluntary regurgitation of foods. Eating disorders include abnormal eating behaviour and preoccupation with food as well as prominent body weight and shape concerns.Feeding or eating disorders
Elimination disorders include the repeated voiding of urine into clothes or bed (enuresis) and the repeated passage of feces in inappropriate places (encopresis). Elimination disorders should only be diagnosed after the individual has reached a developmental age when continence is ordinarily expected (5 years for enuresis and 4 years for encopresis). The urinary or fecal incontinence may have been present from birth (i.e., an atypical extension of normal infantile incontinence), or may have arisen following a period of acquired bladder or bowel control. An Elimination disorder should not be diagnosed if the behaviour is fully attributable to another health condition that causes incontinence, congenital or acquired abnormalities of the urinary tract or bowel, or excessive use of laxatives or diuretics.Elimination disorders are
Disorders of bodily distress and bodily experience are characterized by disturbances in the person’s experience of his or her body. Bodily distress disorder involves bodily symptoms that the individual finds distressing and to which excessive attention is directed. Body integrity dysphoria involves a disturbance in the person’s experience of the body manifested by the persistent desire to have a specific physical disability accompanied by persistent discomfort, or intense feelings of inappropriateness concerning current non-disabled body configuration.Disorders of bodily distress or bodily experience
Disorders due to substance use and addictive behaviours are mental and behavioural disorders that develop as a result of the use of predominantly psychoactive substances, including medications, or specific repetitive rewarding and reinforcing behaviours.
Disorders due to substance use include single episodes of harmful substance use, substance use disorders (harmful substance use and substance dependence), and substance-induced disorders such as substance intoxication, substance withdrawal and substance-induced mental disorders, sexual dysfunctions and sleep-wake disorders.Disorders due to substance use
Disorders due to addictive behaviours are recognizable and clinically significant syndromes associated with distress or interference with personal functions that develop as a result of repetitive rewarding behaviours other than the use of dependence-producing substances. Disorders due to addictive behaviors include gambling disorder and gaming disorder, which may involve both online and offline behaviour.Disorders due to addictive behaviours
Impulse control disorders are characterized by the repeated failure to resist an impulse, drive, or urge to perform an act that is rewarding to the person, at least in the short-term, despite consequences such as longer-term harm either to the individual or to others, marked distress about the behaviour pattern, or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Impulse Control Disorders involve a range of specific behaviours, including fire-setting, stealing, sexual behaviour, and explosive outbursts.Impulse control disorders are
Disruptive behaviour and dissocial disorders are characterized by persistent behaviour problems that range from markedly and persistently defiant, disobedient, provocative or spiteful (i.e., disruptive) behaviours to those that persistently violate the basic rights of others or major age-appropriate societal norms, rules, or laws (i.e., dissocial). Onset of Disruptive and dissocial disorders is commonly, though not always, during childhood.Disruptive behaviour or dissocial disorders
Personality disorder is characterized by a relatively enduring and pervasive disturbance in how individuals experience and interpret themselves, others, and the world that results in maladaptive patterns of cognition, emotional experience, emotional expression, and behaviour. These maladaptive patterns are relatively inflexible and are associated with significant problems in psychosocial functioning that are particularly evident in interpersonal relationships. The disturbance is manifest across a range of personal and social situations (i.e., is not limited to specific relationships or situations). Personality disorder is of long duration, typically lasting at least several years. Most commonly, it has its first manifestations in adolescence and is clearly evident in young adult life.Prominent personality traits or patterns
Trait domain descriptors may be used to characterize the personality features of individuals diagnosed with Personality disorders (in the chapter on Mental and behavioural disorders) or Personality difficulty (in the chapter on Factors influencing health status and contact with health services). A trait domain should be coded only if its features are prominent in the personality makeup of the individual diagnosed with Personality disorder or Personality difficulty and there is evidence that the characteristics described by the trait domain are associated with impairment in psychosocial functioning. Multiple trait domains may be specified, as many as necessary to capture the individual’s characteristics that are relevant to the Personality disorder or Personality difficulty. Unless accompanied by a diagnosis of Personality disorder or Personality difficulty, the Trait domains are not meaningful indicators or descriptors of psychopathology. In addition, this grouping include a designation for borderline pattern in individuals with Personality disorder, which may be used in addition to or instead of the identification of prominent Trait domains.Personality disorders and related traits
Paraphilic disorders are characterized by persistent and intense patterns of atypical sexual arousal, manifested by sexual thoughts, fantasies, urges, or behaviours, the focus of which involves others whose age or status renders them unwilling or unable to consent and on which the person has acted or by which he or she is markedly distressed. Paraphilic disorders may include arousal patterns involving solitary behaviours or consenting individuals only when these are associated with marked distress that is not simply a result of rejection or feared rejection of the arousal pattern by others or with significant risk of injury or death.Paraphilic disorders are
Factitious disorders are characterized by intentionally feigning, falsifying, inducing, or aggravating medical, psychological, or behavioural signs and symptoms or injury in oneself or in another person, most commonly a child dependent, associated with identified deception. A pre-existing disorder or disease may be present, but the individual intentionally aggravates existing symptoms or falsifies or induces additional symptoms. Individuals with factitious disorder seek treatment or otherwise present themselves or another person as ill, injured, or impaired based on the feigned, falsified, or self-induced signs, symptoms, or injuries. The deceptive behaviour is not solely motivated by obvious external rewards or incentives (e.g., obtaining disability payments or evading criminal prosecution). This is in contrast to Malingering, in which obvious external rewards or incentives motivate the behaviour.Factitious disorders are
Neurocognitive disorders are characterized by primary clinical deficits in cognitive functioning that are acquired rather than developmental. That is, neurocognitive disorders do not include disorders characterized by deficits in cognitive function that are present from birth or that arise during the developmental period, which are classified in the grouping neurodevelopmental disorders. Rather, neurocognitive disorders represent a decline from a previously attained level of functioning. Although cognitive deficits are present in many mental disorders (e.g., schizophrenia, bipolar disorders), only disorders whose core features are cognitive are included in the neurocognitive Disorders grouping. In cases where the underlying pathology and etiology for neurocognitive disorders can be determined, the identified etiology should be classified separately.Neurocognitive disorders are Dementia
Dementia is an acquired brain syndrome characterized by a decline from a previous level of cognitive functioning with impairment in two or more cognitive domains (such as memory, executive functions, attention, language, social cognition and judgment, psychomotor speed, visuoperceptual or visuospatial abilities). The cognitive impairment is not entirely attributable to normal aging and significantly interferes with independence in the person’s performance of activities of daily living. Based on available evidence, the cognitive impairment is attributed or assumed to be attributable to a neurological or medical condition that affects the brain, trauma, nutritional deficiency, chronic use of specific substances or medications, or exposure to heavy metals or other toxins.Types of Dementia are
Syndromes associated with pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involve significant mental and behavioural features. If the symptoms meet the diagnostic requirements for a specific mental disorder, that diagnosis should also be assigned.Mental or behavioural disorders associated with pregnancy, childbirth and the puerperium
Psychological and behavioural factors affecting disorders or diseases classified elsewhere are those that may adversely affect the manifestation, treatment, or course of a condition classified in another chapter of the ICD. These factors may adversely affect the manifestation, treatment, or course of the disorder or disease classified in another chapter by: interfering with the treatment of the disorder or disease by affecting treatment adherence or care seeking; constituting an additional health risk; or influencing the underlying pathophysiology to precipitate or exacerbate symptoms or otherwise necessitate medical attention. This diagnosis should be assigned only when the factors increase the risk of suffering, disability, or death and represent a focus of clinical attention, and should be assigned together with the diagnosis for the relevant other condition.Psychological or behavioural factors affecting physical diseases
This grouping includes syndromes characterized by the presence of prominent psychological or behavioural symptoms judged to be direct pathophysiological consequences of a health condition not classified under mental and behavioural disorders, based on evidence from the history, physical examination, or laboratory findings. The symptoms are not accounted for by delirium or by another mental and behavioural disorder, and are not a psychologically mediated response to a severe medical condition (e.g., adjustment disorder or anxiety symptoms in response to being diagnosed with a life-threatening illness). These categories should be used in addition to the diagnosis for the presumed underlying disorder or disease when the psychological and behavioural symptoms are sufficiently severe to warrant specific clinical attention.Secondary mental or behavioural syndromes associated with physical diseases
We treat psychological, behavioral, and mental health issues by a multidisciplinary team, using a judicious mix of various evidence-based scientific treatment methods.
Now, for clarification of the above statement:Psychological issues:
distressing experiences of mind, causing difficulties in personal, psychosocial, and occupational functioning.Behavioral issues:
Visible behaviours are problematic and interfere with personal, psychosocial, and occupational functioning.Mental health issues:
Traditionally, mental illness or mental disorders.
The international classification of diseases by the World Health Organisation, lists various conditions as mental and behavioural disorders. Traditionally, they are also called mental illnesses and constitute the core of the psychiatric speciality.
At Vazhikatti, the treating team consists of psychiatrists, clinical psychologists, counselling psychologists, occupational therapists, psychiatric social workers, and mental health nurses, who are all qualified and experienced in their respective aspects of providing care.
This team approach, meets the care needs of the patient and their family members, in all the important dimensions of mental health care—biological, psychological, and social. Hence, it is also called the Bio-Psycho-Social model of care.The Team:
A team is a group of individuals working together to achieve a goal. At Vazhikatti, the multidisciplinary team members work together to provide the best possible care to our patients.Evidence-based scientific treatment:
At Vazhikatti, treatment decisions are optimised based on the evidence from well designed and well conducted research, in the field of psychiatry, around the world.A judicious mix of treatment methods:
We provide highly individualised treatment depending on the nature and severity of the conditions and the underlying causes. The causes may be multiple and they may vary from individual to individual depending on age, sex, education, occupation, location, health and socioeconomic status, etc. Hence, treatment has to be personalised and optimised to meet the needs of the individual and also his family and life circumstances. This may involve counselling, pharmacotherapy, psychotherapy, psychosocial interventions, lifestyle interventions, etc., in varying combinations. That is what we call the judicious mix of treatment methods.
Stage 1: Point of contact and telephonic triage
Stage 2: In person reception and triage
Step 3: Assessment, diagnosis and treatment planning
Stage 4: Treatment initiation
Stage 5: Reviews and follow treatment
As a patient or attendant, you have the following rights:
As a patient or attendant, you are accountable for: