MENTAL HEALTH DISORDERS

Reporters:
Acope, Nestor C.
Alberca, Sarah Jane C.

MENTAL HEALTH DISORDERS

 Include disturbances in thinking, emotion and behaviour. There is a complex interaction
between the physical, psychologic, social, cultural and hereditary influences.

Factors that contribute to the development of Mental Disorders:

1. Hereditary – ascendants afflicted with the same.
2. Incestuous Marriage – marriage between blood relatives.
3. Impaired Vitality – stress, tension, worry, grief, etc.
4. Poor Moral Training and Breeding – corrupt moral upbringing in the family
5. Psychic factors – love, hate, rage, anger, passion, disappointments, etc.
6. Physical factors:
a. Non-toxic factors – exhaustion from severe physical and mental strain, and traumatic
injuries to the head.
b. Toxic factors – drug addiction and infections of the brain.

Kinds of Mental Health Disorders:

1. Psychosomatic Disorders – this term has often been employed to physical disorders
caused by psychologic factors, but not exclusively.

2. Somatoform Disorders – psychiatric disorders in which people report physical symptoms

but deny having psychiatric problems.
a. Somatization Disorder – chronic, severe illness characterized by many physical
symptoms.
b. Conversion Disorder – physical symptoms that are caused by psychologic conflict
resemble those of a neurologic disorder or other medical condition.
c. Hypochondriasis – psychiatric disorder which reports physical symptoms and
represent a serious disease

3. Generalized Anxiety Disorders – consists of excessive, almost daily anxiety and worry
lasting 6 months or longer.

4. Panic Attacks and Panic Disorder – panic is acute and extreme anxiety; panic attacks
may occur in any anxiety disorder, usually in response to a specific situation

5. Phobic Disorders – involves persistent, unrealistic, intense anxiety in response to

specific external situations.
a. Agoraphobia – fear of being trapped
b. Specific Phobias – most common of the anxiety disorders. (ex.: fear of heights)
c. Social Phobia – situations that commonly trigger anxiety such as public speaking.
6. Obsessive Compulsive Disorder – recurrent, unwanted, intrusive ideas, images, or
impulses that seem silly, weird, nasty, or horrible and an urge to do some thing that will
relieve the discomfort caused by an obsession.

7. Post-Traumatic Stress Disorder – caused by exposure to an overwhelming traumatic

event, in which the person later repeatedly re-experiences the even.

8. Depression and Mania

a. Depression – feeling of intense sadness
b. Mania – excessive physical activity and feelings of extreme elation that are grossly
out of proportion to any positive event.

9. Bipolar (Manic Depressive Illness) – periods of depression alternate with periods of

mania or lesser degree of excitement.
a. Cyclothymic Disorder – milder form of Bipolar Disorder where the periods of elation
and depression are less severe and lasts for only a few days.
b. Mixed Bipolar State – a person with bipolar disorder experiences manic or
hypomanic and depressive symptoms simultaneously.

10. Suicidal Behavior – final act in a course of self-destruction.

a. Suicide gestures – suicide plans and actions, unlikely to be fatal.
b. Suicide attempts – suicide actions that are intended to be fatal but don’t succeed.
c. Completed suicide – results to death
d. Direct suicide – consists of suicide gestures, suicide attempts, and completed
suicide.
e. Indirect suicide – the undertaking of repetitive dangerous activities without a
conscious intention of dying.

11. Eating Disorders

a. Anorexia Nervosa – characterized by a distorted body image, an extreme fear of
obesity, refusal to maintain a minimally normal body weight and in women, the
absence of menstrual period.
b. Bulimia Nervosa – characterized by repeated episodes of binge eating followed by
purging
c. Binge Eating Disorder – characterized by bingering that is not followed by purging.

12. Personality Disorders – characterized by patterns of perceiving and relating to other

people and events.
a. Paranoid personality – they project their own conflicts and hostilities unto others.
b. Schizoid personality – introverted, with drawn and solitary.
c. Schizotypal personality – emotionally and socially detached.
d. Histrionic personality – hysterical personality that conspicuously seeks attention and
behave dramatically.
e. Narcissistic personality – behavior that is usually offensive to others who view them
as being self-centered, arrogant and selfish.
f. Anti-social personality – shows callous disregard for the rights and feelings of others;
mostly male.
 g. Borderline personality – unstable in their self image, moods, behavior, and
interpersonal relationships; mostly women.
h. Avoidant personality – oversensitive to rejection
i. Dependent personality – lack of self-confidence and feel intensely insecure
j. Obsessive-compulsive personality – reliable, dependable, orderly, and methodical
but often cannot adapt to change.
k. Passive aggressive personality – negativistic personality covertly designed to punish
or control others
l. Dissociative disorders – psychologic defense mechanism in which one’s identity is
separated from conscious awareness.
- Dissociative amnesia – inability to recall important information
- Dissociative fugue – a person has one or more episodes of sudden, unexpected
and purposeful travel from home during which he can’t remember some or all of his
past life, lost memory of who he is or has formed a new identity.
- Dissociative identity disorder – two or more identities or personalities alternate in
control of a person’s behavior and in which there are episodes of amnesia.
- Depersonalization disorder – persisting or recurring feelings of being detached from
one’s body or mental processes.
m. Schizophrenia – serious mental disorder characterized by loss of contact with reality,
hallucinations, delusions, abnormal thinking, and disrupted work and social
functioning.
- Paranoid Schizophrenia
- Hebephrenic Schizophrenia
- Catatonic Schizophrenia
- Undifferentiated Schizophrenia
- Negative or Deficit Subtype of Schizophrenia
- Non Deficit Schizophrenia
n. Delusional Disorder – characterized by the presence of one or more false beliefs that
persist for at least one month.
- Erotomanic subtype
- Grandiose Subtype
- Jealous subtype
- Persecutory subtype
- Somatic subtype
o. Psychological Incapacity – covers all possible mental disorders

Manifestations of Mental Disorders:

1. Disorder of Cognition (Knowing)
a. Illusion – false interpretation of an external stimulus.
b. Hallucination – erroneous perception without an external object or stimulus.
- Visual
- Auditory
- Olfactory
- Gustatory
- Tactile
- Kinesthenic
 - Hypnagogic
- Lilliputian

2. Disorder of Memory
a. Dementia – a form of insanity resulting from degeneration or disorder of the brain
- Acute Dementia
- Paralytic Dementia
- Praecox Dementia
- Senile Dementia
- Toxic Dementia
b. Amnesia – loss of memory
- Anterograde Amnesia – loss of memory of recent event
- Retrograde Amnesia – loss of memory of past events

3. Disorders in the Content of Thought – suffering from a warped belief or thinking not in
accord with reality
a. Delusion – a false or erroneous belief in something which is not a fact.
- Delusion of Grandeur
- Delusion of Persecution
- Delusion of Reference
- Delusion of Self-Accusation
- Delusion of Infidelity
- Nihilistic Delusion
- Delusion of Poverty
- Delusion of Control
- Hypochrondriacal Delusion
- Delusion of Depression
- Delusion of Negation
b. Obsession – thought and impulse which continually occur in the person’s mind
despite all his attempts to keep them out.

4. Disorders in the trend of thought – improper and inaccurate processing of logical

thinking.
a. Mania
b. Melancholia

5. Disorders of Emotions or Feelings – a disorder in the state of mind, sentiment, fervor, or

sensibility, not in accord with reality.
a. Exaltation
b. Depression
c. Apathy
d. Phobia

6. Disorders of Volition of Conation (Doing) – uncontrollable and irresistible command to do

or not to do something.
a. Impulsion or Impulse (Compulsion)
 - Pyromania
- Kleptomania
- Dipsomania
- Homicidal impulse
- Sex impulse
- Suicidal impulse

Distinctions between true and false insanity:

TRUE
1. Develops insidiously usually with
the existence of some
predisposition to an exciting cause
if careful history is taken
2. There is a peculiar facial
expression
3. There is a continuous and
persistent manifestation of insanity
4. There is a clinical entity of a
specific mental disorder
5. The patient can endure a violent
or stressful activity without fatigue
6. The patient does not observe
personal hygiene
FALSE
1. Develops suddenly with no
existing predisposition
2. No peculiar facial expression
3. Manifestation of insanity is only
present when the pretender is
under observation
4. No such clinical entity
5. Cannot endure a violent or
stressful activity
6. The pretender observes hygiene

In relation to Criminal Law:

1. As an Exempting Circumstance (Art. 12, RPC)
2. As a Mitigating Circumstance (Art. 13, RPC)

Fundamental Principles of Insanity and Criminal Responsibility:

1. A sane man is assumed to be wholly responsible for the consequence of his crime.
2. A person who commits a criminal act is presume to be sane.
3. Crime is always considered as an affair of the mind as well as the body and to make an
act or omission a crime, there must be a criminal act and a criminal mind.

Conditions to be “Unfit to Plead”:

1. He would be unable to understand the nature of the court proceedings;
2. He would be unable to understand what he was being accused of and why he was there;
3. He would be unable to instruct the lawyers acting in his defense.

Some cases in insanity and criminal responsibility:

1. Epileptic commits a crime while in a feat of epilepsy (People vs. Ancao & Aguilar).
2. Committing a crime while dreaming (People vs. Taneo).
3. Sleep-walking (People vs. Gimena).
4. Malignant Malaria (People vs. Lacena).
MENTAL DEFICIENCY
 Sometimes called Mental Retardation
 It is a sub average intellectual ability present from birth or early infancy

Classification:
1. Idiot
2. Imbecile
3. Feeble Minded
4. Moron
5. Morally Defective

Methods of Estimating Mental Capacity:

1. Intelligence Testing
2. Intelligence Quotient (IQ)

Classification of IQs:

Above 140 Near genius or genius

120-140 Very Superior Intelligence
110-120 Superior Intelligence
90-110 Normal or Average Intelligence
80-90 Dullness, rarely classified as feeble
minded
70-80 Borderline deficiency
Below 70 Definitely feeble-minded

Malingerer
 A malingerer is a person who pretends or protracts illness or injury to escape work or
duty.

Types of Malingerer:
1. Munchausen Syndrome
2. Feigned or Fictitious Malingerer
3. Factitious Malingerer

Other conditions manifesting mental disturbances:

1. Somnambulism
2. Somnolencia
3. Mesmerism
4. Delirium

Legal Importance of determining a person’s state of mind:

1. In Criminal Law:
a. Insanity exempts a person from criminal liability (Art. 12, RPC)
 b. When a person becomes insane after final sentence, the execution and service of
the penalty is suspended (Art. 79, RPC)

2. In Civil Law:
a. Insanity is a restriction of the capacity of a natural person to act (Art. 38, Civil Code)
b. Insanity modifies or limits the capacity of a natural person to act (Art. 39, Civil Code)
c. Insanity at the time of marriage of any or both parties is a ground for the annulment
of marriage.
d. A testator must be of sound mind at the time of execution of the will.
e. A witness to a will must be of sound mind.
f. Insanity of the testator is a ground for disallowance of a will.
g. An insane cannot give consent to a contract.
h. The guardian or the insane himself if there is no parent or guardian shall be held
liable for damages due to his insanity.

3. In the Rules of Court:

a. A guardian for the person of the insane must be appointed.
b. An insane cannot be a witness in court.

Testamentary Capacity
 A testator must be of sound mind at the time of execution of the will and that insanity of
the testator is a ground for disallowance of a will.