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Today, I would like to explain how a decline in ego functions can occur in any mental illness.

Mental disorders are diagnosed using diagnostic criteria that are standardized worldwide. This standardization allows for consistent diagnosis across different regions of the world and ensures that clinical trials for new treatments can be conducted using unified diagnostic criteria.

Furthermore, accurate statistics require these global diagnostic standards, as they provide a common framework for calculating reliable figures.

In Japan, the DSM-5 diagnostic criteria are widely used.

However, even if two patients are diagnosed with depression based on DSM criteria, their conditions may not be identical.

To evaluate the severity of the condition, we also use a scale called the level of pathology to assess the condition.

If the pathology is severe, even patients with depression may exhibit psychotic symptoms such as delusions or hallucinations. This is referred to as the psychotic spectrum.

In cases of anxiety disorders, if the level of pathology is within the psychotic spectrum, extra caution is required. Anxiety symptoms could be a precursor to developing schizophrenia.

The level of pathology is generally assessed by gathering information about the patient\u2019s developmental history.

Even in adult patients, it is important to obtain as much of their developmental history as possible.

Whether or not the patient has developed a basic level of trust is also a key point.

Medication use must be carefully selected based on the level of pathology.

Ego functions\u2014the ability to recognize oneself as distinct from others\u2014also decline when the pathology worsens. As a result, the boundaries of the ego become blurred, and the patient may experience vague feelings of fear.

It seems that fewer psychiatrists today receive training on this aspect.

While standard treatment based on cross-sectional diagnosis using the DSM is essential, the human mind is not always purely logical.
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