Court Opinion

ID: 9538855
Source: CourtListenerOpinion
Date Created: 2023-08-07 07:42:44.75221+00
Date Added: 2024-06-11T14:58:12.444653
License: Public Domain

*344FADELEY, J.,
specially concurring.
I agree that the Psychiatric Security Review Board (PSRB) order must be vacated and the case remanded to that agency for reconsideration. I would so hold based on the provisions of a statute, without reference to any version of the Diagnostic and Statistical Manual of Mental Disorders.
ORS 161.295(2) provides, in part:
“[T]he terms ‘mental disease or defect’ do not include * * * any abnormality constituting solely a personality disorder.”
A PSRB rule, OAR 859-10-005(4)(b) (1987), repeats that exclusion in the exact words of the statute. The issue in this case is whether those words cover a personality disorder that arises organically, as Dr. Jobe testified, from the birth defect of cerebral palsy.
The evidence at the PSRB hearing as to petitioner’s condition at that time was limited to that disorder. Therefore, that “organic personality disorder” is the only condition on which the PSRB could have based its order continuing petitioner in its custody.11 believe that the above-quoted statute expressly exempts organic personality disorders from the kinds of mental diseases and defects over which the PSRB may continue its jurisdiction. Where that is the case, ORS 161.351(1) provides, in part:
“Any person placed under the jurisdiction of the [PSRB] * * * shall be discharged at such time as * * * the person is no longer affected by mental disease or defect [as defined in ORS 161.295(2)]* * *.”
On this record, vacating the continuation order and remanding to the PSRB is appropriate. Given the statutory *345determination that a condition that is “solely a personality disorder” is not a “mental disease or defect,” ORS 161.295(2), I do not see in the record before us the basis for the PSRB’s continuing jurisdiction over petitioner.
Nor do I willingly join in the further, advance discussion of how the case might turn out on remand, a discussion based on the Diagnostic and Statistical Manual of Mental Disorders-III (3d ed 1980) (DSM-III). The PSRB record in the specific hearing that is the foundational basis for this judicial review does not show that the PSRB relied in any way on the material in the DSM-III. It relied only on the evidence, which stated that petitioner’s present condition is an “organic personality disorder.”
Even assuming that the PSRB did rely on the DSM-III, that text does not indicate that the statutory exclusion does not apply or that it is somehow overridden. The DSM-III provides no basis for avoiding the mandatory words of a relevant statute. Moreover, its provisions do not gainsay that petitioner’s present mental condition falls within the coverage of the statutory exception. Instead, the DSM-III’s provisions appear to leave intact the applicability to petitioner of the statutory exception.
The DSM-III is a description and classification system for various medical diagnoses of various mental conditions. It is intended to provide a common language and frame of reference for mental health professionals.
The DSM-III uses what it refers to as a multiaxial evaluation of “every case” to provide a diagnostic description. As stated in the DSM-III at 23, each axis “refers to a different class of information.” (Emphasis added.) It is different “information” to which the DSM-III appears to refer as to each axis, not a different, discrete diagnosis. As stated there, Axis I includes “Clinical Syndromes”; Axis II includes “Personality Disorders”; Axis III includes “Physical * * * Conditions.” DSM-III at 23.
The DSM-III expands on its descriptive diagnosis format, as follows:
“In DSM III a distinction is made between organic brain syndromes and organic mental disorders * * *; ‘organic *346mental disorder’ designates a particular organic brain syndrome in which the etiology is known or presumed.” Id. at 101 (emphasis in original).
That passage from the DSM-III implies that a “syndrome” is not necessarily a separate entity from a “disorder” because a “disorder” is a particular syndrome. Id. at 101-03. When the “etiology is known or presumed,” as it is in this case, the syndrome is called a disorder but remains one and the same entity, it appears.
The DSM-III also defines the word “personality” for its use in the DSM-III, as follows:
“Deeply ingrained patterns of behavior, which include the way one relates to, perceives, and thinks about the environment and oneself. Personality traits are prominent aspects of personality, and do not imply pathology. Personality disorder implies inflexible and maladaptive patterns of sufficient severity to cause either significant impairment in adaptive functioning or subjective distress.” Id. at 366 (emphasis in original).
Nothing in the above text takes this case out of the ORS 161.295(2) exception.2 As stated, according to the testimony at the hearing the word “organic” merely signifies that the “personality disorder” arises from a known organic etiology.
The final order of the PSRB, as compared with the testimony before it, does not include any finding of fact of any specific diagnosis. Indeed, the order neither mentions nor relies on any diagnosis. It includes only the bare conclusion that petitioner is “affected by a mental disease or defect.” There is no explanation of what disease or defect the PSRB thinks is present. Based on the limited record that is before us, I conclude that the diagnosis “organic personality disorder” remains that of “solely a personality disorder” that is exempt from PSRB jurisdiction under ORS 161.295(2), OAR 859-10-005(4)(b) (1987), and ORS 161.351. Of course, more information may be placed in the record on remand, if it is available.
*347The main opinion’s further discussion depends on this court’s making a rediagnosis or differently worded diagnosis than that present in the record. The PSRB’s responding brief refers to petitioner’s condition as “ ‘organic personality disorder.’ ” (Quotation marks in original.) It does not use the terminology “organic personality syndrome,” found in the main opinion. 325 Or at 341. Likewise, the PSRB’s briefs in the Court of Appeals and petitioner’s briefs in the Court of Appeals use “organic personality disorder,” not the main opinion’s “syndrome” language. The petition for review uses only personality “disorder,” not “syndrome.”
The PSRB’s response brief does not justify a switch to the “syndrome” terminology. It argues that “organic personality disorder” is a separate mental entity from “personality disorder.” That response brief does not urge or state that there was in the record any separate “syndrome” diagnosis. The main opinion strays from the argument of the PSRB by denominating the condition as an “organic personality syndrome,” rather than using the wording relied on by the parties.3 But, as indicated above, even if the change in terminology to “syndrome” had been argued to the court, where the DSM-III indicates that the specific syndrome is an organic personality disorder, as appears to be the case here, the statutory exception still potentially would apply.
I do not join in the main opinion’s rediagnosis, nor do I join in the underlying proposition that judicial review of a PSRB order leaves the reviewing court free to diagnose or rediagnose. However that may be, on remand the PSRB may and should determine whether an “organic personality disorder” caused by the birth defect of cerebral palsy is a separate entity from a “personality disorder” of the same etiology.

 At the time, over ten years ago, when petitioner was convicted of burglary “except for insanity,” he was diagnosed with the specific mental disease of schizo-affective disorder and committed to the jurisdiction of the PSRB. However, for much more than the two years prior to the ORS 161.341(4) hearing that is the foundation for the present case, that disease has not been found by his doctors to be present. Instead, petitioner is diagnosed as suffering from an “organic personality disorder.” The word “organic” merely confirms that his “personality disorder” is physically caused by his condition at birth, cerebral palsy. There was no other testimony before the PSRB in the present hearing. The recitation in the main opinion of past testimony and reports was not referred to or relied on by the PSRB in its order continuing jurisdiction.

 Of course, the exception relates only to PSRB jurisdiction and custody, not to other forms of institutionalization.

 All briefs of both parties in this ease refer to the diagnosis testimony at petitioner’s November 1993 hearing as “organic personality disorder.”