Scribd
Upload
75 views

Classification of Psychiatric Disorders: Ug Class Dept. of Psychiatry

This document discusses the classification of psychiatric disorders. It explains that classification involves grouping disorders based on similarities, and is important for communication between professionals, research, and planning services. Current classification systems include ICD-10 from the WHO and DSM-5 from the APA. These systems use a categorical approach but some advocate a dimensional/spectrum approach. The document outlines the history of classification and different approaches over time, moving from organic/functional distinctions to modern empirical approaches.

Uploaded by

tugba1234
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
75 views

Classification of Psychiatric Disorders: Ug Class Dept. of Psychiatry

This document discusses the classification of psychiatric disorders. It explains that classification involves grouping disorders based on similarities, and is important for communication between professionals, research, and planning services. Current classification systems include ICD-10 from the WHO and DSM-5 from the APA. These systems use a categorical approach but some advocate a dimensional/spectrum approach. The document outlines the history of classification and different approaches over time, moving from organic/functional distinctions to modern empirical approaches.

Uploaded by

tugba1234
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 26

Classification of Psychiatric

disorders
UG CLASS
DEPT. OF PSYCHIATRY

Classification
Def:- The process of putting things into groups based

on ways that they are alike (merriam dictionary)


Classification of diseases:- System of categories to

which morbid entities are assigned according to


some established criteria.
Diagnosis and classification are means of viewing

the world (Sartorius,N.1988).

Classification of lung diseases


Acute lung diseases

Chronic lung diseases

Acute bronchitis
Pleurisy
Pneumonia
Pneumothorax
Pulmonary embolism
ARDS

COPD
Asthma
Emphysema
Atelectasis
Bronchiectasis
Pulmonary fibrosis.

Classification in Psychiatry
Classification ideally must be based on aetiology

but do we know the aetiology???


Until we know the cause of the various mental

illnesses what to do???


So a Pragmatic/ Practical approach to classification

is being followed.

Why do we need classification?


Enable us to care for our patients,
To communicate with other health professionals,
To communicate between different geographical

boundaries,
To carry out high-quality research &
Based on epidemiological data to plan services.

Definitions
Syndrome:- It is a constellation of symptoms that are

unique as a group.

May contain some symptoms that occur in other syndromes


also, but
It is the particular combination of symptoms that makes the
syndrome specific.

In psychiatry many syndromes began as one specific

and striking symptom.

Definitions
Sometimes the symptoms of the syndrome seem to

have a meaningful coherence.


Ex, a case of mania may present with

cheerfulness,
over-activity,
pressure of speech and
flight of ideas, all these can be understood as arising from the
elevated mood.

Definitions
Mental disorder:

Clinically significant behavioral or psychological syndrome or


pattern that occurs in an individual,
Associated with persistent distress/disability,
Or with significantly increased risk of suffering death, pain,
disability or an important loss of freedom.

Psychiatric nosology: branch of medicine

concerned with the classification and description of


psychiatric disorders.

Earlier Classifications
Initial classification either arising from disease of the

brain or those with no such basis, i.e. organic &


functional.
As knowledge of neurobiological processes is increasing,
their original meaning is being lost.
Schizophrenia & BPAD were examples of functional
disorders, but the the role of genetics and of neuropathological abnormalities shows that there is at least
some organic basis for these disorders.
These categories of classification (i.e. organic versus
functional) are absurd now!!!...

Organic syndromes
Classified into acute, sub-acute & chronic.
Most common feature is alteration in consciousness.

It includes delirium.
It also includes substance use disorders due to use of
alcohol, cannabis, opium etc..,
Chronic organic states include various dementias,
generalized and focal, as well as amnestic disorders.
In modern classification they find their place in Foo
to F19.

Functional syndromes
Refers to those syndromes where there is no

apparent coarse brain disease.


Although increasingly it is recognized that some

finer variety of brain disease may exist, often at a


cellular level.
It was customary to divide these functional disorders

into neurosis and psychosis.

Functional disorders
Neurosis

Psychosis

Believed to have insight into their illness.


Only a part of their personality involved in the

disorder.
Intact reality testing.
Believed to lack insight into their illness.
Whole of the personality is distorted.
A false environment is constructed out of

their distorted subjective experience.

Neurosis
Neurosis- difficult to define, broad, more info conveyed if

specific diagnosis used.


Used as aetiological meaning in psychodynamic writings.
Not in used DSM 4.
Retained in ICD-10 neurotic stress related somatoform

disorders.
Used as non precise term.

Psychosis
Was used in ICD-9.
Psychosis- little use in classifying disorders.
Difficult to define, broad category.
Used as ICD-10 acute & transient psychotic disorders.
Used in DSM-4 Psychotic disorders NOS.

Neurotic v/s Psychotic


Oversimplification!!!...
Many individuals with neurotic conditions have

No insight,
Far from accepting their illness &
May minimise or deny it totally.

While people with schizophrenia may seek help willingly

during or before episodes of relapse.


Moreover, personality

Can be changed significantly by non-psychotic disorders such as


depressive illness,
It may be intact in some people with psychotic disorders such as
persistent delusional disorder.

Modern classificatory systems


ICD -10- International Classification of Diseases

Clinical descriptions and diagnostic guidelines


DSM-4-TR- Diagnostic and Statistical Manual of

Mental Disorders - 4th edition, Text Revision


DSM 5- 5Th edition of the text.

ICD
VERSION

YEAR

VERSION

YEAR

ICD 1

1900

ICD 6

1949

ICD 7

1958

ICD 8A

1968

ICD 9

1979

ICD 10

1999

ICD 11

2015

ICD 2
ICD 3

1910
1921

ICD 4

1930

ICD 5

1939

DSM
VERSION

YEAR

NO. DIAGNOSIS

DSM I

1952

106

DSM II

1968

182

DSM III

1980

265

DSM III R

1987

265

DSM IV

1994

365

DSM IV TR

2000

365

DSM 5

2013

400+

ICD-10 Chapter 5
Different versions Clinical descriptions & diagnostic guidelines (CDDG)
Diagnostic criteria for research (DCR)
Primary Care version
Multi-axial system
Chapter 5, F category (mental disorder).
New alphanumeric format-more categories.
Descriptive classification.
Groupings based on presumed aetiology e.g.

organic, non-organic psychotic etc..,

ICD- multi axial diagnosis


Axis I - Clinical diagnoses, both mental and general

medical disorders, personality disorders & Mental


retardation.
Axis II Disablements, this axis appraises the

consequences of illness in terms of impairment in


the performance of basic social roles.
Axis III - Contextual Factors, portrays the context of

illness in terms of several ecological domains.

DSM IV TR
Axis 1- Mental disorder
Axis 2- Personality disorders/ Mental retardation
Axis 3- General medical conditions
Axis 4- Psychosocial stressors
Axis 5- GAF (General Activity of Functioning)
DSM 5- does not has the axis diagnosis

ICD-10 v/s DSM IV


ICD-10: 1992

DSM IV: 1994

International-WHO

APA

Different criteria for clinical

One version

& research
All languages
Separate multi-axial
Not include social factors
(international)
Part of general classification
Alpha numerical
classification (F19, F25 etc..)

English
Multi-axial
Includes social factors

(national)
Only mental disorders
Numerical classification
(313.13, 256.21 etc..).

Diagnosis in ICD
F00-F09: Organic, including symptomatic, mental

disorders.
F10--F19: Mental and behavioural disorders due to
psychoactive substance use.
F20-F29: Schizophrenia, schizotypal and delusional
disorders.
F30-F39: Mood [affective] disorders.
F40-F48: Neurotic, stress-related and somatoform
disorders.

Diagnosis in ICD
F50-F59: Behavioural syndromes associated with

physiological disturbances and physical factors.


F60-F69: Disorders of adult personality and
behaviour.
F70-F79: Mental retardation.
F80-F89: Disorders of psychological development.
F90-F98: Behavioural and emotional disorders with
onset usually occurring in childhood and
adolescence.

Classification
Categorical

Dimensional/ Spectrum

Based on separate (but may be overlapping)

categories of disorders.
Termed as Neo-Kraepelinian" (after the
psychiatrist Kraepelin).
It is intended to be atheoretical with regard
to aetiology.
Achieved widespread acceptance in
psychiatry, and
Generally been found to have improved
inter-rater reliability.
Ex:- Bipolar affective disorder, Autism,
Aspergers syndrome etc..

Based on broader underlying "spectra",

where each spectrum links together a


range of related categorical diagnoses
and nonthreshold symptom patterns.
They are intended to be theoretical with
regard to aetiology.
Problem- limited practical value in
clinical practice where yes/no decisions
often need to be made.
Ex:- Bipolar spectrum, Autistic spectrum
disorders etc..

Thank you

You might also like