Classification of Mental Disorders 1.pptx

DSM and ICD system of classification, uses, drawbacks

1. Classification of Mental Disorders: Development of Classification Systems

2. Introduction Classification is the process by which a phenomena is grouped into categories as per some defined criteria. We need to classify mental disorders in order to provide for better treatment and prevention of illnesses. Importance of Classification: - Provides a common language for diagnosing and treating mental disorders . - Ensures consistency and accuracy across healthcare providers. - Enables research and understanding of mental health conditions .

3. Classification of mental disorders also serves the purpose of communication, control, and comprehension . Communication refers to communicating information about the illness and the diagnosis . Thus when a clinician diagnoses a mental disorder as a specific category ( e.g. generalised anxiety disorder) as per a particular classification system, and puts it on an outpatient prescription or the case records; another clinician would understand the clinical symptoms of the patient on seeing the diagnosis in the records . Thus it has served the purpose of communication. Control refers to developing the strategies for modifying the course of illness with treatment and also planning preventive strategies. A definition of disorder as per some classification would make it easy to develop control methods. Comprehension refers to understanding about the illness. Classification has a potential to improve understanding of an illness and hence also the causes and the processes involved in the development of illness and its maintenance.

4. Early Classification Systems Ancient Classifications : The syndromes of melancholia and hysteria find mention in Egyptian and Sumerian literature of 2600 BC. Ayurveda , the Indian system of medicine had included a classification of psychiatric disorders under medical illnesses in 1400 BC . In the modern system of medicine, Hippocrates (460-370 BC) is generally credited for bringing the concept of psychiatric illnesses to medicine. He classified mental illness into delirium, mania , paranoia, hysteria, melancholia resulting from four basic temperaments. Early Modern Attempts: - Emil Kraepelin’s ( 1856-1926) nosology laid groundwork for modern classifications. He used three approaches towards classification of mental disorders: clinical-descriptive, the somatic, and the course . His primary classifications were manic depressive psychosis and dementia praecox.

5. Development of DSM (Diagnostic and Statistical Manual of Mental Disorders ) Was developed by American Psychiatric Association DSM-I (1952 ):- 106 disorders, psychoanalytic influence . DSM-II (1968 ):-182 disorders, more inclusive . DSM-III (1980 ):- Shift to descriptive, symptom-based approach; 265 disorders . DSM-III-R (1987 ):-Revisions and refinements; 292 disorders . DSM-IV (1994 ):- Multi-axial system; 297 disorders . DSM-IV-TR (2000 ):- Text revisions and updates . DSM V - Released in 2013: - Elimination of multi-axial system. - Introduction of dimensional assessments. - 157 disorders, focus on spectrum disorders and cultural considerations.

6. Classification system in the DSM Axis I: Clinical Disorders and Other Conditions That May Be a Focus of Clinical Attention Axis II: Personality Disorders and Mental Retardation Axis III: General Medical Conditions Axis IV: Psychosocial and Environmental Problems Axis V: Global Assessment of Relational Functioning (GARF)

7. International Classification of Diseases (ICD) ICD 10 is developed by WHO. The current version being followed is the 10th version of ICD (ICD-10) that was published in 1992. lCD10 follows an alphanumeric coding scheme , based on codes with a single letter followed by two numbers at the three character level (A00­ ­ Z99 ) Chapter V (F) of lCD-10 deals with mental and behavioural disorders and has 100 categories F00-F99 . The version of ICD 10 used by mental health professionals for clinical purposes is called the Clinical Description and Diagnostic Guidelines version

8. ICD-6 to ICD-10: - ICD-6 (1948): First to include mental disorders. - ICD-10 (1992): Detailed classification, globally used . ICD-11 (2019): - Updated to reflect current knowledge. - User-friendly, better alignment with DSM-5.

9. Comparison Between DSM and ICD Purpose: - DSM: Used in the US for clinical diagnosis. - ICD : Used globally for health statistics and clinical practice . Structure and Classification Criteria: DSM : Detailed criteria, descriptive approach. ICD : Broader categories . Efforts for Harmonization: - Aligning DSM-5 and ICD-11.

10. Current Challenges and Future Directions Cultural and Social Biases: Addressing cultural differences and biases in classification . Advances in Neuroscience and Genetics: - Integration of biological, genetic, and neurological findings . Dimensional and Individualized Approaches: - Move towards personalized approaches .

11. Summary : - Classification systems are crucial for diagnosing and treating mental disorders. - They have evolved significantly. - Ongoing refinement and research are essential.

12. References American Psychiatric Association. (2000). Diagnostic and Statistical Manual 0f Mental Disorders: DSM-IV-TR (2000). 4 th ed., text revision. Washington, DC: American Psychiatric Association. World Health Organisation (1992). The ICD 10 Classification of Mental & Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation Gelder M.G., López-Ibor J.J. & Andreason N. (2009). New Oxford Textbook of Psychiatry , 2nd ed. Oxford: Oxford University Press. .