Icd dsm

mental health nursing

1. ICD & DSM CLASSIFICATION

2. INTRODUCTION The ICD ( The  International Statistical Classification of Diseases ) is the global health information standard for mortality and morbidity statistics. ICD is increasingly used in clinical care and research to define diseases and study disease patterns, as well as manage health care, monitor outcomes and allocate resources .

3. Contd …. More than 100 countries use the system to report mortality data, a primary indicator of health status. This system helps to monitor death and disease rates worldwide and measure progress towards the Millennium Development Goals. About 70% of the world’s health expenditures (USD $ 3.5 billion) are allocated using ICD for reimbursement and resource allocation ICD has been translated into 43 languages. The 11th revision process is underway and the final ICD-11 will be released in 2018

4. DEFINITION ICD-10  is the 10th revision of (The  International Statistical Classification of Diseases ) and Related Health Problems (ICD), a medical classification list by the World Health Organization(WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. Work on ICD-10 began in 1983 ,  became endorsed by the Forty-third World Health Assembly in 1990, and was first used by member states in 1994 .  It remains current until January 1, 2022, when it will be replaced by  ICD-11

5. Contd … The  Diagnostic and Statistical Manual of Mental Disorders  ( DSM ) (latest edition: the DSM-5, published in 2013) is a publication for the classification of mental disorders using a common language and standard criteria. It is published by the American Psychiatric Association (APA) and is used by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical companies, the legal system, and policy makers.

6. Contd … The International Classification of Diseases(ICD ) is produced by the World Health Organization(WHO).  It has broader scope than the DSM, covering overall health; chapter V covers mental and behavioural disorders. While the DSM is the most popular diagnostic system for mental disorders in the U.S., the ICD is used more widely in Europe and other parts of the world, giving it a far larger reach than the DSM.

7. Contd …. The DSM-IV-TR (4th. ed.) contains specific codes allowing comparisons between the DSM and the ICD manuals, which may not systematically match because revisions are not simultaneously coordinated.  Though recent editions of the DSM and ICD have become more similar due to collaborative agreements, each one contains information absent from the other.

8. Contd … In 1917, together with the National Commission on Mental Hygiene (now Mental Health America), the APA developed a new guide for mental hospitals called the  Statistical Manual for the Use of Institutions for the Insane . This included twenty-two diagnoses and would be revised several times by the APA over the years .  Along with the New York Academy of Medicine, the APA also provided the psychiatric nomenclature subsection of the U.S. general medical guide, the  Standard Classified Nomenclature of Disease , referred to as the  Standard .

9. Major classification of mental disorders International classification of disease (ICD). Diagnostic statistical manual classification of mental disorders ( DSM-IV). Indian

10. PURPOSE OF CLASSIFICATION Communication Control :-control is most important purpose of a classification of mental disorders.

11. Contd …. Comprehensive :- comprehensive implies understanding the cause of mental disorders and the processes involved in their development and maintenance

12. HISTORY OF OFFICIAL CLASSIFICATION 1840 : The official system for tabulation mental disorder in U.S with one category –idiotic and insane 1880 : 7 categories { Mania , Malancholic , Monomania , paresis , Dementia , Dipsomania ,Epilepsy ) 1889 : System adopted by American psychiatric association called as standard classified nomenclature of diseases 1935 : Classification was only for chronic patients proved inadequate for use with world war II psychiatric causative acute disturbance psychosomatic personality disorders . 1948 :- WHO revised  

13. Contd … dipsomania

14. Contd … International list of cause of death (1900) I t was revised every ½ year and its 6th revision renamed as manual of the international classification of disease , injuries &causes of death which contained for the first time a manual of mental disorder entitled as (mental psychoneurotic and personality disorder ) with 10 categories of psychosis, 9 categories of psycho neurosis . 7 categories of disorder of character , behavior of intelligence

15. Contd … ICD -10 -1992 –(International Statistical Classifications of disease & related health problem ) earlier called as International C lassification of Disease injuries and cause of death -10 revision

16. International statistical classification of disease and related health problem (ICD In 1960 the WHO drafted the 8th revision of ICD -8. In 1979 ICD -9 was revised and numerical code(001-999)were used. The latest revision (ICD-10) was published in 1992 with its expanded scope and availability of 1000 categories slot of 3 digit level (00.0-99.9)

17. Contd … Chapter V of ICD constitutes the chapter on mental and behavioral disorder . ICD -10 used and alphanumerical code of an alphabet F followed by several digit . The first digit after the alphabet F denoted the main category of the mental and behavior disorder . There 10 category denoted by the digit 0-9 The second digit after the alphabet denote subcategory

18. Contd …. After the third character there is a decimal point to indicate that the third character can be subdivided into ten and each of this into another ten . WHO classification for all disease and related health problems Chapter F- classified psychiatric disorders as mental and behavioral disorders Codes them on an alphanumeric system from F00 to F99.

19. What is difference between ICD and DSM IV The ICD is produced by a global health agency with a constitutional public health mission, professional association. ICD's development is global, multidisciplinary and multilingual; . WHO's primary focus for the mental and behavioral disorders classification is to help countries to reduce the disease burden of mental disorders . The primary constituency of the DSM is U.S. psychiatrists T he DSM is produced by a single national

20. Contd … The ICD is approved by the World Health Assembly, composed of the health ministers of all 193 WHO member countries ; The ICD is distributed as broadly as possible at a very low cost, with substantial discounts to low-income countries, and available free on the Internet The DSM is approved by the assembly of the American Psychiatric Association, a group much like APA's Council of Representatives . T he DSM generates a very substantial portion of the American Psychiatric Association's revenue, not only from sales of the book itself, but also from related products and copyright permissions for books and scientific articles.

21. The main categories of ICD 10 F00-F09 Organic, including symptomatic, mental disorders F00 Dementia in Alzheimer's disease F00.0Dementia in Alzheimer's disease with early onset F00.1Dementia in Alzheimer's disease with late onset F00.2Dementia in Alzheimer's disease, atypical or mixed type F00.9Dementia in Alzheimer's disease, unspecified

22. F01Vascular dementia F01.0Vascular dementia of acute onset F01.1Multi-infarct dementia F01.2Subcortical vascular dementia F01.3Mixed cortical and subcortical vascular dementia F01.8Other vascular dementia F01.9Vascular dementia, unspecified

23. F02Dementia in other diseases classified elsewhere F02.0Dementia in Pick's disease F02.1Dementia in Creutzfeldt-Jakob disease F02.2Dementia in Huntington's disease F02.3Dementia in Parkinson's disease F02.4Dementia in human immunodeficiency virus [HIV] disease F02.8Dementia in other specified diseases classified elsewhere

24. F03Unspecified dementia A fifth character may be added to specify dementia in F00-F03, as follows: .x 0 Without additional symptoms .x 1 Other symptoms, predominantly delusional .x 2 Other symptoms, predominantly hallucinatory .x 3 Other symptoms, predominantly depressive .x 4 Other mixed symptoms

25. Contd … F04- Organic amnesic syndrome, not induced by alcohol and other substances F05- Delirium , not induced by alcohol and other psychoactive substances F05.0- Delirium , not superimposed on dementia, so described F05.1- Delirium , superimposed on dementia F05.8- Other delirium F05.9- Delirium , unspecified

26. ICD & DSM CLASSIFICATION   F06--Other mental disorders due to brain damage and dysfunction and to physical disease F06.0Organic hallucinosis F06.1Organic catatonic disorder F06.2 Organic delusional [schizophrenia-like] disorder F06.3 Organic mood [affective] disorders

27. Contd …  .30 Organic manic disorder  .31 Organic bipolar affective disorder  .32 Organic depressive disorder  .33 Organic mixed affective disorder  F06.4Organic anxiety disorder  F06.5Organic dissociative disorder  F06.6Organic emotionally labile [asthenic] disorder  F06.7Mild cognitive disorder

28. Contd ….  F06.8Other specified mental disorders due to brain damage and dysfunction and to physical disease  F06.9Unspecified mental disorder due to brain damage and dysfunction and to physical disease

29. Contd ….. F07-Personality and behavioral disorder due to brain disease, damage and dysfunction F07.0Organic personality disorder F07.1Postencephalitic syndrome F07.2Postconcussional syndrome F07.8Other organic personality and behavioral disorder due to brain disease, damage and dysfunction

30. Contd … F09Unspecified organic or symptomatic mental disorder F10--F19 Mental and behavioral disorders due to psychoactive substance use F10.-Mental and behavioral disorders due to use of alcohol F11.-Mental and behavioral disorders due to use of opioids F12.-Mental and behavioral disorders due to use of cannabinoids

31. Contd … F13.-Mental and behavioral disorders due to use of sedatives or hypnotics F14.-Mental and behavioral disorders due to use of cocaine F15.-Mental and behavioral disorders due to use of other stimulants, including caffeine F16.-Mental and behavioral disorders due to use of hallucinogens

32. Contd …. F17.-Mental and behavioral disorders due to use of tobacco F18.-Mental and behavioral disorders due to use of volatile solvents F19.-Mental and behavioral disorders due to multiple drug use and use of other psychoactive substance

33. Contd …. F20-F29  Schizophrenia, schizotypal and delusional disorders F20 Schizophrenia  F20.0 Paranoid schizophrenia  F20.1 Hebephrenic schizophrenia  F20.2 Catatonic schizophrenia  F20.3 Undifferentiated schizophrenia

34. Contd.. F20.4 Post-schizophrenic depression F20.5 Residual schizophrenia F20.6 Simple schizophrenia F20.8 Other schizophrenia F20.9 Schizophrenia, unspecified

35. Contd … F21 Schizotypal disorder F22 Persistent delusional disorders F22.0 Delusional disorder F22.8 Other persistent delusional disorders F22.9 Persistent delusional disorder, unspecified

36. Contd ….. F23 Acute and transient psychotic disorders F23.0 Acute polymorphic psychotic disorder without symptoms of schizophrenia F23.1 Acute polymorphic psychotic disorder with symptoms of schizophrenia F23.2 Acute schizophrenia-like psychotic disorder F23.3 Other acute predominantly delusional psychotic disorders F23.8 Other acute and transient psychotic disorders F23.9 Acute and transient psychotic disorders unspecified

37. Contd.. F24 Induced delusional disorder F25 Schizoaffective disorders F25.0 Schizoaffective disorder, manic type F25.1 Schizoaffective disorder, depressive type F25.2 Schizoaffective disorder, mixed type F25.8 Other schizoaffective disorders F25.9 Schizoaffective disorder, unspecified

38. Contd … F28 Other nonorganic psychotic disorders F29 Unspecified nonorganic psychosis F30-F39 Mood [affective] disorders

39. Contd … F30 Manic episode F30.0 Hypomania F30.1 Mania without psychotic symptoms F30.2 Mania with psychotic symptoms F30.8 Other manic episodes F30.9 Manic episode, unspecified

40. Contd.. F31 Bipolar affective disorder F31.0 Bipolar affective disorder, current episode hypomanic F31.1 Bipolar affective disorder, current episode manic without Psychotic symptoms

41. Contd … F31.2 Bipolar affective disorder, current episode manic with psychotic symptoms F31.3Bipolar affective disorder, current episode mild or moderate depression .30 Without somatic syndrome .31 With somatic syndrome

42. Contd.. F31.4 Bipolar affective disorder, current episode severe depression without psychotic symptoms F31.5 Bipolar affective disorder, current episode severe depression with psychotic symptoms F31.6 Bipolar affective disorder, current episode mixed F31.7 Bipolar affective disorder, currently in remission F31.8 Other bipolar affective disorders F31.9 Bipolar affective disorder, unspecified

43. F32 Depressive episode  F32.0 Mild depressive episode Without somatic syndrome  .01 With somatic syndrome  F32.1 Moderate depressive episode  .10 Without somatic syndrome

44. Contd.. .11 With somatic syndrome  F32.2 Severe depressive episode without psychotic symptoms  F32.3 Severe depressive episode with psychotic symptoms  F32.8 Other depressive episodes  F32.9 Depressive episode, unspecified

45. F33 Recurrent depressive disorder F33.0 Recurrent depressive disorder, current episode mild . 00 Without somatic syndrome . 01 With somatic syndrome F33.1 Recurrent depressive disorder, current episode moderate . 10 Without somatic syndrome . 11 With somatic syndrome

46. Contd … F33.2 Recurrent depressive disorder, current episode severe without psychotic symptoms F33.3 Recurrent depressive disorder, current episode severe with psychotic symptoms

47. Contd …  F33.4 Recurrent depressive disorder, currently in remission  F33.8 Other recurrent depressive disorders  F33.9 Recurrent depressive disorder, unspecified

48. Contd … F34 Persistent mood [affective] disorders  F34.0 Cyclothymia  F34.1 Dysthymia  F34.8 Other persistent mood [affective] disorders  F34.9 Persistent mood [affective] disorder, unspecified

49. Contd … F38 Other mood [affective] disorders F38.0 Other single mood [affective] disorders .00 Mixed affective episode F38.1 Other recurrent mood [affective] disorders .10 Recurrent brief depressive disorder F38.8 Other specified mood [affective] disorders

50. Contd … F39 Unspecified mood [affective] disorder F40-F48  Neurotic, stress-related and somatoform disorders  F40 Phobic anxiety disorders  F40.0 Agoraphobia  .00 Without panic disorder

51. Contd … .01 With panic disorder  F40.1 Social phobias  F40.2 Specific (isolated) phobias  F40.8 Other phobic anxiety disorders  F40.9 Phobic anxiety disorder, unspecified

52. Contd …. F41 Other anxiety disorders  F41.0 Panic disorder [episodic paroxysmal anxiety]  F41.1 Generalized anxiety disorder  F41.2 Mixed anxiety and depressive disorder  F41.3 Other mixed anxiety disorders  F41.8 Other specified anxiety disorders  F41.9 Anxiety disorder, unspecified

53. F42 Obsessive - compulsive disorder F42.0 Predominantly obsessional thoughts or ruminations F42.1 Predominantly compulsive acts [obsessional rituals] F42.2 Mixed obsessional thoughts and acts F42.8 Other obsessive - compulsive disorders F42.9 Obsessive - compulsive disorder, unspecified

54. F43 Reaction to severe stress, and adjustment disorders F43.0 Acute stress reaction F43.1 Post-traumatic stress disorder F43.2 Adjustment disorders .20 Brief depressive reaction .21 Prolonged depressive reaction .22 Mixed anxiety and depressive reaction

55. Contd … .23 With predominant disturbance of other emotions .24 With predominant disturbance of conduct .25 With mixed disturbance of emotions and conduct .28 With other specified predominant symptoms F43.8 Other reactions to severe stress

56. Contd …. F43.9 Reaction to severe stress, unspecified

57. F44 Dissociative [conversion] disorders F44.0 Dissociative amnesia F44.1 Dissociative fugue F44.2 Dissociative stupor F44.3 Trance and possession disorders F44.4 Dissociative motor disorders F44.5 Dissociative convulsions F44.6 Dissociative anesthesia and sensory loss

58. Trance & possesion

59. Contd … F44.7 Mixed dissociative [conversion] disorders F44.8 Other dissociative [conversion] disorders .80 Ganser's syndrome .81 Multiple personality disorder

60. Contd ….

61. Contd … .82 Transient dissociative [conversion] disorders occurring in Childhood and adolescence .88 Other specified dissociative [conversion] disorders F44.9 Dissociative [conversion] disorder, unspecified

62. F45 Somatoform disorders F45.0 Somatization disorder F45.1 Undifferentiated somatoform disorder F45.2 Hypochondriacal disorder F45.3 Somatoform autonomic dysfunction .30 Heart and cardiovascular system .31 Upper gastrointestinal tract .32 Lower gastrointestinal tract

63. Contd …. .33 Respiratory system .34 Genitourinary system .38 Other organ or system F45.4 Persistent somatoform pain disorder F45.8 Other somatoform disorders F45.9 Somatoform disorder, unspecified

64. F48 Other neurotic disorders F48.0 Neurasthenia F48.1 Depersonalization - derealization syndrome F48.8 Other specified neurotic disorders F48.9 Neurotic disorder, unspecified

65. Contd …. F50-F59 Behavioral syndromes associated with physiological disturbances and physical factors

66. F50 Eating disorders F50.0 Anorexia nervosa F50.1 Atypical anorexia nervosa F50.2 Bulimia nervosa F50.3 Atypical bulimia nervosa

67. Contd …. F50.4 Overeating associated with other psychological disturbances F50.5 Vomiting associated with other psychological disturbances F50.8 Other eating disorders F50.9 Eating disorder, unspecified  

68. F51 Nonorganic sleep disorders F51.0 Nonorganic insomnia F51.1 Nonorganic hypersomnia F51.2 Nonorganic disorder of the sleep-wake schedule F51.3 Sleepwalking [somnambulism ]

69. Contd …. F51.4 Sleep terrors [night terrors] F51.5 Nightmares F51.8 Other nonorganic sleep disorders F51.9 Nonorganic sleep disorder, unspecified

70. F52 Sexual dysfunction, not caused by organic disorder or disease  F52.0 Lack or loss of sexual desire  F52.1 Sexual aversion and lack of sexual enjoyment  .10 Sexual aversion  .11 Lack of sexual enjoyment  F52.2 Failure of genital response  F52.3 Orgasmic dysfunction

71. Contd … F52.4 Premature ejaculation  F52.5 Nonorganic vaginismus  F52.6 Nonorganic dyspareunia  F52.7 Excessive sexual drive  F52.8 Other sexual dysfunction, not caused by organic disorders or disease  F52.9 Unspecified sexual dysfunction, not caused by organic Disorder or disease

72. F53Mental and behavioral disorders associated with the puerperium , not elsewhere classified F53.0 Mild mental and behavioral disorders associated with the puerperium , not elsewhere classified F53.1 Severe mental and behavioral disorders associated with the puerperium , not elsewhere classified F53.8 Other mental and behavioral disorders associated with the puerperium , not elsewhere classified F53.9 Puerperal mental disorder, unspecified

73. Contd … F54Psychological and behavioral factors associated with disorders or diseases classified elsewhere F55 Abuse of non-dependence-producing substances F55.0 Antidepressants F55.1 Laxatives F55.2 Analgesics F55.3 Antacids F55.4 Vitamins F55.5 Steroids or hormones

74. Contd … F55.6 Specific herbal or folk remedies F55.8 Other substances that do not produce dependence F55.9 Unspecified F59 Unspecified behaviuoral syndromes associated with physiological disturbances and physical factor

75. Contd.. F60-F69 Disorders of adult personality and behavior F60 Specific personality disorders F60.0 Paranoid personality disorder F60.1 Schizoid personality disorder F60.2 Dissocial personality disorder

76. Contd … F60.3 Emotionally unstable personality disorder .30 Impulsive type .31 Borderline type F60.4 Histrionic personality disorder F60.5 Anankastic personality disorder F60.6 Anxious [avoidant] personality disorder F60.7 Dependent personality disorder F60.8 Other specific personality disorders F60.9 Personality disorder, unspecified

77. Contd …. F61 Mixed and other personality disorders F61.0 Mixed personality disorders F61.1 Troublesome personality changes

78. F62 Enduring personality changes, not attributable to brain damage and disease F62.0 Enduring personality change after catastrophic experience F62.1 Enduring personality change after psychiatric illness F62.8 Other enduring personality changes F62.9 Enduring personality change, unspecified

79. F63 Habit and impulse disorders F63.0 Pathological gambling F63.1 Pathological fire-setting [pyromania] F63.2 Pathological stealing [kleptomania] F63.3 Trichotillomania F63.8 Other habit and impulse disorders F63.9 Habit and impulse disorder, unspecified

80. F64 Gender identity disorders F64.0 Trans- sexualism F64.1 Dual-role transvestism F64.2 Gender identity disorder of childhood F64.8 Other gender identity disorders F64.9 Gender identity disorder, unspecified

81. F65 Disorders of sexual preference F65.0 Fetishism F65.1 Fetishistic transvestism F65.2 Exhibitionism F65.3 Voyeurism F65.4 Paedophilia F65.5 Sadomasochism F65.6 Multiple disorders of sexual preference

82. Contd …. F65.8 Other disorders of sexual preference F65.9 Disorder of sexual preference, unspecified

83. F66 Psychological and behavioural disorders associated with sexual development and orientation F66.0 Sexual maturation disorder F66.1 Ego-dystonic sexual orientation F66.2 Sexual relationship disorder F66.8 Other psychosexual development disorders F66.9 Psychosexual development disorder, unspecified

84. Contd …. A fifth character may be used to indicate association with: .x 0 Heterosexuality .x 1 Homosexuality .x 2 Bisexuality .x 8 Other, including prepubertal

85. F68 Other disorders of adult personality and behaviour F68.0 Elaboration of physical symptoms for psychological reasons F68.1 Intentional production or feigning of symptoms or disabilities, either physical or psychological [factitious disorder] F68.8 Other specified disorders of adult personality and behaviour

86. Contd …. F69 Unspecified disorder of adult personality and behavior F70-F79

87. Contd … Mental retardation F70 Mild mental retardation F71 Moderate mental retardation F72 Severe mental retardation F73 Profound mental retardation F78 Other mental retardation F79 Unspecified mental retardation

88. Contd … F80-F89 -- Disorders of psychological development F80 Specific developmental disorders of speech and language F80.0 Specific speech articulation disorder F80.1 Expressive language disorder F80.2 Receptive language disorder F80.3 Acquired aphasia with epilepsy [Landau- Kleffner syndrome] F80.8 Other developmental disorders of speech and language F80.9 Developmental disorder of speech and language, unspecified

89. Contd … F81 Specific developmental disorders of scholastic skills F81.0 Specific reading disorder F81.1 Specific spelling disorder F81.2 Specific disorder of arithmetical skills F81.3 Mixed disorder of scholastic skills F81.8 Other developmental disorders of scholastic skills F81.9 Developmental disorder of scholastic skills, unspecified

90. Contd … F82 Specific developmental disorder of motor function F83 Mixed specific developmental disorders F84 Pervasive developmental disorders F84.0 Childhood autism F84.1 Atypical autism F84.2 Rett's syndrome

91. Contd … F84.3 Other childhood disintegrative disorder F84.4Overactive disorder associated with mental retardation and stereotyped movements F84.5 Asperger's syndrome F84.8 Other pervasive developmental disorders F84.9 Pervasive developmental disorder, unspecified

92. Contd.. F88 Other disorders of psychological development F89 Unspecified disorder of psychological development F90-F98 Behavioral and emotional disorders with onset usually occurring in childhood and adolescence

93. Contd …. F90 Hyperkinetic disorders F90.0 Disturbance of activity and attention F90.1 Hyperkinetic conduct disorder F90.8 Other hyperkinetic disorders F90.9 Hyperkinetic disorder, unspecified

94. F91 Conduct disorders F91.0 Conduct disorder confined to the family context F91.1 Unsocialized conduct disorder F91.2 Socialized conduct disorder F91.3 Oppositional defiant disorder F91.8 Other conduct disorders F91.9 Conduct disorder, unspecified

95. F92 Mixed disorders of conduct and emotions F92.0 Depressive conduct disorder F92.8 Other mixed disorders of conduct and emotions F92.9 Mixed disorder of conduct and emotions, unspecified

96. F93 Emotional disorders with onset specific to childhood F93.0 Separation anxiety disorder of childhood F93.1 Phobic anxiety disorder of childhood F93.2 Social anxiety disorder of childhood F93.3 Sibling rivalry disorder F93.8 Other childhood emotional disorders F93.9 Childhood emotional disorder, unspecified

97. F94 Disorders of social functioning with onset specific to childhood  F94.0 Elective mutism  F94.1 Reactive attachment disorder of childhood  F94.2 Disinhibited attachment disorder of childhood  F94.8 Other childhood disorders of social functioning  F94.9 Childhood disorder of social functioning, unspecified

98. F95 Tic disorders  F95.0 Transient tic disorder  F95.1 Chronic motor or vocal tic disorder  F95.2 Combined vocal and multiple motor tic disorder [Gills de la Tourette's syndrome]  F95.8 Other tic disorders  F95.9 Tic disorder, unspecified

99. F98 Other behavioral and emotional disorders with onset usually occurring in childhood and adolescence F98.0 Nonorganic enuresis F98.1 Nonorganic encopresis F98.2 Feeding disorder of infancy and childhood F98.3 Pica of infancy and childhood F98.4 Stereotyped movement disorders F98.5 Stuttering [stammering]

100. Contd … F98.6 Cluttering F98.8Other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence F98.9Unspecified behavioral and emotional disorders with onset usually occurring in childhood and adolescence

101. Contd … F99 Unspecified mental disorder F99 Mental disorder , not otherwise specified

102. DSM IV & statistical manual of mental disorders It has mainly 5 axis Axis I : clinical psychiatric Axis Axis II: personality disorders & mental retardation Axis III: General medical conditions Axis IV: psychological and environmental problems Axis V: Global assessment of functioning - past one year

103. Contd … DSM IV & statistical manual of mental disorders It has mainly 5 axis Axis I : clinical psychiatric Axis Axis II: personality disorders & mental retardation Axis III: General medical conditions Axis IV: psychological and environmental problems Axis V: Global assessment of functioning - past one year  

104. Contd … DSM I : 1951 U.S with representation of American psychiatric association developed as alternative to mental disorder section of ICD -6 which was published in 1952 . It replace the outdated mental disorders section ANA and first time provided a glossary of definition of categories DSM II : in the 1965 by American psychiatric association . It encouraged multiple diagnosis by clinician unlike DSM –I and the word “ reaction” was eliminated

105. Contd … DSM III : in 1974 -1980was published using poly diagnostic criteria and multi axial system i.e Axis I :- Mental disorders and additional codes Axis II :- Personality disorders and specific development of disorders. Axis III : Physical disorders Axis IV : severity of psychosocial stressors Axis V : Highest level of adaptive functioning past year .

106. Contd … DSM IV : The fourth edition of DSM of mental disorder published in 1994 , is the latest and most up to date classification of mental disorders . It correlation with 10 th edition of WHO ICD.

107. Contd … AXIS I clinical disorders and other condition Disorders usually first diagnosed during infancy childhood , adolescence. Delirium , dementia , amnesia and other cognitive disorder Mental disorder due general medical substance related disorders Mood disorders Anxiety disorders

108. Contd.. Somatoform Factitious disorders Dissociative disorders Sexual and gender identity disorders Eating disorders Sleep disorders impulsive control disorders Adjustment disorders Other condition that may not be focus of clinical attention

109. Axis II Personality disorders and mental Retardation paranoid personality disorders Schizoid personality disorders schizotypical personality disorders Antisocial personality disorders Borderline personality disorders Histrionic personality disorders

110. Contd … Narcissistic personality disorders Avoidant personality disorders Dependent personality disorders Obsessive – compulsive personality disorders Personality – disorders

111. Axis- III General Medical condition Infection parasites disease Endocrine , nutrition , metabolic disease and immune disorders Disorders of blood and blood forming organ Disorders of nervous and sense organ Disorders of circulatory, respiratory, digestive , gastrointestinal C omplication of childbirth , pregnancy , peuperium Disorders of skin and subcutaneous tissues Disorders of musculoskeletal and connective tissues Congenital abnormality

112. Axis –IV psychosocial and environment problems Problem with primary support group Problem related to the social environment Educational problems Occupations Housing Economic

113. Contd … Problem with access to health care system / service Problem related to interaction and the legal Other psychological to environmental problem

114. Axis –V Global assessment of function 91-100- superior function /no symptoms 81 –90 – absent or minimal symptoms good function in all area 71-80 – if system presents , they are transient and expectable reactions to psychological stressors –no more than sight impairment 61-70- some mild symptoms / difficulty but generally function well has some meaningful interpersonal relationship

115. Contd … 51-60 – moderate symptoms / difficulty 41-50 – serious symptoms / difficulty 31-40 – major impairment in several areas –work / school / functions 21-30 - Behavior is conderably influenced by delusion or hallucination or serious impairment in communication / adjustment. 11-20 – some of hurtiy self or other or occotinally fails to maintain personal hygiene and gross impairment of communication 1-10 – persistent danger of hurting self or other

116. Indian classification In India , Neki (1963 ) wig and singer (1967) Vahia (1961) and (1971) have attempted some modification of ICD8 to suit India’s condition of mental health. (A) Psychosis 1. Functional a. schizophrenia b. simple schizophrenia c. Hebephrenic schizophrenia d. Paranoid schizophrenia

117. Contd … 2. Affective a. mania b . Depression Organic a . Acute b . Chronic B. Neurosis 1. Anxiety 2 . Depression neurosis

118. Contd … Hysterical Neurosis 4 . obsessive compulsive neurosis 5 . phobic neurosis

119. Special Disorders Childhood disorders Conduct disorders Emotional disorders 2. Personality disorders Sociopath Psychopath 3. Substance abuse Alcohol abuse Drug abuse

120. Contd … 4. Psycho physiological disorders Asthma Psoriasis D. Mental retardation Mild Moderate Severe Profound

121. Contd … REFERENCES Townsend MC “Psychiatric mental health nursing”8 th edition published by Jaypee brother medical publisher” p p :175-176 Theodore . dorothy d “Mental Health Nursing” volume -1 published reed Elsevier india private limited Pp 305-12 Gupta Ram kumar “Mental Health Nursing” edition 1 st published by s vikas &company Pp:171-75 Sreevani R “A guide to mental health &psychiatric nursing”3 rd edition published by jaypee brothers Pp114-20 Ahuja N.A “Short text book psychiatric” 5 th edition published by jaype brothers Pp155-58 Bhaskara raj D.Elakkuvana “DEBR’S Mental health nursing”1 st edition published by EMMESS Medical PublishersPp22-25 www.slideshare.net-drjayeshpatidar/classification-of-mental-disorder viewed on 16/4/2020.