Classification of psychiatric disorders

Classification of psychiatric disorders

Dr. Safeya Adeeb Alchalabi

There are five types of definition:

Absence of health.
Disease is what doctors treat.
Biological disadvantage.
Pathological process.
Presence of suffering.

Definitions of mental illness

Biomedical
versus
social concepts

Impairment, disability, and handicap

Impairment refers to a pathological defect—for example, hemiparesis after a stroke.
Disability is the limitation of physical or psychological function that arises from an impairment—for example, difficulties with self-care that are caused by the hemiparesis.
Handicap refers to the resulting social dysfunction—for example, being unable to work because of the hemiparesis.
Incapacity refers in a legal sense to the effect that illness has on one’s competence to make treatment decisions.


The DSM-5 definition of a mental disorder
Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities.

Stigma in psychiatry

People fear mental illness and they stigmatize those who are affected by it.

Psychiatric stigma arises from a number of false beliefs. For example, concern about dangerousness is a major component of psychiatric stigma.
Other important components are ideas that:
● people with mental illness are unpredictable
● people with mental illness feel different from the rest of us
● people with mental illness are hard to talk and relate to
● mental illness cannot be cured, and people with mental illness do not recover.
Stigma in psychiatry

Reducing stigma

Campaigns to reduce stigma generally include:

● information about the true nature of mental illness, and about the low frequency of dangerous behaviour
● encouragement to persuade public figures who have had a mental illness to speak out about their experiences
● a focus on young people, whose attitudes may be less fixed than those of their elders.


Organic and functional
Organic disorders are those that arise from a demonstrable cerebral or systemic pathological process; the core disorders are dementia, delirium, and the various neuropsychiatric syndromes.

Organic and functional

‘Functional disorder’ is consequently an umbrella or default term for all other psychiatric disorders.

Neurosis and psychosis

psychosis refers broadly to severe psychiatric disorders, including schizophrenia, and some organic and affective disorders.
the inability to distinguish between subjective experience and external reality, as shown by the presence of delusions and hallucinations.

Neurosis

the term neurosis was introduced by Cullen to denote diseases of the nervous system.
Neurosis and psychosis

Comorbidity(dual diagnosis)

comorbidity is very common
The term comorbidity covers two different circumstances:
● Disorders that are currently considered to be distinct but which are probably causally related. In other words, there is one disease process.
● Disorders that are causally unrelated. This refers to the chance cooccurrence of two disorders—for example, the onset of presenile dementia in a person with longstanding panic disorder.
comorbidity applies only when the criteria for two or more diagnoses are met.


Differences between ICD-10 and DSM-5

ICD-10

DSM-5
Origin
World Health Organization
American Psychiatric Association
Usage
Official global classification, for use by all health practitioners in all health settings
Mainly American psychiatrists, and psychiatric researchers
Languages
Available in all widely spoken languages
English version only
Content
Clinical descriptors and guidance used Guidelines and criteria do not include social consequences of disorders
Operational criteria used Diagnostic criteria usually include significant impairment in social functions
Presentation
Different versions for clinical work, research, and use in primary care
A single document

Thank you