Classification of Mental Disorders

1. By- Inderjeet Singh
PG Psychology
Jammu University

2. Introduction:
 Classification is a process by which complex
phenomena are organized into categories, classes or
ranks so as bring together those things that most
resemble each other & to separate those that differ.
 A mental disorder, also called a mental illness
or psychiatric disorder, is a behavioural or mental
pattern that causes significant distress or impairment
of personal functioning.
 At present there are two major classification for mental
disorders, namely ICD 10 (1992) & DSM IV (1994)

3. ICD 10 (International Statistical Classification of Diseases )
 This is WHO's classification for all diseases & related
health problems.
 ICD is the foundation for the identification of health
trends and statistics globally, and the international
standard for reporting diseases and health conditions.
 ICD defines the universe of diseases, disorders,
injuries and other related health conditions.
 ICD-11 has been adopted by the Seventy-second World
Health Assembly in May 2019 and comes into effect on
1 January 2022.

4. Why ICD ?
 Easy storage, retrieval and analysis of health
information for evidenced-based decision-making.
 Sharing and comparing health information between
hospitals, regions, settings and countries.
 Data comparisons in the same location across different
time periods.
 Monitoring of the incidences and prevalence of
diseases and causes of death.

5. Brief History of ICD:
 The first international classification edition, known as
the International List of Causes of Death, was adopted
by the International Statistical Institute in 1893.
 ICD-10 was endorsed in May 1990 by the Forty-third
World Health Assembly.
 It is cited in more than 20,000 scientific articles and
used by more than 150 countries around the world and
has been translated into more than 40 languages
 The WHO Nomenclature Regulations, adopted in
1967.

6. ICD-10 MAIN CATEGORIES:
 F0: Organic, including symptomatic, mental
disorders.
 F1: Mental and behavioural disorders due to use of
psychoactive substances.
 F2: Schizophrenia, schizotypal and delusional
disorders.
 F3: Mood [affective] disorders.
 F4: Neurotic, stress-related and somatoform disorders.
 F5: Behavioural syndromes associated with
physiological disturbances and physical factors.

7.  F6: Disorders of personality and behaviour in adult
persons.
 F7: Mental retardation.
 F8: Disorders of psychological development.
 F9: Behavioural and emotional disorders with onset
usually occurring in childhood and adolescence
 In addition, a group of "unspecified mental disorders“
(F99).
 Within each group there are more specific
subcategories.(F00-F99)

8. DSM-IV (Diagnostic and Statistical Manual of Mental
Disorders)
 This is the classification of mental disorders by the
American Psychiatric Association(APA). The pattern
adopted by DSM IV is of Multiaxial systems.
 The DSM-IV was originally published in 1994 and
listed more than 250 mental disorders.
 A multiaxial system that evaluates patients
 along several versatile contains Five axes.

9. Why DSM?
 DSM contains descriptions, symptoms, and other
criteria for diagnosing mental disorders.
 It provides a common language for clinicians to
communicate about their patients and establishes
consistent and reliable diagnoses that can be used in
the research of mental disorders.
 It also provides a common language for researchers to
study the criteria for potential future revisions and to
aid in the development of medications and other
interventions.

10. BRIEF HISTORY OF DSM
 The APA published the Diagnostic and Statistical
Manual of Mental Disorders in 1952; it was based off of
the ICD-6 and the military system.
 The DSM-II was published in 1968 but still had
criticism over its validity and reliability.
 The DSM-III was published in 1980. This dramatically
changed the field of psychology.
 The five part multiaxial diagnostic system, still used
today, first appeared in DSM-III.

11.  The revision for DSM-III was published in 1987.
 The DSM-IV was published in 1994.
 The newest revision of the DSM was published in
2000.
 The newest revision is DSM-V.

12. FIVE AXES OF DSM-IV
 Axis I: Clinical Disorders (all mental disorders except
Personality Disorders and Mental Retardation).
 Axis II: Personality Disorders and Mental Retardation.
 Axis III: General Medical Conditions (must be
connected to a Mental Disorder).
 Axis IV: Psychosocial and Environmental Problems
(for example limited social support network).
 Axis V: Global Assessment of Functioning
(Psychological, social and job-related functions are
evaluated on a continuum between mental health and
extreme mental disorder).

13. Changes in DSM V
 The axis classification system was removed in
the DSM-5.
 The DSM-5 is the first DSM to use an Arabic
numeral instead of a Roman numeral in its title, as
well as the first "living document" version of a DSM.
 The elimination of subtypes of schizophrenia.
 The renaming of gender identity disorder to gender
dysphoria.

14. Disadvantages of DSM
 Oversimplification-The latest round of criticism echoes a
long running debate on the nature of mental health. Many
critics of the DSM see it as an oversimplification of the vast
continuum of human behavior. Some worry that by
reducing complex problems to labels and numbers, the
scientific community risks losing track of the unique
human element.
 Misdiagnoses and Over-Diagnoses-vast groups of people
are labelled as having a disorder simply because their
behaviour does not always line up with the current ideal.

15.  Labelling and Stigmatization-Although mental health
disorders are not viewed in the negative light that they
once were, specific disorders can be perceived as
labels.

16. Disadvantages of ICD
 Reimbursement-Filing claims and getting paid is a
crucial element to ICD-10. However, no other country
utilizes these ICD 10 codes, when it comes to paying
physicians.
 Code increase-Tens of thousands of codes are added
through the ICD-10. As you can imagine, there are tons
of variations within these codes. For providers from all
backgrounds, these variations can strike one someone
as extremely confusing. Worse yet, some of the
variations seem to lack anything along the lines of a
purpose.

17.  Denials-The cost-saving measures with ICD 10 has a
foundation in paying less to a provider. This can lead
to physicians spending more time on coding, and less
time on actually getting paid.