2. Classification
- The action or process of classifying something according to
shared qualities or characteristics.
- sorting ,assortment
- It is a scientific clinical tool which places a particular
mental disorder within a system of conventional groupings,
based on important similarities in symptoms.
Mental illness
A classification statement is called a diagnosis.
3. INTRODUCTION:
Most of physical conditions are classified on the basis of
aetiology, e.g.: viral pneumonia.
Or
On the basis of structural pathology, e.g.: Bronchopneumonia.
Or
Based on symptoms, e.g. migraine.
Psychiatric disorders are diagnosed based mainly on symptoms.
Few are based on aetiology e.g. Alzheimer’s disease.
6. PURPOSES OF CLASSIFICATION:
1. acceptable diagnosis.
2. To facilitate communication between psychiatrists, other doctors
and professionals.
3. To make generalizations in treatment response, course &
prognosis of individual patients.
1. To make framework for research in psychiatry.
8. FEATURES SUGGESTING OF ORGANIC MENTAL ILLNESS:
1. Disturbed consciousness.
2. Disturbed cognitive functions:
a. Attention and concentration
b. orientation: time, place & person
c. Memory : immediate, recent and remote
3. Presence of physical illness e.g. DM, HTN
4. Presence of neurological features e.g. dysarthria & ataxia.
5. Old age onset.
December 2006 / wendell
10. NEUROSIS AND PSYCHOSIS
Psychosis:
- unsatisfactory term
- refers broadly to severe forms of mental disorders such as:
a. mood disorders
b. schizophrenia
c. affective disorders
Characteristics:
- greater severity
- lack of insight
- patient’s inability to distinguish between subjective experience and
reality
e.g. hallucinations, delusions.
11. NEUROSIS:
- unsatisfactory term.
- Refers to mental disorders that are generally less severe than
psychosis.
Characteristics:
- Symptoms are closer to normal experience
- e.g. anxiety.
12. PsychosisNeurosis
Major mental illness
Abnormal in quality
e.g. hallucinates
Affected
Drugs & ECT
Minor mental illness
Abnormal in quantity
e.g. anxiety
Preserved
Psychological & drugs
Severity
Features
Insight
Treatment
13. MOST WIDELY USED CLASSIFICATION SYSTEM AMONG
MENTAL HEALTH PROFESSIONALS.
ICD-10 (WHO)
DSM-IV (APA):
15. DSM-IV:
- Diagnostic and statistical manual of mental disorders, 4th
edition,
- American psychiatric association (APA) in 1994.
This classification system is used by most professionals to
diagnose or classify abnormal behavior.
In 2004 APA published DSM-IV TR (text revised).
16. DSM-IV is multi-axial.
It has five axes or dimensions.
Axis I - includes all mental disorders except personality
disorders and mental retardation.
Axis II - deals with personality disorders and mental retardation.
They begin early in life and persist into adult life.
Axis III - describes the general medical condition that seems
relevant to a case (ex. the history of B.P., diabetes, heart attack etc.
of the client).
Axis IV - the psychosocial and environmental problems such as
family atmosphere, work situation and social condition.
Axis V is a global assessment of the individual’s psychological,
social and occupational functioning (GAF). The clinician or
psychiatric social worker makes a rating on a scale from 1 to 100.
High rating indicates good or high functioning.
17. Advantages of DSM-IV classification:
For better communication among professionals
For statistical purpose such as data collection,
classification is convenient.
Multi-axial approach is more comprehensive.
DSM-IV is based on symptoms; hence more
objective.
18. Disadvantages:
It puts a label on a person (stigma).
No two persons are identical. Grouping may go wrong.
A clinician may be biased by the type of training he had,
and may lack objectivity.
Once a patient is diagnosed, even if it is wrong, later
others may exclusively depend on this false
diagnosis.
19. THE BASIC CATEGORIES OF CLASSIFICATION IN PSYCHIATRY:
1. Mental Retardation – impairment of intellectual functioning,
present continuously from early life.
2. Personality Disorders – a pattern of inner feeling experience
and behavior that deviates markedly from the expectations of
the individual’s culture, presents continuously since
adolescence or early adulthood.
3. Mental Disorders – abnormality of behavior or psychological
experience with recognizable onset after a period of normal
functioning.
4. Stress related or adjustment disorders.
5. Other Disorders – e.g. Sexual disorders, drug dependence
6. Learning and developmental disorders.
7. Disorders with onset in childhood or adolescence.
