Categorising Mental Disorders
Categorizing mental disorders involves organizing and classifying different types of mental health conditions based on their symptoms and characteristics. This process helps clinicians and researchers better understand and diagnose mental illnesses, as well as develop effective treatment plans. The Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) are commonly used systems for categorizing mental disorders.
8 Key excerpts on "Categorising Mental Disorders"
eBook - ePub- Naomi Moller, Andreas Vossler, David W Jones, David Kaposi(Authors)
- 2020(Publication Date)
- SAGE Publications Ltd(Publisher)
...This has an impact on clinical practice: in the UK, the National Institute for Health and Care Excellence publishes clinical guidelines on particular ‘conditions’ which draw on research findings using ICD and DSM categories. Mental health services are increasingly organised by diagnostic categories. The high levels of comorbidity (a medical term used to denote when two or more conditions co-occur) that arise when categories such as those of the DSM are used can create problems; to which service should a person with a diagnosis of both depression and personality disorder be referred, for instance? There is an increasing proliferation of diagnosis-specific adaptations of therapies, such as cognitive behavioural therapy (CBT) for psychosis, CBT for anxiety, and so on. The use of diagnosis by health insurers and the NHS can cause a range of dilemmas. What if a clinician thinks that a person needs help but their problems do not map easily on to diagnostic categories? What if someone does not wish to receive a diagnosis? What if a professional feels that the use of diagnosis is pathologising? How can couple and family therapists record their work using a system that provides categories only for individuals? The debate about DSM-5 has again prompted questions about how we understand mental health and the role of social norms. The reliability problem has returned, while diagnosis has expanded further into everyday life. Rates of diagnosis and medication for some problems have increased. This has led to questions being raised about the influence of the pharmaceutical industry. Diagnostic manuals such as the DSM continue to have an impact on both research and mental health services. Conclusion Psychiatric diagnosis involves the application of a medical framework to problems in living. By comparing people’s reported problems against the criteria found in diagnostic manuals such as the DSM, the closest-matching diagnostic category or categories can be identified...
eBook - ePub- Gordon Claridge, Caroline Davis(Authors)
- 2013(Publication Date)
- Routledge(Publisher)
...Third, classification serves a scientific need, by defining the guidelines for studying different types of disorder; it allows researchers interested in a particular disorder to select for investigation only those cases that share defined features of the condition they wish to study. Of course, since such research has to be done in order to help to establish the nosology in the first place, there is an element here of what is often called ‘bootstrapping’, that is, gradually refining the classification on the strength of new knowledge that accumulates from its use. It is evident from the above – and emphasized in the last point – that there is nothing that is cast in stone about current attempts to classify psychological disorders. Nosologies only represent a present state of affairs, an accumulated wisdom, as interpreted by contemporary experts in the field. This is illustrated by considering the two systems of psychiatric classification currently in use. One is the International Classification of Mental and Behavioural Disorders (ICD) (World Health Organization, 1992); the other is the Diagnostic and Statistical Manual of Mental Disorders (DSM) (American Psychiatric Association, 1994). The former, as the name implies, is a universal publication: it provides diagnostic guidelines for clinicians throughout the world and forms the basis for collating cross-national statistics on mental disorder. The DSM, on the other hand, is of North American origin but is also widely referred to outside the USA. Both the ICD and the DSM are essentially handbooks, consisting of lists of disorders, each accompanied by the defining characteristics by which the clinician arrives at a diagnosis in a particular case, Both glossaries are quite similar (or can be translated across from one to the other), but the fact that they are not identical indicates that the diagnostic categories they suggest are somewhat arbitrary and often represent compromise...
eBook - ePub- Sidney Bloch, Bruce S. Singh(Authors)
- 2013(Publication Date)
- Melbourne University Press Digital(Publisher)
...In the past, it was considered that psychiatric illness could be confirmed only with objective evidence of disturbance in one or more areas of mental functioning such as perception, thinking, learning and remembering, impulse control, affect, and the like. Maladaptive or deviant behaviour could be a manifestation of disorder only if associated with specific disturbed mental functioning. However, this definition poses problems in excluding syndromes traditionally considered to be within the domain of psychiatry, particularly personality disorders (see Chapter 14). Notwithstanding these difficulties, there is no reason to see psychiatric disorders as different from the rest of medicine in the context of the medical model of disease. On the other hand, psychosocial factors tend to play a greater role in psychiatry than in other areas of medicine. Hence the adoption of the bio-psycho-social approach that takes into account not only symptoms and signs but also environmental factors and the overall social context (see Chapter 4). It could be argued that all of medicine should pay heed to this approach as it is equally applicable to a person with ischaemic heart disease as it is to a person with major depression. Mental disorders: categorical or dimensional? ICD-10 and DSM-IV both describe psychiatric disorders as discrete categories, i.e. a person either ‘has’ a given disorder or does not. This ‘categorical’ approach is evident in Axis I of DSM-IV (see Table 5.6). Two problems arise out of this convention. First, a disorder might present with varying degrees of severity, merging almost imperceptibly from ‘normality’ to full-blown psychopathology, leading to arbitrary judgement where, and on what basis, a demarcating line can be drawn. This is best illustrated by the personality disorders, where it is the extent to which a dysfunctional personality trait is manifest that will determine whether or not the individual is considered to have a disorder...
- Susan Cave(Author)
- 2005(Publication Date)
- Routledge(Publisher)
...2 Classification, assessment and diagnosis Background Diagnostic and Statistical Manual of Mental Disorders (DSM) Axes I and II: Major categories International Classification of Diseases (ICD) Clinical assessment procedures Evaluation of classification and diagnosis Background One of the key features of the scientific approach to any subject is that it is systematic. The subject matter is grouped into categories of items that share similar features, or subjected to some other form of logical organisation that makes it easier to see patterns or consistencies in what is observed. The natural sciences have long employed classification systems of various sorts, such as the periodic table of the elements used in chemistry or the phylogenetic systems of the biological sciences. In the 19th century, medical science began to make progress by identifying different illnesses and providing different forms of treatment for them. By comparison, there was very little consistency in the approach to abnormal behaviour. In Britain, a classification scheme was produced by the Statistical Committee of the Royal Medico-Psychological Association, but never utilised by the members. In Paris and America similar schemes also failed to gain acceptance. One of these early schemes was that produced by Kraepelin (1883), who is often regarded as the founder of modern psychiatry. His system identified symptom groups or syndromes, which he considered to have organic causes, i.e. they were physically based. For example, severe mental illnesses were divided into dementia praecox (now known as schizophrenia), which was thought to result from a chemical imbalance, and manic-depressive psychosis, which was thought to result from metabolic irregularities. Kraepelin’s system was the basis from which modern diagnostic schemes developed. There are two major schemes in use at present...
eBook - ePubPsychology and Social Work
Applied Perspectives
- Gabriela Misca, Peter Unwin(Authors)
- 2017(Publication Date)
- Polity(Publisher)
...For example, anxiety-related disorders, depression and psychotic disorders have very different aetiologies, and those suffering from them have different needs. However, such classification systems are not free from controversy. These systems have been developed from the medical model and tend to focus on symptoms and define disorders as separate entities, despite the evidence suggesting mental health may be better understood as being a continuum (Larsson et al., 2012). Moreover, by giving diagnostic labels to disorders, there is a risk of inappropriate labelling of a client’s difficulties, and many people are diagnosed with multiple problems, a phenomenon known as comorbidity. The medical model that underpins both the ICD and the DSM places the problem within the individual, a focus on disease and the desire to return the patient to a previous ‘healthy’ state. As mentioned above, the issue of homosexuality has been a subject of great controversy in terms of DSM categorization: it was listed as a disorder until DSM-II, then in DSM-III this ‘diagnosis’ was changed to ‘ego dystonic homosexuality’ (i.e., in conflict with the ego or one’s selfimage). It was only with the publication of the DSM-III-R in 1987 that this was dropped, following a long process of political debate about what constitutes ‘normality’...
eBook - ePubDiagnostic Cultures
A Cultural Approach to the Pathologization of Modern Life
- Svend Brinkmann(Author)
- 2016(Publication Date)
- Routledge(Publisher)
...Chapter 7 Towards a Comprehensive Understanding of Mental Disorder In this chapter I ask how we should define and approach not just psychiatric categories (diagnoses), but also the referents of diagnoses (what they are meant to refer to), which is to say mental disorders as such, from a cultural psychological perspective. First, I provide an outline of definitions of mental disorder from leading scholars (neuroscientists, Boorse, Wakefield and phenomenological perspectives), and I argue that the concept of mental disorder is not held together by necessary and sufficient conditions, but by what Wittgenstein called family resemblance. This leads to the subsequent development of a cultural psychological account of mental disorder on a non-essentialist background, which is meant to articulate a third perspective on diagnoses between essentialism and social constructionism. What is Mental Disorder? Those who develop new diagnostic categories and new treatments rarely discuss the difficult question: what is a mental disorder? That we are in fact shockingly far from being able to give a clear answer to this question is reflected in a thorough book by a leading authority on psychopathology, Derek Bolton. Bolton concludes the following: There is, as far as I can see, no stable reality or concept of mental disorder; it breaks up into many, quite different kinds, some reminiscent of an old idea of madness or mental illness, others nothing like this at all. (Bolton, 2008, p. viii) Bolton thus emphasises the heterogeneity of what is conventionally called mental disorder, and, in the present context, this may serve as an indication that although some diagnostic categories may refer to genuine illnesses that are best understood as brain disorders for example (schizophrenia and bipolar disorder come to mind), others may be very different. Perhaps we should not expect that one approach to mental disorder can capture all of them...
- Prof David Goldberg, Ian M Goodyer(Authors)
- 2014(Publication Date)
- Routledge(Publisher)
...Part I The nature and distribution of common mental disorders Chapter 1 Competing models for common mental disorders DOI: 10.4324/9781315820149-1 Categorical models of common mental disorders The conventional taxonomy of mental disorders is that set out in the fifth chapter of the World Health Organisation's International Classification of Disease, tenth edition (WHO 1988 : ICD-10). This is broadly comparable to the fourth edition of the American Psychiatric Association's (1994) Diagnostic and Statistical Manual, fourth edition (DSM-4). These classifications are arrived at by consensus meetings of distinguished psychiatrists, either in Geneva or in Washington. They are essentially arbitrary, ‘top-down’ classifications — and they are necessarily revised at regular intervals, as new treatments become available, as new mental disorders emerge, or as research findings indicate heterogeneity within diagnostic entities. Inevitably, it is easier to reach consensus about major, severe disorders that are worldwide in their distribution — like dementia, mental retardation, schizophrenia and bipolar disorder. It is far more difficult to achieve consensus about the common mental disorders, where cultural factors and differing diagnostic habits dictate different patterns of common symptoms of mental distress. Thus, ‘brain fag’ (Africa), ‘kidney weakness’ (China), ‘Jibyo’ (Japan), ‘burn-out’ (USA), ‘chronic fatigue’ (UK) or ‘neurasthenia’ (Asia) are all ways of referring to syndromes of disordered function in various parts of the world that have no known organic pathology. One solution to this otherwise intractable problem is to impose the diagnostic concepts that have been agreed by senior psychiatrists upon general physicians in the rest of the world...
- Bruce B. Frey(Author)
- 2018(Publication Date)
- SAGE Publications, Inc(Publisher)
...Diana Joyce-Beaulieu Diana Joyce-Beaulieu Joyce-Beaulieu, Diana Diagnostic and Statistical Manual of Mental Disorders Diagnostic and statistical manual of mental disorders 503 507 Diagnostic and Statistical Manual of Mental Disorders The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, is considered the authoritative source within the United States for mental health diagnoses. The manual offers detailed guidance on mental health concerns across the life span from early childhood neurodevelopmental disorders to adult personality disorders and later geriatric neurocognitive disorders. Clinicians and researchers utilized this resource across multiple disciplines, including counseling, education, medicine, psychology, psychiatry, rehabilitation, and social work fields. Therefore, the DSM offers a common theoretical framework for understanding mental health issues and a recognized nomenclature to facilitate cross-discipline collaboration. In addition, the DSM coded diagnoses data collected through hospitals and treatment providers, yielding important national information on diagnoses trends, which then informs policy decisions for service provision, research funding, and educational initiatives. This entry begins by reviewing the history of the editions of the DSM and how the fifth edition of DSM (DSM-5) is organized. Next, the importance of the International Classification of Diseases (ICD) is considered, followed by a look at how symptoms and measures in the DSM assist in diagnoses. Finally, the entry provides a warning about using the DSM without proper qualifications and considers changes that may be made to future revisions of the DSM. History of the DSM The first edition of the DSM (i.e., DSM-I) was published in 1952 and focused primarily on adult mental health needs across three classifications (i.e., organic brain disorders, functional disorders, and mental deficiency disorders)...
