This document discusses the classification of psychiatric disorders. It explains that psychiatric disorders are mainly diagnosed based on symptoms, unlike physical conditions which are often classified by etiology or structural pathology. The purposes of psychiatric classification include making agreed-upon diagnoses, facilitating communication between professionals, and establishing frameworks for research. There are three main types of psychiatric classification: categorical, dimensional, and multiaxial. Categorical classification groups disorders into separate categories based on symptoms, course, and outcome. Dimensional classification diagnoses patients on separate dimensions like psychoticism. Multiaxial classification uses multiple sets of information, as seen in systems like the DSM and ICD. The document also discusses organic vs. non-organic disorders, psychosis vs. neuro
2. Introduction:
Most of physical conditions are classified on the basis of
etiology, 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 etiology e.g. Alzheimer’s disease.
3. Purposes of Classification:
1. To make generally acceptable diagnosis.
2. To facilitate communication between psychiatrists,
other doctors and professionals.
3. To make generalizations in treatment response,
course & prognosis of individual patients.
4. To make framework for research in psychiatry.
4. Types of Classification
1. Categorical Classification:
- Grouping disorders into separate entities according to
symptom – pattern, course and outcome.
- It includes hierarchal categories.
e.g.: Organic mental disorders then functional psychotic
disorders (e.g. Schizophrenia) then neurotic disorder
(e.g. generalized anxiety disorder) then personality
disorders.
- Also it includes in-built hierarchy of significance
within the disorders themselves.
e.g.: Anxiety symptoms occur commonly with depressive
disorder.
5. 2. Dimensional Classification:
- Diagnosing individual patients by giving him scores
on separate dimensions.
e.g. Psychoticism, neuroticism, introversion and
extroversion
6. 3. Multiaxial Approach:
- Applied to schemes of classifications in which two or
more separate sets of information are coded
e.g. DSM, ICD
7. 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.
9. Neurosis and Psychosis
Psychosis:
- unsatisfactory term
- refers broadly to severe forms of mental disorders such
as:
a. organic mental diseases
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.
10. Neurosis:
- unsatisfactory term.
- Refers to mental disorders that are generally less severe
than psychosis.
Characteristics:
- Symptoms are closer to normal experience e.g. anxiety.
11. Psychosis
Neurosis
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
12. 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.
