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Categorising Mental Disorders

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Categorising Mental Disorders

How do doctors know if someone has a mental disorder or not? Who decides what should be categorised as a mental disorder or is just normal behavior? There are two major organizations that do this: the American Psychiatric Association and the World Health Organization.

The seven major types of mental disorders

Categorising mental disorders is considered to be important because:

  • It allows for an objective diagnosis of a disorder someone may have.

  • It shows symptoms of disorders to allow for easier identification of a potential disorder.

  • It can be used to identify if participants have mental disorders researchers are interested in.

The two most common psychiatric classification systems are the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD).

The classification of mental disorders is also called psychiatric nosology.

There are seven major types of mental disorders:

Category of mental disorderExample mental disorder
Affective/ Mood disorder Depression
AnxietyGeneralised anxiety disorder
Personality disordersBorderline personality disorder
Psychotic disorders Schizophrenia
Eating disorders Anorexia nervosa
Trauma-related disordersPost-traumatic stress disorder
Substance abuse disorders Drug addiction

How are mental disorders diagnosed in psychology?

Clinical psychology attempts to identify ways to diagnose mental disorders. The purpose of this is so that clinicians can diagnose patients so that effective treatment can then be used. The correct diagnosis of mental disorders is also important for research.

Benefits of labelling and categorising mental disorders

The benefit of labelling and categorising mental disorders is that it makes it easier to identify the support people with mental disorders need. In addition, by identifying all of the symptoms of mental disorders, professionals can provide interventions that aim to reduce symptoms, improve patients’ quality of life and potentially treat the mental disorder.

Clinical psychology research tends to identify if a treatment is effective by comparing intervention results in patients. An incorrect diagnosis can lead to invalid results and ineffective treatments, which can be dangerous.

Categorising mental disorders two men, one in a lab coat, facing a wall attentively and talking StudySmarterDoctors, pexels.com

Diagnostic and Statistical Manual of Mental Disorders (DSM)

The DSM is a manual that trained therapists use to diagnose mental illnesses. This manual is widely used in America. The APA (American Psychiatric Association) developed and published the DSM. The DSM was created to allow a common way to communicate disorders between psychiatrists. It has multiple editions that are revised based on advancements in our understanding of mental health. The latest edition is the DSM-5.

In DSM-1 and 2, homosexuality was listed as a ‘sociopathic personality disorder’.

The DSM provides information on:

  • Categories of mental disorders.
  • Symptoms lists for each mental disorder.
  • Details of how long symptoms need to last for a diagnosis.

The DSM criteria for social pragmatic communication disorder are:

  • Constant difficulties in social communication (verbal and non-verbal)
    • Difficulties in social communication in context, e.g. introducing oneself when meeting someone new
    • Difficulties in changing social communication when the situation changes, e.g. inability to react appropriately when someone randomly starts to cry
    • Difficulties following unwritten roles of communication, e.g. turn-taking during a conversation
    • Difficulties understanding the hidden meaning of things, e.g. taking metaphors as literal facts
  • The deficits cause difficulties in proper communication, social interactions, forming and maintaining relationships, academic and workplace tasks.
  • Symptoms usually begin during early life; however, symptoms may not develop until later years.
  • Symptoms are not a result of other medical/ neurological conditions such as autism spectrum disorder.

Details of the current version DSM-5

The previous version (4th) had a multi-axial approach; it categorised disorders into different axes. There were five axes: clinical syndromes, personality disorders and mental retardation, general medical conditions (conditions that make the first two axes worse, such as brain injuries), psychosocial and environmental problems (problems that may affect the first two axes, such as unemployment, divorce), global assessment of functioning.

In the DSM-5, these axes were removed as there were criticisms that they were artificial and made it difficult to find a link between different symptoms. The DSM-5 removed any unnecessary and overused diagnoses.

There is just one category of ‘autistic spectrum disorder’. Previously, there were a lot of different classifications: autism, Asperger’s, childhood disintegrative disorder, and pervasive developmental disorder.

There were some changes to the DSM-5 to reflect changes in society. As we are now a multi-cultural society, the DSM reflects this too. Previous versions had a list of ‘culture-bound syndromes’, but the DSM-5 replaced it with ‘Cultural Concepts of Distress’. The DSM-5 has updated language with more inoffensive terms.

Previous editions had the term ‘mental retardation’, which ‘intellectual disability’ or intellectual development disorder now replaced.

Categorising Mental Disorders,  DSM manual, StudySmarterDSM manual, Manreet Thind - StudySmarter

Strengths and weaknesses of the DSM

The strengths of the DSM are:

  • The newer editions of the DSM have adjusted the listed mental disorders to consider social changes in society.

The DSM now separates mild and major dementia to consider that the average life expectancy has increased. Dementia is more likely to be diagnosed earlier, and people can get the required support earlier.

  • The diagnostic manual is regularly updated based on rigorously tested empirical psychology evidence. Updates ensure the manual is accurate.

The weaknesses of the DSM are:

  • There are overlapping symptoms of mental illnesses, such as the various types of developmental disorders known as co-morbidity. Co-morbidity makes it difficult for clinicians to identify which mental illness to diagnose patients, with serious implications.

  • Since the American Psychological Association (APA) designed the manual, it can be considered ethnocentric. The manual may not consider cultural differences, which may have limited utility because it may only benefit the American population.

International Classification of Diseases (ICD)

The ICD is a similar concept to the DSM. It is a manual that lists all known mental illnesses and their symptoms. The difference is that the World Health Organisation (WHO) ICD created it. Health professionals worldwide use it (except in America and some other countries). The ICD has been translated into many languages and is relatively cheap to be accessible to low-income countries. The current version is the ISD-11.

There are some differences between the ICD and DSM, such as:

  • The ICD emphasises clinical judgment – the manual allows the clinicians’ judgment to influence whether a person should be diagnosed with a mental disorder. The DSM attempts to limit judgement influencing diagnosis. Instead, it attempts to provide enough descriptive information to only the manual is required.

  • The ICD does not attempt to give operational criteria, whereas the DSM does.

  • The DSM typically has listed more mental disorders and associated symptoms than the ICD.

  • There are differences in symptoms of mental disorders.

In the DSM, some autism spectrum disorder (ASD) symptoms have to persist for at least six months for a diagnosis. However, the ICD does not give a time frame of how long symptoms have to be experienced.

The F20.0 is a numerical coding system the ICD uses. This system codes and classifies all of the illnesses and diseases recorded by the ICD. Its purpose is to make it easier to identify illnesses.

In a study by Wilson et al. (2013), 75% of participants met the criteria for ASD based on the revised version of ICD-10. In contrast, 42% of the participants were diagnosed with ASD when DSM-5 was used for diagnosis. This shows that the DSM may be more restrictive than the ICD. Or, the DSM may be more precise at diagnosis. This finding cannot be identified if one is better than the other. The ICD symptoms of ASD may overlap with other mental disorders, so participants diagnosed may have other mental disorders. Or the DSM may be too restrictive.

Strengths and weaknesses of the ICD

The strengths of the ICD are:

  • It is a diagnostic manual that is free of charge, which the World Healthcare Organisation (WHO) designed. The manual is available for anyone, making the mental health diagnosis easily and readily available to anyone, including third-world countries. This can help reduce the block of mental health interventions not advancing in some countries.

  • The manual lists all known diseases and illnesses, which helps clinicians identify diseases and illnesses of patients which may be less known.

The weaknesses of the ICD are:

  • Some argue that the ICD is beneficial for identifying mental illnesses but not as much for determining the severity of symptoms (Hoffman et al., 2015).

  • The model takes the medical model approach to mental illness and ignores other alternatives such as the humanistic or psychodynamic explanations.

  • The ICD considers that mental illnesses can be understood based on symptoms experienced and ignores important factors such as childhood experiences or self-actualisation factors.

Psychiatric classification system strengths and limitations

Psychiatric classification systems are used throughout the world to diagnose mental disorders. However, different countries may use different classification systems. The classification systems used to categorise mental disorders have advantages and disadvantages.

Validity

Overlap of symptoms between mental disorders makes diagnosis difficult. Does the individual have one mental disorder, the other, or both? This is important to understand to create an effective intervention plan. There is empirical evidence of mental disorders existing. These usually go through vigorous testing in controlled settings, which increases the validity of diagnostic manuals. It is regularly updated based on new knowledge learned, so it can be considered valid.

Reliability

There are differences between ICD and DSM. Cultural differences may influence how mental disorders are categorised. Research shows that culture plays a role in mental disorders. However, the ICD is used worldwide, which may not be appropriate. When someone is diagnosed with a mental disorder and visits another country with a different diagnosis, problems arise, such as problems with getting medication. How does the person know which diagnosis is correct?

The manuals may not be generalisable to the entire or diverse (minorities) population, which suggests reliability issues. The ICD also allows professionals’ judgement to influence analysis. These opinions may differ, and so diagnosis may not be reliable. This factor is advantageous as mental disorders are not clear-cut. For example, individual differences may lead to people presenting symptoms differently.

Other advantages and disadvantages

Both manuals have practical applications. They allow for people to get diagnosed and get the support they need. They are also used in research to make sure researchers measure mental disorders they intend to. This increases the validity of the research.

Misdiagnosis can be dangerous. Diagnosis leads to treatment, such as drug therapy, which causes literal changes in the body and can have serious side effects. Therefore, clinicians need to be very careful. However, laws have been established. The diagnosis of mental disorders may lead to prejudice and unequal opportunities in school, the workplace, and society.

Categorising mental disorders an image of many different kinds of pills and a syringe StudySmarterTreatment, pexels.com

Categorising Mental Disorders - Key takeaways

  • The two most common psychiatric classification systems are the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD).
  • There are seven major types of mental disorders that have been identified.
  • The ICD and DSM are both diagnostic manuals that list known mental disorders and their symptoms.
  • WHO designed the ICD for multiple countries. APA created the DSM for use in America.
  • There are strengths and issues to the reliability and the validity of the ICD and DSM.

Frequently Asked Questions about Categorising Mental Disorders

Examples of some uncommon mental disorders are:

  • Alien hand syndrome 
  • Clinical Lycanthropy
  • Stendhal Syndrome
  • Apotemnophilia
  • Todd syndrome

Based on research, most mental disorders have been found to have a biological component.

Mental disorders are disturbances to internal processes, thoughts, and behaviour that stop people's ‘normal’ functioning. 

Psychiatric nosology is another term used for the classification of mental disorders. 

The reasons for classifying mental disorders are:

  • It allows people to identify the support/intervention they need to alleviate symptoms.
  • Clinical purposes – researchers can ensure they are measuring the mental disorder of interest.

Final Categorising Mental Disorders Quiz

Question

What is psychiatric nosology?

Show answer

Answer

Psychiatric nosology is another term used for the classification of mental disorders. 

Show question

Question

What is the reason for classifying mental disorders?

Show answer

Answer

The reasons for classifying mental disorders are:

  • It allows people to identify the support/intervention they need to alleviate symptoms.
  • Clinical purposes – researchers can ensure they are measuring the mental disorder of interest.

Show question

Question

How do the ICD and DSM differ? 

Show answer

Answer

The ICD and DSM differ as: 

  • The ICD allows the trained clinicians to make some judgement in diagnosis, whereas the DSM does not.
  • WHO designed the ICD for multiple countries. APA created the DSM for use in America.
  • The DSM requires mental disorders to be clinically proven to exist. However, this is not always the case in the ICD.

Show question

Question

What type of mental disorders are characterised by trouble sleeping, negative thoughts, and fatigue? 

Show answer

Answer

Affective disorders

Show question

Question

Is anxiety disorder classified as a mood disorder? 

Show answer

Answer

No

Show question

Question

What type of disorder is schizophrenia? 

Show answer

Answer

Psychotic disorder 

Show question

Question

What information does the DSM provide? 

Show answer

Answer

The DSM provides information on:

  • Categories of mental disorders.
  • Symptoms lists for each mental disorder.
  • Details of how long symptoms need to last for a diagnosis.

Show question

Question

Who created the DSM? 

Show answer

Answer

APA

Show question

Question

What did Wilson et al. (2013) find? 

Show answer

Answer

In a study by Wilson et al. (2013), 75% of participants met the criteria for ASD based on the revised version of ICD-10. In contrast, 42% of the participants were diagnosed with ASD when DSM-5 was used for diagnosis. This shows that the DSM may be more restrictive than the ICD. Or, the DSM may be more precise at diagnosis.

Show question

Question

What can be inferred from the Wilson et al. (2013) study? 

Show answer

Answer

From the Wilson et al. (2013) study, it can be inferred that the DSM may be more restrictive than the ICD or that the DSM may be more precise at diagnosis. 

Show question

Question

What is co-morbidity? 

Show answer

Answer

Co-morbidity is the overlap of symptoms between mental disorders.

Show question

Question

What are the indicators of the diagnostic manuals being a valid measure to diagnose mental disorders? 

Show answer

Answer

The diagnostic manuals can be argued to be valid as they are regularly updated and based on evidence.

Show question

Question

What are the issues of the differences between the ICD and DSM? 

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Answer

The issues of differences between the ICD and DSM suggest the diagnostic manuals may not be reliable measures. 

Show question

Question

How may diagnosis of mental disorders affect individuals in school or workplace settings? 

Show answer

Answer

Although, laws have been established. The diagnosis of mental disorders may lead to prejudice, unequal opportunities in school, the workplace and society.

Show question

Question

What are the seven major types of mental disorders? 

Show answer

Answer

The seven major types of mental disorders are:

  1. Mood/affective disorders 
  2. Anxiety disorders 
  3. Psychotic disorders 
  4. Eating disorders 
  5. Trauma disorders 
  6. Substance-related disorders 
  7. Personality disorders 

Show question

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