Classification of Psychiatric Disorders by 917mMF


									Classification of
Psychiatric Disorders

   Dr. Fatima Al-Haidar
   Associate Professor & Consultant
   Child & Adolescent Psychiatry
   College of Medicine, KSU.

    Most of physical conditions are classified on the basis of
     aetiology, e.g.: viral pneumonia.
      On the basis of structural pathology, e.g.:
     Based on symptoms, e.g. migraine.

    Psychiatric disorders are diagnosed based mainly on
      Few are based on aetiology e.g. Alzheimer’s disease.
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.
     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
     - Also it includes in-built hierarchy of significance
     within the disorders themselves.
e.g.: Anxiety symptoms occur commonly with depressive
2. Dimensional Classification:

   - Diagnosing individual patients by giving him scores
     on separate dimensions.

  e.g. Psychoticism, neuroticism, introversion and
3. Multiaxial Approach:

  -   Applied to schemes of classifications in which two or
      more separate sets of information are coded

      e.g. DSM
     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
6.   Learning and developmental disorders.
7.   Disorders with onset in childhood or adolescence.
                         Psychiatric Disorders

             Organic                                    Non-Organic

Acute        Chronic     Others        Psychoses        Neuroses            Others
Delirum      Dementia    Alcohol …     Schizophrenia    Anxiety disorders   Personality dis.
Wernicke’s   Korsakoff   Head Injury   Mood disorders   Adjustment dis.     Sleep disorder
                         Etc….         Etc….            Dysthymia           Sex disorder
                                                        Dissociative dis.   Etc…
   Neurosis and Psychosis

- unsatisfactory term
- refers broadly to severe forms of mental disorders such
    a. organic mental diseases
    b. schizophrenia
    c. affective disorders

- greater severity
- lack of insight
- patient’s inability to distinguish between subjective
 experience and reality e.g. hallucinations, delusions.

-   unsatisfactory term.
-   Refers to mental disorders that are generally less severe
    than psychosis.

- Symptoms are closer to normal experience e.g. anxiety.
                 Neurosis              Psychosis

Severity    Minor mental illness    Major mental illness
Features    Abnormal in quantity    Abnormal in quality
                e.g. anxiety         e.g. hallucinates

 Insight         Preserved               Affected

Treatment   Psychological & drugs      Drugs & ECT
          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 &
5.       Old age onset.

December 2006 / wendell

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