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Transcript
CLASSIFICATION
OF MENTAL
DISORDERS
WHICH WAY?
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.
ICD-10
• International Statistical Classification of Diseases
and Related Health Problems
• This is used worldwide and published by the
World Health Organization (WHO).
• Currently, it is in its 10th revision.
• Chapter 5 is entitled Mental and Behavioral
Disorders
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.
ICD - Mental and Behavioral Disorders
• F0 Organic, including symptomatic, mental disorders
• F1
•
•
•
•
•
•
•
•
•
Mental and behavioral disorders due to
psychoactive substance use
F2 Schizophrenia, schizotypal and delusional disorders
F3 Mood (affective) disorders
F4 Neurotic, stress-related and somatoform disorders
F5 Behavioral syndromes associated with physiological
disturbances and physical factors
F6 Disorders of adult personality and behavior
F7 Mental retardation
F8 Disorders of psychological development
F9 Behavioral and emotional disorders with onset usually
occurring in childhood and adolescence
F10 Unspecified mental disorder
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.
DSM-IV
• Diagnostic and Statistical Manual of Mental Disorders,
fourth revision
• The classification system used in the U.S.
• Developed by the American Psychiatric Association (APA)
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.
DSM 4 – Clinical Disorders
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence
Delirium, Dementia, and Amnestic and Other Cognitive Disorders
Mental Disorders Due to a General Medical Condition Not Elsewhere
Classified
Substance-Related Disorders
Schizophrenia and Other Psychotic Disorders
Mood Disorders
Anxiety Disorders
Somatoform Disorders (Disorders with somatic symptoms)
Facticious Disorders (Disorders involving faking)
Dissociative Disorders (for example multiple personalities)
Sexual and Gender Identity Disorders
Eating Disorders
Sleep Disorders
Impulse Control Disorders Not Elsewhere Classified
Adjustment Disorders
Other Conditions That May Be a Focus of Clinical Attention
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.
Classification Challenges
• Mental disorders comingle with other mental disorders.
• A person with a mood disorder (DSM-IV #6) might also at times
have psychotic episodes (5) and at other times have serious sleep
problems (13).
• A person with an adjustment disorder (15) might also be very
anxious (7).
• Instead of each classification staying within neat
boundaries . . .
Alzheimer
anxiety
depression
ADHD
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.
Classification Challenges
• There can be overlap in symptoms, causes, and
treatments.
depression
Alzheimer
anxiety
ADHD
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.
Classification Challenges
• Much thought and research go into updating the DSM.
• Some disorders are added and some are deleted, so
things change.
Alzheimers
depression
anxiety
autism
ADHD
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.
Classification Challenges
• Some publications
go a safe route and
list mental disorders
alphabetically.
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.
Classification Challenges
• Even the most
dedicated professional
can find it exhausting!
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.
DSM History
• DSM-I, 1952 – 106 diagnoses
• DSM-II, 1968 – 185 diagnoses
• DSM-III, 1980 – 265 diagnoses
• DSM-IV, 1994 – 365 diagnoses
• Does this mean that more people are developing mental
disorders?
• It means that our understanding of mental disorders is
improving and diagnosis can be more specific. Instead of one
classification for bipolar, now there are bipolar 1, bipolar 2,
rapid cycling, and others. This enables diagnosis and treatment
to be more accurate and effective.
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.
DSM-V
• And if it’s not challenging enough to classify and organize
the current knowledge about mental disorders, they keep
updating.
• Publication of the fifth edition of the Diagnostic and
Statistical Manual of Mental Disorders (DSM-5) is
scheduled for May 2013.
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.
• There is a proposed chapter reorganization.
• For instance, all of the chapters are organized in a
developmental lifes pan fashion, starting with
Neurodevelopmental Disorders, which often are
diagnosed in infancy and early childhood, and
progressing through diagnostic areas more commonly
diagnosed in adulthood, such as Sleep-Wake Disorders.
• This revised chapter ordering also makes a greater
attempt to closely situate diagnostic areas that seem to be
related to one another, such as creating a specific
category for Bipolar and Related Disorders and placing it
immediately after Schizophrenia Spectrum and Other
Psychotic Disorders.
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.
Proposed DSM-5 Organizational Structure
• Neurodevelopmental Disorders
• Feeding and Eating Disorders
• Schizophrenia Spectrum and
• Elimination Disorders
•
•
•
•
•
•
•
Other Psychotic Disorders
Bipolar and Related Disorders
Depressive Disorders
Anxiety Disorders
Obsessive-Compulsive and
Related Disorders
Trauma- and Stressor-Related
Disorders
Dissociative Disorders
Somatic Symptom Disorders
• Sleep-Wake Disorders
• Sexual Dysfunctions
• Gender Dysphoria
• Disruptive, Impulse Control, and
•
•
•
•
•
Conduct Disorders
Substance Use and Addictive
Disorders
Neurocognitive Disorders
Personality Disorders
Paraphilias
Other Disorders
Copyright © Notice: The materials are copyrighted © and trademarked ™ as the property of The Curriculum Center for Family and Consumer Sciences, Texas Tech University.