Essay, Question 1
Mental disorder can be classified in many ways. Earliest attempts can be traced back to the ancient Greece. In 5 B.C. Hippocrates tried to establish a classification system for mental disorder. He used words such as mania, hysteria to classify mental illness. In the course of time the vocabulary had been enhanced by word such as circular madness, paranoia etc. However, the first classification system with real scientific profile was provided by Emil Kreapelin (1856-1926). Nowadays, the World Health Organization´s International Classification of Diseases 10 ( ICD -10) and the American Psychiatric Association´s Diagnostic and Statistical Manual (of Mental disorders) IV (DSM – IV TR) (2000) are the most commonly used classification systems in the world. They two have gone through several revisions before the most recent versions could be published. The ICD is an international classification system for all diseases, which did not include any diagnostic criteria for mental disorder before the 6th version of ICD have been published. DSM IV TR is the primary system used in the USA to classify and diagnose people. The first two manuals were published in 1952 and 1968. The two were criticized for their low reliability/validity and bad utility of syndromal diagnosis. The third edition (1972) was an important development, as it was the first empirical based nomenclature of the DSMs. It improved the reliability, validity and utility of syndromal diagnosis substantially. It introduced the multiaxial approach of five scales, which is characteristic for the 4th edition of DSM. Professionals are using those five axes to asset the patient`s presenting complaint. It is quite common that patients are classified as having two different disorders from Axis I or Axis II respectively. The new edition DSM IV (1994), chaired by the psychiatrist Allen Frances, should provide a better documentation of the empirical support. The purpose was to improve the utility of the manual and the congruency with ICD -10. DSM IV TR (2000) is the most current version of the Diagnostic and Statistical Manual. The difference between DSM IV TR and his predecessors it, that DSM IV TR is based on data analysis and re-analysis, literature reviews and field trials. The predecessors were generally focused on descriptive rather than etiological factors. Also, all version of DSM including the last one still do not suggest treatment approaches. The following list illustrates the five axes and what they represent, with an example for each axes. Axis I Mental disorder
300.4 Dysthymic Disorder
315.00 Reading Disorder
Axis II Personality disorders and mental retardation
V71.09 No diagnosis
Axis III Physical conditions and disorders
382.9 Otitis media, recurrent
Axis IV Psychosocial and Environmental Stressors/Problems
Victim of child neglect
Axis V Global Assessment of Function using the GAF scale GAF = 53 (current)”
The Code of DSM IV match with some codes in ICD -10. The ‘diagnostic criteria’ for a particular condition is represented by those codes.
The Diagnostic criteria for 295.90 is an example of criteria used by DSMIV to diagnose a person’s present complaint “Diagnostic criteria for 295.90 Undifferentiated Type:
A type of Schizophrenia in which symptoms that meet Criterion A are present, but the criteria are not met for the Paranoid, Disorganized, or Catatonic Type.” According to’ this diagnostic criteria’, it is also necessary to look up for the criteria of Schizophrenia. In 1996 the study: “Prevalence of DSM IV Diagnostic Criteria of Insomnia: Distinguishing Insomnia Related to Mental Disorders from Sleep Disorders” (Maurice M. Ohayon) was aimed to examine whether DSM IV Diagnostic criteria is a necessary tool to determine whether a person suffering from a sleep disorder or whether the insomnia constitutes a symptom of a mental...
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