Approaches to classification Flashcards
Approach to classification which uses precise clinical descriptions of disorders, with exclusion and inclusion criteria
Operationalised approach
Symptoms which are pertinent to a diagnosis
Characteristic symptoms
Symptoms which are necessary for a diagnosis
Discriminating symptoms
Symptoms which strongly favour one diagnosis
Pathognomic symptoms
Approach to classification where diseases are described according to their observed characteristics, not any theory of what might have caused the symptoms
Atheoretical approach
Approach which labels an individual as either meeting or not meeting the diagnostic criteria
Categorical approach
Approach which uses a continuum from high to low, along which a measurement is made
Dimensional approach
Approach to classification which is argued as having poor validity as it need to include criteria such as psychosis - not otherwise specified
Categorical approach
Approach to classification which is said to be more useful in describing emotional and cognitive states as many exist without a clear cut-off point between being ill and well
Dimensional approach
Approach to classification which has been argued as less useful as it is difficult to map to interventions to monitor response
Dimensional approach
Traditional hierarchy for mental health disorders, from top to bottom
Organic disorders Substance issues Psychosis Affective and neurotic disorders Personality issues
The idea that if a disorder further up the hierarchy can explain the symptoms, a disorder further down should not be diagnosed
Hierarchical organisation
Example of hierarchical organisation
E.g. a patient with dementia who experiences visual hallucinations which started after their cognitive issues would not also be diagnosed with a psychotic disorder
The idea that in a hierarchical organisation disorders can manifest as disorders lower down the hierarchy but not further up
Non-reflexive
Three axes of the ICD 10
The mental disorder
The degree of disability
The current psychosocial problems
The five axes of DSM IV
Clinical disorders Personality disorders/mental retardation General medical conditions Psychosocial and environmental problems Global assessment of functioning
Axis 1 of DSM IV
Clinical disorders
Axis 2 of DSM IV
Personality disorders/mental retardation
Axis 3 of DSM IV
General medical conditions
Axis 4 of DSM IV
Psychosocial and environmental problems
Axis 5 of DSM IV
Global assessment of functioning
Remit for the first ICD
Classification of causes of death
Letter or number designated to mental and behavioural disorders in ICD 10
V(five) or F
Four versions of ICD 10
Clinical descriptions and diagnostic guidelines
Diagnostic criteria for research
Primary care version
Clinical coding manual
Version of ICD 10 for general clinical use, used most often by psychiatrists
Clinical descriptions and diagnostic guidelines
Version of ICD 10 used to identify homogenous patient groups for research
Diagnostic criteria for research
Version of ICD 10 aimed towards GPs, which includes diagnostic flowcharts and treatment recommendations
Primary care version
Version of ICD 10 aimed at clerical workers for easy coding
Clinical coding manual
Change made for ICD 11 regarding personality disorders
Different personality disorders replaced with a single diagnosis of personality disorder labelled by severity and as having maladaptive personality traits
Severity ratings for personality disorder in ICD 11
Mild
Moderate
Severe
Maladaptive personality traits described within personality disorders in ICD 11
Negative affectivity Detachment Dissociality Disinhibition Anankastia Borderline pattern
Maladaptive personality traits within personality disorders in ICD 11 which is actually a composite of the other maladaptive personality traits
Borderline pattern
Type of disorder in ICD 11 which has been removed from the stress-induced disorders section and given its own section
Dissociative disorders
Type of disorder in ICD 11 which has been removed from the anxiety disorders section and given its own section
Obsessive compulsive or related disorders
Type of disorder in ICD 11 which has been removed from the ‘other disorders of adult personality and behaviour’ section and given its own section
Factitious disorders
Changes to gender identity disorders in ICD 11
Moved from mental and behavioural disorders to conditions related to sexual health
Transsexualism and transvestitism removed
Gender identity disorder changed to gender incongruence
New diagnostic category in ICD 11 characterised by psychomotor disturbance, and no longer classed as a subgroup of schizophrenia
Catatonia
New diagnostic category in ICD 11 characterised by at least one hypomanic episode and at least one depressive episode, but not requiring a manic episode
Bipolar II
New diagnostic category in ICD 11 characterised by a persistent preoccupation with a perceived bodily flaw, no longer in the hypochondriacal disorder section
Body dysmorphic disorder
New diagnostic category in ICD 11 characterised by belief that one is emitting a foul smell, contained within the obsessive-compulsive and related disorders grouping
Olfactory reference disorder
New diagnostic category in ICD 11 and DSM V characterised by accumulation of possessions regardless of their actual value
Hoarding disorder
New diagnostic category in ICD 11 and DSM V characterised by recurrent picking of skin, no longer within the diseases of skin section
Excoriation disorder
New diagnostic category in ICD 11 characterised by disturbances in affect regulation, self-esteem and relationships following exposure to a threatening or horrific event, in addition to the core features of PTSD
Complex PTSD
New diagnostic category in ICD 11 characterised by an abnormally persistent and disabling response to bereavement
Prolonged grief disorder
New diagnostic category in ICD 11 characterised by frequent binges of food without regular inappropriate compensatory behaviours aimed at preventing weight gain
Binge eating disorder
New diagnostic category in ICD 11 characterised by abnormal feeding patterns resulting in a lack of ability to meet energy or nutritional requirements, but not meeting criteria for anorexia nervosa
Avoidant-restrictive food intake disorder
New diagnostic category in ICD 11 and DSM V characterised by mood, somatic or cognitive symptoms occuring several days before the onset of menses
Premenstrual dysphoric disorder
Disorder which lost its subtypes for ICD 11 and DSM V such as simple, catatonic, hebephrenic
Schizophrenia
New diagnostic category in ICD 11 characterised by persistent or recurrent gaming activity, controversial for its potential to pathologise gaming activity
Gaming disorder
New diagnostic category in ICD 11 characterised by failure to control intense sexual impulses, controversial for its potential to pathologise normal sexual behaviours
Compulsive sexual behaviour disorder
Changes to multiaxial system for DSM V
Removal of personality disorders and medical conditions leaving three axes
Delusion type removed from DSM V
Bizarre
Mood disorders merged for DSM V
Dysthymia and chronic depression
Changes to ASD in DSM V
Asperger’s syndrome removed and merged with autism as ASD
New diagnostic category in ICD 11 characterised by the desire to become physically disabled in a significant way
Body integrity dysphoria
Movement of elective mutism from ICD 10 to ICD 11 - also renamed to selective mutism
Moved from disorders of social functioning with onset specific to childhood and adolescence, to anxiety or fear-related disorders
Practitioners DSM is aimed at
Psychiatrists
Practitioners ICD is aimed at
All practitioners
Edition of ICD which removed homosexuality as a mental illness
ICD10
Main ways to improve reliability of psychiatric diagnoses
Use semi-structured or standardised interviews
Define all the items of psychopathology covered in an interview
Use an operationalised system for diagnosis to ensure any given combination of symptoms leads to the same diagnosis
Definition of prevalence of a disease
Number of cases present within a defined population
Definition of incidence of a disease
Number of new cases arising in a population in a specified period of time, usually a year
Three axes of ICD 10
Mental disorder
Degree of disability
Current psychosocial problems
Axis 1 of ICD 10
Mental disorder including personality disorder and intellectual disability
Axis 2 of ICD 10
Degree of disability
Axis 3 of ICD 10
Current psychosocial problems
First classification system to include separate categories for mental disorders
ICD 6
