Diagnosis Classification Systems Flashcards
Diagnosis Classification Systems
DSM
Americans but used in the Uk during Research
Established in 1952 by the american Psych Association
its a Diagnostic and Statistical Manual
Used to Diagnose Mental Disorders by looking for sertain symptoms
and possibly find treatments
Curently on DSM-V since 2013
Diagnosis Classification Systems
DSM I
in 1952 the American Psych Association (APA) developed a varient of the ICD-6
this was called the DSM I
it contained a glossary of descriptions of diagnosis catagorys
and was the 1st mental dissorder mannual to focus on clinical use
In this version there was lots of the use of the word reaction which reflected the view that mental disorders were reactions of the personality to psychology social and biological factors
Diagnosis Classification Systems
DSM II
In 1968 the dsm2 was released which was similar to the original however there was no use of the word reaction as the view had changed to a more specific definitions of disorders
Mrs due to a British psychologist called stengel who didn’t investigation for The WHO (world health org)
However not much of his overall advice actually made it to the dsm-2 or the ICD 8
Diagnosis Classification Systems
DSM III
In 1980 the dsm III was released and had some inconsistencies in the system
which included where the diagnosis criteria for some mental disorders was unclear
So it was revised in 1987 for the DSM-III-R
Diagnosis Classification Systems
DSM IV (NOT IV-TR)
In 1994 the DSM 4 released
which included a comprehensive review of literature by thousands of individuals to establish a firm empirical basis for making modifications
changes were made to classification (add or removing and reorganising disorders), diagnosis criteria and the descriptive text
The DSM 4 and the icd-10 worked closely together in their developments so there is less differences between the two systems now
Diagnosis Classification Systems
DSM-IV-TR
in the year 2000 the dsm-4 was revised into the DSM-IV-TR
With the latter standing for text revision
9 diagnosis criterias were changed
Passive developmental disorders definition was reverse back to what it was in the DSM 3R
And Aspergers disorder was entirely rewritten
Diagnosis Classification Systems
5 Axis System (DSM IV TR)
This version of the DSM (IV-TR) included the five axis models to aid the diagnosis of mental disorders they are as followed:
Axis 1: clinical disorder / substance-use disorder
which is any mental health condition which ≠ personality or developmental disorders for example:
SZ, anxiety disorders, sleeping disorders and sexual/ gender identity disorders etc.
Axis 2: Personality and mental health conditions
For example antisocial personality disorder, paranoid personality disorder, obsessive compulsive personality disorder and mental retardation
Axis 3: General medical conditions
Normal medical conditions that may affect mental health such as
cancer which you would have chemotherapy for which would lead to anxiety and depression
Axis 4: Psychosocial and Enviromental problems
Psychosocial meaning relating to social environment
and environmental problems which are factors affecting a person’s mental health
For example: housing, education, economic problems
and previous interaction with the justice system problems
Axis 5: GAF scale (Global assessment of Functioning)
A 0 to 100 scale which summarizes in a singular number how serious a mental illness may be
100= no symptoms
70 = mild
50 = serious w/ implecations on school/work/social functions
30= behavior considerably influenced by hallucinations and delusions such as impaired communication, judgment, functioning in all areas
10= persistent danger to self/others or suicidal
Diagnosis Classification Systems
DSM V
In 2013 the DSM V released
it contained psychiatric diagnoses and treatment recommendations
It was developed from the 2000 where scientific research on psychiatric diagnosis took place where gaps existed in the current research
• the DSM V had 22 major diagnostic criterias (1 was other)
• this grouped 200 + psychiatric disorders
• the categories these disorders are placed in develop over time and maybe reorganized in future versions
• it was made to aid clinics in recognizing mental disorders in patients and established a diagnosis then treatment based on the current established science
• it identified previously unrecognized diseases
• and improve the accuracy of diagnosis but added overall less new conditions
• it was revised in 2022 to produce the dsm V TR
This included new classifications to diagnosis criteria
and the prolonged grief disorder was added
Diagnosis Classification Systems
DSM IV TR AND DSM V DIFFERENCES
in terms of Substance use
In terms of substance use
The DSM 4 broke it down into two separate diagnoses which were substance abuse and substance dependence
these were combined in the dsm5 for just substance used disorder
Differences in how many Symptomns needed for diagnisus
DSM IV = 1 symptom = substance abuse diagnosis
DSM V = 2+ symptoms = diagnosed with Substance abuse disorder
Diagnosis Classification Systems
DSM IV TR and DSM V
general differences
DSM V:
3 categories of disorder severity formed:
Out of 11 potential symptoms:
if show 2-3 = mild substance use diagnosis
4-5 = moderate
6+ = severe
The DSM IV had 16 general diagnosis classes of mental disorders
DSM V had 21 (and 1 for other)
Dsm-4TRs axis system was discontinued
DSM V
New diagnosis system was based on a scheme of diagnostic classes
organised by defining characteristics and evolutionary criteria
Checking if these appear in the person’s childhood, Addoleccence and Adulthood
in each diagnosis?
An example of the dsm V’s diagnostic classes:
is the schizophrenia spectrum and other psychiatric disorders
Diagnosis Classification Systems
ICD 10
The international classification of diseases or icd version 10
was created by the world Health Organization (WHO) in 1994
and went to the UK in 1995
It is a clinical cataloging system
It’s caterlogues health conditions by categories of similar diseases under which specific conditions are listed
It uses codes to identify diagnoses
Allowing for specifying the cause, manifestation, location, severity and type of injury/disease
The icd-10 contains around 18,000 codes over 22 chapters
This system and the icd itself is used for mental disorders and general diseases
All this means the accuracy and and how specific a clinical diagnosis can be is all very high in the icd-10
Diagnosis Classification Systems
how does the ICD 10 work?
THE ICD 10 works by
Using a person’s symptoms and context to identify a code
which leads being able to specifying the cause, manifestation, location, severity and type of injury/disease
From this Code
Which then leads to the identification of a diagnosis
which then may lead to a treatment being formed
Here is how the codes work
The Section (the letter) is first
This is the mental health disorder
Each section groups each disease into a family
For example SZ and delusional disorders are under section f20-29
F20 = SZ
This is further differentiated by F20.0 = paranoid SZ and F20.1 which is hebephrenic SZ
Each section has left over codes so new disorders can be added
CODE E.G:
S52.521 A
S = Section
52 = Catagory (appart of a Family)
.
521 = the etiology (cause), anatomical site, severity and other vital clinical details (each number adds a level of Specificallity to this)
A = extension ( additional things or some other specific details 〔such as continuing the previous section’s specificallity〕 or variations)
Diagnosis Classification Systems
DSM and ICD
Similaritys
• both systems the dsm-v and icd 11 use Anasological approach
Base the classification of mental disorders on psychopathology
• both systems time course criteria was made similar
• and the dimensional assessment which uses measures to evaluate the extent to which it symptoms exist were introduced in both systems
• Neva system as introduced neurobiological or genetic Factors in the classification of psychotic disorders
• attenuated psychotic syndrome symptoms didn’t receive full diagnostic status
indicating the difference between normal and abnormal behaviors is still unclear in both systems
and open for discussion
on concepts of subclinical / dimensional ratings of sub diagnostic symptoms in the general population?
Diagnosis Classification Systems
ICD and DSM differences
The icd is often used for clinical and broadly examining the general health of the population whereas dsm is often used as a research tool in the United Kingdom of Great Britain and Northern Ireland
The DSM is only used for mental disorders diagnosis
The icd is used for the diagnosis of mental disorders (not in the same depth as a DSM), diseases and other conditions relating to the entire human physiology
• major difference in the role of functional impairments which are the functional limitations (as in due to the illness you can’t do certain functions day to day)
Which remain mandatory in the dsm-5 but not in the icd 11
• another difference is the duration criteria (which is how long must someone have the symptoms before diagnosis is allowed)
Due to these differences it leads to differing approaches regarding brief psychotic disorders
• there are still some differences in timecourse criteria and in the Handling of Brief psychotic disorders
which may indicate different concepts of chronicity underlying these decisions
• the differences in the duration criteria are as followed
DSM V: (for ptsd) more than 1 month of disturbances and it’s classed as delayed PTSD if not mating the full diagnosis criteria within ATLEAST six months
ICD 10: (for PTSD): must meet all criteria WITHIN six months after the stressful event MAX
