Introduction to Classification and Diagnosis

Question 1

Classification

Answer 1

General: Classification refers to the act of distributing things into categories of the same type.

Psychopathology: Classification refers to the process of identifying and grouping mental disorders based on their symptoms and characteristics, using symptoms like the DSM (Diagnostic and Statistical Manual of Mental Disorders) or ICD (International Classification of Diseases).

For example, a number of symptoms may be organised in different clusters or groups.

Question 2

Diagnosis

Answer 2

The recognition and identification of a disease or condition by its signs and symptoms.

Question 3

Signs

Answer 3

Signs are the results of objective tests, such as blood or urine tests.

Question 4

Symptoms

Answer 4

Symptoms are reports from patients about how they feel, e.g., how much pain they are feeling or how tired they are.

Question 5

Syndromes

Answer 5

Clusters of symptoms and behaviours which are regularly found together in a particular combination.

Question 6

Reasons for Classification and Diagnosis

Answer 6

Example: Abnormality

Abnormality is difficult to define. One of the problems is trying to decide where normal behaviour stops and abnormal behaviour takes over.

Prior to the 20th century, there was a tendency to label people who behaved in a psychologically abnormal way as ‘mad’ or ‘deviant’. However, this blanket description failed to take into account different types of abnormal behaviour.

We know now that mental disorders can take many forms and that treatments vary enormously depending on the type of disorder.

For this reason, clinicians and researchers working in the field of psychopathology have developed classification systems to help them make an accurate diagnosis.

Question 7

The biological or medical model, which is the dominant approach to psychopathology, makes a number of assumptions:

Answer 7

1. Mental abnormality manifests itself in signs and symptoms.
2. Signs and symptoms occur together in clusters;
   ‘syndromes’.
3. Syndromes represent distinctive disorders that can be considered independently of one another.
4. Explanations and remedies can be found for each of these separate disorders.

Question 8

Classification in Psychiatry

Answer 8

Classification in psychiatry raises particular challenges, which are not the same for other scientific disciplines. For example it differs from physical disorders in several ways:

• There is less agreement about what actually constitutes illness with regard to mental disorder as opposed to physical disorders.
• In physical illness, the cause of the problem is apparent, often detected through signs. With mental disorders, clinicians often depend on the patients’ account of their symptoms.

Question 9

Advantages of Diagnosing

Answer 9

1. Communication shorthand: They make communication between professionals working within the field of psychopathology easier.
2. Aetiology (causes): Classification systems are used to understand more about the possible causes of mental disorders and possibly indicate preventative measures.
3. Prognosis: The predicted outcome or course of a mental disorder, including the chances of recovery and recurrence.
4. Treatment: Diagnosis of the disorder aids choosing an appropriate treatment.
5. Research: Classification systems make the research more reliable, i.e. ensuring that research is conducted with comparable groups.

Question 10

Disadvantages of Diagnosing

Answer 10

1. Social stigma: It has been suggested that placing a patient in a diagnostic category can lead to stigma whereby an individual with a mental illness is wrongly judged as dangerous, unpredictable, unemployable, etc.
2. Labelling: Labels are ‘sticky’ and apart from affecting treatment by others, they may lead to self-fulfilling prophecies.
3. Social control: There have been cases of abuse in psychiatry where diagnoses have been used for political reasons. For example, in the Soviet Union, political dissidents were controlled through forced psychiatric treatment, imprisonment, surveillance, and censorship to silence opposition and maintain power.
4. Cultural considerations: Despite being used universally, classification systems are mostly Western-based. Therefore, they may have questionable validity in different cultural contexts.
5. Gender considerations: Gender differences may not always be acknowledged and addressed by a general, universal diagnostic system.