Classification refers to the procedure in which ideas or objects are recognized, distinguished and understood. Currently, two leading systems are used for grouping of mental disorder namely International Classification of Disease (ICD) by World Health Organization (WHO) and the Diagnostic and Statistical Manual of Mental disorders (DSM) by the American Psychiatric Association (APA). Other classifications include Chinese classification of mental disorder, psycho-dynamic diagnostic manual, Latin American guide for psychiatric diagnosis etc. A survey of 205 psychiatrists, from 66 different countries across all continents, found that ICD-10 was more customarily used and more valued in clinical practice, while the DSM-IV was more valued for research .
1. It aids us to communicate our understanding with other experts. Trull (2004, pp. 125-126) referred to diagnosis as “verbal shorthand” for elucidating the features of a particular mental disorder . It will be challenging for us to convey schizophrenia to other professionals just by using the clinical features, without a diagnosis. Listening to a diagnosis, immediately conjures up a doppelganger in our mind about what the patient can be suffering from.
2. A proper classification method removes the guess work for diagnosis. It serves as a guide to reach a precise diagnosis. Diagnostic criterion helps the clinician to make an interim diagnosis and clarify it in further assessments.
3. In the absence of a consistent classification, assortment and assessment of subjects will become nearly unmanageable. Researchers use diagnostic sets that empower them to draw deductions and comparison among different research groups.
4. Standardization of diagnoses helps to warr...
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8. Kendell, R. and Jablensky, A. (2003), Distinguishing between the validity and utility of psychiatric diagnoses, American Journal of Psychiatry, Vol. 160, No. 1, pp. 4-12.
9. Frances, A. (2010), Psychiatric fads and over diagnosis, DSM-5 in Distress.
10. Paris, J. (2004), Psychiatric diagnosis and the bipolar spectrum, in Canadian Psychiatric Association Bulletin, viewed on 28 March 2014, http://ww1.cpa-apc.org:8080/publications/bulletin/currentjune/editorialEn.asp.
11. Caplan, P. (2012), Psychiatry’s bible, the DSM, is doing more harm than good, The Washington Post, 27 April.
12. Doward, J. (2013), Medicine's big new battleground: does mental illness really exist? The Observer 12 May.
13. Insel, T. (2013), Mental disorders as brain disorders, TEDx talk at California Institute of Technology in Pasadena, 23 April.
This fifth revision of the Diagnostic and Statistical Manual of Mental Disorders or DSM will be the standard classification of mental disorders (Nauert, 2011). Mental health professionals and other health professionals will use this standard in their diagnoses and researches. The American Psychiatric Association released a draft of proposed changes after a decade of review and revision by the Association. Allen Frances, chairman and editor of DSM IV, and Robert Spitzer, editor of DSM III, expressed objections to the task force conducting the revisions and the proposed revisions. Present chairman is David Kupfer and vice chairman is Darrel Regier (Nauert; Collier, 2010).
A classification system such as the DSM-5 is judged by its reliability and validity. Define and discuss both reliability and validity and why they are important criteria for DSM-5.
Frances, A., & Ross, R. (1996). DSM-IV case studies a clinical guide to differential diagnosis. Washington, DC: American Psychiatric Press, Inc.
Goldberg, Richard, M.D. Diagnosing Disorders of Mood, Thought and Behavior. Medical Examination Publishing: New York, 1981.
`In the past, I worked in such a research setting, where if a person was found to meet criteria for opiate dependence they received treatment, however if even slightly short of DSM-IV criteria for the disorder they would have to look elsewhere. This was a continual concern for me, as the person who met criteria was not always the person with the most distress, and alternative treatments were not easy for people to find. Largely from this experience, I find the current categorical approach to classifying persons with psychopathology to be an imperfect system at best, with the primary advantage of being convenience when communicating with other professionals. I question whether this convenience comes at a severe cost to accuracy, the result of which is an artificial limit to the range of presentations that occur in psychopathology. As the example above illustrates, the particular aspect that I find most problematic is the use of cutoffs for specific symptoms, for instance the length symptoms must have been present for it to be classified as a disorder, or even the number of symptoms that need to be present. I think it is unlikely that a person who “almost” meets criteria for a disorder would be significantly different from a person with similar symptoms who just barely meets criteria. In private practice these two cases would likely be treated similarly, but in a setting where diagnosis serves as a screening tool the client who met criteria may get treatment while the other does not. In this case I feel that less specific guidelines, lacking specific numerical limits would alleviate many of the problems.
Whitaker, Leighton C. "Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America." Ethical Human Psychology and Psychiatry 13.2 (2011): 169-71. Print.
This means that their diagnostic criteria are different than Americans, resulting in inconsistency. This has always struck a chord with me. How is it possible to compare research done in different countries if the subjects may or may not qualify for a certain diagnosis? It is something I never fathomed and I think it shows by my hesitancy to cite data for research articles outside of the US because I feel like data would not be reflective of the American population since we are using a completely different system. Lastly, I find it striking that because of these differences some disorders are less common across the pond than here in the States. I do not recall all of the disorders that are increasingly more prevalent here, but I think they were Pervasive Developmental Disorders and ADHD. The inconsistency across all countries means that we will never have concrete definitions for diagnoses and in this case families will be the ones to suffer and difficult for researchers to continue with studies. I think this holds especially true for childhood disorders like Bipolar where it is difficult to diagnose for multiple reasons, as stated
The Diagnostics and Statistical Manual of Mental Disorders and other assessment tools assist in the identification and development of treatment options. Application of the DSM-5 requires knowledge of possible advantages and limitations. Is it also helpful to understand when it is appropriate to apply the information provided in the DSM-5. The DSM was essentially developed to provide a ‘common language for mental health professionals (Butcher, Hooley, & Mineka, 2014). This fifth edition continues an evolutionary process aimed at maintaining guidelines for diagnoses that advise and analyze clinical practice (APA, 2013).
The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been used for decades as a guidebook for the diagnosis of mental disorders in clinical settings. As disorders and diagnoses evolve, new versions of the manual are published. This tends to happen every 10 years or so with the first manual (DSM-I) having been published in 1952. For the purpose of this discussion, we will look at the DSM-IV, which was published originally in 1994, and the latest version, DSM-5, that was published in May of 2013. Each version of the DSM contains “three major components: the diagnostic classification, the diagnostic criteria sets, and the descriptive text” (American Psychiatric Association, 2012). Within the diagnostic classification you will find a list of disorders and codes which professionals in the health care field use when a diagnosis is made. The diagnostic criteria will list symptoms of disorders and inform practitioners how long a patient should display those symptoms in order to meet the criteria for diagnosis of a disorder. Lastly, the descriptive text will describe disorders in detail, including topics such as “Prevalence” and “Differential Diagnosis” (APA, 2012). The recent update of the DSM from version IV-TR to 5 has been controversial for many reasons. Some of these reasons include the overall structure of the DSM to the removal of certain disorders from the manual.