Categorising Mental Disorders

Why may it be useful to categorise mental illnesses?

• Categorise their severity

• Specific treatments

• More accurate statistics about the prevalence of mental illness

• Can more easily signpost symptoms making diagnosis easier

• Validation for patient

• More understanding within society- acceptance

What is the DSM-5?

• Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

• Used and developed in the USA

• Focuses on mental health disorders

What is the ICD?

• The International Classification of Diseases

• Created by WHO and globally recognised

• Contains every illness (not just psychological)

What are the three steps to make a diagnosis with the DSM?

• Diagnostic classification

• Diagnostic criteria sets

• Descriptive text

What is diagnostic classification is in the D

• This is the list of mental disorders which are grouped together

• Every diagnosis has a code

What are diagnostic criteria sets in the DSM?

• For each disorder there is criteria of what symptoms must be present and for how long

• Also listed are symptoms, disorders and conditions that may rule out a particular diagnosis

What is descriptive text in the DSM?

• This is the final step before diagnosis

• The DSM 5 gives additional information to help a psychiatrist reach a diagnosis

• This includes headings such as “gender related diagnostic issues” and “culture related diagnostic issues”

  • For example, in some cultures, hearing a god’s voice is celebrated as a religious experience but a psychiatrist in the US may hear this an think they are schizophrenic

What are the strengths of making a diagnosis with the DSM?

• Validity- having required symptoms as well as symptoms you can rule out for diagnoses makes them more accurate

  • For schizophrenia, 2 symptoms should be exhibited over a period of 6 months

• Reliability- All US doctors use the same diagnostic criteria

• Effective treatments- valid and reliable diagnosis should mean patients receive the correct treatment and medication

  • This improves patient’s mental health, trust in the system and people are more likely to come forwards to seek help for mental health

What are the weaknesses of making a diagnosis with the DSM?

• There are no biological tests for any disorder- based on subjective opinion

  • Strong religious beliefs could be seen as symptoms of schizophrenia

• Low inter-rater reliability when diagnosing

  • Inconsistency may lead to misdiagnosis of patient, leads to the wrong treatment which could make their symptoms worse

• Medicalisation of normal behaviour- depressive symptoms after significant bereavement would be diagnosed as depression rather than a normal part of the grieving process

  • Stigma associated with diagnostic label, medication given when it is not needed