1. Categorising mental disorders

Question 1

Making a diagnosis with the DSM-5

Answer 1

1. Diagnostic classification
   The first step is to look at the diagnostic classification which is a list of all the different disorders. Similar disorders are grouped together to make diagnosis easier. E.G. All schizophrenia related disorders are grouped together
2. Diagnostic criteria sets.
   For each disorder a set of diagnostic criteria indicates what symptoms must be present (and for how long) as well as symptoms, disorders, and conditions that may rule out a particular diagnosis. Severity may be specified for some disorders. It may also take into account if the symptoms have affected the functioning of the individual
3. Descriptive Text
   There is also the descriptive text which has additional information which should be taken into account. E.G. Cultural related issues

Question 2

International Classification of Diseases and Related Health Problems (ICD-11) (3 things)

Answer 2

With around 55,000 codes that can be used to classify diseases, disorders, injuries, and causes of death. Both physical and mental conditions ARE COVERED.

It is designed to map health conditions to corresponding generic categories together with specific variations, assigning to these a designated code, up to six characters long. The numerical coding is 1A00. 00 to ZZ9Z.

Each listed disorder includes a description with guidance.

Question 3

Strengths - V__________

Answer 3

Validity – by having factors that should be ruled out, as well as symptoms that are required, should make diagnosis more accurate e.g.

When diagnosing schizophrenia they rule out Schizoaffective disorder, bipolar, depressive disorder with psychotic features.

Question 4

Strengths - R____________

Answer 4

Reliability – As all US doctors use the same diagnostic criteria this should increase the reliability e.g.

As they are using the same criteria they should be consistent in their diagnosis e.g. symptoms should be continuous for a set period of time (6 months).

Question 5

Strengths - ___________ _____________

Answer 5

Effective treatments– valid and reliable diagnosis should mean patients receive the correct treatment/medication.

This enables patients to manage their symptoms and function more positively within society.

Question 6

Weakness - V_________

Answer 6

Validity – There are no biological tests for any disorder, they are based on the subjective opinion of the psychiatrist, this means bias can occur e.g.

It may be harder for doctors to comprehend cultural differences and interpretation may be bias. E.g. hearing voices people believe to be god- a psychiatrist may believe this to be auditory hallucination

Question 7

Weakness - ______________ __ ________ _____________

Answer 7

Medicalisation of normal behaviour – In DSM-5 depressive symptoms shown after significant bereavement would be diagnosed as depression rather than seen as a normal part of grieving process.

Because this medicalized normal logical feelings and provides treatment further problems can be caused, there could be a negative impact of receiving a label of being mentally unwell.

Question 8

Diagnosing Schizophrenia checklist

Answer 8

Symptoms. At least one of these must be (1), (2), or (3):
1. Delusions
2. Hallucinations
3. Disorganised speech (e.g. frequent derailment or incoherence).
4. Grossly disorganised or catatonic behaviour
5. Negative symptoms (i.e. diminished emotional expression)

2. Impairment in one of the major areas of functioning for a significant period of time since the onset of the disturbance: Work, interpersonal relations, or self-care.
3. Some signs of the disorder must last for a continuous period of at least 6 months.
4. Schizoaffective disorder and bipolar or depressive disorder with psychotic features have been ruled out:
   No major depressive or manic episodes occurred concurrently with active phase symptoms
5. The disturbance is not caused by the effects of a substance or another medical condition
6. If there is a history of autism spectrum disorder or a communication disorder (childhood onset), the diagnosis of schizophrenia is only made if prominent delusions or hallucinations, along with other symptoms, are present for at least one month.