Mental health: DSM & ICD

Question 1

What are the main classification systems that clinicians used to diagnose people (with mental disorders)?

Answer 1

1. The DSM-5
2. The ICD011

Question 2

What does ‘ICD’ stand for?

Answer 2

The International Classification of Diseases (and Related Health Problems)

Question 3

Outline origin of the ICD

Answer 3

-> 1948:
1. The World Health Organisation (WHO) was created.
2. Post war - United Nations set up - put together so all people could use it - more universal understanding of mental health.

-> WHO:
Published a classification system for ALL DISEASES AND DISORDERS.

-> Revised over years. Now on ICD-11. (Textbook = ICD-10).

Question 4

What version of the ICD are we using now?

Answer 4

ICD-11

Question 5

What does ‘DSM’ stand for?

Answer 5

Diagnostic & Statistical Manual

Question 6

Outline origin of the DSM

Answer 6

-> 1952:
The APA independently devised another classification system (the DSM).

-> How:
Independent clinicians gathered together to produce the DSM based around their experiences in practice.

-> Growth:
Gone from containing 250 psychological orders to 380.

-> Today:
Revised 4 times: DSM-5

Question 7

Explain why the creation of the DSM may be affected by subjectivity.

Answer 7

-> Clinicians produced DSM together (and later revised it 4 times).

-> Therefore based off of personal experience in practice / each individuals’ opinion rather than scientific fact thus meaning not objective, so subjective.

Question 8

What other issues are raised as a result of the DSM being subjective?

Answer 8

->False information:
The mental disorders included may be incorrect. Thus spread false information.
Resulting in patients receiving unsuitable treatment.

-> Unreliable:
Not consistent if based off of opinions

-> generalisability:
Lack of generalisability - could be based off of a unique case.

-> Not scientific:
Not objectifiable (as subjective), not repeatable (unreliable), and not falsifiable.

-> Lack of validity:
Lack of evidence to prove measure is accurate - only based on opinions.

-> Reductionist:
Putting people in a box when their symptoms may range.

Question 9

Outline the DSM-5’s structure.

Answer 9

Structured into 3 sections:

SECTION 1:
Outlines;
-> How to use to manual.
-> Outlines purpose, structure, content and use.
-> process of DSM4 -> DSM5
-> Cautionary use of DSM in forensic setting (risks & limitations).

SECTION 2:
Consists of 20 chapters containing mental disorders / their diagnostic criteria (includes codes from ICD).

Examples of chapters:
4. Depressive disorders.
5. Anxiety disorders.
10. Deeding & eating disorders.

SECTION 3:
Tools and techniques to enhance the clinical decision making process.

Question 10

Summarise the DSM

Answer 10

The DSM (Diagnostic and Statistical Manual) is a book created by independent clinicians by APA in 1952.
It contains their opinions / experiences in practice of exclusively mental disorders.
It has been revised 4 times and it’s intended to diagnose patients and offer them a treatment program (& to monitor their progress).

3 sections:
1. Instructions on how to use it & cautionary use.
2. 20 chapters containing mental disorders.
3. Tools & techniques to enhance the clinical decision making process.

Question 11

State similarities between the ICD and the DSM.

Answer 11

1. Updated
   It has been reviewed, revised and edited over time (Now on ICD-11 and DSM-5).

As views in mental health has progressed some disorders have been voted out e.g., homosexuality, and others have been added e.g., gaming disorder.

2. Mental disorders
   Both have been used to identify and diagnose mental disorders and to access treatment.
3. Coding
   Coding used in ICD is also used in DSM.
   - ICD uses it for access to insurance.
   - DSM uses it for consistency.
4. Subjective
   Both devised through medical opinion and disorders added through voting (popular opinion).

Question 12

State differences between the ICD and the DSM.

Answer 12

1. Ethnocentrism / creators.
   ICD = WHO (World Health Organisation) - less ethnocentric.
   DSM = APA - American - more ethnocentric.
2. Reductionist / holistic.
   **ICD = ** Holistic: Encompasses both mental & physical disorders.
   DSM = Reductionist: Exclusively mental disorders.
3. Area of use
   ICD = Used Internationally.
   DSM = Used in America.
4. Accessibility
   ICD = Easily accessible due to low cost & free online.
   DSM = Costly & has to be purchased (generates a substantial portion of APA’s revenue).
5. Axis
   ICD-10 = Does not have a separate axis & is more criteria based (list) diagnosis.
   DSM = Has separate axis.
6. Purpose
   **ICD = **Structure for research (so more complex).
   DSM = Diagnostic tool.

Question 13

What did Broverman (1970) find?

(And thus suggests)

Answer 13

That mental health progessionals used different adjectives to describe the ‘normal’ male and female.

Normal females were seen as submissive and concerned with their appearance.

Broverman suggests that this would make any female who is not submissive appear to be abnormal, and therefore more likely to be diagnosed.