diagnostic classification (the DSM and ICD)

Question 1

what is the ICD?

Answer 1

• the “International Classification of Disease”
• used to classify all diseases and health conditions, including mental health disorder for clinicians and public health purposes
• published by the WHO (world health organisation) in 1992
• free of charge
• used worldwide + more popular

the ICD-10: includes 10 groups of mental disorders

Question 2

what is the DSM?

Answer 2

• the “Diagnostic and Statistical Manual of Mental Disorders”
• a manual used to diagnose and classify mental health disorders
• first published in in 1952
• contains statistics gathered across mental hospitals
• contains over 300 disorders, divided into over 20 categories

Question 3

what is the purpose of diagnosis?

Answer 3

to determine the nature of a disease or disorder and distinguish it from other possible conditions

Question 4

abnormal behaviour

Answer 4

• behaviour that is statistically less likely to occur in society
• behvaiour that goes against sociocultural norms
• behaviour that causes the subject distress for themself and others

Question 5

normal behaviour

Answer 5

behaviour that follows the sociocultural norms of society

Question 6

what are the similarities of the DSM-5 and ICD-10?

Answer 6

• both are diagnosis and categorizing manuals, which require two or more symptoms to be present in order for the diagnosis to be made
• both are intended to be used by qualified health professionals and are used worldwide as reliable and valid tools
• DSM-5 is now designed to mirror the ICD-10 anf follow symptoms and removed GAF scales to become more objective like the ICD-10 using a symptom-based approach

[Jackobsen et al] found there was a good agreement in the diagnosis of schizophrenia between the ICD-10 and other classification systems, showing that the ICD-10 is reliable due to its consistent diagnoses with other classification systems

Question 7

what are the differences between the DSM and ICD?

Answer 7

• the ICD-10 can be viewed online and is distributed freely by the WHO, where the DSM must be paid for and generates a huge income from the APA (American Psychological Association)
• The ICD is used more compared the the DSM
• [Reed et al] found the ICD was used 70% vs 23% DSM for diagnosing individuals
• most disorders in medicine are classified using the ICD
• [Andrews et al] found only a 68% agreement between the ICD and DSM on an assesment of 1,500 patients - however, andrews found agreement on diagnosis for depression

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Question 8

what do diagnostic manuals contain?

Answer 8

• the classifications of disorders into different types
• physical and cognitive symptoms of disorders

Question 9

what are the three main sections of the DSM-5?

Answer 9

section 1: guidance in using the system for diagnosis

section 2: disorders are categorised, based on recent research, into their underlying causes
- includes categories such as depressive disorders, substance-use disorders and eating disorders
- a severity rating was introduced (e.g. mild, moderate, severe) to try to improve the reliability and validity of diagnosis

section 3: Includes suggestions for disorders to be considered in future revisions (e.g. Internet gaming disorder), which will require further research
- includes discussion of how culture affects symptom presentation, communication and diagnosis, in order to reduce cultural bias

Question 10

what does validity of diagnosis mean?

Answer 10

• validity measures how accurately classification systems assess the mental disorders they claim to measure
• a system cannot be valid if it lacks reliability, as this indicates potential diagnostic bias.
• predictive validity occurs when a diagnosis accurately forecasts the progression of a mental disorder
• validity is supported if a diagnosis leads to effective treatment based on the classification system.
• classification systems should include operationalized and measurable symptoms to ensure accurate and valid diagnoses (e.g., requiring specific symptoms over a defined period for schizophrenia).

Question 11

what does reliability of diagnosis mean?

Answer 11

• reliability in diagnosis means that the same person receives the same diagnosis from two different clinicians
• inter-rater reliability occurs when the same clinician diagnoses a patient consistently at different times
• a diagnosis is reliable if two different classification systems identify the same disorder for the same patient

Question 12

describe how the ICD is used as a classification system for mental health

Answer 12

A clinician may consult a patient and use the ICD criteria to identify a specific disorder under the section, based on the symptoms a patient expresses to the clinician