Introduction to IDC and DSM: Classification Flashcards
Classification
The act of distributing things into classes or categories of the same type
Diagnosis
Identification of disease by its signs and symptoms
Issues with the diagnosis of mental illnesses…
- There may be many similar symptoms for different illnesses; misdiagnosis leads to inappropriate treatment
- When you are diagnosed by a doctor, you are more likely to believe in the illness even if its not there, which may make it worse and become more serious
- Others may act differently towards you if they know you have a mental illness, which may make symptoms worse
IDC
-This is produced by the world health organisation (WHO), and is currently on its 10th edition. IDC-11 is planned for 2018. Mental disorders were not included in the IDC until 1952. Out of the 21 chapters, only one is devoted to mental illnesses.
DSM
-This is produced by the American psychiatric association and is the dominant manual in the US. In the US research on disorders has to use DSM classifications and a DSM diagnosis is essential for health insurance
Why has the DSM been continuously revised?
- Things change with time; societies views, as being gay was considered a mental illness. Also events in history may have created new mental disorders e.g. shell shock
- We have a more advanced knowledge and technology of how things work as time changes
- New research will have been conducted
- The first DSM’s were very vague so hard to make diagnosis
The GAF scale in DSM-IV
GAF (General Assessment of Functioning) measures how well patients are functioning. But his scale has now been dropped and in DSM 5 it now states that doctors should use ICD’s equivalent scale the WHODAS (World Health Organisation Disability Assessment Schedule)
What is the main goal of DSM?
-To better recognise disorders and diagnose them with a treatment; improving better quality of care for patients; improving quality of life)
What should be the relationship between DSM and the state of scientific knowledge about mental illness?
-Should be at the same level, slightly behind but does not jump ahead without scientific evidence
Symptoms of schizophrenia (clinical characteristics)
- Delusions
- Hallucinations
- Disorganised thinking (speech)
- Grossly disorganised or catatonic behaviour
- Negative symtoms
Delusions:
-Fixed false beliefs resistant to change in the light of contrary evidence: These include delusions of persecution, reference or grandeur, thought withdrawal, thought insertion and delusions of control.
Hallucinations:
-Perception-like experiences without an external stimulus: Most commonly auditory, but in other sense modalities e.g. visual or olfactory. They need to be distinguished from normal religious experience.
Disorganised thinking (speech):
-Disorganised thought inferred from speech: Involves (switching of topics), irrelevance and incoherence.
Grossly disorganised or catatonic behaviour:
- Disorganised behaviour: Includes unpredictable agitation
- Catatonic behaviour: is a marked decrease in reactivity to the environment, including rigid posture, lack of verbal or motor responses
Negative symptoms:
- Diminished emotional expression: reduction in eye contact, facial expressions, hand movements.
- Avolition: decrease in motivated self-initiated purposeful activities, level of functioning in one or more areas such as work, interpersonal relations or self-care must have diminished.
