Classification of Psychiatric Disorders

1. Classification of Psychiatric Disorders Dr. Fatima Alhaidar Professor & Consultant Child & Adolescent Psychiatrist College of Medicine, KSU.

2. Introduction: • Most of physical conditions are classified on the basis of etiology, e.g.: viral pneumonia. Or On the basis of structural pathology, e.g.: Bronchopneumonia. Or Based on symptoms, e.g. migraine. • Psychiatric disorders are diagnosed based mainly on symptoms. Few are based on etiology e.g. Alzheimer’s disease.

3. Purposes of Classification: • To make generally acceptable diagnosis. • To facilitate communication between psychiatrists, other doctors and professionals. • To make generalizations in treatment response, course & prognosis of individual patients. • To make framework for research in psychiatry.

4. Types of Classification • Categorical Classification: - Grouping disorders into separate entities according to symptom – pattern, course and outcome. - It includes hierarchal categories. e.g.: Organic mental disorders then functional psychotic disorders (e.g. Schizophrenia) then neurotic disorder (e.g. generalized anxiety disorder) then personality disorders. - Also it includes in-built hierarchy of significance within the disorders themselves. e.g.: Anxiety symptoms occur commonly with depressive disorder.

5. 2. Dimensional Classification: - Diagnosing individual patients by giving him scores on separate dimensions. e.g. Psychoticism, neuroticism, introversion and extroversion

6. 3. Multiaxial Approach: • Applied to schemes of classifications in which two or more separate sets of information are coded e.g. DSM, ICD

7. The Basic Categories of Classification in Psychiatry: • Mental Retardation – impairment of intellectual functioning, present continuously from early life. • Personality Disorders – a pattern of inner feeling experience and behavior that deviates markedly from the expectations of the individual’s culture, presents continuously since adolescence or early adulthood. • Mental Disorders – abnormality of behavior or psychological experience with recognizable onset after a period of normal functioning. • Stress related or adjustment disorders. • Other Disorders – e.g. Sexual disorders, drug dependence • Learning and developmental disorders. • Disorders with onset in childhood or adolescence.

8. Psychiatric Disorders Organic Non-Organic Acute Delirum Wernicke’s Chronic Dementia Korsakoff Others Alcohol … Head Injury Etc…. Psychoses Schizophrenia Mood disorders Etc…. Neuroses Anxiety disorders Adjustment dis. Dysthymia Dissociative dis. Others Personality dis. Sleep disorder Sex disorder Suicide

9. Neurosis and Psychosis Psychosis: - unsatisfactory term - refers broadly to severe forms of mental disorders such as: a. organic mental diseases b. schizophrenia c. affective disorders Characteristics: - greater severity - lack of insight - patient’s inability to distinguish between subjective experience and reality e.g. hallucinations, delusions.

10. Neurosis: • unsatisfactory term. • Refers to mental disorders that are generally less severe than psychosis. Characteristics: - Symptoms are closer to normal experience e.g. anxiety.

12. Features Suggesting of Organic Mental Illness: • Disturbed consciousness. • Disturbed cognitive functions: a. Attention and concentration b. orientation: time, place & person c. Memory : immediate, recent and remote • Presence of physical illness e.g. DM, HTN • Presence of neurological features e.g. dysarthria & ataxia. • Old age onset.