Classification of Psychiatric Disorders Dr Fatima Alhaidar Professor

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

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.

Purposes of Classification: 1. 2. 3. 4. 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.

Types of Classification 1. 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.

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

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

The Basic Categories of Classification in Psychiatry: 1. 2. 3. 4. 5. 6. 7. 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.

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

Neurosis and 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.

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

Neurosis Psychosis Severity Features Minor mental illness Abnormal in quantity e. g. anxiety Major mental illness Abnormal in quality e. g. hallucinates Insight Preserved Affected Treatment Psychological & drugs Drugs & ECT

Features Suggesting of Organic Mental Illness: 1. 2. 3. 4. 5. 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.