Dx Classification 462 Psych Prof Alsughayir 1 Lecture

Dx & Classification 462 Psych Prof. Alsughayir 1

Lecture Title : Level Diagnosis & Classification in Psychiatry : 4 th year Medical Students Lecturer : Prof. Mohammed Alsughayir ������ �� Dx & Classification 462 Psych Prof. Alsughayir 2

Lecture Objectives : At the end of the lecture students should be able to: -Know Basics of Diagnosis & Classification in Psychiatry. -Know the difference between organic &functional d. - Know the cues suggestive of organic mental disorders. -Know the difference between psychosis &neurosis. - Know positive & negative psychotic features. Introduction 462 psych Prof. Alsughayir 3

DIAGNOSIS IN PSYCHIATRY Depends mainly on signs & symptoms (psychopathology). Rarely we use external validation; lab tests , brain imaging , … Clinical skills are essential. Dx & Classification 462 Psych Prof. Alsughayir 4

CLASSIFICATION ICD Organic d. ………. . ……… Childhood DSM Childhood d. cognitive d. ……… ……… ⇨ Multiaxial 1 -Psych. Dis. 2 - M. R. Personality d. 3 - Physical illness 4 - Stresses 5 -Functioning level Dx & Classification 462 Psych Prof. Alsughayir 5

ORGANIC Detectable bio. etiology. e. g. FUNCTIONAL No detectable bio. etiology. Neurotransmitters disturbance. Head Trauma Brain Tumor Sub. Abuse Delirium Dementia CVA TLE SLE e. g. schizophrenia mood disorders anxiety disorders adjustment dis. others. Dx & Classification 462 Psych Prof. Alsughayir 6

Cues suggestive of organic etiology Disturbance of : - consciousness - cognitive functions - vital signs Presence of : - visual hallucinations - neurological signs e. g. dysarthria - physical illness HTN, DM, … -old age Dx & Classification 462 Psych Prof. Alsughayir 7

Dx & Classification 462 Psych Prof. Alsughayir 8

PSYCHOSIS -Impaired insight NEUROSIS - Impaired reality testing. -No psychotic features. - Impaired judgment. -Abnormal quantity of symptoms. - Presence of active/positive psychotic features. E. g. anxiety , phobias, -Presence of negative features. E. g. Schizophrenia Dx & Classification 462 Psych Prof. Alsughayir 9

Positive Psychotic Features Major disturbances in : perception e. g. hallucination. thinking e. g. delusions , FOI mood e. g. extreme euphoria. behavior e. g. disorganized beh. Dx & Classification 462 Psych Prof. Alsughayir 10

Negative Features Poverty of thoughts & speech. Lack of ambition , interest & initiation. Restricted affect. Self-neglect. Poor self care & hygiene Dx & Classification 462 Psych Prof. Alsughayir 11

Summary Diagnosis in psychiatry is based mainly on clinical features. There are 2 main systems of classification ; ICD & DSM. Multiaxial Record. Organic vs. Functional. Cues suggestive of organic mental disorder. Psychosis vs. Neurosis. Positive vs. Negative features. Dx & Classification 462 Psych Prof. Alsughayir 12

Reference Basic Psychiatry , Prof. Alsughayir chapter 4 (P 51 - 57). Etiology 462 psych Prof. Alsughayir 13