CLASSIFICATIONOFMENTAL DISORDERS

INTRODUCTION

• Classification is a process by which complexphenomena are organized into categories, classes orranks so as bring together those things that mostresemble each other & to separate those that differ.• Like any growing branch of medicine, psychiatric hasbeen rapid changes in classification to keep upgrowing research data dealing withepidemiology, symptomatology, prognosticfactors, treatment methods & new theories forcausation of psychiatric disorder.• At present there are two major classification inpsychiatry, namely ICD 10 (1992) & DSM IV (1994)

ICD 10(InternationalStatisticalClassification ofDisease & RelatedHealth Problems 

ICD 10(InternationalStatisticalClassification ofDisease & RelatedHealth 

 ICD 10 (International StatisticalClassification of Disease & RelatedHealth Problems)- 1992 :-• This is WHO’s classification for all diseases &related health problems.• The chapter ‘F’ classifies psychiatric disorder asmental & behavioral disorders & codes them onan alphanumeric system from F00 to F99.The Main Categories in ICD 10

F00 – F09 Organic, IncludingSymptomatic, Mental disordersF00 – Dementia in Alzheimer’s diseaseF01 – Vascular dementiaF04 – Organic amnestic syndromeF05 – DeliriumF06 – Other mental disorders due to brain damage &dysfunction & to physical diseaseF07 – Personality & behavioral disorders due to braindisease, damage & dysfunction

F10 – F19 Mental & behaviouralDisorders due to PsychoactiveSubstance useF10 – Mental & behavioral disorders due to use ofalcoholF11 - Mental & behavioral disorders due to use of opioidsF12 – Mental & behavioral disorders due to use ofcannabinoidsF13 – Mental & behavioral disorders due to use ofsedatives & hypnoticsF14 – Mental & behavioral disorders due to use ofcocaineF16 – Mental & behavioral disorders due to use ofhallucinogens

F20 – F29Schizophrenia, Schizotypal &Delusional DisordersF20 – SchizophreniaF20.0 – Paranoid SchizophreniaF20.1 – Hebephrenic SchizophreniaF20.2 – Catatonic SchizophreniaF20.3 – Undifferentiated SchizophreniaF20.4 – Post-schizophrenia depressionF20.5 – Residual SchizophreniaF20.6 – Simple SchizophreniaF21 – Schizotypal disorderF22 – Persistent delusional disordersF23 – Acute & Transient psychotic disordersF24 – Induced Delusional disordersF25 – Schizoaffective disorders

F30 – F39 Mood (affective) DisordersF30 – Manic episodeF31 – Bipolar affective disorderF32 – Depressive episodeF33 – Recurrent depressive disorderF34 – Persistent mood disorder

F40 – F49 Neurotic, Stress-rapid &somato-form disordersF40 – Phobic anxiety disordersF41 – Other anxiety disordersF42 – Obsessive – Compulsive disorderF43 – Reaction severe stress & adjustment disordersF44 – Disociative (Conversion) disordersF45 – Somatoform disorders

F50 – F59 Behavioral syndromesassociated with physiologicaldisturbances & physical factorsF50 – Eating DisordersF51 – Non-organic sleep disordersF52 – Sexual dysfunction

F60 – F69 Disorders of adultpersonality & behaviorF60 – Specific personality disordersF60.0 – Paranoid personality disordersF60.1 – Schizoid personality disordersF60.2 – Dissocial personality disordersF60.3 – Emotionally unstable personality disorderF60.4 – Histrionic personality disordersF60.5 – Anankastic personality disordersF60.6 – Anxious personality disordersF60.7 – Dependent personality disordersF61 – Mixed & other personality disordersF62 – Enduring personality changes, not attributableto braindamage & diseaseF63 – Habit & impulse disordersF64 – Gender identity disordersF65 – Disorders of sexual preference

F70 – F79 Mental RetardationF70 – Mild Mental RetardationF71 – Moderate Mental RetardationF72 – Severe Mental RetardationF73 – Profound Mental Retardation

F80 – F89 Disorders of psychologicaldevelopmentF80 – Specific developmental disorders of speech &languageF81 – Specific developmental disorders of scholasticskillsF82 – Specific developmental disorders of motorfunctionF83 – Mixed specific developmental disordersF84 – Pervasive developmental disorders

F90 – F98 Behavioral & emotionalDisorders with onset usuallyoccurring in childhood &adolescenceF90 – Hyperkinetic disordersF91 – Conduct disordersF93 – Emotional disorders with onset specific tochildhoodF94 – Disorders of social functioning with onsetspecific to childhood & adolescenceF95 – Tic DisordersF98 – Other behavioral & emotional disorders withonset usually occurring in childhood & adolescence

F99 – Unspecified mental Disorders

DSM IV(Diagnostic &StatisticalManual)

DSM IV (Diagnostic & StatisticalManual) – 1994 :-• This is the classification of mental disordersby the American Psychiatric Association(APA). The pattern adopted by DSM IV is ofMultiaxial systems.• A multiaxial system that evaluates patientsalong several versatile contains Five axes.Axis I & II make up the entire classificationwhich contains more than 300 specificdisorders

The Five Axes of DSM IV Are:-Axis I : Clinical psychiatric diagnosisAxis II : Personality disorder & mental retardationAxis III ; General medical conditionsAxis IV : Psychosocial & environmental problemsAxis V : Global assessment of functioning in current& past one year

INDIANCLASSIFICATION

 Indian Classification:-In India Neki (1963), Wig &Singer (1967), Vahia (1961) & Varma (1971) haveattempted some modification of ICD8 to suit Indianconditions.A)Psychosis:-1. Functional:- Schizophrenia2. Affective:- Mania & Depression3. Organic:- Acute or Chronic

COUNT…B) Neurosis:-Anxiety neurosisDepressive neurosisHysterical neurosisObsessive-compulsive neurosisPhobic neurosisC) Special disorders:Childhood disordersPersonality disordersSubstances abusesPsycho physiologicaldisordersMental retardation

Differences Between ICD10 &DSMIV:-ICD10 DSM IVOrigin International American psychiatricassociationPresentation Different version for clinical work,research & primary careA single versionLanguage Available in all widely spokenlanguagesEnglish version onlyStructure Single axis multiaxialContent Diagnostic criteria do not includesocial consequences of the disorderDiagnostic criteria usuallyinclude occupational orother areas of functioning

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