PSY 4372 Lecture Notes - Lecture 5: World Health Organization, Mental Disorder, American Psychiatric Association
5 Jun 2018
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Lecture 5: Classification
The purposes of a diagnostic classification system include a concise description, common language used by trained
professionals, may contain information about etiology, comorbidity, and prognosis. For searching for treatment
organization and the insurance reinforcement for the cost of services.
• diagnosis allows for the systematic treatment and effective series
• provides a way for experts to communicate
• allows for categorization and procedures
• helps us define what we are looking at
• if you are a clinician it provides clues as to assessment and treatment
• this is useful for insurance purposes
Categorial Approach: ICD-10
• specific criteria (Kareplinian apprach)
This includes the prototype approach, like the ICD-10. The ICD relies mre on clinical judgement and is more
subjective. It requires a skilled clinical to catch small or weird symptoms. Flexibility may lead to over diagnosis, but
research suggests that this isn’t the case
Dimensional Approach: DSM
• specific criteria approach
• the person needs to meet a list of required symptoms
ICD-10
In typical mild, moderate, or severe depressive episodes, the patient suffers from lowering of mood, reduction of
energy, and decrease in activity. Capacity for enjoyment, interest, and concentration is reduced, and marked
tiredness after even minimum effort is common. Sleep is usually disturbed and appetite diminished. Self-esteem and
self-confidence are almost always reduced and, even in the mild form, some ideas of guilt or worthlessness are often
present. The lowered mood varies little from day to day, is unresponsive to circumstances and may be accompanied
by so-called "somatic" symptoms, such as loss of interest and pleasurable feelings, waking in the morning several
hours before the usual time, depression worst in the morning, marked psychomotor retardation, agitation, loss of
appetite, weight loss, and loss of libido. Depending upon the number and severity of the symptoms, a depressive
episode may be specified as mild, moderate or severe.
DSM-5
A: Five or more of the following symptoms have been present during the same 2 – week period and represent a
change from previous functioning: at least one of the symptoms is either (1) depressed mood or (2) loss of interest
of pleasure
Note: Do not include symptoms that are clearly due to a general medical condition or mood-incongruent delusions
or hallucinations
Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty)
or observation made by others (e.g., appears tearful) Note: In children and adolescents, can be irritable mood.
Markedly diminished interest or pleasure in all, almost all, activities, most of the day, nearly every day (as indicated
by either subjective account or observation made by others)
Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month),
or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight
gains.
Insomnia or hypersomnia nearly every day.
Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of
restlessness or being slowed down)
Fatigue or loss of energy nearly every day
Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not
merely self-reproach or guilt about being sick)
Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as
observed by others)
Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide
attempt or a specific plan for committing suicide
B The symptoms do nto meet criteria for a Mixed Episode
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
The purposes of a diagnostic classification system include a concise description, common language used by trained professionals, may contain information about etiology, comorbidity, and prognosis. Categorial approach: icd-10: specific criteria (kareplinian apprach) This includes the prototype approach, like the icd-10. The icd relies mre on clinical judgement and is more subjective. It requires a skilled clinical to catch small or weird symptoms. Flexibility may lead to over diagnosis, but research suggests that this isn"t the case. Dimensional approach: dsm: specific criteria approach, the person needs to meet a list of required symptoms. In typical mild, moderate, or severe depressive episodes, the patient suffers from lowering of mood, reduction of energy, and decrease in activity. Capacity for enjoyment, interest, and concentration is reduced, and marked tiredness after even minimum effort is common. Self-esteem and self-confidence are almost always reduced and, even in the mild form, some ideas of guilt or worthlessness are often present.
