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Chapter 3

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University of Toronto Scarborough
Konstantine Zakzanis

Abnormalpsych chapter 3th now in its 4Diagnostic and statistical manual of mental disorders DSM edition commonly referred to as DSM IVor DSM IVTR The DSM is published by the American psychiatric association A BRIEF HISTORY OF CLASSIFICATIONBloodletting was part of treatment of all physical problemsDevelopment of the WHO and DSM systemsIn 1939 the world health organization WHO added mental disorders to the international list of causes of deathIn 1948 the list was expanded to become the international statistical classification of diseases injuries and causes of death ICD a comprehensive listing of all diseases including a classification of ab beh Metal disorders section was not widely acceptedAmerican psychiatric association published its own diagnostic and statistical manual DSM in 1952ndIn 1969 the WHO published a new classification system that was more widely accepted A 2 version of the American psychiatric associations DSM DSMII was similar to the WHO systemThe WHO classifications were simply a listing of diagnostic categories the actual beh or symptoms that were the bases for the diagnoses were not specifiedIn 1980 the American psychiatric association published an extensively revised diagnostic manual a somewhat revised version DSMIIIR appeared in 1987DSM IV is used throughout the US and Canada is becoming widely accepted around much of he world THE DIAGNOSITIC SYSTEM OF THE AMERICAN PSYCHITIARTC ASSOCIATION DSMIV AND DSMIVTRThe term mental disorder is problematic and that no definition adequately specifies precise boundaries for the concept DSMIVTR provides the following definitionA clinically significant beh or psychological syndrome or pattern that occurs in an indiv and that is associated with present distress or disability or with a significantly increased risk of suffering death pain disability or an important loss of freedomFive dimensions of classificationMost sweeping change in the use of multiaxal classification whereby each indiv is rated on 5 separate dimensions or axesThe five axes are1 axis I all diagnosis categories except personality disorder and mental retardation2 axis II personality disorders and mental retardation3 axis III general medical conditions4 axis IV psychological and environmental problems 5 axis Vcurrent level of functioningmost ppl consult a mental health professional for an Axis I conditionalthough the remaining three axes not needed to make the actual diagnosis their inclusion in the DSM indicates that factors other than a persons symptoms should be considered in an assessment so that the persons overall life situation can be better be understoodaxis III conditions may be quite common A recent study in Toronto found that more tan half of the inpatients had an identifiable medical condition and that having an infectious disease was associated with disruptive behthese include occupational problems economic problems interpersonal difficulties with family members and a verity of problems in other life areas that may influence psychological functioninglife areas considered are social relationships occupational functioning are supposed to give info about the need for treatmentDiagnostic Categoriesthe DSM indicates that the disorder may be due to a medical condition or substances abuseDSMIII there has been a dramatic expansion of theof diagnostic categoriesIssues and possible categories in need of further study BOXCaffeine withdrawal caffeine withdrawal results in significant distress or impairment in occupational or social functioning Symptoms include headache fatigue anxiety depression nauseas and impaired thinking
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