Psychiatry for Physicians: Classification - Part 1
Classification in psychiatry is important due to three main reasons. They are
1) For providing a language for communication in clinical setting.
2) To study the natural history of a disease & develop effect treatment.
3) To understand the causes of disease.
In my description I will mainly take guideline from the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association. But before proceeding towards classification of mental disorder we must understand what mental disorder is or how the classification system defines mental disorder. In the DSM IV mental disorder has been assumed to have the following criteria
1) Clinical significance
2) Association with practical difficulty
3) Association with increase in risk of other untoward conditions
4) Unacceptability and not expected
5) Neither deviation nor conflict primarily
The main problem in the DSM is its limitation in defining boundaries, especially in between normal and pathological patterns. One must remember that the pattern we are talking about is of the condition a person has, not of the person himself or herself.
The trend of classifying mental disorder was very feeble starting from 1840 to 1880. Mental disorder was considered as a single disease that meant insanity for the society. Then in 1880 eight classes of mental disorders were established. Afterwards the World Health Organization established the International Classification of Diseases and Related Health Problems for mental disorders and the American Psychiatric Association established the Diagnostic and Statistical Manual of Mental Disorders. The first version of DSM was published in 1952 with 106 categories of disorders. The DSM II was published in 1968 with 182 categories of disorders. The DSM III was published with 265 categories of disorders. The DSM III R was published in 1987 with 292 diagnoses. In 1994, the DSM IV was published with 297 categories of disorders. The DSM IV TR was published in the year 2000 with no increase in the number of disease categories.
I am avoiding the details about ICD because I want to utilize one of the two trends for my descriptions so that the description does not get ambiguous.
About the Author:
Dr. Mohammad Samir Hossain PhD is a researcher teacher of Psychiatry and a Psychotherapist in Bangladesh. He is renouned for his educational and research activity in mental health sector nationally and internationally. The Dictionary of International Biography cites his brief biography starting from its 33rd edition. One of the best educational institutions involved with his educational activity is the Harvard Medical School of USA. Visit his personal page at http://www.samirhossain.org
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