1Dx & Classification 462Psych Prof. Alsughayir

2 Lecture Title : Diagnosis & Classification in Psychiatry Level : 4 th year Medical Students Lecturer : Prof. Mohammed Alsughayir أد محمد الصغـيّر

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. 3Introduction 462psych Prof. Alsughayir

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

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

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

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 7Dx & Classification 462Psych Prof. Alsughayir

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

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. 10Dx & Classification 462Psych Prof. Alsughayir

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

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. 12Dx & Classification 462Psych Prof. Alsughayir Summary

Reference Basic Psychiatry,Prof. Alsughayir chapter 4 (P ). Etiology 462psych Prof. Alsughayir13