Classification of Psychiatric Disorders Chapter Two

Mental Disorder/Psychiatric Disorder Is an illness with psychogenic or behavioral manifestations associated with impairment in functioning due to biologic, social, psychogenic, genetic, physical and chemical disturbances. Each illness has characteristics signs and symptoms

Two main Classification Systems ICD 10 (International Classification of Diseases) DSM 5 (Diagnostic and Statistical Manual) Over 200 types of psychiatric illness are classified and according to ICD 10 the main categories of illness or disorders are-

The main categories of ICD 10 Organic including symptomatic, mental disorders Mental and behavioral disorders due to psychoactive substance use. Schizophrenia, Schizotypal and Delusional disorder. Mood (Affective) disorders Neurotic, Stress related and Somatoform disorder. Behavioral syndromes associated with physiological disturbance and physical factors Disorders of adult personality and behaviour Mental retardation Disorders of psychological development Behavioral and emotional disorders with onset usually occurring in childhood or adolescences.

Classification of psychiatric disorders (Davidson) Stress related disorders Acute stress disorder Adjustment disorder Post-traumatic disorder Anxiety disorders Generalized anxiety Phobic anxiety Panic anxiety Obsessive-compulsive anxiety Affective mood disorders Depressive disorder Mania and bipolar disorder Schizophrenia and delusional disorders Substance misuse disorders Alcohol Drugs

Disorders of adult personality and behavior Personality disorder Organic disorders Acute, e.g. delirium Chronic, e.g. dementia Disorders of adult personality and behavior Personality disorder Factitious disorder Eating disorders Anorexia nervosa Bulimia nervosa Somatoform disorders Somatisation disorder Dissociative (conversion) disorder Pain disorder Hypochondriasis Body dysmorphic disorder Somatoform autonomic dysfunction Neurasthenia Puerperal mental disorders

Old Classification of Psychiatric Disorders Organic Psychiatric Disorders Functional Psychiatric Disorders Major/Psychosis Minor/Neurosis Others

Difference between Psychosis and Neurosis I. Etiology i. Genetic factors More important (in disorders like schizophrenia, mood disorders etc.) Less important (important in making a personality vulnerable) ii. Stressful life events Less important More important II. Psychopathology Personality disintegration Total Partial

III. Clinical Features i. Touch with reality Lost Not ii. Insight into the illness Lost (Patient usually brought by the relatives). Present (Patient himself comes for treatment). iii. Judgment Impaired Intact iv. Social relationships and behavior Markedly affected Usually not affected v. Neglect of Personal hygiene May be present vi. Disturbances of memory, orientation, consciousness and intelligence Common (in organic psychoses) Rare vii. Disturbances of thinking (delusions) and Perception (illusions and hallucinations) Common Rare

IV. Treatment i . Electroconvulsive Very useful (in Not useful therapy Functional Psychoses) ii. Drugs Neuroleptics (Major Minor tranquillizers and tranquillizers) and anti - depressants antidepressants commonly used commonly used iii. Psychotherapy Supportive type (useful Analytic, supportive and when the patient is in other types very useful. remission )

V. Prognosis Difficult to treat. Recovery may not be possible. Relapses are common Easy to treat. Recovery is possible and complete. Relapses are uncommon

The END