1. Classification in Psychiatric Nursing LECTURE NO. 3

2. Learning Objectives Describe the purpose of classification in psychiatry Discuss the basis of classification in psychiatry Enumerate the various categories of psychiatric disorders Describe the international systems of classification in psychiatry

3. Introduction In general, medical conditions can be classified on the basis of: i.Aetiology i.Aetiology ii.Structural pathology ii.Structural pathology iii.Symptoms However, most psychiatric disorders are classified by symptoms only.

4. Purpose of Classification The three basic purposes of classification are: i.Comprehension i.Comprehension ii.Communication ii.Communication iii.Control of data

5. Purpose of Classification (cont.) The purposes of classification can be further expanded as follows: i.Reduces complexity i.Reduces complexity ii.Compresses knowledge and facilitates communication ii.Compresses knowledge and facilitates communication iii.Helps in deciding the treatment

6. iv.Predicts the course and prognosis of the disorder v.Controls and compiles data and helps in research v.Controls and compiles data and helps in research Purpose of Classification (cont.)

7. Basis of Classification Psychiatric disorders can be classified into: i.Functional disorders i.Functional disorders ii.Organic disorders

8. 1. Functional disorders These disorders are a heterogeneous group with no history/clinical examination suggestive of organicity and where the disorders are subclassified on the basis of shared features such as symptoms. Functional disorders can be classified into: i.Psychosis i.Psychosis ii.Neurosis

9. i. Psychosis Refers to severe forms of psychiatric disorders Patients lack insight into the disorder and lose touch with reality. Patients also are unable to differentiate between subjective experiences and external reality. An example of psychosis is schizophrenia.

11. ii. Neurosis Refers to disorders that are less severe than psychosis and the symptoms are closer to normal experiences Patients do not lose touch with external reality.

12. 2. Organic disorders These are the disorders in which the history, clinical examination or investigations suggest a cause for the disorder. Organic disorders can be classified into disorders with: i.Acute onset i.Acute onset ii.Insidious onset

13. i. Acute onset These are the disorders which are usually short-lasting and can be treated by removing or treating the cause of the disorder. For example, delirium due to diabetes can be reversed by controlling the blood sugar level.

14. ii. Insidious onset Are long lasting Can be superimposed by acute onset disorders For example, delirium in a patient with dementia.

15. Categories of Psychiatric Disorders The modern classificatory systems divide functional disorders into discrete categories such as: i.Psychotic disorders i.Psychotic disorders ii.Mood disorders ii.Mood disorders iii.Anxiety disorders iv.Personality disorders v.Childhood and adolescence disorders v.Childhood and adolescence disorders vi.Miscellaneous

16. Systems of Classification (cont.) The two major classification systems used worldwide to classify psychiatric disorders are: i.International Classification of Diseases (ICD) i.International Classification of Diseases (ICD) ii. Diagnostics and Statistics Manual of Mental Disorders (DSM)

17. Systems of Classification (cont.) The ICD-10 and the DSM-IV are parallel and compatible with each other although minor differences in nomenclature of the diagnostic categories and criteria exist between them.

18. 1. The International Classification of Diseases (ICD) The international standard diagnostic classification for a wide variety of health conditions. There are many versions of the ICD-10. ICD-10: Chapter V (F) focuses on mental and behavioural disorders.

19. 2. The Diagnostics and Statistics Manual of Mental Disorders (DSM) DSM is produced by the American Psychiatric Association (APA). Only describes mental disorders The DSM-IV is a multiaxial diagnostic system using 5 axes. A multiaxial system allows for the recording of detailed information.