Thursday, January 28, 2021

Classification of Psychopathology

Psychopathology

          The science that studies and diagnose psychological disorders.

 


Introduction

          Classification is the central component of science which is a process to construct categories and to assign people to these categories on the basis of their attributes. It improves the objectivity, understanding and ease of handling. Taking cue from this the Psychological disorders are also classified into different categories. So, that exact diagnosis & etiology of the disorder can be assessed and subsequently best suitable treatment can be designed.

 

Terms Used in Psychopathology in Comparison to Pathology

          Client in place of Patient

          Disorder in place of Disease

          Talking cure in place of Medicines

          Formulation in place of diagnosis, symptoms and etiology.

 

Classification Approaches

          There are three approaches to classify Psychological Disorders.

(i)       Categorical approach

(ii)      Dimensional approach

(iii)     Prototypical approach

 

(i)      Categorical approach - This approach assumes that each mental disorder is distinct and exclusive from others. A categorical approach to classification assumes that distinctions among members of different categories are qualitative.

Kraepelin classified the psychological disorders from a biological perspective for the first time. According to him every mental disorder has one defining criteria, which everybody in the category should meet, e. g. Schizophrenia. Once a category has been defined then an individual is either a member of the category or not.

(ii)     Dimensional approach - In this approach, various cognitive dimensions of the client are observed and quantified using a rating scale. For example, on a scale of 1 to 5, a client’s depression is rated, 5 is for severe depression, 4 for significant 3 for mild 2 for border line 1 for insignificant. This approach assumes that cognitive components and personality traits exists in continuity in other words they are continuous variables. Other important assumption of this approach is that cognitive components can be quantified.

(iii)     Prototypical approach: This approach identifies certain defining features of a disorder. This approach is flexible and allows room for existence of other normal features in the individual along with defining features that have no role in classification. This approach suggests that an individual should meet some criterion [not all] to be included in to a particular classification. For example, to designate an individual suffering from depression, he should manifest at least 3 symptoms out of are five important symptoms

          (a)      In depressed condition all day,

          (b)      Significant weight loss (5% of total body weight),

          (c)      Severe insomnia,

          (d)      Acute fatigue and

          (e)      Sustained and continuous feeling of worthlessness.

 

History of Classification

          Hippocrates (460–370 B.C.) classified mental illness into delirium, mania, paranoia, hysteria and melancholia. Philippe Pinel’s (1745–1826) classified mental disorders on the basis of functional disorders of nervous system. He described four functional disorders: dementia, mania, melancholia and idiotism. Karl Ludwig Kahlbaum (1828-1899) differentiated between organic and non-organic mental disorders.

 

          Emil Kraepelin’s (1856-1926) classified mental disorders on the basis of clinical features of disorders: cause, course and outcomes in manic depressive psychosis and dementia. Eugen Bleuler combined Kraepelin and Meyerian approaches and classified mental disorders on the basis of psychopathological processes.

 

          The oldest systematic classification of diseases is found in the Ayurveda. The publication of International Statistical Classification of Diseases and Related Health Problems-1 (ICD-1) by the World Health Organization in 1900 initiated the process of classification of physical diseases. But mental disorders could not find its place in this publication. It took almost 49 years for recognition and subsequent classification of mental disorders in ICD-6. The ICD-10 (1992) which is the outcome of Copenhagen conference held in 1982. The chapter V (F) of ICD-10 deals with the classification of mental disorders. The latest publication of WHO is ICD-11 (2019) chapter 06 contains Mental, behavioural and neurodevelopmental disorders.

 

Description by ICD-11

          Mental, behavioural and neurodevelopmental disorders are syndromes characterized by clinically significant disturbance in an individual's cognition, emotional regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes that underlie mental and behavioural functioning. These disturbances are usually associated with distress or impairment in personal, family, social, educational, occupational, or other important areas of functioning.

Classification of mental disorders as per ICD-10

(i)    F00-F09: Organic, including symptomatic, mental disorders: Dementia, delirium.

(ii)      F10-F19: Mental and behavioural disorders due to use of psychoactive

substances: Alcohol, cocaine and tobacco.

(iii)     F20-F29: Schizophrenia, schizotypal and delusional disorders.

(iv)     F30-F39: Mood (affective) disorders: Manic, bipolar, depressive.

(v)     F40-F48: Neurotic, stress-related and somatoform disorders: Phobia, OCD, adjustment, dissociative.

(vi)     F50-F59: Behavioural syndromes associated with physiological disturbances and physical factors: Eating, sleep, sexual disorders.

(vii)    F60-F69: Disorders of personality and behaviour in adult persons: Specific, impulse disorder, gender identity.

(viii)   F70-F79: Mental retardation

(ix)   F80-F89: Disorders of psychological development: Speech and language, pervasive development.

(x)      F90-F98: Behavioural and emotional disorders with onset usually occurring in childhood and adolescence: Hyperkinetic, conduct, tic.

(xi)     F-99: Unspecified mental disorders

 

References:

1.       Verma, L. P. (1965). Psychiatry in ayurveda. Indian J Psychiatry.           1965;7:292.

2.       पांडेय, जगदानंद. (1956). असामान्य मनोविज्ञान. पटना: ग्रंथमाला प्रकाशन           कार्यालय।

3.       http://egyankosh.ac.in/bitstream/123456789/21119/1/Unit-2.pdf.

4.       https://icd.who.int/browse11/l-m/en.

 

******

No comments:

Post a Comment

Yoga Day Meditation at Home