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.
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