ICD 10 Classification In Psychiatry

6,432 views

Published on

ICD 10 Classification In Psychiatry

Published in: Health & Medicine, Technology

ICD 10 Classification In Psychiatry

  1. 1. Dr. Renjan Roy Mathew Clinical Psychologist
  2. 2. Definitions… <ul><li>Taxonomy </li></ul><ul><ul><li>Classification of entities for scientific purposes </li></ul></ul><ul><li>Nosology </li></ul><ul><ul><li>Classification system that applies to clinical areas </li></ul></ul><ul><li>Nomenclature </li></ul><ul><ul><li>Names or labels that make up the nosology </li></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  3. 3. Classification ? <ul><li>Method of grouping of items scientifically </li></ul><ul><li>According to purpose & </li></ul><ul><li>Codifying them with numerical (or alpha-numerical) identification </li></ul><ul><li>According to certain principles </li></ul>© Dr. Renjan Roy Mathew [email_address]
  4. 4. History of Classification <ul><li>Ayurveda </li></ul><ul><li>Plato </li></ul><ul><ul><li>4 th Century B.C </li></ul></ul><ul><li>Asclepiades </li></ul><ul><ul><li>1 st Century B.C </li></ul></ul><ul><li>Current popular systems </li></ul><ul><ul><ul><ul><li>ICD-10 (1992) - WHO </li></ul></ul></ul></ul><ul><ul><ul><ul><li>DSM-IV (1994) - APA </li></ul></ul></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  5. 5. Classification systems <ul><li>Categorical Approach </li></ul><ul><ul><li>Emil Kraepelin </li></ul></ul><ul><ul><li>Pathophysiological course </li></ul></ul><ul><ul><li>Useful in medicine </li></ul></ul><ul><ul><li>Biopsychosocial Interaction </li></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  6. 6. Classification systems <ul><li>Dimensional Approach </li></ul><ul><ul><li>Quantitative rating of A-B-C on a scale to create a profile of functioning </li></ul></ul><ul><ul><li>No agreement on the number of dimensions for a particular functioning </li></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  7. 7. Classification systems <ul><li>Prototypical Approach </li></ul><ul><ul><li>Identifies certain essential characteristics </li></ul></ul><ul><ul><li>Allows for variation in other characteristics that are often associated with the disorder </li></ul></ul><ul><ul><li>Overlap of symptoms </li></ul></ul><ul><ul><ul><li>Sleep disorder & mood disorders </li></ul></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  8. 8. Validity of diagnostic systems <ul><li>Validity </li></ul><ul><ul><li>Construct validity </li></ul></ul><ul><ul><ul><li>Symptoms chosen as criteria are consistently associated with the disorder </li></ul></ul></ul><ul><ul><li>Predictive validity </li></ul></ul><ul><ul><ul><li>The extent to which a diagnosis is able to predict the course of the disorder and the likely effect of treatment </li></ul></ul></ul><ul><ul><li>Content validity </li></ul></ul><ul><ul><ul><li>The extend to which a diagnosis reflect what experts in that field think of a diagnosis </li></ul></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  9. 9. Reliability of diagnostic systems <ul><li>Reliability </li></ul><ul><ul><li>The degree to which a measurement is consistent </li></ul></ul><ul><ul><li>The extent to which different clinicians agree in identifying a disorder </li></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  10. 10. Major purposes of classification <ul><li>To enhance communication </li></ul><ul><li>To enhance reliability </li></ul><ul><li>To comprehend regarding the etiology </li></ul><ul><li>To understand the prognosis </li></ul><ul><li>To aid in Medico-legal issues </li></ul><ul><li>To formulate the management plan </li></ul>© Dr. Renjan Roy Mathew [email_address]
  11. 11. ICD 10 <ul><li>The purpose of the ICD is to permit </li></ul><ul><ul><li>Systematic recording </li></ul></ul><ul><ul><li>Analysis </li></ul></ul><ul><ul><li>Interpretation and comparison of mortality & morbidity data collected in different countries or areas and at different times </li></ul></ul><ul><li>Translate diagnoses of diseases from words into an alphanumeric code </li></ul><ul><ul><li>Easy storage, retrieval & analysis of the data </li></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  12. 12. Extended Purpose <ul><li>To classify data recorded under headings </li></ul><ul><ul><li>Diagnosis </li></ul></ul><ul><ul><li>Reason for admission </li></ul></ul><ul><ul><li>Conditions treated </li></ul></ul><ul><ul><li>Reason for consultation </li></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  13. 13. <ul><li>ICD WAS NOT BUILT IN A DAY </li></ul>© Dr. Renjan Roy Mathew [email_address]
  14. 14. Evolution of ICD <ul><li>Nosologia Methodica </li></ul><ul><ul><li>Francois Bossier de Lacroix (1706-1777) </li></ul></ul><ul><li>Genera Morborum </li></ul><ul><ul><li>Linnaeus </li></ul></ul><ul><li>Synopsis Nosologiae Methodicae </li></ul><ul><ul><li>William Cullen (1710-1790) simplified the system for general use and published </li></ul></ul><ul><li>William Farr (1807-1883) </li></ul><ul><ul><li>First medical statistician who spelt out principles that should govern a statistical classification of disease </li></ul></ul><ul><ul><li>Urged the adoption of a uniform classification internationally </li></ul></ul><ul><ul><li>Jacques Bertillon ( 1893 ) </li></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  15. 15. Volumes of ICD10 <ul><li>Volume 1 </li></ul><ul><ul><li>Main classifications </li></ul></ul><ul><li>Volume 2 </li></ul><ul><ul><li>Guidance to users </li></ul></ul><ul><li>Volume 3 </li></ul><ul><ul><li>Alphabetical Index </li></ul></ul><ul><li>21 chapters </li></ul>© Dr. Renjan Roy Mathew [email_address]
  16. 16. Chapters of ICD-10 <ul><li>Chapters I to XVII </li></ul><ul><ul><li>Diseases and other morbid conditions </li></ul></ul><ul><li>Chapter XVIII </li></ul><ul><ul><li>Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified. </li></ul></ul><ul><li>Chapter XIX </li></ul><ul><ul><li>Injuries, poisoning and certain other consequences of external causes. </li></ul></ul><ul><li>Chapter XX </li></ul><ul><ul><li>External causes of morbidity and mortality, </li></ul></ul><ul><li>Chapter XXI </li></ul><ul><ul><li>Factors influencing health status and contact with health services. </li></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  17. 17. Structure and Principles of ICD <ul><li>Originally conceived by William Farr </li></ul><ul><li>The Classification is grouped as below </li></ul><ul><li>- Epidemic diseases </li></ul><ul><li>- Constitutional or general diseases </li></ul><ul><li> - Local diseases arranged by site </li></ul><ul><li> - Developmental diseases </li></ul><ul><li> - Injuries </li></ul>© Dr. Renjan Roy Mathew [email_address]
  18. 18. Mental and Behavioral Disorders (ICD-10) <ul><li>F00- F09 </li></ul><ul><ul><li>Organic including Symptomatic Mental Disorders </li></ul></ul><ul><li>F10- F19 </li></ul><ul><ul><li>Mental and Behavioral Disorders due to Psychoactive Substance Use </li></ul></ul><ul><li>F20- F29 </li></ul><ul><li>Schizophrenia, Schizotypal and Delusional Disorders </li></ul>© Dr. Renjan Roy Mathew [email_address]
  19. 19. Mental and Behavioral Disorders (ICD-10) <ul><li>F31- F39 </li></ul><ul><ul><li>Mood (Affective) Disorders </li></ul></ul><ul><li>F40-F48 </li></ul><ul><ul><li>Neurotic, Stress-Related and Somatoform Disorders </li></ul></ul><ul><li>F50-F59 </li></ul><ul><ul><li>Behavioral Syndromes Associated with Physiological Disturbances and Physical Factors </li></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  20. 20. Mental and Behavioral Disorders (ICD-10) <ul><li>F60- F69 </li></ul><ul><ul><li>Disorders of Adult Personality and Behavior </li></ul></ul><ul><li>F70-F79 </li></ul><ul><ul><li>Mental Retardation </li></ul></ul><ul><li>F80-F89 </li></ul><ul><ul><li>Disorders of Psychological Development </li></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  21. 21. Mental and Behavioral Disorders (ICD-10) <ul><li>F90- F98 </li></ul><ul><ul><li>Behaviroal and Emotional Disorders with Onset usually occurring in childhood and Adolescence </li></ul></ul><ul><li>F99 </li></ul><ul><ul><li>Unspecified Mental Disorders </li></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  22. 22. Multi-Axial Classification <ul><li>Axis I </li></ul><ul><ul><li>Clinical Psychiatric diagnosis </li></ul></ul><ul><ul><ul><li>Schizophrenia-catatonic type </li></ul></ul></ul><ul><li>Axis II </li></ul><ul><ul><li>Personality Disorders and Mental Retardation </li></ul></ul><ul><li>Axis III </li></ul><ul><ul><li>General Medical Conditions </li></ul></ul><ul><ul><ul><li>Diabetes mellitus </li></ul></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  23. 23. Multi-Axial Classification <ul><li>Axis IV </li></ul><ul><ul><li>Psychosocial and Environmental Problems </li></ul></ul><ul><ul><ul><li>Martial discord </li></ul></ul></ul><ul><li>Axis IV </li></ul><ul><ul><li>Global Assessment of Functioning </li></ul></ul><ul><ul><ul><li>Current and in one year (rated on a scale) </li></ul></ul></ul>© Dr. Renjan Roy Mathew [email_address]
  24. 24. Problems encountered <ul><li>Size of the Classification </li></ul><ul><li>No formal training </li></ul><ul><li>No user-friendly software to guide </li></ul><ul><li>No abridged Classification of Diseases based on Indian condition & requirement </li></ul><ul><li>No Online Help-line system </li></ul>© Dr. Renjan Roy Mathew [email_address]
  25. 25. © Dr. Renjan Roy Mathew [email_address]

×