Mental disorder classification

1. Classification of
Psychiatric Disorders
Dr. Khalid Bazaid, MB BS, FRCPC
Assistant Professor & Consultant
Child & Adolescent Psychiatrist
College of Medicine
King Saud University

2. Introduction:
 Most of physical conditions are classified on the basis of
etiology, e.g.: viral pneumonia.
Or
On the basis of structural pathology, e.g.:
Bronchopneumonia.
Or
Based on symptoms, e.g. migraine.
 Psychiatric disorders are diagnosed based mainly
on symptoms.
Few are based on etiology e.g. Alzheimer’s
disease.

3. Purposes of Classification:
1. To make generally acceptable diagnosis.
2. To facilitate communication between psychiatrists,
other doctors and professionals.
3. To make generalizations in treatment response,
course & prognosis of individual patients.
4. To make framework for research in psychiatry.

4. Types of Classification
1. Categorical Classification:
- Grouping disorders into separate entities according to
symptom – pattern, course and outcome.
- It includes hierarchal categories.
e.g.: Organic mental disorders then functional psychotic
disorders (e.g. Schizophrenia) then neurotic disorder
(e.g. generalized anxiety disorder) then personality
disorders.
- Also it includes in-built hierarchy of significance
within the disorders themselves.
e.g.: Anxiety symptoms occur commonly with depressive
disorder.

5. 2. Dimensional Classification:
- Diagnosing individual patients by giving scores on
separate dimensions.
e.g. Psychoticism, neuroticism, introversion and
extroversion

6. 3. Multiaxial Approach:
- Applied to schemes of classifications in which two or
more separate sets of information are coded
e.g. DSM, ICD

7. CLASSIFICATION
Organic d.
………
.........
………
Childhood
ICD10
Childhood d.
cognitive d.
………
………
………
1-Psych. Dis.
2- M.R.
Personality d.
3- Physical illness
4- Stresses
5-Functioning level
Multiaxial
⇨
DSM 4

8. Psychiatric Disorders
Organic
(Body)
Non-Organic
(Mind)
Chronic
Dementia
Korsakoff
Others
Alcohol …
Head Injury
Etc….
Acute
Delirum
Wernicke’s
Psychoses
Schizophrenia
Mood disorders
Etc….
Neuroses
Anxiety disorders
Adjustment dis.
Dysthymia
Dissociative dis.
Others
Personality dis.
Sleep disorder
Sex disorder
Etc…

9. Neurosis and Psychosis
Psychosis:
- unsatisfactory term
- refers broadly to severe forms of mental disorders such
as:
a. organic mental diseases
b. schizophrenia
c. affective disorders
Characteristics:
- greater severity
- lack of insight
- patient’s inability to distinguish between subjective
experience and reality e.g. hallucinations, delusions.

10. Neurosis and Psychosis
Neurosis:
- unsatisfactory term.
- Refers to mental disorders that are generally less severe
than psychosis.
Characteristics:
- Symptoms are closer to normal experience e.g. anxiety.

11. Psychosis
Neurosis
Major mental illness
Abnormal in quality
e.g. hallucinates
Affected
Drugs & ECT
Minor mental illness
Abnormal in quantity
e.g. anxiety
Preserved
Psychological & drugs
Severity
Features
Insight
Treatment

12. NEGATIVE FEATURES
Poverty of thoughts & speech.
Lack of ambition interest &
initiation.
Restricted affect.
Self-neglect.
Poor self care & hygiene

13. Features Suggesting of Organic Mental Illness:
1. Disturbed consciousness.
2. Disturbed cognitive functions:
a. Attention and concentration
b. Orientation: time, place & person
c. Memory : immediate, recent and remote
3. Presence of physical illness e.g. DM, HTN
4. Presence of neurological features e.g. dysarthria &
ataxia.
5. Old age onset.