This document provides an overview of mental health nursing and the classification of mental disorders. It outlines the objectives of explaining classifications of mental disorders according to the ICD-10, DSM-V systems, and differentiating between the two. Key points covered include definitions of mental illness and psychiatric nursing, the historical development of psychiatry, and classifications of disorders by the ICD-10 including organic disorders, substance use disorders, schizophrenia and mood disorders. DSM-V criteria and the axes system are also summarized. Traditional classifications of mental disorders are mentioned.

1. Mental Health Nursing
MANU SHARMA
MN 1ST YEAR
PAHS

2. • General objective
At the end of this session M.N students will able to explain
classification of mental disorder.

3. Specific Objectives:
At the end of this session, the MN first year student will be able to:
Identify the mental health illness
enlist the traditional classification of mental health illness.
Describe the ICD -10 classification of mental illness.
state the DSMV classification of mental illness
Differentiate between the ICD – 10 classification and DSMV
classification of mental illness.

4. Contd.
Mental health Nursing/ Psychiatric nursing
“ A specialty nursing practice focusing on the identification
of mental health issues, prevention of mental health
problems, and the care and treatment of persons with
psychiatric disorders.”
- The American Psychiatric Nurses Association

5. Contd.
Mental Illness
“Maladaptive response to stressors from the internal or external
environment, evidenced by thoughts, feelings and behaviors that are
incongruent with the local and cultural norms and interfere with the
individual’s social, occupational, and/or physical functioning.”
- Townsend (2009)

6. Historical development of psychiatric nursing
Psychiatry – etymology
• Psychiatry is derived from the Greek words:
- Psyche: meaning “Mind” or “soul”
- Iatros: meaning “Physician”
• The term was coined by the German Physician Johann Christian Reil
in 1808

7. Classification of Mental Illness according to ICD 10
• The International Statistical Classification of Diseases and Related
Health Problems, usually cited by short form: ICD ( International
Classification of Disease)
• It is : “standard diagnostic tool for epidemiology, health management
and clinical purpose”
• Published by WHO

8. Major Classification of Mental Disorder/ Illness
Traditional Classification of Mental Illness(Neurosis and Psychosis)
• DSM V

10. F00-F09 Organic, including symptomatic, mental disorders
• F00 Dementia in Alzheimer's disease
• F01Vascular dementia
• F02 Dementia in Pick's disease(frontal lobe)
• F03Unspecified dementia
• F04Organic amnesic syndrome,
• F05 Delirium, not induced by alcohol and other psychoactive
substances

11. • F06 Other mental disorders due to brain damage and
dysfunction and to physical disease
• F07 Personality and behavioral disorder due to brain disease,
damage and dysfunction
• F09 Unspecified organic or symptomatic mental disorder

12. F10--F19 Mental and behavioural disorders due
to psychoactive substance use
• F10 Mental and behavioral disorders due to use of alcohol
• F11Mental and behavioral disorders due to use of opioids
• F12Mental and behavioral disorders due to use of
cannabinoids
• F13Mental and behavioral disorders due to use of sedatives
or hypnotics
• F14Mental and behavioral disorders due to use of cocaine
• F15Mental and behavioral disorders due to use of other
stimulants, including caffeine

13. • F16Mental and behavioral disorders due to use of
hallucinogens
• F17Mental and behavioral disorders due to use of tobacco
• F18Mental and behavioral disorders due to use of volatile
solvents
• F19Mental and behavioral disorders due to multiple drug use
and use of other psychoactive substances

14. F20-F29 Schizophrenia, schizotypal and delusional
disorders
F20 Schizophrenia
F20.0 Paranoid schizophrenia
 F20.1 Hebephrenic schizophrenia
F20.2 Catatonic schizophrenia
F20.3 Undifferentiated schizophrenia
F20.4 Post-schizophrenic depression
F20.5 Residual schizophrenia
F20.6 Simple schizophrenia
F20.8 Other schizophrenia
F20.9 Schizophrenia, unspecified

15. • F21schizotypal
• F22 persistent delusional disorder
• F23 acute polymorphic psychotic disorder without symptoms of
schizophrenia.
• F24 Induced delusional disorder
• F25 Schizo affective disorder
• F28 Other non organic psychotic disorder
• F29 unspecified non organic psychosis

16. F30-F39 Mood [affective] disorders
• F30 Manic episode
• F30.0 Hypomania
• F30.1 mania without psychiatric symptom
• F30.2 Mania with psychotic symptoms
• F30.8 Other manic episodes
• F30.9 Manic episode, unspecified
• F31. Bipolar affective disorder

17. F31 Bipolar affective disorder
• F31.0 Bipolar affective disorder, current episode
hypomanic
• F31.1Bipolar affective disorder, current episode manic
without psychotic symptoms
• F31.2Bipolar affective disorder, current episode manic
with psychotic symptoms
• F31.3Bipolar affective disorder, current episode mild
or moderate depression Depression 17

18. F31 Bipolar affective disorder contd..
• F31.4Bipolar affective disorder, current
episode severe depression without psychotic
symptoms
• F31.5Bipolar affective disorder, current
episode severe depression with psychotic
symptoms
Depression 18

19. F31 Bipolar affective disorder contd..
• F31.6Bipolar affective disorder, current
episode mixed
• F31.7Bipolar affective disorder, currently in
remission
• F31.8Other bipolar affective disorders
• F31.9Bipolar affective disorder, unspecified
Depression 19

20. F32 Depressive episode
F 32.0 Mild depressive episode
F 32.1 Moderate depressive episode
• F32.2 Severe Depressive Episode
• F32.3 Severe Depressive Episode With Psychotic Symptoms.
• F33 Recurrent Depressive Disorder
• F 34 Persistent Mood Affective Disorder
- F34.0 cyclothymia
-F34.1 Dysthymia

21. F40-F48 Neurotic, stress-related and
somatoform disorders
• F40 Phobic anxiety
• F40.0 agrophobia
• F40.1 socio phobias
• F40.2 specific phobia
• F41 other anxiety disorder
• F41.0 panic disorder
• F41.1 generalized anxiety disorder

22. • F42 Obsessive - compulsive disorder
• F43 Reaction to severe stress, and adjustment disorders
• F43.0 acute stress reaction
 F43.1 post traumatic stress disorder
 F43.2 adjustment disorder

23. F44 Dissociative [conversion] disorders
• F44.0 Dissociative amnesia
• F44.1 Dissociative fugue
• F44.2 Dissociative stupor
• F44.3 trance and possession disorder
• F44.4 Dissociative motor disorder
• F44.5 Dissociative convulsion
• F44.6 Dissociative anesthesia and sensory loss
• F44.7 mixed Dissociative disorder

24. F44.8 other Dissociative disorders
Gansers syndrome
Multiple personality disorder
Transient dissociative disorder occurring in childhood and
adolescence

25. • F45 somatoform disorder
• F45.0 somatization disorder
• F45.1 undifferentiated somatoform disorder
• F45.2 hypochondrial disorder
• F45.3 somatoform autonomic dysfunction
• F45.4 persistent somatoform pain disorder

26. • F48 other neurotic disorder
• F48.0 neurasthenia
• F48.1 depersonalization – derealization syndrome

27. F50-F59 Behavioural syndromes associated with
physiological disturbances and physical factors
• F50 Eating Disorder
F50.0 Anorexia Nervosa
F50.1atypical Anorexia Nervosa
F50.2 Bulimia Nervosa
F50.3 Atypical Bulimia Nervosa

28. F51 Nonorganic Sleep Disorders
F51.0 nonorganic insomnia
F51.1 nonorganic hypersomnia
F51.2 non organic disorder of sleep wake schedule
F51.3 sleep walking
F31.4 sleep terrors
F51. 5 Nightmare

29. F52 Sexual dysfunction, not caused by organic disorder or
 F52.0 lack or loss of sexual desire
 F52.1sexual aversion and lack of sexual enjoyment
 F52.3 failure to genital response
 F52.4 orgasmic dysfunction
 F52.5 premature ejaculation
 F52.6 non organic dyspareunia
 F52.7 excessive sexual drive

30. • F53 Mental and behavioural disorders associated with the puerperium,
• F54Psychological and behavioural factors associated with disorders or
diseases classified elsewhere

31. F55 Abuse of non-dependence-producing substances
 F55.0 antidepressant
 F55.1 laxatives
 F55.2 analgesic
 F55.3 antacids
 F55.4 vitamins
 F55.5 steroids or hormones
 F55.6 specific herbal or folk remedies

32. F60-F69 Disorders of adult personality and
behaviour
• F60 Specific personality disorders unspecified
• F60.0paranoid personality
• F60.1 schizoid personality disorder
• F60.2 dissocial personality disorder
• F60.3 emotionally unstable personality
• F60.4 histrionic personality disorder
• F60.5 anankastic personality disorder
• F60.6 anxious personality disorder
• F60.7 dependent personality disorder

33. • F61 Mixed and other personality disorders
• F62 Enduring personality changes, not attributable to brain damage
and disease

34. • F63 Habit and impulse disorders unspecified
• F63.0 pathological gambling
• F63.1 pathological fire setting
• F63.2 pathological stealing
• F63.3 trichotillomania
• F64 Gender identity disorders
• F64.0transsexualiasm
• F64.1 dual role transvestism
• F64.2 gender identity disorder of childhood

35. F65 Disorders of sexual preference
• F65.0 Disorders of sexual preference Fetishism
• F65.1 Fetishistic transvestism
• F65.2 Exhibitionism
• F65.3 Voyeurism
• F65.4 Paedophilia
• F65.5 Sadomasochism
• F65.6 Multiple disorders of sexual preference -

36. F68 Óther disorders of adult personality and behaviour
F69 Unspecified disorder of adult personality and behaviour

37. F66 Psychological and behavioural disorders associated
with sexual development and orientation
• Sexual maturation disorder -F66.0
• Ego dystonic sexual orientation -F66.1
• Sexual relationship disorder -F66.2
• A fifth character may be used to indicate association with:
• Heterosexuality
• Homosexuality
• Bisexuality
• Other, including pre-pubertal
• F68 Other disorders of adult personality and behaviour
• F69 Unspecified disorder of adult personality and behaviour

38. • F70-F79: MENTAL RETARDATION
• F70 Mild mental retardation
• F71 Moderate mental retardation
• F72 Severe mental retardation
• F73 Profound mental retardation
• F78 Other mental retardation
• F79 unspecified mental disorder

39. F80-F89: DISORDERS OF PSYCHOLOGICAL DEVELOPMENT
• F80 Specific developmental disorders of speech and language
• F80.0 Specific speech articulation disorder
• F80.1 Expressive language disorder
• F80.2 Receptive language disorder
• F80.3 Acquired aphasia with epilepsy [Landau-Kleffner syndrome.)

40. F81 . Specific developmental disorder of scholastic skills
• F81.0 Specific reading disorder
 F81.1 Specific spelling disorder
 F81.2 Specific disorder of arithmetical skills
F81.3 Mixed disorder of scholastic skills
• F82 Specific developmental disorder of motor function
• F83 Mixed specific developmental disorders Pervasive developmental
disorders

41. F84 pervasive developmental disorder
 F84.0 Childhood autism
F84.1 Atypical autism
F84.2 Rett's syndrome
F84.3 Other childhood disintegrative disorder
F84.4 0veractive disorder associated with mental retardation
and stereotyped movements
F84.5 Asperger's syndrome
• F88 Other disorders of psychological development
• F89 Unspecified disorder of psychological development

42. F90-F98: BEHAVIOURAL AND EMOTIONAL DISORDERSWITH
ONSET USUALLY OCCURRING IN CHILDHOOD AND
ADOLESCENCE
• F90 Hyperkinetic disorders
• F91 Conduct disorders
• F92 Mixed disorders of conduct and emotions
• F93 Emotional disorders with onset specific to childhood
 Separation anxiety disorder of childhood F 93.0
 Phobic anxiety disorder of childhood F93.1
 Social anxiety disorder of childhood F93.2
 Sibling rivalry disorder F93.3

43. F94 Disorders of social functioning with onset specific to
childhood and adolescence
F95 Tic disorders
Transient tic disorder F95.0
Chronic motor or vocal tic disorder F95.1
 Combined vocal and multiple motor tic disorder [Tourette's
syndrome] -F95.2

44. • F98 Other behavioural and emotional disorders with onset usually
occurring in childhood and adolescence
Nonorganic enuresis -F98.0
Nonorganic encopresis -F98.1
 Feeding disorder of infancy and childhood F98.2
Pica of infancy and childhood F98.3
Stereotyped movement disorders F98.4
Stuttering [stammering] F98.5
Cluttering F98.6
• F99 Unspecified mental disorder
• F99 Mental disorder, not otherwise specified

45. • Traditional classification
Nice to know

46. Mental Disorders
Psychosis Neurosis
- Anxiety disorder
- OCD
- Dissociative
disorder
Special disorders
- Childhood disorders
- Personality disorders
- Substance use
disorders
- Somatoform
disorders
- Mental retardation
Affective
- Mania
- Depression
- Bipolar/ cyclic
Functional
- Schizophrenia
Organic
- Delirium
- Dementia

47. The DSM - IV
• The diagnostic and Statistical Manual of Mental Disorders (DSM)
published by American Psychiatric Association, offers a common
language and standard criteria for the classification of mental
disorders.
• Used together with the alternatives such as ICD

48. Contd.
The DSM – IV – TR (text Revision, 2000) consisted of five axes (domains)
on
Which disorder could be assessed. The Five axes were:
Axis I: Clinical Disorders (all mental disorders except Personality Disorders
and Mental Retardation)
Axis II: Personality Disorders and Mental Retardation
Axis III: General Medical Conditions (must be connected to a Mental
Disorder)

49. Contd.
Axis IV: Psychosocial and Environmental Problems (for example
limited social support network)
Axis V: Global Assessment of Functioning (Psychological, social and
job-related functions are evaluated on a continuum between
mental health and extreme mental disorder)

50. The Dx criteria and codes in DSM -5
1.2.1 Neurodevelopmental disorder.
1.2.2 schizophrenia spectrum and other psychiatric disorder
1.2.3 bipolar and related disorder.
1.2.4 depressive disorder
1.2.5 anxiety
1.2.6 OCD related disorder
1.2.7 trauma related disorder
1.2.8 dissociative disorder

51. • 1.2.9 somatic symptom
• 1.2.10 feeding and eating disorder
• 1.2.11 sleep wake disorder
• 1.2.12 sexual dysfunction
• 1.2.13 gender dysphoria
• 1.2.14 disruptive impulse control.
• 1.2.15 substance related and addictive disorder
• 1.2.16 neurocognitive disorder
• 1.2.17 paraphilic disorder
• 1.2.18 personality disorder

52. Summary
• Mental Health
• Classification
1. Indian classification
2. ICD Classification
3. DCMV Classification

53. References
• Ahuja N.A short Textbook of Psychiatry.7thed. New Delhi:Jaypee
Brothers Medical Publishers (P)Ltd;2011.
• Sreevani R. A Guide to Mental Health and Psychiatric Nursing .4th
ed.New Delhi:Jaypee Brothers ;2018.
• Sharma C, sharma p, Essentials of Psychiatric and Mental Health
Nursing.3rd ed.Kathmandu:Saurav and Awish ;2019.
• World Health Organization (WHO).ICD -10:International statistical
classification of diseases and related health problem.Tenth revision
,2nd ed.Geneva:WHO ;2004.Retrived from
https://www.who.int/classifications/icd/en/bluebook.pdf on 5th
April,2021