Last Updated on May 5, 2021 by Atif
There are plenty of mental health disorders in the world. Each one has its own set of symptoms. This is a vast topic with lots of potentials to study. Debates are going on in the medical and psychiatric fields. An accurate diagnosis can help a patient to get relevant treatment. Whereas an incorrect diagnosis can cost a patient’s life. Detailed evaluation can equip the patient with effective care and methods to deal with symptoms of any co-occurring disorders.
Who can Determine the Criteria for the Diagnostic and Statistical Manual of Mental Disorders (DSM)?
The diagnostic and Statistical Manual of Mental Disorders (DSM) was established by an APA (American Psychiatric Association). It is a manual that mental health care professionals use to diagnose mental health disorders. This handbook contains detailed descriptions, possible symptoms, and remaining criteria for accurate diagnosis of mental disorders. It helps doctors to understand what their patient is trying to describe. This results in better communication between clinicians and their patients. This also helps in the revision of the subject material, along with enhancements and interventions.
Till now, this manual has been revised five times. The latest was released in May 2013. It was first introduced in 1952. If you are wondering why is DSM periodically revised? Well, it is because there is constant research going on about mental disorders. It leads to new revelations and advanced tools for better diagnosis.
To date, DSM is a document used very widely in the field of mental health and its treatment. Professionals follow it as it assists them in any challenges they may face while dealing with a patient. It also allows them to diagnose the disorder accurately along with suggesting the most effective treatment.
How the Diagnostic Criteria for Disorders are Determined?
First of all, the symptoms of a mental health disorder should be studied in detail. However, the question is, how do doctors determine that whether the signs portrayed by a patient are reflective of a mental health disorder? It is important to understand that diagnosing a disorder by properly identifying symptoms is very crucial. The process of diagnosis helps the professionals to communicate with their counterparts in the same field, along with communicating with the patient about the disorder. Due to this, it is very important to have proper classification systems.
Deciding the diagnostic criteria for different mental health diagnoses is a constantly evolving process. As mentioned above, DSM has five versions. The most recent version was under revision more than a year before it was published.
The Steps Includes:
- Three six-week commentary periods from patients, their family members, mental health activists, and mental health specialists over two years
- 13 workgroups committed to investigating possible problems with the DSM-IV and writing revision suggestions
- Introduction of revisions to the psychiatric group and the public to speak about matters
- A new round of proposals and a return to writing proposals centered on response
The APA works to consider the requirements of the patients with mental health disorders along with that of their families. This hardworking organization also takes into account the tactics used by the insurance companies to use these documents to lay out insurance plans. APA constantly takes notice of the recent understanding of a mental health disorder and includes patient problems coupled with advanced scientific research.
How Many Variant Degrees of Mental Health Disorders are There?
Let me explain this to you in simple terms. Depression is a common mental health disorder. However, a professional can diagnose it as one of the 14 types of depressive disorder. An accurate and specific diagnosis can only be made by the experience the patient had with it along with particular symptoms. It can determine the following elements:
- Is the disorder in remission?
- Is the remission full or partial?
- Did the patient suffer a single episode, constant depression or several episodes?
- Is the depression described by psychotic features?
- If you are displaying any mild, moderate, or severe symptoms of depression
Also, depression may not lead to any disorder related to depression but any other mental health disorder. The variety in symptoms allows for a variety of patient experiences which results in better classification and effective treatment. The treatment can then be personalized to fit the patient’s needs and experience.
International Classification of Diseases (ICD)
The second system of classification of mental health disorders is known as the International Classification of Diseases (ICD). It is also commonly accepted. It was published by the World Health Organization (WHO). The history of ICD is that it was developed after WORLD WAR II, and in Europe. It has also been revised multiple times.
There are quite a few similarities in ICD and DSM including the constant revisions, the categories of mental health disorders, and the criteria for the diagnosis of different disorders. The ICD is more of a tool that examines the overall health of people. It also supervises the prevailing diseases and health problems on a global scale. The ICD has been revised double the times DSM has been updated, and so, the ICD’s latest version was the 10th edition.
Moreover, efforts are being made to revise ICD for the 11th time, but this development is in efforts are now underway to develop a new edition (ICD-11) that, in unification with the alterations made in DSM-5. This is aimed at harmonizing both classification systems as much as possible for accurate diagnosis of mental health disorders.
A study shows that ICD is more frequently used worldwide, especially for medical diagnosis so mental health problems can be treated accordingly. DSM is used more for research purposes. The recent research regarding the diagnosis and treatment of mental health disorders is done according to the criteria laid out in the DSM. There are very elaborate criteria to diagnose disorders, along with explanatory material.
3 Approaches to Classification of Mental Health Disorders
The DSM and ICD, both, are detailed guides to diagnose mental health disorders. Both these approaches use a classification system based on categories. In easier words, certain conditions are categorized within a spectrum of a specific disorder. Let me put out an example for better understanding. Let’s say, the condition is known as “separation anxiety disorder” which is classified within the wider category of Anxiety Disorders. The condition defined in a category has to meet the criteria to be legitimately classified as that disorder.
This category-based approach helps simplify the entire process of diagnosis of mental health problems. However, the downfall of this category-based structure is that it can lead to a comorbid diagnosis. This is when people are diagnosed with multiple mental disorders. This system is also often criticized for illogical borders drawn between disorders and non-disorders.
Dr. Bruce Cuthbert, Ph.D., of the NIMH RDoC Unit, says that these issues partially result from the fact that this structure of diagnosis came into being decades ago. Back then, advanced knowledge of brain functions wasn’t even available. According to him, these systems do not reflect the vast knowledge we have acquired in today’s era. He went on to say that these categories are not just diseases but should be classified as syndromes. This means we should take them as symptoms that can be displayed together for different mental health issues.
The third and final approach is the RDoC. It takes a different method to classify mental health disorders. Its purpose is not to be a guide for better diagnosis, rather to serve as a framework to aid research. This intends to help professionals understand the multiple factors involved in mental function. Some factors are environmental, biological, social, developmental, etc. Thus, RDoC is not limited by categories or methods of classification.
The RDoC structure is devised as a format that focuses on five main domains. These affect systems like cognitive systems, and other human functions. Each domain contains behavioral elements that are a result of these systems. Concepts are explored along with a variety of functions that range from normal to abnormal. This happens with the understanding that each function is affected by factors like environment or internal development. These concepts can be analyzed using self-assessments, behaviors, genetics, etc.
Dr. Cuthbert thinks that RDoC is an effort to produce data that will contribute to a more precise diagnosis and resulting treatment. He thinks that a better understanding of the dysregulated functions can even help in the prevention of such disorders. However, it is important to note that RDoC is not aimed to replace any current diagnostic system. It has been developed to help improve the process of diagnosis and the treatment of mental disorders.
In conclusion, there have been major advancements in the field of medical science, Thus, the classification systems and diagnosis methods constantly evolve. Three major systems are used for classification of the mental health disorders. However, the DSM and ICD are used more for clinical purposes while RCoD focuses on how to make the classification process better for the professionals of this field.
All thank the advancement in medical science, more and more disorders are being diagnosed accurately, which allows for effective treatment for different mental health problems. In short, lives are being saved!
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