Tuesday, 19 May 2015

DISORDERS - Diagnosing disorders


There are two main manuals which give details about the categories of dysfunctional behaviour and disorders, and thus are manuals on how to diagnose dysfunctional behaviour. The International Classification of Diseases (ICD) is probably more widely used, whilst many studies conducted in the UK and US refer to the Diagnostic and Statistical Manual (DSM), which is a specific manual for psychological disorders, whilst the ICD contains one chapter on psychological disorders and is as a whole a manual on health disorders generally.

The DSM is a practical guide based on field trials and empirical research, as well as referring to past editions of both the DSM and ICD. It was produced by the APA and instructs psychiatrists to evaluate the patient in terms of five axes, although the latter two are optional. The axes are as follows: clinical disorders (such as depression), personality disorders (such as mental retardation), physical health (due to recognising that long-term illness, for example, can influence mental health), environmental factors (such as family problems), and global assessment of functioning. These axes reflect an understanding that disorders result from an interaction of biological, psychological and social factors, and thus it is necessary to look at these axes to give a thorough analysis and diagnosis.

The ICD is an international standard diagnostic classification manual, published by the World Health Organisation – it is now in its tenth revision. Chapter 5 is the only chapter relevant for mental and behavioural disorders, as it is a manual for all health disorders. It is more symptom-based than the DSM, and lists clinical and personality disorders on the same axis. There are also 5 more groups of disorders than in the DSM, with ten therefore in total. These axes include: organic mental disorders, delusional disorders, mood disorders, mental retardation, and stress-related and neurotic disorders.

It is important to know that other cultures have diagnostic manuals, for example the Chinese Classification of Mental Disorders. Interestingly it includes 40 culturally-related diagnoses.


Anxiety disorders - 

An anxiety disorder is broadly described as a disorder which gives a continuous feeling of fear or anxiety, which is disabling and reduces daily functioning. Anxiety may be triggered by something that appears trivial to others, or may even be “non-existent” – but it feels very real and can have disastrous effects on the person with the disorder. Anxiety disorders encompass many different types of disorders, such as OCD and phobias.


The DSM IV will classify a phobia on the basis that the phobic reaction is marked, persistent and excessive or unreasonable and recognised as so.

SPADE: (Rhymes with afraid = phobia) 

S – six months under the age of 18
P – persistent fear
A – avoid phobic situation
D – disrupts normal life
E – excessive fear is recognised

These are the symptoms that most with phobias will exhibit; however one or two not shown in the patient is unlikely to hinder their diagnosis as individual differences means people react differently to phobias.

Affective (mood) disorders -

An affective disorder is one which is affects someone’s mood and emotions. Whilst it is completely normal to have varied and sometimes irrational moods, sometimes such severe or debilitating moods are the result of an affective disorder. The most common affective disorder is depression, which is likely to affect most people directly either through an individual themselves having it or someone they are close to having it.


The DSM IV would require a patient or client to be exhibiting five or more of the listed symptoms in the manual in order to diagnose somebody with depression. Symptoms are frequently split with episodes of perceived normality, and periods of mania and depression can last anywhere between days and years.

Because when you FLIRT with someone and get rejected, you get depressed :(

F – Fidgeting
L – Less ability to concentrate
I – Insomnia
R – Recurrent thoughts of death
T – Tiredness
F – Feelings of worthlessness, guilt

Psychotic disorders - 

Psychosis is the general term for disorders which involve loss of contact with “reality”, and those diagnosed with psychotic disorders frequently exhibit symptoms such as disordered thought and speech, delusions and withdrawal from the outside world. One psychotic disorder in which these symptoms are typical is schizophrenia.


The DSM would require two or more of these symptoms in order for a diagnosis to be made, as well as social occupational dysfunction which is unexplained by medication or developmental disorders.

Because I couldn't think of a word that made sense, and its hilarious! :) 

D – Delusions
D- Disorganised speech
D- Disorganised behaviour
S – Social Occupational
N- Negative symptoms
H- Hallucinations
S- Six months duration

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