Comparative Analysis of DSM and ICD Classifications of Mental Disorders
Mood disorder is an umbrella term used by both DSM and ICD classification. A mood disorder is any type of psychiatric illness that affects your mood. These disorders could be depressive disorders, manic or major, bipolar disorders, seasonal affective disorder, along with new modern terms such as Disruptive mood dysregulation disorder. All these disorders can be categorised by the symptomatic mood changes someone who suffers with them may experience. Most of these disorders will make the patient feel low in mood, fatigued, irritable and the feeling of helplessness. These disorders also cause emotional turmoil, showing emotions by exhibiting crying, anxiety, fear, and even anger. Due to these disorders affecting a person’s mood they can also have the opposite effect. If you suffer from a manic disorder such as manic depression or bipolar, you can experience extreme ‘highs’. In which someone may become hyper, extremely happy or the feeling of which you could burst. However with this comes extreme crashes after such events which usually plunge people into the darkest spaces of their emotions and moods. Mood disorders once diagnosed, are usually treated with medication, as often the disorders affecting your mood are caused by a chemical imbalance within your brain. This can cause an imbalance of serotonin and dopamine within your brain which creates the feeling of joy, and balances your moods.
There are many different disorders and mental health conditions that affect your personality. According to ICD classification personality disorders are classed into prominent personality traits. These are regularly used to separate the severity of the disorder, ranging from mild to serve. ICD classifieds disorders such as schizophrenia depending on how it affects the patients everyday life and relationships. Personality disorders in all classifications affect your personality or cause you to have multiple personalities. This means the same person may present differently within seconds depending on which side or which personality comes out. Personality disorders are often linked with psychosis and hearing voices.
DSM classification related disorders slightly differently and happens to be the more modern way of identifying them. For instance these disorders are often separated into ten identities: paranoid, schizoid,schizotypal, antisocial, borderline, narcissistic, historic, obsessive compulsive, dependant, avoidant. These also may also be used within another umbrella section of DSM which links disorders into whether it was caused from illness, medical condition side effects and also unspecified which could be any disorder that does not fit any or all criteria. Much like ICD this is manly used to develop the severity of disorder. EG: borderline personality disorder under borderline as it presents mild symptoms of a more complex multiple personality disorders or DID (Dissociative Identity Disorder).
Anxiety disorders are simply a pronounced feeling of worry or anxiousness that does not go away easily, even worrying over simple tasks. This disorder can often make the patient feel physically ill with symptoms classified in both DSM and ICD of anxiousness along with physical nausea, sweating, a tight chest, hyperventilating and panic attacks. In both classifications anxiety disorders range from anxiety, feeling concerned or overly worried for a long period of time, DSM states 6months, to Obsessive compulsive disorder. Compulsive disorders can come under a range of mental health diagnosis due to the range of symptoms. Within anxiety, someone with OCD may feel anxious about not completing a task or urge and the feeling that something bad may happen if it is not complete. This often produces symptoms of anxiety and can create a lot of stress on the patient. For example someone with OCD may believe if they do not repeat a pattern by tapping a wall a certain way their family may die. OCD sufferers genuinely believe this and with in both DSM and ICD being unable to act upon an OCD urge is described as a wave of anxiousness, worry and dread.
The classification within Psychotic disorders in ICD and DSM differ greatly. There are a lot of challenges from both classifications. ICD separates psychotic disorders into separate groups and sub groups. Such as the variation of types/ severity of schizophrenia, such as paranoid, catatonic, simple and otherwise. DSM on the other hand has removed this type of division and categorises via symptoms and attributes. Such as someone suffering acute schizophrenic tendencies. There is also a difference in how short psychotic disorders, or psychotic breaks are labelled. In DSM short lived psychotic disorders such as postpartum psychosis is labelled as ‘brief psychotic disorder’ (BPD) meanwhile in ICD it is labelled under acute and transient psychotic disorders (ATPDs). This gives the impression that under DSM BPD experiences are short lived and the patient may recover quickly. The word transient in ICD diagnosis imposes that it may occur again and has periods of subsidence before psychosis reoccurs. ICD focuses mostly on schizophrenic episodes and psychotic hallucinations. Focusing many of the umbrella terms over schizophrenic episodes, whether long or short. DSM uses the phrases psychotic episodes, and focuses more on the fact someone is diagnosed through symptoms and the length of time they are displayed. Meaning someone showing symptoms of psychosis, would be deemed as having episodes, labelled with a phrase such as psychotic tendencies, rather than being diagnosed with a labelled disorder. DSM does have a much more varied diagnosis platform than ICD. However it is not as simple and up front, it seems to refuse many labels and does not appear to often give a general diagnosis that ICD-10 would. ICD-10 in particular appears to be the classification of choice for many psychiatrists and case studies.
Substance-related disorders or substance use disorders, is used to describe a wide variety of disorders from addiction to psychotic disorders caused by substance abuse. DSM and ICD both describe substance use disorders differently and categorise them separately. DSM categorises substance disorders as taking the substance in larger amounts and for longer than you are meant to, trying to stop using the substance but failing too, spending a lot of time using, sourcing and recovering from the substance. DSM also focuses largely on addiction. And uses the term addiction to categorise Substance disorders. DSM impresses that substance related disorders such as psychotic illnesses are all a result of abusing drugs or alcohol. Therefore the idea behind the DSM category is without being addicted you would not become mentally ill. This even suggested that some people are predisposed to become addicted to things therefore vulnerable to being diagnosed with related mental health complications. ICD on the other hand is a much more in depth categorisation. ICD suggests that drugs and alcohol are ‘psychoactive’. Individuals who take these psychoactive drugs are at high risk of psychotic disorders, of which using ICD are greatly self diagnosed, with evidence for diagnosis having to be collected and trusted from the patient. Along with this blood and urine samples may be taken, and third party accounts to clarify the substance being abused. ICD also has a class system for substance disorders, ranging from F10-F19. These include substance abuse of alcohol, abuse of caffeine and stimulants, mental health complications of tobacco, uses of psychoactive drugs and so on. This means the diagnosis and treatment of a disorder will come under one of these classes, meaning treatment is more targeted towards one drug in particular.
There is a range of eating disorder diagnosis within mental Health. ICD recognises Eating Disorders as a behavioural disorders. ICD believes and demonstrates within diagnosis that eating disorders such as anorexia nervosa, bulimia, purging and binging, all stem from a mismanagement of food or childhood trauma related to food. ICD recognises that this behaviour could be learnt from role models and parents. Anorexia (typical and nervosa) is characterised through deliberate weight loss. Although depending on how long the disorder has gone on for some do not even realize they have it or are purposefully doing it. Anorexia is normally seen by victims losing weight as a diet plan but then becoming obsessive. Many people hear voices in their heads or suffer from body dysmorphia where they see their body as very different or overweight to what it actually looks like. ICD categorizes eating disorders similarly with other ‘behavioural’ based disorders and illnesses such as insomnia and sexual disorders. DSM also categories similarly, stating eating disorders can stem from environmental, biological or trauma. However DSM also places some disorders in a Not otherwise specified category. DSM establishes similar diagnosis such as anorexia and bulimia but it believes in a further more wide spread category where someone may suffer from multiple symptoms or not fit fully into a treatment programme. Teh ‘NOS’ is the biggest area of the diagnosis category according to DSM, where patients either suffer from a bad relationship with food through mental health, working, habit or other issues. It also includes those who simply suffer from multiple eating disorders that then becomes one None specified disorder.
The definition of cognitive disorders or neurocognitive disorders as they are also known, is quite similar according to ICD and DSM. Both categories see cognitive disorders as mental health disorders that affect physical cognitive ability along with memory and brain function. An example found in both DSM and Icd is dementia. Labelled as a cognitive disorder, dementia affects memory, perception and in some forms such as vascular there can come a point where it effects abilities such as mobility and swallowing. DSM recognises that other disorders such as anxiety and mood disorders can affect memory and function but unlike ICD that does not mean they come under cognitive disorders, and believe that only disease that purley attacks brain function can be labeled as cognitive.
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