Anorexia nervosa or otherwise? The usefulness of adult diagnostic systems in child and adolescent eating disorders

2006 ◽  
Vol 23 (4) ◽  
pp. 156-158
Author(s):  
Alma Lydon ◽  
Onome Agbahovbe ◽  
Brendan Doody
Keyword(s):  
Anorexia Nervosa ◽  
Paediatric Population ◽  
Classification Systems ◽  
Childhood And Adolescence ◽  
Diagnostic Systems ◽  
Young Males ◽  
Icd 10 ◽  
Inpatient Management ◽  
Dsm Iv ◽  
Adolescent Eating Disorders

AbstractWe report on the case of a 15-year-old boy referred to Warrenstown inpatient unit for management of what appeared to be a typical case of anorexia nervosa. Over the course of his admission however, this diagnosis was no longer considered appropriate and substituted for a food avoidance emotional disorder. This is one of a number of cases of young males who have recently been referred for inpatient management of anorexia nervosa but which emerged into something quite atypical. The limited usefulness of the ICD-10/DSM-IV criteria in the diagnosis of an eating disorder in childhood and adolescence in this case reflects a broader level of discontent with the application of such diagnostic classification systems in a paediatric population.

scholarly journals Classification of psychiatric disorders in childhood and adolescence: building castles in the sand?

2002 ◽  
Vol 8 (3) ◽  
pp. 205-213 ◽  
Author(s):  
Stephen Scott
Keyword(s):  
Treatment Plan ◽  
International Classification Of Diseases ◽  
Classification Systems ◽  
Childhood And Adolescence ◽  
Diagnostic Systems ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
The Difference

A classification system can benefit disturbed children enormously by bringing to bear a wealth of knowledge and experience. This can make all the difference between an inadequate consultation and a precise formulation of the nature and extent of a child's difficulties, their cause, the likely outcome and a realistic treatment plan. However, inappropriate application of a diagnostic label that has little validity could do more harm than good, and classification systems can be misused. This paper discusses, with examples, issues particular to childhood and adolescence that diagnostic systems need to address if they are to be useful. It considers different solutions applied by the two most widely used schemes, the International Classification of Diseases (ICD–10; World Heath Organization, 1992) and the Diagnostic and Statistical Manual of Mental Disorders (DSM–IV; American Psychiatric Association, 1994). Finally, the types of criteria used to validate categories are discussed.

scholarly journals Classification in psychiatry: ICD–10 v. DSM–IV

1999 ◽  
Vol 175 (3) ◽  
pp. 205-209 ◽  
Author(s):  
Michael B. First ◽  
Harold Alan Pincus
Keyword(s):  
Mental Disorders ◽  
American Psychiatric Association ◽  
Classification Systems ◽  
Diagnostic Classification ◽  
Two Systems ◽  
Icd 10 ◽  
Harmful Use ◽  
Dsm Iv

The editorial by Andrews et al (1999) usefully calls attention to issues of compatibility between diagnostic classification systems but we believe that the editorial greatly overstates the compatibility problem as well as its implications. The article begins with the suggestion that the DSM–IV authors' position is to downplay the differences between DSM–IV and ICD–10. After stating that the American Psychiatric Association “felt sufficiently confident to publish a DSM–IV International Version in which the DSM–IV criteria are listed against the ICD–10 codes”, the authors go on to report concordances between the classifications for the main mental disorders as ranging from a low of 33% (for substance harmful use or abuse) to 87% (for dysthymia), with an overall concordance of only 68%. The authors conclude that if this “unnecessary dissonance between the classification systems continues, patients, researchers and clinicians will be all the poorer”. Although we acknowledge that there are a number of differences between the two systems, the authors fail to assess fully the sources, significance and solutions for this compatibility problem.

scholarly journals Psychopathy in childhood: is it a meaningful diagnosis?

2012 ◽  
Vol 200 (3) ◽  
pp. 175-176 ◽  
Author(s):  
Michael Rutter
Keyword(s):  
Antisocial Behaviour ◽  
Classification Systems ◽  
Icd 10 ◽  
Dsm Iv

SummaryPsychopathy is not included in either of the main classification systems (ICD-10 or DSM-IV). Research has now extended the concept of psychopathy to childhood and has produced evidence that it is meaningfully distinct from antisocial behaviour. It is proposed that psychopathy should be accepted as a meaningful diagnosis in childhood.

scholarly journals Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence

2012 ◽  
Vol 6 (1) ◽  
pp. 40 ◽  
Author(s):  
Carmen Adornetto ◽  
Andrea Suppiger ◽  
Tina In-Albon ◽  
Murielle Neuschwander ◽  
Silvia Schneider
Keyword(s):  
Anxiety Disorders ◽  
Childhood And Adolescence ◽  
Icd 10 ◽  
Dsm Iv

Delirium classification by the diagnostic and statistical manual – a moving target

2015 ◽  
Vol 27 (6) ◽  
pp. 881-882 ◽  
Author(s):  
Karin J. Neufeld
Keyword(s):  
Rating Scale ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Classification Systems ◽  
Diagnostic Systems ◽  
Delirium Assessment ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Medical Inpatients ◽  
Dsm Iv

The following paper, entitled “A Comparison of Delirium Diagnosis in Elderly Medical Inpatients using the CAM, DRS-R98, DSM-IV and DSM-5 Criteria” by Adamis and colleagues, reports the results of a single delirium assessment of 200 medical inpatients, aged 70 years and older. The aim was to compare the prevalence of delirium using two different diagnostic classification systems (DSM-5 and DSM-IV) and two commonly used research tools (Confusion Assessment Method and the Delirium Rating Scale-Revised ‘98). This editorial focuses on the comparison of the two versions of the DSM. The authors conclude that, while both diagnostic systems identify a core concept of delirium, the DSM-IV criteria are the most inclusive of the four approaches and the DSM-5, the most restrictive, identifying a prevalence of 19.5% and 13%, respectively in this sample. Furthermore, they conclude that these two systems do not appear to detect the same patients: only 14 of 26 (54%) individuals identified as delirious by the more exclusive DSM-5 criteria were also identified as such by DSM-IV.

A Qualitative Analysis on What Brazilian Psychiatrists Want from Current Diagnostic Classifications

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
A. Santos Júnior ◽  
L.F.A.L. Silva ◽  
C.E.M. Banzato ◽  
M.E.C. Pereira
Keyword(s):  
Daily Practice ◽  
Diagnostic Systems ◽  
Diagnostic Categories ◽  
Frequent Use ◽  
Open Questions ◽  
Dsm V ◽  
The Everyday ◽  
Icd 10 ◽  
Axis I ◽  
Dsm Iv

Aims:To analyze the qualitative answers profile of an anonymous standardized survey, with qualitative and quantitative questions, about the Brazilian psychiatrists' perceptions on their use of the multiaxial diagnostic systems ICD 10 and DSM-IV and on their expectations about future revisions of these classifications (ICD-11 and DSM-V).Method:the questionnaire, elaborated by Graham Mellsop (New Zealand), was translated into Portuguese and sent through mail to 1050 psychiatrists affiliated to the Brazilian Psychiatry Association. The quantitative analysis is presented elsewhere.Results:One hundred and sixty questionaries returned (15,2%). From these, 71,1% of the open questions where answered. The most needed and/or desirable qualities in a psychiatric classification were found to be: simplicity, criteria clarity, objectivity, comprehensibility, reliability and ease to use. The axis I of the ICD-10 was reported to be the most used due to its instrumental character in addition to being the official classification, including for legal and bureaucratic purposes. The DSM-IV was also used in the everyday practice, mostly for education and research purposes, by psychiatrists with academic affiliations. The less frequent use of the multiaxial systems was justified by the lack of training and familiarity, the overload of information and by the fact they are not mandatory. It was evaluated that some diagnostic categories must be reviewed, like: mental retardation, eating disorders, personality disorders, sleeping disorders, child and adolescence disorders, affective and schizoaffective disorders.Conclusion:This material offers a systematic panorama about the psychiatrists' opinions and expectations concerning the diagnostic instruments used in the daily practice.

Anorexia nervosa - Die Trias von Metrik-Index, BMI-Altersperzentilenkurve und Zielgewicht

1999 ◽  
Vol 27 (1) ◽  
pp. 5-17 ◽  
Author(s):  
K.-J. Neumärker ◽  
A. J. Bartsch ◽  
M. W. Bzufka ◽  
U. Dudeck ◽  
H. Greil ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Icd 10 ◽  
Dsm Iv

Zusammenfassung: Anhand von n = 133 adoleszenten Patientinnen der Berliner Anorexie-Studie belegen Quer- und Längsschnittdaten der stationären Therapie bei Anorexia nervosa (n = 104; Achse-I-Hauptdiagnose nach ICD-10 und DSM-IV-Kriterien), Bulimia nervosa (n = 19) und atypischen Eßstörungen (n = 10) eine signifikante Verschiebung der nach dem Metrik-Index kategorisierten typologischen Häufigkeitsverteilung in Richtung leptomorpher Körperbauvarianten (p < 0.050, χ2/Fisher's). Drei Erklärungsmodelle werden diskutiert. Es wird auf die diagnostische und therapeutische Bedeutung eingegangen, insbesondere für eine körperbautypgerechte Zielgewichtsbestimmung bei Anorexia nervosa. Ein entsprechender Algorithmus unter Nutzung von Metrix-Index und geschlechtsspezifischen BMI-Altersperzentilen wird vorgeschlagen.

Eating disorders

Psychiatry ◽  
2019 ◽  
Author(s):  
Rebecca McKnight ◽  
Jonathan Price ◽  
John Geddes
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Weight Control ◽  
Positive Association ◽  
Classification Systems ◽  
Eating Disordered ◽  
Icd 10 ◽  
Abnormal Eating ◽  
Significant Impairment

The term ‘eating disorder’ describes a range of conditions characterized by abnormal eating habits and methods of weight control which lead to a significant impairment of psychological, social, and physical functioning. Eating disorders are serious, complex conditions; they are not simply a problem of eating too much or too little, or an attempt to achieve the perfect physique. Anorexia nervosa has the highest mortality of any psychiatric disorder, and it is notoriously difficult both to engage eating- disordered patients, and to treat them success­fully. There is a positive association between early diag­nosis and prognosis, so the skills to recognize an eating disorder— whether they present with psychological or physical symptoms— are essential for all clinicians. At the time of writing, the description of eating dis­orders within diagnostic classification systems has been undergoing considerable change. Under the ICD- 10 and DSM- IV classification systems, three main eating disorders were recognized (Fig. 27.1): … 1 anorexia nervosa; 2 bulimia nervosa; 3 eating disorder not otherwise specified (EDNOS). … However, this classification has been shown to have various difficulties: … ● The majority of cases were attracting an ‘EDNOS’ label, whereas it was supposed to be a residual category (Fig. 27.1). ● EDNOS contained within it the subdiagnosis ‘binge eating disorder’ (BED). Recent research has demonstrated BED accounts for approximately 10 per cent of eating disorders in clinical cohorts. ● The categorical nature of the system does not allow for the fact that most eating disorders change over time, and frequently move back and forth along the spectrum of presentations. ● The DSM- 5 classification system (see ‘Further reading’) has tried to tackle the first two of these difficulties, and the upcoming ICD- 11 will echo these changes (Table 27.1) There is now a separate category for BED, and three other defined conditions. This is a positive change, but has only reduced the ‘NOS/ unspecified’ percentage to some extent, and has not considered the changeable nature of eating disorder symptomatology. Hopefully in the future a solution to the difficulty of turning a spectrum of pathology into a categorical system will emerge.

Psychotic States Arising in Late Life (Late Paraphrenia)

1995 ◽  
Vol 166 (2) ◽  
pp. 205-214 ◽  
Author(s):  
Osvaldo P. Almeida ◽  
Robert J. Howard ◽  
Raymond Levy ◽  
Anthony S. David
Keyword(s):  
Psychiatric Symptoms ◽  
Current Trend ◽  
Late Life ◽  
Signs And Symptoms ◽  
Diagnostic Systems ◽  
Formal Thought Disorder ◽  
Wide Range ◽  
Icd 10 ◽  
Dsm Iv ◽  
State Examination

BackgroundThis study explored the psychopathological state of a sample of ‘late paraphrenic’ patients and the reliability of their diagnosis according to the most widely used systems of classification of mental disorders.MethodThe presence and severity of psychiatric symptoms were assessed with the Present State Examination (PSE), the Scale for the Assessment of Positive Symptoms (SAPS), and the High Royds Evaluation of Negativity (HEN) scale. Patient signs and symptoms were classified according to the PSE9–CATEGO4, DSM–III–R, DSM–IV, and ICD–10 diagnostic systems. Agreement among the 11 most widely used criteria for the diagnosis of schizophrenia was assessed for these patients. These included DSM–III–R, DSM–IV, ICD–10, Schneider, Langfeldt, New Haven Schizophrenia Index, Carpenter, Research Diagnostic Criteria (RDC), Feighner, Taylor & Abrams, and PSE9–CATEGO4. The study assessed 47 patients, including in-patients, out-patients, day-patients, and those in the community. Thirty-three elderly controls were recruited from luncheon clubs in Southwark and Lambeth (London, UK).ResultsPatients showed a wide range of delusional ideas, most frequently involving persecution (83.0%) and reference (31.9%). Eighty-three per cent of patients reported some sort of hallucination, most frequently auditory (78.7%). Formal thought disorder was very rare, only one patient showing mild signs of circumstantial speech. No patients exhibited catatonic symptoms or inappropriate affect. Shallow, withdrawn, or constricted affect was found in only 8.5% of patients. The various systems of classification indicated that most patients displayed typical schizophrenic symptoms, although up to one-third of them did not meet criteria for the diagnosis of schizophrenia. There was poor agreement among the different diagnostic schedules as to whether to classify patients as schizophrenic (0.02 < k < 0.45).ConclusionPsychotic states arising in late life are accompanied by various psychiatric symptoms that are not entirely typical of early-onset schizophrenia. The current trend to include ‘late paraphrenia’ into the diagnosis of schizophrenia or delusional disorder has poor empirical and theoretical bases.

Considerations on classification of alcohol induced mental disorders

2011 ◽  
Vol 26 (S2) ◽  
pp. 90-90
Author(s):  
I. Pajević ◽  
M. Hasanović
Keyword(s):  
Mental Disorders ◽  
Delirium Tremens ◽  
Alcohol Withdrawal Syndrome ◽  
Classification Systems ◽  
Dimensional Structure ◽  
Clinical Samples ◽  
Dsm V ◽  
Icd 10 ◽  
Dsm Iv ◽  
Substance Related Disorders

IntroductionCurrent valid classification systems (ICD-10 and DSM-IV) of the alcohol-induced disorders include: acute intoxication, pathological intoxication, alcohol withdrawal syndrome, psychotic disorder with delusions or hallucinations, delirium tremens, amnesic syndrome, mood disorders and anxiety disorders caused by alcohol consumption (only in DSM-IV) and sexual dysfunction.AimTo consider adequacy of existing classifications of alcohol dependency and to offer more adequate suggestion for ICD-11 and DSM-V.MethodologyAuthors compared and analyzed the diagnostic criteria that are offered in the current classifications for these disorders.ResultsThere are many similarities and many differences between existing diagnostic criteria's. The former name of the DSM-IV (Substance related disorders, which include Alcohol related disorders) is inappropriate since it excludes other related disorders. Another important issue that is currently a subject of extensive discussions in the process of finalizing the DSM-V refers to the current distinction terms abuse and alcohol dependence. Scientific documents about the criteria of abuse and dependence in clinical samples and samples from the general population suggest that the DSM-IV criteria for abuse and dependence can be considered as part of a one-dimensional structure, thus for DSM-V it could be combined into a single disorder, with two criteria to make a diagnosis.ConclusionIt is expected that the principles adopted by the WHO during the preparation for ICD-11, which includes bridging the differences between ICD and DSM and the introduction of the person centered integrative diagnosis (PID) will be an important step forward in understanding and distinction among alcohol induced mental disorders.

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