scholarly journals Vagueness in Psychiatry

2016 ◽  
Keyword(s):  
Mental Disorders ◽  
Mentally Ill ◽  
Classification Systems ◽  
Psychiatric Classification ◽  
Therapeutic Practice ◽  
Legal Implications ◽  
Health And Disease ◽  
Pros And Cons ◽  
Recurrent Theme

Blurred boundaries between the normal and the pathological are a recurrent theme in almost every publication concerned with the classification of mental disorders. However, systematic approaches that take into account the philosophical discussions about vagueness are rare. This is the first volume to systematically draw various lines of philosophical and psychiatric inquiry together–including the debates about categorial versus dimensional approaches in current psychiatric classification systems, the principles of psychiatric classification, the problem of prodromal phases and subthreshold disorders, and the problem of overdiagnosis in psychiatry–and to explore the connections of these debates to philosophical discussions about vagueness. The book consists of an introduction (Part I) followed by three parts. Part II encompasses historical and recent philosophical positions regarding the nature of demarcation problems in nosology. Here the authors discuss the pros and cons of gradualist approaches to health and disease and the relevance of philosophical discussions of vagueness to these debates. Part III narrows the focus to psychiatric nosology. The authors approach the vagueness of psychiatric classification by drawing on contentious medical categories, such as PTSD or schizophrenia, and on the dilemmas of day-to-day diagnostic and therapeutic practice. Against this background, the chapters critically evaluate how current revisions of the ICD classifications and DSM manuals conceptualize mental disorders and how they are applied in various contexts. Part IV is concerned with social, moral, and legal implications that arise when being mentally ill is a matter of degree. Not surprisingly, the law is ill-equipped to deal with these challenges due to its binary logic. Still, the authors show that there are more and less reasonable ways of dealing with blurred boundaries and of arriving at warranted decisions in hard cases.

scholarly journals From measurement to classificatory practice: improving psychiatric classification independently of the opposition between symptom-based and causal approaches

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Alessandra Basso
Keyword(s):  
Mental Disorders ◽  
Classification Systems ◽  
Psychiatric Classification ◽  
Way Of Thinking

AbstractThe article advances a new way of thinking about classifications in general and the classification of mental disorders in particular. By applying insights from measurement practice to the context of classification, I defend a notion of epistemic accuracy that allows one to evaluate and improve classifications by comparing different classifying methods to each other. Progress in classification arises from the mutual development of classification systems and classifying methods. Based on this notion of accuracy, the article illustrates with an example how psychiatric classifications can be improved via circumscribed comparisons of different perspectives on mental disorders, without relying on complete models of their complex aetiology. When applying this strategy, the traditional opposition between symptom-based and causal approaches is of little consequence for making progress in the epistemic accuracy of psychiatric classification.

Prospects for the classification of mental disorders of children and adolescents

2008 ◽  
Vol 23 (7) ◽  
pp. 481-485 ◽  
Author(s):  
M.H. Schmidt ◽  
J. Sinzig
Keyword(s):  
Mental Disorders ◽  
Children And Adolescents ◽  
Classification Systems ◽  
General Question ◽  
Specific Information ◽  
Specific Symptom ◽  
Trade Offs ◽  
Dimensional Classification ◽  
Dsm V

AbstractSuggestions for classification of mental disorders of children and adolescents in DSM-V and ICD-11 have been made, which differ strongly from the current descriptive approach of dimensional classification.These suggestions even comprise a dichotomized system for health care as well as for scientific purposes.Nevertheless it is obvious that we are far behind an “etiological” classification, so that trade-offs have necessarily to be made in DSM-V and ICD-11.Appropriate proposals concern the strict separation of disorders that are typical for children and adolescents as well as for adults.Furthermore a differentiation of diagnosis for infants, toddlers and preschool children is required in both classification systems. As far as it is relevant for treatment, combined diagnosis in DSM-V and subthreshold diagnosis as well as coding-possibilities for findings in molecular biology should be permitted.As personality disorders should only be diagnosed after the age of 16, it is recommended to dimensionally classify personality traits that are pathognomonic for specific symptom patterns and of prognostic relevance.DSM-V and ICD-11 should allow age-specific information on axis-IV. The article discusses the general question of how relational disorders respectively disturbances should be classified and include furthermore special recommendations concerning ICD and DSM categories.

Classification

2017 ◽  
pp. 21-34
Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel
Keyword(s):  
International Classification Of Diseases ◽  
Classification Systems ◽  
World Health ◽  
Psychiatric Classification ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
History Of ◽  
Key Issues

‘Classification’ introduces concepts of mental illness before briefly reviewing the reasons for, and criticisms of, psychiatric classification. Key issues of reliability, validity, and stigma associated with classification are covered. After an overview of the history of classifications, the organizing principles of the two current major classification systems used in psychiatry (ICD-10 and DSM-5) are then outlined: the World Health Organization’s International Classification of Diseases (‘ICD-10’), and the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (‘DSM-5’). Additional schemes, used in particular countries, are also briefly mentioned. Finally, the chapter summarizes how psychiatric classification may develop in the future, with particular reference to ICD-11, which is due in 2018 or 2019.

scholarly journals Making a good mental health diagnosis: Science, art and ethics

2020 ◽  
Vol 49 (12) ◽  
pp. 797-802
Author(s):  
Louise Stone ◽  
Elizabeth Waldron ◽  
Heather Nowak
Keyword(s):  
General Practice ◽  
Classification Systems ◽  
Mental Illnesses ◽  
Psychiatric Classification ◽  
Ethical Implications ◽  
Illness Experiences ◽  
Good Mental Health ◽  
Evidence Based Treatments ◽  
Art And Ethics

Background There are limitations to psychiatric classification, which affects the utility of diagnosis in general practice. Objective The aim of this article is to explore the principles of science, art and ethics to create clinically useful psychiatric diagnoses in general practice. Discussion Psychiatric classification systems provide useful constructs for clinical practice and research. Evidence-based treatments are based on the classification of mental illnesses. However, while classification is necessary, it is not sufficient to provide a full understanding of ‘what is going on’. A good psychiatric diagnosis will also include a formulation, which provides an understanding of the psychosocial factors that provide a context for illness. Experiences such as trauma and marginalisation will change the illness experience but also provide other forms of evidence that shape therapy. Diagnoses also carry ethical implications, including stigma and changes in self‑concept. The science, art and ethics of diagnosis need to be integrated to provide a complete assessment.

Angststörungen – von der ICD-10 zur ICD-11

2020 ◽  
pp. 1-5
Author(s):  
Timo D. Vloet ◽  
Marcel Romanos
Keyword(s):  
Mental Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.

Diagnoses, Dimensions, and DSM-5

2010 ◽  
pp. 254-279
Author(s):  
Thomas A. Widiger ◽  
Maryanne Edmundson
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Paradigm Shift ◽  
Empirical Support ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Dimensional Classification ◽  
Diagnosis And Classification

The Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) is often said to have provided a significant paradigm shift in how psychopathology is diagnosed. The authors of DSM-5 have the empirical support and the opportunity to lead the field of psychiatry to a comparably bold new future in diagnosis and classification. The purpose of this chapter is to address the validity of the categorical and dimensional models for the classification and diagnosis of psychopathology. Considered in particular will be research concerning substance use disorders, mood disorders, and personality disorders. Limitations and concerns with respect to a dimensional classification of psychopathology are also considered. The chapter concludes with a recommendation for a conversion to a more quantitative, dimensional classification of psychopathology.

Sign in / Sign up

Export Citation Format

Share Document