Mental Disorders ‘By the Book’: About the DSM and ICD Diagnostic Categories

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Two of the most commonly used standards for categorizing forms of psychological distress in the psychiatric profession are the Diagnostic and Statistical Manual of Mental Disorders and the International Statistical Classification of Diseases.

Mental health professionals who make formal diagnoses of psychological disorders, such as psychiatrists, employ standardized lists of clinically observable symptoms to ensure some degree of uniformity and consistency of diagnosis across the profession. The most widely-used standard is set by the Diagnostic and Statistical Manual of Mental Disorders, or ‘DSM’ for short, which typically defines a diagnosis in terms of the presence of some sub-set of an overall list of symptoms. For well over a decade, the current version of the DSM was the DSM-IV TR. Published in 2000, the DSM-IV TR was a relatively minor text revision of the 1994 DSM-IV. More recently, both have been superseded by the DSM-V.

A complete list of DSM diagnostic codes is available separately; small changes to diagnostic codings are made from time to time, but these are primarily of administrative significance and do not correspond directly to any specific changes in the underlying symptom lists themselves.

A second standard — particularly used in Europe — is provided by the ICD-10, formally known as The International Statistical Classification of Diseases and Related Health Problems, tenth revision. Since the WHO updates the overall ICD on a regular basis, individual classifications within it may or may not change from year to year; therefore, you should always check directly with the WHO to be sure of obtaining the latest revision for any particular individual classification

It is clear that diagnostic criteria like these do not lend themselves to a great deal of precision, and crucially, these diagnoses are defined purely symptomatically; see my comments about diagnostic criteria (“Basic Science: Treatment, Therapy and Diagnostic Criteria for Mental Disorders”) for more on why this places psychiatric diagnostic coding on far shakier scientific footing than the usual notion of ‘diagnosis’ common to Western medicine. However, such lists do make possible some measure of consistency, so that at the very least, what one person means by the symptoms of depression or of obsessive-compulsive disorder or of some other mental disorder or type of psychological distress can be more easily understood by another person.

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