Psychiatric Diagnosis and Classification - ResearchGate
Psychiatric Diagnosis and Classification - ResearchGate
Psychiatric Diagnosis and Classification - ResearchGate
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228 PSYCHIATRIC DIAGNOSIS AND CLASSIFICATION<br />
to medical illness or prescribed medication. Such an ``either±or'' view can<br />
lead primary care physicians to overlook important opportunities for treatment.<br />
In some primary care surveys, presence of a chronic medical illness<br />
has been associated with decreased likelihood that anxiety or depressive<br />
disorders will be recognized.<br />
ADAPTING PSYCHIATRISTS' CLASSIFICATIONS TO THE<br />
NEEDS OF PRIMARY CARE<br />
The Special Version of the Mental Disorders Section of<br />
ICD-10 for Use in Primary Care ICD-10-PHC)<br />
The tenth revision of the ICD has some important differences from its<br />
predecessor where mental disorders are concerned. The traditional dichotomy<br />
between ``psychosis'' <strong>and</strong> ``neurosis'' is no longer recognized; the user<br />
is provided with clear diagnostic criteria for use in research projects; <strong>and</strong><br />
special versions of the classification are available for use in specialized<br />
settings.<br />
The ICD-10-PHC classification [22] is unusual in a number of important<br />
respects. It is user-friendly, consisting of about 26 rather than 440 different<br />
disorders; it gives clear advice about probable presenting complaints <strong>and</strong><br />
the differential diagnosis of such complaints; <strong>and</strong>, most important of all, it<br />
gives clear advice about the management of each disorder. The set of<br />
disorders found useful in one country may well be different from that<br />
found useful in another, <strong>and</strong> each country is allowed to make its own<br />
selection of disorders to be adopted. It may not be necessary to include<br />
eating disorders in India, or conversion hysteria in Sc<strong>and</strong>inavia. However,<br />
most of the disorders will be common to all countries, <strong>and</strong> the categories<br />
will correspond broadly to those recognized by the more detailed ICD-10<br />
used by psychiatrists [23]. The ICD-10-PHC classification is not simply a<br />
condensed version of the larger classification system for specialists. It is a<br />
separate system created for primary care, but designed to be compatible<br />
with the classification system used by specialists.<br />
The classification is accompanied by a choice of other supporting materials:<br />
a glossary giving definitions of all technical terms used; advice on the<br />
way in which psychological inquiries should be fitted into the course of the<br />
usual medical consultation, <strong>and</strong> the circumstances which should act as<br />
``triggers'' for the GP to focus upon psychological adjustment; <strong>and</strong> a diagnostic<br />
flow chart showing how the various diagnoses logically relate to<br />
one another. The conditions which have been suggested for inclusion in<br />
ICD-10-PHC are shown in Table 9.2.