Psychiatric Diagnosis and Classification - ResearchGate
Psychiatric Diagnosis and Classification - ResearchGate
Psychiatric Diagnosis and Classification - ResearchGate
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INTERNATIONAL CLASSIFICATIONS 27<br />
examples will inevitablyaccumulate to identifyparadoxes between the<br />
appearance <strong>and</strong> the essence i.e. the underlying mechanisms).<br />
The classification of mental disorders is built on observation of pathological<br />
human behaviors. It identifies patterns of signs or symptoms that are<br />
stable over time <strong>and</strong> across different cultural settings, <strong>and</strong> can be informed<br />
bynew knowledge of the waythe mind <strong>and</strong> brain work. Such a classification<br />
is a reflection of a) natural observable ``phenomena'', b) cultural ways<br />
of underst<strong>and</strong>ing these, <strong>and</strong> c) the social context in which these experiences<br />
occur. Since one of the major purposes of a diagnostic classification is to<br />
help clinicians communicate with each other byidentifying patterns linked<br />
to disability, interventions <strong>and</strong> outcomes, these classifications have often<br />
evolved based on the ``sorting techniques'' that clinicians use. All psychiatric<br />
classifications are therefore human tools intended for use within a<br />
social system. Therefore, in thinking about the classification of mental disorders,<br />
multiple factors need to be taken into account, simplybecause our<br />
underst<strong>and</strong>ing of genetics, physiology, individual development, behavioral<br />
patterns, interpersonal relations, familystructures, social changes, <strong>and</strong> cultural<br />
factors all affect how we think about a classification. The twentieth<br />
centuryhas been marked byseveral distinct phases in the waymental<br />
phenomena <strong>and</strong> disorders have been understood. The determinism of psychoanalysis<br />
<strong>and</strong> early behaviorism has been superseded by the logical<br />
empiricism of biological psychiatry that is searching for the underpinnings<br />
of human behavior in the brain in particular, <strong>and</strong> in human biologyin<br />
general. Our current knowledge of mental disorders remains limited because<br />
of the lack of disease-specific markers, <strong>and</strong> is largelybased on observation<br />
of concurrent behavioral <strong>and</strong> psychological phenomena, on response<br />
to pharmacological <strong>and</strong> other treatments <strong>and</strong> on some data on familial<br />
aggregation of these elements. The task of creating an international classification<br />
of mental disorders is, therefore, a verychallenging multiprofessional<br />
<strong>and</strong> multicultural one that seeks to integrate a varietyof findings within a<br />
unifying conceptual framework.<br />
STRENGTHS OF ICD-10: A RELIABLE INTERNATIONAL<br />
OPERATIONAL SYSTEM<br />
The ICD is the result of an effort to create a universal diagnostic system that<br />
began at an international statistical congress in 1891 with an agreement to<br />
prepare a list of the causes of death for common international use. Subsequently,<br />
periodic revisions took place <strong>and</strong> in 1948, when the World Health<br />
Organization was formed, the sixth revision of the ICD was produced.<br />
Member states since then have decided to use the ICD in their national<br />
health statistics. The sixth revision of the ICD for the first time contained a