What Is Involved in Psychiatric Classification?

The diagnosis and treatment of psychiatric disorders has a long and varied history filled with lively debate. Psychiatrists use classification systems to diagnose and treat their patients, and over time psychiatric treatment theories have varied in their classification of mental disorders. The American Psychiatric Association and the World Health Organization both categorize mental health issues, and each of their systems share some similar categories and codes. Published systems of psychiatric classification are updated based on new information and changes in psychiatric theories.

Hippocrates produced the first recorded groupings for psychiatric illness. His system was comprised of phobias and fears, melancholia — which was probably depression — mania, paranoia and oddly enough, transvestism. Rudiments of the modern psychiatric diagnosis and treatment began in the early 1800s. The Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) systems of classification were developed in the 20th century, and as of November 2011 both are in the process of being revised and updated.

The DSM, which is issued by the American Psychiatric Association, is a well-known psychiatric classification system based on five major areas or axes that are believed to describe mental disorders. Symptoms in each category aid the psychiatrist in evaluating a patient and making a diagnosis. Clinical disorders, such as depression and schizophrenia, belong in one major axis. Another main group is personality and developmental disorders, which includes narcissistic personality, obsessive compulsive and antisocial behaviors as well as mental retardation. Behaviors resulting from medical conditions, such as Alzheimer disease and brain injury, belong in another category.

The World Health Organization also publishes a psychiatric classification system for the diagnosis and treatment of mental conditions. A system for cateogorizing all types of human disease, the ICD employs ten different groupings for analyzing mental disorders. These categories include biological issues affecting mental functioning, behavioral issues, delusional mood disorders, illness resulting from substance abuse, mental retardation and developmental problems, and stress related disorders.

Evolution in psychiatric theory has led to debate about the efficiency of psychiatric classification. Some experts in the field claim that the determination of symptoms and diagnosis of mental disorders is too subjective. This may be true, especially because the diagnosis often relies so heavily on patient disclosure of symptoms. Some critics of psychiatric classifications claim they can potentially cause harm to patients by unfairly stigmatizing them and subjecting them to treatments that may not be beneficial.