CLASSIFICATION OF MENTAL ILLNESS

It’s important to classify mental illness because it serves as a guide to Diagnosis and Prognosis (outcome).

Importance of Classification

• Diagnosis: Classification helps healthcare professionals identify specific mental illnesses based on their symptoms and characteristics.

• Prognosis: It provides information about the likely course and outcome of the illness, guiding treatment planning and expectations.

• Research: Classification systems provide a common language for researchers to study and compare different mental illnesses.

• Treatment: Different classifications may suggest different treatment approaches, ensuring the most appropriate interventions are used.

In psychiatry, classification is based on the clinical description of the disease.

Current Classification Systems

1. International Classification of Diseases (ICD-11):

   • Developed by the World Health Organization (WHO).

   • Categorizes mental disorders based on their symptoms, causes, and severity.

   • Widely used in clinical and research settings globally.

2. Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

   • Developed by the American Psychiatric Association (APA).

   • Provides detailed diagnostic criteria for mental disorders.

   • Widely used in the United States and other countries.

Traditional Classification (Neurosis and Psychosis)

The traditional classification of mental illness divides disorders into Neurosis and Psychosis.

1. Neurosis

It refers to a group of mental disorders characterized by a combination of symptoms in which there is no evidence of organic brain disorder. People who suffer from these conditions don’t lose touch with external reality; the behavior may be affected but remains within socially acceptable limits.

• Characterized by anxiety, fear, and emotional distress.

• Individuals with neurosis maintain contact with reality and often experience significant distress.

Examples:

• Anxiety Disorders: Disorders occur in various combinations of psychological and physical symptoms. Anxiety is a vague feeling, worry, and tension characterized by excessive fear and apprehension.

• Obsessive-Compulsive Disorder (OCD): Characterized by recurring, persistent thoughts, impulses, or images that the patient regards as unpleasant, while recognizing them as physical and dissociative problems.

• Phobias: Irrational fear of things.

• Post-Traumatic Stress Disorder (PTSD): A group of mental symptoms that usually follow a traumatizing experience (like war, floods, epidemics, rape, defilement, and accident). The condition is characterized by severe anxiety, persistent disturbing, and recurring thoughts or nightmares of the experience.

• Conversion and Dissociation Disorder (Hysteria): Present as physical problems that originate as psychological issues.

2. Psychosis

This is a severe form of mental disorder characterized by loss of touch with reality. A person who has lost touch with reality has abnormal thoughts or beliefs (delusions) and abnormal sensory experiences (hallucinations).

Psychoses are divided into Organic and Functional (Inorganic) psychosis.

A. Organic Psychosis

• Caused by identifiable medical conditions affecting the brain, such as head injury, stroke, or substance abuse.

• Symptoms can include confusion, memory problems, and changes in personality.

• Results from identifiable causes, e.g., malaria, HIV/AIDS, gonorrhea, syphilis, head injury.

Organic mental disorders can be acute or chronic:

• Acute Organic Disorder (Delirium): Characterized by fluctuation in the level of consciousness or clouding of consciousness, hallucinations, and loss of memory.

• Chronic Organic Disorder (Dementia): There is no impairment of consciousness, but there is a gross impairment of memory which is due to damage.

B. Functional/Inorganic Psychosis

• Do not result from an easily identifiable cause.

• No structural damage in brain cells.

Examples:

• Schizophrenia: One of the worst forms of chronic illness characterized by loss of touch with reality, social withdrawal, disturbed thinking, altered perception, and behavior.

• Affective Disorder: Characterized by mood changes, i.e., mania and depression. Characterized by disturbances in mood.

  • Individuals with affective disorders may experience significant changes in their energy levels, sleep patterns, and appetite.

  • Examples: Major depressive disorder, bipolar disorder.

  • Depression: Characterized by persistent low mood, reduced activity, and persistent physical complaints.

  • Mania: Characterized by excessive happiness, increased activity, and pressure of speech.

Key Differences Between Neurosis and Psychosis