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classification systems - Coggle Diagram

- - - - Each disorder has a code, starting with F. The disorders are listed consecutively and there are 11 sections. For example, schizophrenia, delusional disorders is one section grouped as F20-29.
      - Each section has a few ‘leftovers’ codes, allowing new disorders to be added, without having to recode the other disorders.
      - The codes are used for indexing medical records, making it easy when conducting research to find examples of people with specific conditions. The system attempts to be comprehensive enough to include all known conditions but also to avoid repetition or overlap
  - - - The presentation, communication and interpretation of symptoms is shaped by language and culture (an issue for the DSM as well). This ‘cultural bias’ means that clients in one culture could be given a different diagnosis from clients in another culture, despite presenting very similar symptoms because of different use of language or different norms.
      - This has posed problems for the international research community with ICD services and led to rigorous research programmes to review differences in diagnosis practice and differing use of diagnostic terminology across the world. The result was that the ICD-10 is available in many different languages and in appropriate cultural forms.
      - The ICD-10 is now described as clear, simple and logically organised
- - - - Axis I - disorders, clinical and mental
        
        Axis II - personality (underlying) including mental retardation.
        
        Axis III - medical and physical conditions
        
        Axis IV - environmental factors
        
        Axis V - global functioning
- - - - One strength of the ICD-10 is improvements in reliability
      - Research evidence by Alexander Ponizovsky et al (2006) from a large-scale longitudinal study, found the PPV scores increased by 26% for schizophrenia, 16% for mood same disorders and 8% for anxiety disorders
      - This clearly shows improved reliability and suggests that the increased numbers of disorders from ICD-9 to ICD-10 has not detracted from the reliability of those diagnoses.
      - It is important to note that the diagnosis of affective (mood) disorders has poor reliability using the DSM -5 as low as 0.28 and thus the ICD-10 may be preferable for these specific disorders.
      - COMPETEING ARGUMENT
        
        The study did reveal some less satisfactory results for childhood disorders and personality disorders where PPVs were as low as 55% and 56% respectively
      - High in comparison with some of the figures quoted from the DSM but these figures are based on agreement at the category levels whereas the DSM figures are more for specific diagnosis. - ICD may not be so reliable
    - - A strength is good consistency when two clinicians access the same clients using the ICD-10.
        
        For example - Gian Galeazzi et al arranged for two researchers to conduct a joint interview to access 100 consecutive clients for psychosomatic symptoms. This encourages conferences for using the ICD-10 at least for some disorders.
- - - - The WHOs approach to the development of ICD-11 is that they aim to improve the ‘clinical utility’ of this system
- - - - Stereotypical views of certain groups - may prevail and therefore a lack of understanding of culture may lead to misdiagnosis
      - Tests used to aid diagnosis - can be racially biased eg IQ designed from a western perspective
      - Difficulty in opening up to someone different from yourself and the stigma - some cultures attach to mental illness may lead to misdiagnosis or understanding diagnosis
      - Culture bound syndromes
      - A lack of knowledge about cultural differences - can lead to overdiagnosis in particular sections of the population
      - Mental health professionals need to be sensitive to cultural diversity - when making a diagnosis
  - - - the clinician might not speak the same language as the person they are attempting to diagnose.
      - certain things can be lost in translation
      - this can lead to inappropriate treatment or no treatment at all
  - - - mental health problems with a set of symptoms found and recognised as an illness in only one culture
      - many psychiatrists reject the idea of culture bound syndromes
      - the most commonly recognised syndromes are listed on the DSM-IV