Advertisement

Classification of Psychiatric Disorders

  • Yong-Ku Kim
  • Seon-Cheol ParkEmail author
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1192)

Abstract

Because of the poor link between psychiatric diagnosis and neurobiological findings, it is difficult to classify mental disorders. The changes made to psychiatric diagnostic systems over the years can be understood in terms of “practical conservatism.” The Diagnostic and Statistical Manual of Mental Disorders (DSM)-I and DSM-II were theoretically supported by the psychoanalytic and psychodynamic approach. Subsequently, psychiatric diagnoses of this kind were opposed by the anti-psychiatry movement, as well as by the findings of the Rosenhan experiment. Thus, the DSM-III revolution contained more empiricism, aligning psychiatry with biomedicine. Psychiatric diagnoses are classified and defined in terms of Kraepelinian dualism, using a categorical approach. The empirical trend was continued in the DSM-IV. To overcome the limitations of current psychiatric diagnostic systems and integrate fundamental genetic, neurobiological, behavioral, environmental, and experimental components into psychiatry, the Research Domain Criteria (RDoC) were established. To overcome the limitations of the categorical approach, psychiatrists have considered adopting a dimensional approach. However, their efforts were frustrated in the DSM-5 revision process. Thus, the DSM-5 is characterized by the rearrangement of psychiatric diagnoses, the partial adoption of a dimensional approach, the introduction of new diagnoses, and harmonization with the International Classification of Diseases.

Keywords

Categorical approach Dimensional approach Psychiatric diagnosis DSM Research domain criteria (RDoC) 

References

  1. 1.
    Adam D. Mental health: on the spectrum. Nature. 2013;496(7446):416–28.PubMedCrossRefGoogle Scholar
  2. 2.
    Sadler JZ. Considering the economy of DSM alternatives. In: Paris J, Phillips J, editors. Making the DSM-5: concepts and controversies. New York: Spinger; 2013. p. 21–38.CrossRefGoogle Scholar
  3. 3.
    Pincus H, Frances A, Davis WW, First M, Widiger T. DSM-IV and new diagnostic categories: holding the line on proliferation. Am J Psychiatry. 1992;149(1):112–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Whooley O, Horwitz AV. The paradox of professional success: grand ambition, furious resistance, and the derailment of the DSM-5 revision process. In: Paris J, Phillips J, editors. Making the DSM-5: concepts and controversies. New York: Springer; 2013. p. 75–92.CrossRefGoogle Scholar
  5. 5.
    Kupfer DJ, Regier DA. Neuroscience, clinical evidence, and the future of psychiatric classification in DSM-5. Am J Psychiatry. 2011;168(7):672–4.PubMedCrossRefGoogle Scholar
  6. 6.
    Shorter E. The history of DSM. In: Paris J, Phillips J, editors. Making the DSM-5: concepts and controversies. New York: Spinger; 2013. p. 3–20.CrossRefGoogle Scholar
  7. 7.
    Ghaemi SN. The perils of open-mindedness: Adolf Meyer’s psychobiology. In: Ghaemi SN, editor. The rise and fall of the biopsychosocial model: reconciling art & science in psychiatry. Baltimore: The Johns Hopkins University Press; 2010, p. 3–11.Google Scholar
  8. 8.
    Park S-C. Karl Jaspers’ general psychopathology (Allgemeine Psychopathologie) and its implication for the current psychiatry. Psychiatry Investig. 2019;16(2):99–108.PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Rosenhan DL. On being sane in insane places. Science. 1973;179(4070):250–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Goffman E. Asylums: essays on the social situations of mental patients and other inmates. Piscataway, NJ: Aldine Transaction; 2007.Google Scholar
  11. 11.
    Kesey K. One flew over the cuckoo’s nest. New York: Penguin Classics; 2002.Google Scholar
  12. 12.
    Bayer R. Homosexality and American psychiatry: the politics of diagnosis. Princeton, NJ: Princeton University Press; 1987.Google Scholar
  13. 13.
    Engstrom EJ, Kendler KS. Emil Kraepelin: icon and reality. Am J Psychiatry. 2015;172(2):1190–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Kendler KS, Engstrom EJ. Criticisms of Kraepelin’s psychiatric nosology: 1896-1927. Am J Psychiatry. 2018;175(4):316–26.PubMedCrossRefGoogle Scholar
  15. 15.
    Kinghorn W. The Biopolitics of Defining “Mental Disorder.”. In: Paris J, Phillips J, editors. Making the DSM-5: concepts and controversies. New York: Spinger; 2013. p. 47–61.CrossRefGoogle Scholar
  16. 16.
    McHugh PR, Slavney PR. Mental illness—comprehensive evaluation or checklist? N Engl J Med. 2012;366(20):1853–5.PubMedCrossRefGoogle Scholar
  17. 17.
    Sass H, Volpe U. Karl Jaspers’ hierarchical principle and current psychiatric classification. In: Stanghellini G, Fuchs T, editors. One century of Karl Jaspers’ general psychopathology. Oxford: Oxford University Press; 2013. p. 185–207.Google Scholar
  18. 18.
    Rosenman S, Nasti J. Psychiatric diagnoses are not mental processes: Wittgenstein on conceptual confusion. Aust N Z J Psychiatry. 2012;46(11):1046–52.PubMedCrossRefGoogle Scholar
  19. 19.
    Park S-C, Kim JM, Jun TY, Lee MS, Kim JB, Yim HW, Park YC. How many different symptom combinations fulfill the diagnostic criteria for major depressive disorder? Results from the CRESCEND study. Nord J Psychiatry. 2017;71(3):217–22.PubMedCrossRefGoogle Scholar
  20. 20.
    Regier DA, Narrow WE, Kuhl EA, Kupfer DJ. The conceptual development of DSM-V. Am J Psychiatry. 2009;166(6):645–50.PubMedCrossRefGoogle Scholar
  21. 21.
    Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):126–36.CrossRefGoogle Scholar
  22. 22.
    Engel GL. The clinical application of the biopsychosocial model. Am J Psychiatry. 1980;137(5):535–44.PubMedCrossRefGoogle Scholar
  23. 23.
    Park S-C, Kim Y-K. More integrated biopsychosocial approach to psychiatric disorders. In: Kim Y-K, editor. Research methods and interventions in psychiatry: artificial intelligence, precision medicine, and other paradigm shifts. New York: Springer; 2019 (in press).Google Scholar
  24. 24.
    Kendler KS, Zachar P. The incredible insecurity of psychiatric nosology. In: Kendler KS, Parnas J, editors. Philosophical issues in psychiatry: explanation, phenomenology, and nosology. Baltimore: The Johns Hopkins University Press; 2008. p. 368–82.Google Scholar
  25. 25.
    Andreasen NC. DSM and the death of phenomenology in America: an example of unintended consequences. Schizophr Bull. 2007;33(1):108–12.PubMedCrossRefGoogle Scholar
  26. 26.
    Parnas J. DSM-IV and the founding prototype of schizophrenia: are we regressing to a Pre-Krapelinian nosology? In: Kendler KS, Parnas J, editors. Philosophical issues in psychiatry II: nosology. Oxford: Oxford University Press; 2012. p. 237–59.CrossRefGoogle Scholar
  27. 27.
    Park S-C, Jang EY, Lee KU, Lee K, Lee HY, Choi J. Reliability and validity of the korean version of the scale for the assessment of thought, language, and communication. Compr Psychiatry. 2015;61:122–30.PubMedCrossRefGoogle Scholar
  28. 28.
    Park S-C, Jang EY, Lee KU, Lee JG, Lee HY, Choi J. Psychometric properties of the korean version of the clinical language rating scale (CLANG). Clin Psychopharmacol Neurosci. 2016;15(1):49–56.CrossRefGoogle Scholar
  29. 29.
    Park YC, Lee MS, Si TM, Chiu HFK., Kanba S, Chong M-Y, Tripathi A, Udomratn P, Chee KY, Tanra AJ, Rabbani G, Javel A, Kathiarachchi S, Myint WA, Cuoung TV, Sim K, Yang SY, Sartorius N, Tan CH, Shinfuku N, Park S-C. Psychotropic drug-prescribing correlates of disorganized speech in Asians with Schizophrenia: the REAP-AP study. Saudi Pharm J. 2019;27(2):246–253.PubMedCrossRefGoogle Scholar
  30. 30.
    Cubert BN, Insel TR. Toward the future of psychiatric diagnosis: the seven pillars of RDoC. BMC Med. 2013;11:126.CrossRefGoogle Scholar
  31. 31.
    Miller G. Beyond DSM: seeking a brain-based classification of mental illness. Science. 2010;327(5872):1437.PubMedCrossRefGoogle Scholar
  32. 32.
    Insel T, Cuthbert B, Garvey M, Heissen R, Pine DS, Quinn K, Sanislow C, Wang P. Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry. 2010;167(7):748–51.PubMedCrossRefGoogle Scholar
  33. 33.
    Kupfer DJ, First MB, Regier DA, editors. A research agenda for DSM-V. Washington, DC: American Psychiatric Association; 2002.Google Scholar
  34. 34.
    Dutta R, Greene T, Addington J, McKenzie K, Phillips M, Murray RM. Biological, life course, and cross-cultural studies all point toward the value of dimensional and developmental rating in the classification of psychosis. In: Tamminga CA, Sirovatka PJ, Regier DA, van OS J, editors. Deconstructing psychosis: refining the research agenda for DSM-V. Washington, DC: American Psychiatric Association; 2010. p. 11–44.Google Scholar
  35. 35.
    Clarke DE, Narrow WE, Regier DA, Kuramoto SJ, Kupfer DJ, Kuhl EA, Greiner L, Kraemer HC. DSM-5 field trials in the United States and Canada, part I: study design, sampling strategy, implementation, and analytic approaches. Am J Psychiatry. 2013;170(1):43–58.PubMedCrossRefGoogle Scholar
  36. 36.
    Regier DA, Narrow WE, Clarke DE, Kraemer HC, Kuramoto SJ, Kuhl EA, Kupfer DJ. DSM-5 field trials in the United States and Canada, part II: test-retest reliability of selected categorical diagnoses. Am J Psychiatry. 2013;170(1):59–70.PubMedCrossRefGoogle Scholar
  37. 37.
    Narrow WE, Clarke DE, Kuramoto SJ, Kraemer HC, Kupfer DJ, Greiner L, Regier DA. DSM-5 field trials in the United States and Canada, part III: development of reliability testing of a cross-cutting symptom assessment for DSM-5. Am J Psychiatry. 2013;170(1):71–82.PubMedCrossRefGoogle Scholar
  38. 38.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, D.C.: American Psychiatric Association; 2013.CrossRefGoogle Scholar
  39. 39.
    Song JY. Introduction to psychopathology. Seoul: Jipmoondang Publishing Co.; 2012.Google Scholar
  40. 40.
    Mckinejad K, Sharifi V. Wittgenstein’s phiolosophy and a dimensional approach to the classification of mental disorder: a preliminary scheme. Psychopathology. 2006;39:126–9.CrossRefGoogle Scholar
  41. 41.
    Musalek M, Larach-Walters V, Lepine JP, Millet B, Gaebel W. WFSBP task force on nosology and psychopathology. Psychopathology in the 21st century. World J Biol Psychiatry. 2010;1(7):844–51.PubMedCrossRefGoogle Scholar
  42. 42.
    Frances A. DSM in philosophyland: curiouser and curiouser. In: Paris J, Phillips J, editors. Making the DSM-5: concepts and controversies. New York: Spinger; 2013. p. 95–103.CrossRefGoogle Scholar
  43. 43.
    Pierre JM. Overdiagnosis, underdiagnosis, synthesis: a dialectic for psychiatry and the DSM. In: Paris J, Phillips J, editors. Making the DSM-5: concepts and controversies. New York: Spinger; 2013. p. 105–24.CrossRefGoogle Scholar
  44. 44.
    Paris J. The ideology behind DSM-5. In: Paris J, Phillips J, editors. Making the DSM-5: concepts and controversies. New York: Spinger; 2013. p. 39–44.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of PsychiatryCollege of Medicine, Korea University Ansan HospitalAnsanRepublic of Korea
  2. 2.Department of PsychiatryInje University Haeundae Paik HospitalBusanRepublic of Korea

Personalised recommendations