CLASSIFICATION AND TERMINOLOGIES IN

MENTAL HEALTH DISORDERS

Dr. Muhammad Arsyad Subu

Assistant Professor in Nursing

August 7, 2018
 Objectives
• Classify mental health disorders according to ICD-10 mental health

classification

• Classify mental health disorders according DSM-V Mental health disorders

classification

• Identify common terminologies of mental health disorders

 TOPICS
• DSM-5 : Diagnostic and Statistical Manual of Mental Disorders (Fifth edition)
- APA
• ICD-10: International Statistical Classification of Diseases and Related
Health Problems 10th Revision - WHO
• Common terminologies in psychiatric-Mental Health Disorders
 Classification
• Classification is “the activity of ordering or arrangement of objects into groups
or sets on the basis of their relationships”

• “procedure for constructing groups or categories and for assigning entities

(disorders or persons) to these categories on the basis of their shared attributes
or relations”.

• Millon T.(1991) J. Abnorm.Psychol., 100:245-261

 The Diagnostic and Statistical Manual of Mental
Disorders (DSM)
• The DSM is now in its fifth edition, DSM-5, published on May
18, 2013 by the American Psychiatric Association (APA)
• Offers a common language and standard criteria for
the classification of mental disorders.
• It is used by clinicians, researchers, psychiatric drug regulation
agencies, insurance and pharmaceutical companies, the legal
system, and policy makers.
 The International Statistical Classification of Diseases and
Related Health Problems
• It is usually called by the short-form: International Classification of
Diseases (ICD) – published by the World Health Organization (WHO)
• It is the international "standard diagnostic tool for epidemiology, health
management and clinical purposes".
• It is a healthcare classification system, providing a system of
diagnostic codes for classifying diseases
 DSM-V: CLASSIFICATION
• Neurodevelopmental disorders
• Schizophrenia spectrum & other
psychotic disorders
• Bipolar & related disorders
• Depressive disorders
• Anxiety disorders
• Obsessive-compulsive & related
disorders
• Trauma- & stressor-related disorders
• Dissociative disorders
• Somatic symptom & related disorders
• Feeding & eating disorders
• Sleep–wake disorders
• Sexual dysfunctions
• Gender dysphoria
• DIC Disruptive, impulse-control, &
conduct disorders
• Substance-related & addictive disorders
• Neurocognitive disorders
• Paraphilic disorders
• Personality disorders
 Neurodevelopmental Disorders

• They are impairments of the growth and development of

the brain or central nervous system.

• Disorders of brain function that affect emotion, learning

ability, self-control and memory and that unfolds as the
individual grows.
 Neurodevelopmental Disorders

• Intellectual Disabilities
• Communication Disorders
• Autism Spectrum Disorder
• Attention-Deficit/Hyperactivity Disorder
• Specific Learning Disorder
• Motor Disorders
• Other Neurodevelopmental Disorders
 Schizophrenia Spectrum & Other Psychotic Disorders

• They are abnormalities in one or more of the following five domains: delusions,
hallucinations, disorganized thinking (speech), grossly disorganized or
abnormal motor behavior (including catatonia), and negative symptoms.
 Schizophrenia Spectrum & Other Psychotic
Disorders
• Schizotypal (Personality) Disorder
• Delusional Disorder
• Brief Psychotic Disorder
• Schizophreniform Disorder
• Schizophrenia
• Schizoaffective Disorder
• Substance/Medication-Induced Psychotic Disorder
• Psychotic Disorder Due to another Medical Condition
• Catatonia
 Bipolar & Related Disorders

• They involve clear changes in moods, energy, and

activity levels.
• These moods range from periods of extremely “up,”
elated, and energized behavior (known as manic
episodes) to very sad, “down,” or hopeless periods
(known as depressive episodes).
 Bipolar & Related Disorders
• Bipolar I Disorder

• Bipolar II Disorder

• Cyclothymic Disorder

• Substance/Medication-Induced Bipolar and Related Disorder

• Bipolar and Related Disorder Due to another Medical Condition

• Other Specified Bipolar and Related Disorder

• Unspecified Bipolar and Related Disorder

 Depressive Disorders
• They are common serious mood disorders that cause severe symptoms that affect how
people feel, think, and handle daily activities, such as sleeping, eating, or working.

• They are persistent feelings of sadness and worthlessness as well as a lack of desire to
engage in pleasurable activities.
 Depressive Disorders
• Disruptive Mood Dysregulation Disorder
• Major Depressive Disorder, Single and Recurrent Episodes
• Persistent Depressive Disorder (Dysthymia)
• Premenstrual Dysphoric Disorder
• Substance/Medication-Induced Depressive Disorder
• Depressive Disorder Due to another Medical Condition
• Other Specified Depressive Disorder
• Unspecified Depressive Disorder
 Anxiety Disorders
• A group of mental disorders characterized by feelings of anxiety and fear.

• Anxiety is a worry about future events and fear is a reaction to current events.

• These feelings may cause physical symptoms, such as a fast heart rate and shakiness.
 Anxiety Disorders

• Separation Anxiety Disorder • Generalized Anxiety Disorder

• Selective Mutism • Substance/Medication-Induced Anxiety
• Specific Phobia Disorder
• Social Anxiety Disorder (Social Phobia) • Anxiety Disorder Due to another
• Panic Disorder Medical Condition

• Panic Attack (Specifier) • Other Specified Anxiety Disorder

• Agoraphobia • Unspecified Anxiety Disorder

 Obsessive-Compulsive & Related Disorders
(OCD)
• OCD involves unwanted and disturbing thoughts, images, or urges
(obsessions) that intrude into a person’s mind and cause a great deal of
anxiety or discomfort, which the person then tries to reduce by engaging in
repetitive behaviors or mental acts (compulsions).
• OCD is a mental disorder where people feel the need to check things
repeatedly, perform certain routines repeatedly (called "rituals"), or
have certain thoughts repeatedly.
 Obsessive-Compulsive & Related Disorders
• Obsessive-Compulsive Disorder
• Body Dysmorphic Disorder
• Hoarding Disorder
• Trichotillomania (Hair-Pulling Disorder)
• Excoriation (Skin-Picking) Disorder
• Substance/Medication-Induced Obsessive-Compulsive and Related Disorder
• Obsessive-Compulsive and Related Disorder Due to Another Medical Condition
• Other Specified Obsessive-Compulsive and Related Disorder
• Unspecified Obsessive-Compulsive and Related Disorder
 Trauma- & Stressor-Related Disorders

• They include disorders in which exposure to a traumatic or stressful event

is listed explicitly as a diagnostic criterion.
 Trauma- & Stressor-Related Disorders

• Reactive Attachment Disorder

• Disinhibited Social Engagement Disorder
• Posttraumatic Stress Disorder
• Acute Stress Disorder
• Adjustment Disorders
• Other Specified Trauma- and Stressor-Related Disorder
• Unspecified Trauma- and Stressor-Related Disorder
 Dissociative Disorders
• They are conditions that involve disruptions or breakdowns of memory,
awareness, identity, or perception.

• People with dissociative disorders use dissociation, a defense mechanism,

pathologically and involuntarily.
 Dissociative Disorders
• Dissociative Identity Disorder
• Dissociative Amnesia
• Depersonalization/Derealization Disorder
• Other Specified Dissociative Disorder
• Unspecified Dissociative Disorder
 Somatic Symptom & Related Disorders

• In somatic symptom disorders, the person's main concern is with

physical (somatic—from soma, the Greek word for body) symptoms,
such as pain, weakness, fatigue, nausea, or other bodily sensations.

• The person may or may not have a medical disorder that causes or
contributes to the symptoms.
 Somatic Symptom & Related Disorders
• Somatic Symptom Disorder
• Illness Anxiety Disorder
• Conversion Disorder (Functional Neurological Symptom Disorder)
• Psychological Factors Affecting Other Medical Conditions
• Factitious Disorder
• Other Specified Somatic Symptom and Related Disorder
• Unspecified Somatic Symptom and Related Disorder
 Feeding & Eating Disorders
• They are characterized by a persistent disturbance of feeding, eating or eating-
related behavior that results in the altered consumption or absorption of food and
that significantly impairs physical health or psychosocial functioning.
 Feeding & Eating Disorders
• Pica
• Rumination Disorder
• Avoidant/Restrictive Food Intake Disorder
• Anorexia Nervosa
• Bulimia Nervosa
• Binge-Eating Disorder
• Other Specified Feeding or Eating Disorder
• Unspecified Feeding or Eating Disorder
 Elimination Disorders
• They all involve the inappropriate elimination of urine or feces and are usually first
diagnosed in childhood or adolescence.

• These disorders includes enuresis, the repeated voiding of urine into inappropriate places,
and encopresis, the repeated passage of feces into inappropriate places.
 Elimination Disorders

• Enuresis

• Encopresis

• Other Specified Elimination Disorder

• Unspecified Elimination Disorder

 Sleep-Wake Disorders
• Individuals with these disorders typically present with sleep-wake complaints of
dissatisfaction regarding the quality, timing, and amount of sleep.

• Resulting daytime distress and impairment are core features shared by all of these
sleep-wake disorders.
 Sleep-Wake Disorders
• Insomnia Disorder • Sleepwalking
• Hypersomnolence Disorder • Sleep Terrors & Nightmare
• Narcolepsy Disorder
• Breathing-Related Sleep Disorders • Rapid Eye Movement Sleep
• Parasomnias Behavior Disorder
• Non–Rapid Eye Movement Sleep • Restless Legs Syndrome
Arousal Disorders • Substance/Medication-Induced
Sleep Disorder
 Sexual dysfunction
• It refers to a problem occurring during any phase of the sexual response cycle that
prevents the individual or couple from experiencing satisfaction from
the sexual activity.
• The sexual response cycle traditionally includes excitement, plateau, orgasm, and
resolution.
 Sexual Dysfunctions
• Delayed Ejaculation
• Erectile Disorder
• Female Orgasmic Disorder
• Female Sexual Interest/Arousal Disorder
• Genito-Pelvic Pain/Penetration Disorder
• Male Hypoactive Sexual Desire Disorder
• Premature (Early) Ejaculation
• Substance/Medication-Induced Sexual Dysfunction
• Other Specified Sexual Dysfunction
• Unspecified Sexual Dysfunction
 Gender Dysphoria
• The condition of feeling one's emotional and psychological identity as
male or female to be opposite to one's biological sex.
• It is the dysphoria (distress) a person experiences as a result of
the sex and gender they were assigned at birth.
 Gender Dysphoria

• Gender Dysphoria
• Other Specified Gender Dysphoria
• Unspecified Gender Dysphoria
 Disruptive, Impulse - Control, & Conduct Disorders

• They include conditions involving problems in the self-control of emotions

and behaviors.
• The disorders are unique in that these problems are manifested in
behaviors that violate the rights of others (e.g., aggression, destruction of
property) and/or that bring the individual into significant conflict with
societal norms or authority figures.
 Disruptive, Impulse - Control, & Conduct Disorders

• Oppositional Defiant Disorder

• Intermittent Explosive Disorder
• Conduct Disorder
• Antisocial Personality Disorder
• Pyromania
• Kleptomania
• Other Specified Disruptive, Impulse-Control, and Conduct Disorder
• Unspecified Disruptive, Impulse-Control, and Conduct Disorder
 Substance-Related & Addictive Disorders

• They can be diagnosed with physiological dependence, evidence of

tolerance or withdrawal, or without physiological dependence.
• Addiction is the continued repetition of a behavior despite adverse
consequences, or a neurological impairment leading to such behaviors.
 Substance-Related & Addictive Disorders
• Substance-Related Disorders
• Alcohol-Related Disorders
• Caffeine-Related Disorders
• Cannabis-Related Disorders
• Hallucinogen-Related Disorders
• Inhalant-Related Disorders
• Opioid-Related Disorders
• Sedative-, Hypnotic-, or Anxiolytic-Related Disorders
• Stimulant-Related Disorders
• Tobacco-Related Disorders
• Other (or Unknown) Substance–Related Disorders
• Non-Substance-Related Disorders - Gambling Disorder
 Neurocognitive Disorders
• The neurocognitive disorders (NCDs) (referred to in DSM-IV as “Dementia, Delirium,
Amnestic, and Other Cognitive Disorders”)
• The NCD category encompasses the group of disorders in which the primary clinical deficit is
in cognitive function, and that are acquired rather than developmental.
• Although cognitive deficits are present in many if not all mental disorders (e.g., schizophrenia,
bipolar disorders), only disorders whose core features are cognitive are included in the NCD
category.
 Neurocognitive Disorders
• Delirium
• Major or Mild Neurocognitive Disorder Due to Alzheimer’s disease
• Major or Mild Frontotemporal Neurocognitive Disorder
• Major or Mild Neurocognitive Disorder With Lewy Bodies
• Major or Mild Vascular Neurocognitive Disorder
• Major or Mild Neurocognitive Disorder Due to Traumatic Brain Injury
• Substance/Medication-Induced Major or Mild Neurocognitive Disorder
• Major or Mild Neurocognitive Disorder Due to HIV Infection
• Major or Mild Neurocognitive Disorder Due to Prion Disease
• Major or Mild Neurocognitive Disorder Due to Parkinson’s Disease
• Major or Mild Neurocognitive Disorder Due to Huntington’s Disease
• Major or Mild Neurocognitive Disorder Due to Another Medical Condition
• Major or Mild Neurocognitive Disorder Due to Multiple Etiologies
• Unspecified Neurocognitive Disorder
 Personality disorders
• They are a class of mental disorders characterized by enduring maladaptive patterns
of behavior, cognition, and inner experience, exhibited across many contexts and
deviating markedly from those accepted by the individual's culture.
• They involve long-term patterns of thoughts and behaviors that are unhealthy and
inflexible.
 Personality Disorders
• Cluster A Personality Disorders
• Paranoid Personality Disorder
• Schizoid Personality Disorder
• Schizotypal Personality Disorder
• Cluster B Personality Disorders
• Antisocial Personality Disorder
• Borderline Personality Disorder
• Histrionic Personality Disorder
• Narcissistic Personality Disorder
• Cluster C Personality Disorders
• Avoidant Personality Disorder
• Dependent Personality Disorder
• Obsessive-Compulsive Personality Disorder
• Other Personality Disorders
• Personality Change Due to Another Medical
Condition
• Other Specified Personality Disorder
• Unspecified Personality Disorder
 Paraphilic Disorders

• They are also known as sexual perversion and sexual deviation) is the experience of
intense sexual arousal to atypical objects, fetishes, situations, fantasies, behaviors, or
individuals
• There is still debate over which, if any, of the paraphilias should be listed in diagnostic
manuals, such as DSM or ICD.
 Paraphilic Disorders
• Voyeuristic Disorder
• Exhibitionistic Disorder
• Frotteuristic Disorder
• Sexual Masochism Disorder
• Sexual Sadism Disorder
• Pedophilic Disorder
• Fetishistic Disorder
• Transvestic Disorder
• Other Specified Paraphilic Disorder
• Unspecified Paraphilic Disorder
 Medication-Induced Movement Disorders & Other Adverse
Effects of Medication

• They occurs due to treatment with antipsychotic medications.

• They are caused by medications that block the action of dopamine,
a neurotransmitter that allows communication between two
neurons to take place and that is necessary for coordination of
movements of different parts of the body.
Medication-Induced Movement Disorders & Other Adverse
Effects of Medication
• Neuroleptic-Induced Parkinsonism
• Neuroleptic Malignant Syndrome
• Medication-Induced Acute Dystonia
• Medication-Induced Acute Akathisia
• Tardive Dyskinesia
• Tardive Dystonia
• Tardive Akathisia
• Medication-Induced Postural Tremor
• Antidepressant Discontinuation Syndrome
 Other Conditions That May Be a Focus of Clinical
Attention
• Relational Problems
• Abuse and Neglect
• Educational and Occupational Problems
• Nonadherence to Medical Treatment
 ICD-10
CLASSIFICATION OF MENTAL AND
BEHAVIOURAL DISORDERS
ICD-10: Classification of Mental and Behavioural Disorders
• Organic, including symptomatic, mental
disorders
• Mental and behavioural disorders due to
psychoactive substance use
• Schizophrenia, schizotypal and delusional
disorders
• Mood [affective] disorders
• Behavioural syndromes associated with
physiological disturbances and physical
factors
• Neurotic, stress-related and somatoform
disorders
• Disorders of adult personality and
behaviour
• Mental retardation
• Disorders of psychological development
• Behavioural and emotional disorders with
onset usually occurring in childhood and
adolescence
• Unspecified mental disorder
Organic, including symptomatic, mental disorders (F00-F09)

• A range of mental disorders grouped together on the basis of their having

in common etiology in cerebral disease, brain injury, or other insult leading
to cerebral dysfunction.
 Organic, including symptomatic, mental disorders
• Dementia in Alzheimer's disease
• Vascular dementia
• Dementia in other diseases classified elsewhere
• Unspecified dementia
• Organic amnesic syndrome, not induced by alcohol and other psychoactive
substances
• Delirium, not induced by alcohol and other psychoactive substances
• Other mental disorders due to brain damage and dysfunction and to physical
disease
• Personality and behavioural disorders due to brain disease, damage and
dysfunction
 Mental & behavioural disorders due to psychoactive
substance use (F10-F19)

• A wide variety of disorders that differ in severity and clinical form but that are all
attributable to the use of one or more psychoactive substances, which may or may not
have been medically prescribed.
 Mental & behavioural disorders due to psychoactive
substance use
• Mental and behavioural disorders due to:
– use of alcohol, opioids, cannabinoids, sedatives or hypnotics,
cocaine, other stimulants, including caffeine, hallucinogens,
tobacco
– use to volatile solvents (e.g. glue, aerosol, paints, thinners,
gasoline, and cleaning fluids)
– multiple drug use and use of other psychoactive substances
(e.g. alcohol, Ecstasy etc.)
 Schizophrenia, schizotypal and delusional disorders
(F20-F29)

• This brings together schizophrenia, as the most important member of the group,
schizotypal disorder, persistent delusional disorders, and a larger group of acute and
transient psychotic disorders.
• The schizophrenic disorders are characterized in general by fundamental and
characteristic distortions of thinking and perception, and affects that are inappropriate
or blunted.
 Schizophrenia, schizotypal & delusional disorders
• Schizophrenia
• Schizotypal disorder
• Persistent delusional disorders
• Acute and transient psychotic disorders
• Induced delusional disorder
• Schizoaffective disorders
• Other nonorganic psychotic disorders
• Unspecified nonorganic psychosis
 Mood [affective] disorders (F30-F39)
• This contains disorders in which the fundamental disturbance is a change
in affect or mood to depression (with or without associated anxiety) or to
elation.
• Most of these disorders tend to be recurrent and the onset of individual
episodes can often be related to stressful events or situations.
 Mood [affective] disorders

• Manic episode • Phobic anxiety disorders

• Bipolar affective disorder
• Depressive episode
• Recurrent depressive disorder
• Persistent mood [affective] disorders
• Other mood [affective] disorders
• Unspecified mood [affective] disorder
• Other anxiety disorders
• Obsessive-compulsive disorder
• Reaction to severe stress, and
adjustment disorders
• Dissociative [conversion] disorders
• Somatoform disorders
• Other neurotic disorders
 Neurotic, stress-related and somatoform disorders (F40-F48)

• Neurotic, stress-related, and somatoform disorders have common

historical origin with the concept of neurosis and association of a
substantial proportion of these disorders with psychological causation.
• Mixtures of symptoms, especially anxiety and depressive ones are
common in these disorders
• With the exception of social phobia their frequency is higher in women
than in men.
 Neurotic, stress-related and somatoform disorders

• Phobic anxiety disorders

• Other anxiety disorders
• Obsessive-compulsive disorder
• Reaction to severe stress, and adjustment
disorders
• Dissociative [conversion] disorders
• Somatoform disorders
• Other neurotic disorders
 Behavioural syndromes associated with physiological
disturbances & physical factors (F50-F59)

• This contains disorders related to unspecified behavioral syndromes

associated with some different physiological disturbances and physical
factors
Behavioural syndromes associated with physiological disturbances &
physical factors
• Eating disorders
• Nonorganic sleep disorders
• Sexual dysfunction, not caused by organic disorder or disease
• Mental and behavioural disorders associated with the puerperium, not
elsewhere classified
• Psychological and behavioural factors associated with disorders or
diseases classified elsewhere
• Abuse of non-dependence-producing substances
• Unspecified behavioural syndromes associated with physiological
disturbances and physical factors
 Disorders of adult personality & behaviour (F60-
F69)

• This includes a variety of conditions and behaviour patterns of clinical significance which
tend to be persistent and appear to be the expression of the individual's characteristic
lifestyle and mode of relating to himself or herself and others.
• They represent extreme or significant deviations from the way in which the average
individual in a given culture perceives, thinks, feels and, particularly, relates to others.
 Disorders of adult personality & behaviour
• Specific personality disorders

• Mixed and other personality disorders

• Enduring personality changes, not attributable to brain damage and disease

• Habit and impulse disorders

• Gender identity disorders

• Disorders of sexual preference

• Psychological and behavioural disorders associated with sexual development and orientation

• Other disorders of adult personality and behaviour

• Unspecified disorder of adult personality and behaviour

 Mental retardation (F70-F79)

• A condition of arrested or incomplete development of the mind, which is

especially characterized by impairment of skills manifested during the
developmental period, skills which contribute to the overall level of
intelligence, i.e. cognitive, language, motor, and social abilities.
Retardation can occur with or without any other mental or physical
condition.
 Mental retardation
• Mild mental retardation
• Moderate mental retardation
• Severe mental retardation
• Profound mental retardation
• Other mental retardation
• Unspecified mental retardation
 Disorders of psychological development
(F80-F89)

• The disorders include: (a) onset invariably during infancy or childhood; (b)
impairment or delay in development of functions that are strongly related
to biological maturation of the central nervous system; and (c) a steady
course without remissions and relapses.
• In most cases, the functions affected include language, visuo-spatial skills,
and motor coordination.
 Disorders of psychological development
• Specific developmental disorders of speech and language
• Specific developmental disorders of scholastic skills
• Specific developmental disorder of motor function
• Mixed specific developmental disorder
• Pervasive developmental disorders
• Other disorders of psychological development
• Unspecified disorder of psychological development
 Behavioural and emotional disorders with onset usually
occurring in childhood and adolescence (F90-F98)

• The disorders are closely related to some common behavioural and

emotional disorders that usually occur in children and adolescence that
significantly impair their academic, social and work performance.
 Behavioural and emotional disorders with onset usually occurring in
childhood & adolescence

• Hyperkinetic disorder
• Conduct disorders
• Mixed disorders of conduct and emotions
• Emotional disorders with onset specific to childhood
• Disorders of social functioning with onset specific to childhood and adolescence
• Tic disorders
• Other behavioural and emotional disorders with onset usually occurring in childhood and
adolescence
 Unspecified mental disorder
• Mental disorder, not otherwise specified (NOS)
• When the symptoms exhibited point toward a mental disorder but do not
fall into one of the generally accepted categories of mental illnesses, it is
classified as unspecified mental disorder.
• The main cause may not be known, there are common symptoms that
appear in people who suffer from this mental illness
 Readings
• American Psychiatric Association. Diagnostic and Statistical Manual of
Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric
Association, 2013.
• Kapoor B. Textbook of Psychiatric Nursing Vol. 1. India: Kumar
Publishing; 2010. Chapter 3, pp. 79-86.
• Queensland transcultural mental health Centre. Glossary of mental
health terms for interpreters and translators English - Chinese, Italian,
Spanish & Vietnamese. Queensland Australia, Queensland health,
2006. Available at
https://www.health.qld.gov.au/metrosouthmentalhealth/qtmhc/docs/gloss
ary_mh_terms_v1.pdf
• World Health Organization. The ICD-10 Classification of Mental and
Behavioural Disorders Diagnostic criteria for research. Geneva, World
 THANK YOU

QUESTIONS SHOULD BE SENT TO:

arsyad@gmu.ac.ae