Diagnosis of Dysfunctional Behaviour

There are two main diagnosis manuals that have been used to help categories dysfunctional behaviour with some reliability in diagnosis. These are the Diagnostic Statistics Manual (DSMIV) which tends to be used in the USA, and the International Classification of Disorder (ICDXI) which tends to be used outside of the USA.

Categorising disorders

Diagnostic Statistics Manual (DSMIV):

DSM and ICD are diagnostic tools designed to enable practitioners to identify and treat a particular disorder, which are updated. Disorders will change with time, for example until 1973 homosexuality was perceived as a mental disorder. As society started to accept that it couldn’t be cured then it was removed from the DSM.

The DSM was compiled by over 1000 people who collaborated to produce a practical guide to clinical diagnoses. As this manual is the main diagnostic tool used in the USA, there is also an attempt to highlight the ethnic diversity of the US population and suggest that diagnosing may be more difficult if the culture of the patient is different from that of the clinician.

DSMIV has classifications such as:

• Learning disorders.
• Dementia.
• Sleep disorders.

International Classification Disorders (ICDXI):

Used in many countries throughout the world in diagnosing both physical and mental conditions. Some of the categories related to specific childhood or development disorders, while others, such as eating disorders, are applicable to both children and adults.

ICDXI has classifications such as:

• schizophrenia
• mood (affective) disorder
• personality disorders

Differences between DSMIV and ICDXI:

The major difference between the two is that DSM is a multi-axial tool. Clinicians have to consider whether the disorder is from Axis 1, clinical disorders and/or Axis 2, personality disorders. Then the patient's general physical condition is considered, plus any social and environmental problems. This is used to access the patients functioning on a scale of 1 to 100. This makes the DSM more holistic in relation to diagnosis than ICD's rather reductionists approach to criteria-based diagnoses. Also the DSM has 16 categories of mental disorder whereas the ICD has 11.