Other Psychiatric Classification Systems

International Classification of Diseases (ICD)

From www.cdphe.state.co.us/hs/

    In some ways, it is inappropriate to list the ICD as an “other classification system.”  It is actually the official international system for the classification of mental and physical disease.   However, since the DSM is currently the more popular system for mental health in the United States, it demanded more attention on this website.

    The ICD was developed by the World Health Organization (WHO) to create a standard format for collecting and comparing mortality statistics.  The first edition appeared in 1900 and it has undergone a revision every 10 years or so. 

    The current edition is ICD-10 (1999).  Its authors were somewhat resentful of the success of the DSM.  Therefore, ICD’s format changed in order to make it more like the DSM.  Like DSM, ICD employed extensive field trials and explicit criteria to ensure reliability.  Unlike DSM, ICD-10 is a 2-volume work, with the Blue manual offering clinical descriptions and the Green manual offering criteria.  ICD-10 also did not accept the multiaxial system of DSM-III and DSM-IV.  It has 389 diagnoses for mental disorders, making it quite similar to the DSM-IV-TR.

Anna Freud’s Developmental Profile, 1965
In Achenbach, 1995

    According to Achenbach, there is little research on how to use this system for diagnosis.  Much of the available material offers categorical descriptions, such as, “There is permanent drive regression to fixation points which leads to conflicts of a neurotic type.”

Group for Advancement of Psychiatry, 1966
In Achenbach, 1995

    The Group did not provide any methods, making it difficult to use their system for diagnosis.  Although their intent was to define disorders so that inferences were unnecessary, their categories required extensive psychodynamic inferences.


Diagnostic Classification: 0 to 3, 1994

In Scotti and Morris, 2000

    This classification system was created by the National Center for Clinical Infant Programs.  It provides a means for the multiaxial assessment of very young children.  The five axes include Primary Diagnosis, Relationship Disorder, Medical and Developmental Disorders and Conditions, Psychosocial Stressors, and Functional Emotional Developmental Level.  Although these axes are very similar to those found in the DSM, they employ a developmental perspective and require exploration of different areas of functioning.


Dimensional Approaches
   In Scotti and Morris, 2000

    As an alternative to the categorical approach of DSM and ICD, some researchers have begun to propose dimensional systems.  One such researcher is Achenbach, whose classification system has only 2 major dimensions: internalizing and externalizing.  Each dimension subsumes narrow clusters, such as anxious/depressed or aggressive behavior.

    DSM-IV-TR addresses the growing attraction of dimensional approaches.  DSM-IV-TR concedes that such an approach would increase reliability and communicate more clinical information.  However, dimensional approaches are less familiar to clinicians than categorical approaches, and there would be no agreement on the choice of dimensions.

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