Classification Of Mood Disorders A Background

Although modern psychiatrists seek to classify psychiatric disorders based on biochemical, genetic, and immunologic findings as well as the interaction with the environment, almost all existing psychiatric classifications use the descriptive method in which diseases are named and grouped based on similar patterns of clinical presentations across different individuals. Leonhard (1959) suggested that unipolar (UP) and bipolar (BP) disorders were different entities. After Angst (1966) and Perris (1968) reported systematic family history data supporting Leonhard's theory, these disorders were independently included in modern psychiatric classifications. In 1948, a committee was instituted by the American Psychiatric Association to create a single national system of classification that would solve the chaotic situation existing as new psychiatric diagnoses were being independently devised by different researchers since the 19th century. In 1952, the first system of classification was published, the Diagnostic and Statistical Manual of Mental Disorders, known as DSM-I. The current fourth edition (DSM-IV), published in 1994, uses specific diagnostic criteria (i.e., a list of individual features required for a diagnosis to be made) and a multiaxial approach to classify psychiatric disorders. Axis I refers to clinical disorders. Therefore, the presence of UP or BP disorder would be recorded in this axis. Supplemental information for the clinician is provided by axis II, which consists of personality disorders, as well as axes III and IV, which record associated physical conditions and psychosocial stressors, respectively. Using axis V, which consists of the Global Assessment of Functioning Scale, the clinician can also assess the patients' highest level of social, occupational, and psychological functioning at the time of evaluation.

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