Mental Health Disorder Diagnosis

When someone is diagnosed as having a particular mental illness, it is done so based on that person meeting the criteria for that illness as set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is a team effort produced from the work of doctors, psychologists, and psychiatrists and published by the American Psychiatric Association (APA). The fifth edition (DSM V) was released in May of this year (2013) but I am going to refer to the fourth edition (DSM IV) because it has been in use since 2000 meaning that most people currently living with a mental illness would have been diagnosed according to the DSM IV.The DSM IV is broken down into axes:

Axis I     Clinical Disorders

               Other Conditions That May Be a Focus of Clinical Attention

Axis II    Personality Disorders

               Mental Retardation

Axis III   General Medical Conditions

Axis IV  Psychosocial and Environmental Problems

Axis V   Global Assessment of Functioning

I will be covering some of the conditions in a later post but at this time I just want to make these statements:

If you were to look through the criteria of the various conditions within the DSM, then every human on this planet would be diagnosed with some type of mental illness. In order to be diagnosed with a particular disorder, a person must exhibit a certain number of the criteria listed for that disorder. Let us suppose five out of nine traits were required for diagnosis and then we can say “congratulations Jill, you are now the proud owner of the label Major Depressive Disorder”. You see often it is just a label. No every person has the same traits or to the same degree and yet they still get the same level. In this example, how important are the four out of nine traits that Jill doesn’t have? Another person may have those four traits and one that Jill has and get the same diagnosis.

Sometimes this is a tremendous issue because depending on the diagnosis, the patient can start to be treated in a way that is very detrimental to them. For example, some conditions have a lot of stigma attached to them and unfortunately it is often mental health professionals that cause the most problems by discriminating and handing out certain labels for patients they do not have the skill to treat. I will come back to this issue in a later post about personality disorders.

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4^th ed.). Washington, DC: Author.

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