Classifcation of “reactive” mental disorders in ICD and DSM
Reactive mental disorders are those that are presumed to occur in reaction to one or more stressful life events. Linden has described a novel syndrome, Post-traumatic Embitterment Disorder, in which the emotional state of embitterment is precipitated by an exceptional life event (Linden 2003). As such, it is being conceptualized by Linden as a reactive mental disorder. In this paper, we review the different ways the DSM-IV and ICD-10 classify reactive mental disorders by dividing them up into three tiers which are implemented hierarchically, i. e., disorders in first tier (i. e., stress-reactive-specific disorders like PTSD) should be considered first when determining the differential diagnosis of a reactive mental disorder, followed by disorders in the second tier (other disorders meeting full criteria for a specific DSM-IV Axis I Disorder) and then finally, if the disturbance is not covered by any disorders in the first two tiers, Adjustment Disorder (tier 3) is diagnosed.
KeywordsAnxiety Disorder Major Depressive Disorder Posttraumatic Stress Disorder Psychotic Disorder Severe Trauma
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