Skip to main content

Psychiatric Classification

  • Living reference work entry
  • First Online:
Tasman’s Psychiatry
  • 100 Accesses

Abstract

The most important goals of psychiatric classifications like the Mental, Behavioral and Neurodevelopmental Disorders chapter in the World Health Organization’s International Classification of Diseases, Eleventh Revision (ICD-11) and the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition – Text Revision (DSM-5-TR) are to allow mental health practitioners and researchers to communicate more effectively with each other by establishing a convenient shorthand for describing the mental disorders that they see. as well as to facilitate the identification and management of mental disorders in clinical settings. This chapter begins by discussing the different approaches to classification (etiological vs. descriptive, symptom-based vs. syndrome based, categorical vs. dimensional). Because of our lack of knowledge about the underlying causes and pathophysiology of mental disorders, the ICD and DSM have adopted a descriptive syndrome-based categorical approach. The chapter then provides a historical overview of the classification systems that are the predecessors to ICD-11 and DSM-5-TR. The ICD-11 and DSM-5-TR classifications are then described in some detail, focusing both on the organizational structure of the diagnostic groupings as well as providing an overview of the various disorders contained within the diagnostic groupings. The chapter concludes with a look at the future of the ICD-11 and DSM-5-TR classifications in terms of what to expect regarding the next steps.

This chapter is an update from the 4th edition. Previous edition author was Michael B. First

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • Aggrawal, A. (2008). Appendix 1. In Forensic and medico-legal aspects of sexual crimes and unusual sexual practices (pp. 369–382). CRC Press.

    Chapter  Google Scholar 

  • American Psychiatric Association. (1952). Diagnostic and statistical manual of mental disorders. American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (1968). Diagnostic and statistical manual of mental disorders (2nd ed.). American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (Third ed.). American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (third ed. – revised (DSM-III-R)). : American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). American Psychiatric Association.

    Book  Google Scholar 

  • Andrews, G., Brugha, T., Thase, M. E., Duffy, F., Rucci, P., & Slade, T. (2007). Dimensionality and the category of major depressive episode. International Journal of Methods in Psychiatric Research, 16(suppl 1), 541–551.

    Google Scholar 

  • Baird, G., & Norbury, C. F. (2014). Social (pragmatic) communication disorders and autism spectrum disorder. Archives of Disease in Childhood, 101(8), 745–751.

    Article  Google Scholar 

  • Boissier de Sauvages, F. (2012). Nosologie Methodique, Ou Distribution Des Maladies En Classes, En Genres, Et En Especies. Nabu Press.

    Google Scholar 

  • Boyd, J., Burke, J., Gruenberg, E., Holzer, C., Rae, D., George, L., … Nestadt, G. (1984). Exclusion criteria of DSM-III: a study of co-occurrence of hierarchy-free syndromes. Archives of General Psychiatry, 41, 983–989.

    Google Scholar 

  • Casey, P., & Bailey, S. (2011). Adjustment disorders: The state of the art. World Psychiatry, 10(1), 11–18.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cassano, G., Dell’Osso, L., Frank, E., Miniati, M., Faqiolini, A., Shear, K., … Maser, J. (1999). The bipolar spectrum: a clinical reality in search of diagnostic criteria and an assessment methodology. Journal of Affective Disorders, 54(3), 318–328.

    Google Scholar 

  • Clark, L. (2005). Temperament as a unifying concept in the study of personality and psychopathology. Journal of Abnormal Psychology, 114(4), 505–521.

    Article  PubMed  Google Scholar 

  • Clark, L., Watson, D., & Reynolds, S. (1995). Diagnosis and classification of psychopathology: Challenges to the current system and future directions. Annual Review of Psychology, 46, 121–153.

    Article  CAS  PubMed  Google Scholar 

  • Cloninger, C. (1998). A new conceptual paradigm from genetics and psychobiology for the science of mental health. Australian and New Zealand Journal of Psychiatry, 33, 174–186.

    Article  Google Scholar 

  • Cohen, J. (1983). The cost of dichotomization. Applied Psychological Measurement, 7, 249–253.

    Article  Google Scholar 

  • Decker, H. (2013). The making of DSM-III: A diagnostic manual’s conquest of American psychiatry. Oxford University Press.

    Google Scholar 

  • Degenhardt, L., Bharat, C., Bruno, R., Glantz, M. D., Sampson, N. A., Lago, L., … Collaborators., W. W. M. H. S. (2019). Concordance between the diagnostic guidelines for alcohol and cannabis use disorders in the draft ICD-11 and other classification systems: analysis of data from the WHO’s World Mental Health Surveys. Addiction, 114(3), 534–552.

    Google Scholar 

  • Drescher, J., Cohen-Kettenis, P., & Winter, S. (2012). Minding the body: Situating gender identity diagnoses in the ICD-11. International Review of Psychiatry, 24(6), 568–577.

    Article  PubMed  Google Scholar 

  • Evan, s. S. C., Burke, J. D., Roberts, M. C., Paula, J. F., Lochman, J. E., de la Peña, F. R., & Geoffrey, M. R. (2017). Irritability in child and adolescent psychopathology: An integrative review for ICD-11. Clinical Psychology Review, 53, 29–45.

    Article  Google Scholar 

  • Fairburn, C., Cooper, Z., Bahn, K., O’Connor, M., Doll, H., & Palmer, R. (2007). The severity and status of eating disorder NOS: Implications for DSM-V. Behaviour Research and Therapy, 45(8), 1705–1715.

    Article  PubMed  PubMed Central  Google Scholar 

  • Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Jr., Winokur, G., & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26(1), 57–63. Retrieved from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=5009428

    Article  CAS  PubMed  Google Scholar 

  • First, M. (1992). Trends in psychiatric classification: DSM-III-R to DSM-IV. Psychiatria Hungarica, 7, 539–546.

    Google Scholar 

  • First, M. (1994). Principles of disease classification and diagnostic criteria. In J. Olesen (Ed.), Headache classification and epidemiology (pp. 17–26). Raven Press.

    Google Scholar 

  • First, M. (2005a). Clinical utility: A prerequisite for the adoption of a dimensional approach in DSM. Journal of Abnormal Psychology, 114(4), 560–564.

    Article  PubMed  Google Scholar 

  • First, M. (2005b). Mutually exclusive versus co-occurring diagnostic categories: The challenge of diagnostic comorbidity. Psychopathology, 38(4), 206–210.

    Article  PubMed  Google Scholar 

  • First, M. B. (2009). Harmonisation of ICD-11 and DSM-V: Opportunities and challenges. The British Journal of Psychiatry, 195(5), 382–390. Retrieved from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19880924

    Article  PubMed  Google Scholar 

  • First, M. (2013). Diagnostic and statistical manual of mental disorders, 5th edition, and clinical utility. Journal of Nervous and Mental Disorders, 201(9), 727–729.

    Article  Google Scholar 

  • First, M. B. (2016). Adopting a continuous improvement model for future DSM revisions. World Psychiatry, 15(3), 223–224.

    Article  PubMed  PubMed Central  Google Scholar 

  • First, M. B., & Fisher, C. E. (2012). Body integrity identity disorder: The persistent desire to acquire a physical disability. Psychopathology, 45, 3–14.

    Article  PubMed  Google Scholar 

  • First, M., & Pincus, H. (2002). The DSM-IV text revision: Rationale and potential impact on clinical practice. Psychiatric Services, 53(3), 288–292.

    Article  PubMed  Google Scholar 

  • First, M., & Westen, D. (2007). Classification for clinical practice: How to make ICD and DSM better able to serve clinicians. International Review of Psychiatry, 19(5), 473–481.

    Article  PubMed  Google Scholar 

  • First, M. B., Reed, G. M., Hyman, S. E., & Saxena, S. (2015). The development of the ICD-11 clinical descriptions and diagnostic guidelines for mental and behavioural disorders. World Psychiatry, 14(1), 82–90.

    Article  PubMed  PubMed Central  Google Scholar 

  • First, M. B., et al. (2021). An organization- and category-level comparison of diagnostic requirements for mental disorders in ICD-11 and DSM-5. World Psychiatry, 20, 34–51.

    Article  PubMed  PubMed Central  Google Scholar 

  • First M. B., Clarke D. E., Yousif L., Eng A. M., Gogtay N., Appelbaum P. S. (2022). DSM-5-TR: Rationale, process, and overview of changes. Psychiatric Services 2022 Dec 13:appips20220334. https://doi.org/10.1176/appi.ps.20220334. Epub ahead of print. PMID: 36510761.

  • Flint, J., & Munafo, M. R. (2007). The endophenotype concept in psychiatric genetics. Psychological Medicine, 37(2), 163–180.

    Article  PubMed  Google Scholar 

  • Frances, A., Widiger, T., & Pincus, H. (1989). The development of DSM-IV. Archives of General Psychiatry, 46, 373–375.

    Article  CAS  PubMed  Google Scholar 

  • Frances, A., Pincus, H., Widiger, T., Davis, W., & First, M. (1990). DSM-IV: Work in progress. The American Journal of Psychiatry, 147, 1439–1448.

    Article  CAS  PubMed  Google Scholar 

  • Goldberg, D. (1996). A dimensional model for common mental disorders. The British Journal of Psychiatry, 168(suppl. 30), 44–49.

    Article  Google Scholar 

  • Grob, G. (1991). Origins of DSM-I: A study in appearance and reality. The American Journal of Psychiatry, 148(4), 421–431.

    Article  CAS  PubMed  Google Scholar 

  • Guze, S. (1974). Psychiatric disorders and the medical model. Biological Psychiatry, 5(3), 221–224.

    Google Scholar 

  • Irwin, D. E., Stucky, B., Langer, M. M., Thissen, D., DeWitt, E. M., Lai, J.-S., … DeWalt, D. A. (2010). An item response analysis of the pediatric PROMIS anxiety and depressive symptoms scale. Qualify of Life Research, 21(2), 195–207.

    Google Scholar 

  • Jablensky, A. (1999). The nature of classification: Issues beyond ICD-10 and DSM-IV. Australian and New Zealand Journal of Psychiatry, 33, 137–144.

    Article  CAS  PubMed  Google Scholar 

  • Keeley, J. W., Reed, G. M., Roberts, M. C., Evans, S. C., Medina-Mora, M. E., Robles, R., … Saxena, S. (2016). Developing a science of clinical utility in diagnostic classification systems: Field study strategies for ICD-11 Mental and Behavioural Disorders. American Psychologist, 71, 3–16. https://doi.org/10.1037/a0039972.

  • Kendell, R. (1982). The choice of diagnostic criteria for biological research. Archives of General Psychiatry, 39(11), 1334–1339.

    Article  CAS  PubMed  Google Scholar 

  • Kendler, K. S. (1996). Major depression and generalized anxiety disorder: Same genes, (partly) different environments – Revisited. The British Journal of Psychiatry, 168(suppl. 30), 68–75.

    Article  Google Scholar 

  • Klerman, G. (1983). The significance of DSM-III in American psychiatry. In R. L. Spitzer, J. B. W. Williams, & A. Skodol (Eds.), International perspectives on DSM-III (pp. 3–25). American Psychiatric Press.

    Google Scholar 

  • Klerman, G. (1984). A debate on DSM-III. The American Journal of Psychiatry, 141(4), 539–553.

    Article  CAS  PubMed  Google Scholar 

  • Kraemer, H., Noda, A., & O‘Hara, R. (2004). Categorical versus dimensional approaches to diagnosis: Methodological challenges. Journal of Psychiatric Research, 38, 17–25.

    Article  PubMed  Google Scholar 

  • Krueger, R. F., & Hobbs, K. A. (2020). An overview of the DSM-5 alternative model of personality disorders. Psychopathology, 53, 126–132.

    Article  PubMed  Google Scholar 

  • Krueger, R., Markon, K., Patrick, C., & Iacono, W. (2005). Externalizing psychopathology in adulthood: A dimensional-spectrum conceptualization and its implications for DSM-V. Journal of Abnormal Psychology, 114(4), 537–550.

    Article  PubMed  PubMed Central  Google Scholar 

  • Li, N., Mitchison, D., Touyz, S., & Hay, P. (2019). Cross-sectional comparison of health-related quality of life and other features in people with and without objective and subjective binge eating using a general population sample. BMJ Open, 9, 2.

    Google Scholar 

  • Lochman, J. E., Evans, S. C., Burke, J. D., Michael C. R., Paula J. F., Reed, G. M., … Elena Garralda, M. (2015). An empirically based alternative to DSM-5’s disruptive mood dysregulation disorder for ICD-11. World Psychiatry, 14(1), 30–33.

    Google Scholar 

  • Mack, A., Forman, L., Brown, R., & Frances, A. (1994). A brief history of psychiatric classification. From the ancients to DSM-IV. The Psychiatric Clinics of North America, 17, 515–523.

    Article  CAS  PubMed  Google Scholar 

  • Mayes, R., & Horwitz, A. (2005). DSM-III and the revolution in the classification of mental illness. Journal of the History of the Behavioral Sciences, 41(3), 249–267.

    Article  PubMed  Google Scholar 

  • McHugh, P. (2005). Striving for coherence: Psychiatry’s efforts over classification. JAMA, 293, 2526–2528.

    Article  CAS  PubMed  Google Scholar 

  • Mellsop, G., Menkes, D., & El-Badri, S. (2007). Releasing psychiatry from the constraints of categorical diagnosis. Austrialis Psychiatry, 15(1), 3–5.

    Article  Google Scholar 

  • Mineka, S., Watson, D., & Clark, L. (1998). Psychopathology: Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology, 49, 377–412.

    Article  CAS  PubMed  Google Scholar 

  • Mulder, R. T. (2021). ICD-11 personality disorders: Utility and implications of the new model. Frontiers in Psychiatry 12:655548.

    Google Scholar 

  • Norbury, C. F. (2014). Practitioner review: Social (pragmatic) communication disorder conceptualization, evidence and clinical implications. Journal of Child Psychology and Psychiatry, 55(3), 204–216.

    Article  PubMed  Google Scholar 

  • Parker, G. (2005). Beyond major depression. Psychological Medicine, 35, 467–474.

    Article  PubMed  Google Scholar 

  • Peralta, V., & Cuesta, M. (2000). Clinical models of schizophrenia: A critical approach to competing conceptions. Psychopathology, 33, 252–258.

    Article  CAS  PubMed  Google Scholar 

  • Peralta V., Cuesta M. J., Giraldo C., Cardenas A., Gonzalez F. (2002). Classifying psychotic disorders: Issues regarding categorial vs. dimensional approaches and time frame to assess symptoms. Eur Arch Psychiatry Clin Neurosci., 252(1), 12–8.

    Google Scholar 

  • Phillips, J. (2013). Review of the conceptual evolution of DSM-5: Darrel A. Regier, William E. Narrow, Emily. Kuhl, and David J. Kupfer Eds. (2011) Arlington VA: American Psychiatric Publishing. Journal of Nervous and Mental Disorders, 201(9), 8280829.

    Article  Google Scholar 

  • Pilkonis, P. A., Choi, S. W., Reise, S. P., Stover, A. M., Riley, W. T., & Cella, D. (2011). Item banks for measuring emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS): Depression, anxiety, and anger. Assessment, 18(3), 263–283.

    Article  PubMed  PubMed Central  Google Scholar 

  • Poldrack, R. A. (2007). Can cognitive processes be inferred from neuroimaging data? Trends in Cognitive Sciences, 10(2), 59–63.

    Article  Google Scholar 

  • Prigerson, H. G., Shear, M. K., & Reynolds, C. F. (2022). Prolonged grief disorder diagnostic criteria – Helping those with maladaptive grief responses. JAMA Psychiatry, 79, 277–278.

    Article  PubMed  Google Scholar 

  • Reed, G. M., First, M. B., Kogan, C. S., Hyman, S. E., Gureje, O., Gaebel, W., … Saxena, S. (2019). Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders. World Psychiatry, 18(1), 3–19.

    Google Scholar 

  • Regier, D., Narrow, W., Kuhl, E., & Kupfer, D. (2009). The conceptual development of DSM-V. The American Journal of Psychiatry, 166(6), 645–650.

    Article  PubMed  Google Scholar 

  • Regier, D., Narrow, W., Kuhl, E., & Kupfer, D. (Eds.). (2011). The conceptual evolution of DSM-5. American Psychiatric Publishing.

    Google Scholar 

  • Robins, E., & Guze, S. (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. The American Journal of Psychiatry, 126(7), 983–987.

    Article  CAS  PubMed  Google Scholar 

  • Sateia, M. J. (2014). International classification of sleep disorders-third edition: Highlights and modifications. Chest, 146(5), 1387–1394.

    Article  PubMed  Google Scholar 

  • Smoller, J., & Tsuang, M. (1998). Panic and phobic anxiety: Defining phenotypes for genetic studies. The American Journal of Psychiatry, 155(9), 1152–1162.

    Article  CAS  PubMed  Google Scholar 

  • Spitzer, R., & Fleiss, J. (1974). A re-analysis of the reliability of psychiatric diagnosis. The British Journal of Psychiatry, 125, 341–347.

    Article  CAS  PubMed  Google Scholar 

  • Spitzer, R. L., & Willaims, J. (1987). Revising DSM-III, the process and major issues. In G. Tischler (Ed.), Diagnosis and classification in psychiatry. A critical appraisal of DSM-III. Cambridge University Press.

    Google Scholar 

  • Spitzer, R. L., Endicott, J., & Robins, E. (1978). Research diagnostic criteria: Rationale and reliability. Archives of General Psychiatry, 35(6), 773–782.

    Article  CAS  PubMed  Google Scholar 

  • Spitzer, R., Forman, J., & Nee, J. (1979). DSM-III field trials: I. initial interrator diagnostic reliability. The American Journal of Psychiatry, 136, 815–817.

    Article  CAS  PubMed  Google Scholar 

  • Szasz, T. (1960). The myth of mental illness. American Psychologist, 15, 113–118.

    Article  Google Scholar 

  • Tien, A., & Gallo, J. (1997). Clinical diagnosis: A marker for disease? The Journal of Nervous and Mental Disease, 185(12), 739–747.

    Article  CAS  PubMed  Google Scholar 

  • Watson, D. (2005). Rethinking the mood and anxiety disorders: A quantitative hierarchical model for DSM-V. Journal of Abnormal Psychology, 114(4), 522–536.

    Article  PubMed  Google Scholar 

  • Widiger, T., & Samuel, D. (2005). Diagnostic categories or dimensions: A question for the diagnostic and statistical manual of mental disorders – fifth edition. Journal of Abnormal Psychology, 114(4), 494–504.

    Article  PubMed  Google Scholar 

  • Widiger, T., Frances, A., Pincus, H., & Davis, W. (1990). DSM-IV literature reviews: Rationale, process, and limitations. Journal of Psychopathology and Behavioral Assessment, 12(3), 189–202.

    Article  Google Scholar 

  • Widiger, T., Frances, A., Pincus, H., Davis, W., & First, M. (1991). Toward an empirical classification for the DSM-IV. Journal of Abnormal Psychology, 100(7), 280–288.

    Article  CAS  PubMed  Google Scholar 

  • Widiger, T., Frances, A., Pincus, H., First, M., Ross, R., & Davis, W. (Eds.). (1994). DSM-IV sourcebook (Vol. 1). American Psychiatric Association.

    Google Scholar 

  • Widiger, T., Frances, A., Pincus, H., Ross, R., First, M., & Davis, W. (Eds.). (1996). DSM-IV sourcebook (Vol. 2). American Psychiatric Association.

    Google Scholar 

  • Widiger, T., Frances, A., Pincus, H., Ross, R., First, M., & Davis, W. (Eds.). (1997). DSM-IV sourcebook (Vol. 3). American Psychiatric Association.

    Google Scholar 

  • Widiger, T., Frances, A., Pincus, H., Ross, R., First, M., Davis, W., & Kline, M. (Eds.). (1998). DSM-IV sourcebook (Vol. 4). American Psychiatric Association.

    Google Scholar 

  • Wilberg, T., Hummelen, B., Pedersen, G., & Karterud, S. (2008). A study of patients with personality disorder not otherwise specified. Comprehensive Psychiatry, 49(5), 460–468.

    Article  PubMed  Google Scholar 

  • Wilson, M. (1993). DSM-III and the transformation of American psychiatry: A history. The American Journal of Psychiatry, 150(3), 399–410.

    Article  CAS  PubMed  Google Scholar 

  • Wittenborn, J., Holzberg, J., & Simon, B. (1953). Symptom correlates for descriptive diagnosis. Genetic Psychology Monographs, 47(2), 237–302.

    CAS  PubMed  Google Scholar 

  • World Health Organization. (2012). Measuring health and disability: Manual for WHO disability assessment schedule (WHODAS 2.0). World Health Organization.

    Google Scholar 

  • World Health Organization. (1993). The ICD-10 classification of mental and behavioural disorders – Diagnostic criteria for research. World Health Organization.

    Google Scholar 

  • Zachar, P., Krueger, R. B., & Kendler, K. S. (2016). Personality disorder in DSM-5: An oral history. Psychological Medicine, 46(1), 1–10.

    Article  CAS  PubMed  Google Scholar 

  • Zachar, P., Regier, D. A., & Kendler, K. S. (2019). The aspirations for a paradigm shift in DSM-5: An oral history. Journal of Nervous and Mental Disease, 207(9), 778–784.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael B. First .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

First, M.B. (2023). Psychiatric Classification. In: Tasman, A., et al. Tasman’s Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-42825-9_91-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-42825-9_91-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-42825-9

  • Online ISBN: 978-3-030-42825-9

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics