1.5. Explain the classification of mental health

This guide will help you answer 1.5. Explain the classification of mental health.

Mental health refers to a person’s emotional, psychological, and social well-being. It affects how individuals think, feel, and behave, as well as how they handle stress, relate to others, and make decisions. Mental health conditions vary greatly in terms of their severity and symptoms. Classifying these conditions provides a framework for understanding, diagnosing, and treating them effectively. In this guide, we cover the mental health classifications.

The Purpose of Classification

Classifying mental health helps healthcare professionals identify specific conditions and apply the most appropriate treatments. Classifications standardise mental health care, ensuring consistency in diagnosis and communication between professionals. They also assist in research by grouping similar conditions and making it easier to study trends, causes, and treatments.

Mental health classifications also help reduce stigma. By recognising these as medical conditions, society gradually understands that mental health issues are not personal failings but health challenges that require support and intervention.

Two primary systems are used to classify mental health conditions:

• International Classification of Diseases (ICD)
• Diagnostic and Statistical Manual of Mental Disorders (DSM)

The ICD

The International Classification of Diseases (ICD) is a global diagnostic tool maintained by the World Health Organisation (WHO). It covers all health conditions, including physical and mental illnesses. The current version, ICD-11, was introduced in 2022.

Chapter V of the ICD-11 focuses on mental, behavioural, and neurodevelopmental disorders. These conditions are grouped into categories based on shared characteristics. Examples of main groups include:

• Mood Disorders: These include depression and bipolar disorder, which affect a person’s emotional state.
• Anxiety Disorders: These include generalised anxiety disorder, panic disorder, and phobias, which involve excessive fear or worry.
• Psychotic Disorders: These include schizophrenia, characterised by loss of contact with reality.
• Neurodevelopmental Disorders: These include conditions like autism spectrum disorder and attention deficit hyperactivity disorder (ADHD).
• Substance Use Disorders: These cover addictions, such as alcohol or drug dependence.
• Eating Disorders: These include anorexia nervosa and bulimia nervosa, involving harmful attitudes towards food and body image.

The ICD is widely used worldwide, including in the UK.

The DSM

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is primarily used in the United States but also influences mental health practice in other countries. It is published by the American Psychiatric Association (APA). The current version is the DSM-5, released in 2013.

The DSM-5 offers detailed criteria to diagnose mental health conditions. It classifies disorders into categories similar to the ICD but uses slightly different terms. For example:

• Mood Disorders in the ICD are called Affective Disorders in the DSM.
• The DSM groups some conditions, like obsessive-compulsive disorder (OCD), into distinct categories rather than including them under Anxiety Disorders.

The DSM-5 is renowned for its comprehensive nature, offering information on prevalence rates, risks, and cultural factors related to each condition.

Category Breakdown

Let’s take a closer look at some major mental health categories that appear in these classification systems.

Mood (Affective) Disorders

Mood disorders involve severe disturbances in an individual’s emotional state. These conditions impact daily life, relationships, and productivity. Examples include:

• Depression: Persistent low mood, loss of interest in activities, fatigue, and feelings of worthlessness.
• Bipolar Disorder: Alternating periods of depression and mania (high energy, impulsiveness, and risk-taking behaviour).

Both ICD and DSM outline specific diagnostic criteria, such as the duration and severity of symptoms.

Anxiety Disorders

These conditions cause overwhelming fear, worry, or panic, often unrelated to the actual level of danger. Examples include:

• Generalised Anxiety Disorder (GAD): Chronic worry that interferes with everyday life.
• Panic Disorder: Sudden panic attacks, accompanied by physical symptoms like chest pain and rapid heartbeat.
• Phobias: Intense fear triggered by specific objects, places, or experiences (e.g., heights or spiders).

Classifications provide descriptions to help identify and address these issues in individuals.

Psychotic Disorders

Psychotic disorders significantly affect an individual’s sense of reality. The most well-known condition in this category is schizophrenia. Symptoms often include:

• Hallucinations (seeing or hearing things that aren’t there).
• Delusions (firm beliefs in things that are not true).
• Disorganised thinking or speech.

Both ICD and DSM provide detailed criteria to diagnose and differentiate psychotic disorders from other conditions.

Neurodevelopmental Disorders

These conditions typically emerge in childhood and can impact development, learning, and behaviour. Examples include:

• Autism Spectrum Disorder (ASD): A range of conditions characterised by difficulty in social interaction and repetitive behaviours.
• Attention Deficit Hyperactivity Disorder (ADHD): Hyperactivity, impulsiveness, and difficulty maintaining attention.

Neurodevelopmental disorders are increasing in awareness, highlighting the need for early diagnosis.

Eating Disorders

Eating disorders involve harmful thought patterns and behaviours related to food and body image. Common examples are:

• Anorexia Nervosa: Extreme food restriction leading to severe weight loss and nutritional deficits.
• Bulimia Nervosa: Cycles of binge eating and purging (vomiting or excessive exercise).
• Binge Eating Disorder: Consuming large quantities of food without purging.

Offering specific labels for these behaviours supports targeted treatments, such as counselling or nutritional therapy.

Substance Use Disorders

Substance use disorders focus on the misuse of alcohol, drugs, or other substances. Key criteria include:

• Loss of control over usage.
• Increased tolerance (needing more to achieve the same effect).
• Physical withdrawal symptoms when not using.

Classifications highlight the physical, psychological, and social impacts of addiction, ensuring that proper interventions can be offered.

Alternative Classifications

Beyond ICD and DSM, mental health can also be classified in less formal ways. Some professionals may group conditions according to underlying factors, such as:

• Biological Factors: Disorders arising from genetics or chemical imbalances (e.g., schizophrenia).
• Psychological Factors: Issues resulting from trauma or learned behaviours (e.g., post-traumatic stress disorder, PTSD).
• Social Factors: Problems linked to environment, such as poverty or discrimination (e.g., adjustment disorders).

Cultural differences also influence how conditions are seen and classified. For instance, what is considered abnormal in one society might be acceptable in another.

Limitations of Classification

While mental health classification helps diagnosis and treatment, it has limitations. For instance:

• Overlapping Symptoms: Some conditions share similar symptoms, making diagnosis tricky.
• Stigma: Labelling someone with a mental health condition can sometimes lead to discrimination.
• Cultural Variability: Certain behaviours are normal in some cultures but seen as disorders in others.

Despite these challenges, classification systems like the ICD and DSM continue to evolve, aiming to improve accuracy and reduce stigma.

Final Thoughts

Classifying mental health is essential for identifying, diagnosing, and treating mental health conditions. The ICD and DSM are the two main systems used globally, offering structured frameworks to manage mental health effectively. Categories such as mood disorders, anxiety disorders, and psychotic disorders highlight the diversity of mental health conditions. Despite some limitations, these classifications play a crucial role in improving mental well-being and supporting those in need.