Research has emphasized that mental health illness can be described as being identically related to physical illness Pattyn Verhaeghe Sercu Bracket 2013 as it is known to have a biogenetic cause that has existing ways to be treated this means that emotions that were once perceived as badness has been conceptualised as sickness or a medical issue Pattyn et al 2013 Thus this essay seeks to critically evaluate the diagnostic approach in psychiatry and psychotherapy by taking a critical look at the diagnostic approach of the Diagnostic and Statistical Manual of Mental Disorders 5 This essay will shed light on the history of the DSM its reliability validity and utility of DSM 5 However a definition of what the diagnostic approach is will first be defined What is meant by the diagnostic approach Brief background of the development of the DSM The DSM has been in existence for several years It has become one of the most widely and predominantly used manual within mental health Tsou 2011 Before its development diagnosis in psychiatry was known to be disorganised The first dissemination of the manual was in 1952 which included 102 disorders Tsou 2011 and was developed based on Sigmund Freud's psychodynamic principles Giordano Kawa 2012
The diagnostic categories within the DSM I was divided into two main groups it first refers to the disorders that are presumptively organic brain dysfunctions that are linked to the manifestations disturbances of certain changes in basic physiological functioning such as trauma intoxication or a range of psychological illnesses The second category on the other hand looked at disorders that seemingly resulted from the impact an individual experience due to his her ability of not being able to adapt to the pressures brought on by socio environmental stressors American Psychiatric Association DSM 1 1952 The DSM II on the other hand consisting of 182 disorders was published in 1968 with the attempt of making up for the shortcomings of DSM I American Psychiatry Association DSM II 1968 The DSM II s focus was on the organization of mental disorders into ten separate groups some of these groups included mental retardation organic brain syndromes psychoses not attributed physical conditions neuroses etc APA DSM II 1968 Additionally also included within this DSM were changes to the definition of mental illness that took into consideration the less invasive conditions that exist within the general population Included in these less invasive issues are individuals who although may not present with a serious mental issue but may still see it as necessary to be evaluated by a psychiatrist Giordano Kawa 2012 Moreover DSM III was subsequently published in 1980 American Psychiatric Association DSM III 1980
Because of the elimination of the psychoanalytic framework the DSM III was viewed as a stepping stone in Psychiatry Tsou 2011 Since this specific DSM was not based on or concerned with theory as it relates to etiology it tried to effectively characterize what the symptoms of mental illness were but seldom defined the origin of the disturbances APA DSM III 1980 The diagnostic categories within the DSM III were increased to 265 and many of the terms used in previous editions were replaced by more biological terms Also other disorders were added such as post traumatic stress disorder attention deficit disorder etc just to name a few Additionally in 1987 the DSM III was not only revised but was reorganised and renamed the DSM III R which contained 292 diagnostic categories but removes many others that were seemingly creating a number of controversies American Psychiatric Association 1987 After the publication of the DSM III R the DSM IV later followed and was published in 1994 and consisted of 297 different disorders The DSM IV was not only utilized for the treatment and diagnosis of patients but was also used to effectively collect accurate public health statistical information American Psychiatric Association 1994 According to APA 1994 the DSM IV looks at the classification of mental diseases from a descriptive point of view and thus has contributed to the development of psychiatric research and clinical practice by producing a clear definition of the diagnostic categories
This is in order to develop the competence of clinicians and other frontline workers to be able to diagnose impart and provide effective treatment for people with diverse mental disorders APA 1994 It is important to understand that although empirical data exist to support the DSM IV there are still many queries left unanswered Egger Francess 1999 The latest and current manual published in 2013 is the DSM V American Psychiatric Association 2013 The introduction of the DSM V has triggered major debates about the present approach to psychiatric classification Jonge Wardenaar 2013 Despite the harsh criticisms the current DSM is still utilized by a vast majority of mental health workers as it appears to promote the development of objective assessment regarding the presentation of symptoms in various clinical settings APA 2013 The fairly new updated DSM is said to be easily understood The DSM V consists of three main sections these are diagnostic classification diagnostic criteria sets and descriptive text APA 2013 The diagnostic classification can be described as a list of mental disorders accepted and supported within the DSM V Within the manual every disorder has a set of criteria it needs to meet in order to be diagnosed this is referred to as diagnostic criteria sets Lastly is the descriptive text which provides information about each disorder under specific subheadings APA 2013
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