Psychiatric Diagnostic Classification Systems and Suboptimal Outcome for Patients

Running head: NURSING
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Introduction
Psychosis is a term that is used to describe a different range mental health
complication like schizophrenia. As per the common identified mental health complications
symptoms like the DSM V (Diagnostic and Statistical Manual of Mental Disorders) and as
per the findings reported by the Mental State Examination (MSE) tool, the common mental
health symptoms exhibited by the people suffering from psychosis include hearing of voice,
visual hallucinations and paranoia. For numerous decades, psychiatry has regarded, visual
and audio-visual hallucinations and hearing of voices as an enemy. This is because, these
behavioral or mental health expression is regarded as a symbol of insanity or madness.
However, today new scientific and psychological insights are helping to understand how the
brain actually works and thus opening avenues towards radical rethinking and how these
complications can be treated by going beyond psychosis.
One of the major debates in the mental health is whether or not the DSMV and the
International Classification for Diseases (ICD) medicalise the normal human behavioural or
psychological reactions to particular situations and simultaneously label them as diagnosable
mental health problems. The following essay will raise voice in favour of the opinion that,
“psychiatric diagnostic classification systems lead to suboptimal outcome for patients”.
Diagnostic and Statistical Manual of Mental Disorders (DSM V) Validity
DSM V is regarded as one of the successful technologies that is being used in the
modern times for the diagnosis and classification of the mental health disorder. One of the
main critique of against the mental health classification by DSM V is, problems associated
with the daily living like the occupational hardships and the associated distress are converted
into psychological or medical problems. This approach, obscure the role of the surrounding
environmental factors likes poverty, social life, financial factors and other associated
financial factors in developing mental or physical health-related distress. This particular view
shrinks rather than expanding the optimal opportunity for getting freedom, dignity and
growth. The DSM classification also ignores the theory proposed by vast literature that
unusual environment generate unusual behaviour that have no direct relation with any
significant mental health complication (Gambrill, 2014). For example, sudden loss of family
members is associated with the signs of significant mental distress like low mood, sadness,
disturbance in sleep, loss of appetite, and increase level of fatigue and difficulty in

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concentration. This behavioural symptom of bereavement coincides with the symptoms of the
major depressive symptoms as classified under the DSM V if they last for more than 2 weeks.
Bandini (2015) argued in favour of the bereavement exclusion (BE) from the criteria of the
diagnosis of the major depressive symptoms in DSMV. This is because medicalization of
grief leads to over-diagnosis or over-treatment of the mental health conditions leading to sub-
optimal outcome. Vancayseele, Rotsaert, Portzky and Van Heeringen (2019) stated that
medicalization of grief or bereavement under mis-diagnosis of the DSMV lead to unwanted
use of the anti-psychotic medications and thus increasing the vulnerability of developing
different physical co-morbidities. McGorry and Nelson (2016) are of the opinion that the
symptoms of different mental health complications are overlapping and this leads to the
overlapped diagnosis of the mental health condition. For example as per the BBC
documentary, by Mendham and Farnham (2017), Rachel was with schizophrenia, borderline
personality disorder, schizoaffective disorder, dissociative identity disorder, psychosis and
complex traumatic stress disorder. This leads to over-burden of the mental health
complications. Rachel has stated that, “When I was a patient of mental health system, I felt
like I was written off as severely mentally ill, with no hope of recovery”.
Biomedical Model for Classification of Mental Health Disorders
According to the biomedical model, mental health disorders are brain diseases that
emphasize over the importance of pharmacological treatment in order to address the
presumed biological abnormalities. The biomedical model for the mental health disorders
state that brain diseases are mainly cause by disruption in the chemical equilibrium of the
brain and thus citing the importance of the usage of the neurotransmitter specific drugs in
order to treat the condition. However, biomedical model for the classification of the mental
health disorder are criticised for lack of proper clinical innovation and poor mental health
outcomes. Moreover, the biomedical paradigm is significantly affected the approach of the
clinical psychology through the adoption of the drug trial methodology under psychotherapy
research and this has increased the unwanted usage of the harmful antipsychotic drugs
leading sub-optimal mental health outcome. Murray, Toussaint, Althaus and Loewe (2016)
stated that there is a limited application of the biomedical model for the diagnosis of non-
specific, somatoform and functional disorders under the primary healthcare setup and this
leads to the generation of the sub-optimal outcome. Rachel of the “Why Did I Go Mad?” of
Mendham and Farnham (2017) has stated that she was victims of over use of the
antipsychotic medications in order to treat her complex psychological problems. However,