Mental Health & Psychiatric Nursing

This assignment delves into various aspects of mental health and psychiatric nursing. It requires an analysis of diagnostic criteria used in the ICD-11 and DSM-5, alongside discussions on cultural considerations in diagnosis, the impact of psychiatric classifications on individuals, and current research trends like the RDoC framework. Furthermore, it emphasizes the role of psychiatric mental health nurses in providing evidence-based care.

Running head: PSYCHIATRIC DIAGNOSTIC CATEGORIES AND ITS IMPACT
Mental health diagnostic categories and its impact
Name of the student
Name of the university:
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1PSYCHIATRIC DIAGNOSTIC CATEGORIES AND ITS IMPACT
Table of Contents
Introduction:....................................................................................................................................2
Progress of diagnostic procedure in mental health:.........................................................................3
DSM5 and ICD10:...........................................................................................................................4
Benefits of diagnostic characteristics in psychology:......................................................................5
Argument on the validity and reliability of the diagnostic procedures:..........................................7
Conclusion:......................................................................................................................................8
References:....................................................................................................................................10

2PSYCHIATRIC DIAGNOSTIC CATEGORIES AND ITS IMPACT
Introduction:
The science of health care is strict, and hence each and every stage of providing optimal
health care to the patients relies on the scientific and reasonable steps. The medical science has
advanced considerably in the last decade and the concept of clinically reasonable diagnoses has
revolutionized the health care system effectively. In case of mental health sector however, the
concept of different diagnostic categories is new. The implementation of a categorizing and
systematic diagnostic system like DSM5 or ICD10 has undoubtedly been extremely helpful in
understanding the particular patterns and symptoms that define the different categories of mental
illnesses (American Psychiatric Association., 2013). There has been a consensus regarding the
viability, validity and utility of the different diagnostic procedures opted in case of psychology.
This assignment will attempt to critically analyze the statement that Diagnosis leads to reliable
and valid categories of mental illness with respect to DSM5 and ICD10.
Progress of diagnostic procedure in mental health:
Considering the American system of psychological diagnoses, the revolution of opinion
based diagnosis has been changed to the process of scientific research based psychoanalytical
diagnostic classification system in the middle to late 19th century. The DSM psychological
diagnostic method had been introduced first in the year of 1958, however after almost a decade a
second edition of the DSM had been introduced. Along with American psychiatric association
implemented DSM manual for mental illness diagnosis addressing the concern of diagnostic co-
morbidity. The world health organization also implemented another set of standardized
diagnostic procedure for the benefit of the patients, in the name of international classification of
diseases.

3PSYCHIATRIC DIAGNOSTIC CATEGORIES AND ITS IMPACT
DSM5 and ICD10:
DSM5 refers to the fifth revised edition of the diagnostic and statistical manual for
mental disorders, a taxonomic diagnostic tool that have been introduced by the American
psychiatric association. The last set of amendments or revisions have been done to the standards
in the year of 2013 and it is the most recent version that is being utilized abundantly in the
present age. The DSM5 had been implemented on 18th of May, 2013 that replaced the DSM-IV-
TR that had been in use since the year of 2000. There have been three changes or amendments in
the fifth revision of the diagnostic tool, in the section I, II and III. In the final or last recent
amendment the DSM5 system had discarded the multi-axial system of diagnosis and
implemented an alternative hybrid dimensional-categorical model for personality disorders.
The ICD10 stands for the 10th revision in the international statistical classification of
diseases and related health problems, a diagnostic tool that had been introduced by the world
health organization. The last recent revision on the diagnostic standard had been made in the year
of 1993 and there are 14400 different codes that control and track different health adversities
associated with both physical and mental health and also track many of the new diagnostic
procedures as well. The crucial amendment that had been to the 10th version of the ICD includes
separation or categorization of the mental and behavioral disorders into separate non-overlapping
categories or blocks. This diagnostic tool attempts to group the different mental or physical
disorder on the basis of a common theme in the origin or manifestation of the particular mental
disorder (Cooper, 2015).
Both DSM5 and ICD10 had been and still continue to be used abundantly used in the
diagnostic procedure in the mental health sector since many years. Both these diagnostic
procedures are categorical and there are countless benefits of using these diagnostic systems for

4PSYCHIATRIC DIAGNOSTIC CATEGORIES AND ITS IMPACT
categorizing the different mental disorders, although there also is a growing consensus that
questions the viability and relevance of these diagnostic system with respect to the present
condition of the society.
Benefits of diagnostic characteristics in psychology:
The introduction of the diagnostic characteristics can be defined as the most
revolutionary step in the evolution of psychiatric treatment. The first step for the psychological
evolution in medicine had been the move of the psychiatric medicine towards a more
scientifically reasonable and medical model, which brought forward the ideas of different
diagnostic characteristics for defining the different characteristics of mental disorders into a
systematic pattern of classification so that the best answers could be found and the patients can
be referred to the correct treatment plan for him or her. No it has to be mentioned that the DSM5
manual that is presently in abundant use in the mental health sector as the therapist’s bible. It has
to be mentioned in this context that this particular diagnostic procedure has the most diverse
range of different specific diagnostic criteria and illustrations based on which a variety of
different mental disorders can be easily identified and categorized. According to First et al.
(2015), the most important benefit that these diagnostic criteria are the fact that these diagnostic
modules, both DSM 5 and ICD 10 provide the therapists and psychologists with the aid of a
series of scientific psychiatric codes that allows the psychologist professionals with the
opportunity to easily summarize and categorize complicated mental health conditions and hence
it is known to save a considerable amount of time which is easily invested in the care planning
and delivery to the particular mental patient under consideration. On the other hand, as explained
by the authors, the methods or techniques that are used in the diagnostic procedures are
associated with other advantages as well; first and foremost, it has to be mentioned that the

5PSYCHIATRIC DIAGNOSTIC CATEGORIES AND ITS IMPACT
diagnostic tools like DSM- 5 or ICD- 10 provide the opportunity to standardize the entire
diagnostic procedure into a single and simplified procedure across different kinds of treatment
pathways. Now it has to be considered that the most impactful challenge in the mental health
sector that has complicated the path for similar pattern of psychiatric car to the patients.
According to the Frances (2013), the differential pattern of both diagnosis and care delivery had
been one of the prime source of challenges and disparities in the mental health sector and the
standardization process of the mental diagnoses had been a break through to streamline the
diagnostic diversities across different regions into a single and simplified pattern. On the
contrary, it has to be mentioned in this context that the introduction of the diagnostic categories
in the mental health sector had been one of the most revolutionary steps taken, and despite the
disparities that are prevalent in the implementation of the diagnosis procedures, the foundation of
the mental health care delivery is determined by the diagnostic categories. However, it has to be
mentioned that the DSM5 or ICD10 depends heavily upon the categorical system and hence, it
has to be mentioned that the lack of any dimensional understanding in the diagnostic procedure
has limited the validity of the tools effectively. It has to be mentioned in this context that despite
the abundant use and popularity of the categorical diagnosis in the mental health sector, yet there
are multiple psycho-social factors that cannot be categorically explained without
oversimplification of the factors, and hence many of the authors have discussed the need for a
dimensional input in the diagnostic manuals that are being used in the clinical psychology
(Milyavskaya & Koestner, 2011).
Argument on the validity and reliability of the diagnostic procedures:
According to the article by the Jablensky (2016), the DSM- 5 and ICD- 10 are no longer
systematic classification tools, instead they are effective tools for communication and these

6PSYCHIATRIC DIAGNOSTIC CATEGORIES AND ITS IMPACT
diagnostic tolls play an important part in the research, clinical management and teaching
purposes. The diagnostic unreliability of the diagnostic tools that are presently being utilized in
the mental health sector has been studied extensively in the past. And here are many factors that
have been identified that complicate the reliability and viability of the diagnostic tools when used
on its own. First and foremost, it has to be mentioned that in case of mental health, the patients
are not always capable of providing authentic and valid subjective data which complicates the
reliability of the diagnosis by the use of the these tools. Another very important and decisive
factor associated with this particular scenario is the fact that in cases that the clinicians depend
on either DSM 5 or ICD 10 for the diagnostic procedure relies on only the typical representation
of the disorders. Although, it must not be neglected that the mental state of the different
individuals are different and the manifestation of a particular disorder might also not match
completely with the other. According to Insel et al., 2010, the mental health patient is showing
atypical representation of the mental disorder symptoms, it becomes extremely difficult for the
clinicians to depend solely on DSM or ICD to categorize the exact mental health condition of the
patient.There is a significant risk of mis-diagnosis and over- diagnosis when utilizing the
diagnostic tools and hence the reliability of these tools has been questioned time and again by the
psychology researchers.
According to Fairburn et al. (2015), the most plausible diagnostic procedure in case of the
mental health sector has to be the trans- diagnostic procedure. It has to be mentioned in this
context that the author has proposed the tarns- diagnostic approach h o the entire mental health
diagnosis and treatment sector with emphasis on the fact that each and every mental patient is
different and is in specific care need for the purpose of recovery. The transdiagnosis procedure
emphasizes on different pathways of diagnosis and treatments so that each and every care need is

7PSYCHIATRIC DIAGNOSTIC CATEGORIES AND ITS IMPACT
considered for the patient and the diagnosis is patient centred and specific as well (Polanczyk et
al., 2015). It has to be mentioned that human mental disorders and its sufferings are not always
divisible among the diagnostic characteristics associated with the DSM5 or the ICD 10, and in
order to categorize the manifestations that are beyond the limits of the DSM 5 or ICD 10,
requires the counter diagnosis to ensure that the best techniques are being implemented to
discover the optimal results for the mental disorder (Insel et al., 2010).
According to Weisz et al. (2011), the oversimplification of the psychosocial factors might
lead to misdiagnoses in case of more complicated and diverse range of mental disorders due to
the strictly categorical approach that these diagnostic categories depend on. The idiographic
approach can also be an ideal counter diagnosis technique that could extremely benefit in
discovering the intricate and overlapping psycho-social determinants of the mental disorders.
The idiographic approach, on the contrary to other categorical diagnostic tools is associated with
the phenomenon of each individual possessing a unique psychological structure and hence
manifestation of any mental disorders is unique in the different individuals as well. According to
the authors, the idiographic assimilation of the psychosocial factors that are contributing wither
directly or indirectly to the mental disorder that the mental patient is going through will
gradually integrate dimensional impact on the diagnostic categorizing, eventually canceling out
or overcoming the limitations imposed by the categorical approach imposes on the diagnosis
procedure of the mental patients. Most of the authors have discussed the traditional DSM5 and
ICD10 approaches are fast becoming obsolete in providing the most reliable and viable tool
assisting the process of mental health diagnoses due to the extreme emphasis on oversimplifying
the different symptoms and psychosocial contributing factors into the limited set of diagnostic
categories as elaborated in the DSM and ICD (Weisz et al., 2011). Hence, there is a dire need for

8PSYCHIATRIC DIAGNOSTIC CATEGORIES AND ITS IMPACT
the implementation of the dimensional approaches like the idiographic approach to revive the
viability and reliability of the diagnostic tools that once revolutionized the progress of clinical
psychology.
Conclusion:
In mental health sector, the different diagnostic procedures had been a revolutionary
change which has standardized the mental health care delivery and diagnosis of different mental
health disorders. The evidence based nature and simplified coding structure of these diagnoses
have materialized fast and effective diagnosis of the mental disorders. The only consensus
regarding the diagnostic tools has been oversimplification and generalization of the tools that has
questioned the reliability and validity of the mental health disorders. Although, a possible
solution to this challenge has been propose b y the trans- diagnostic procedure, in which both the
diagnosis and the treatment procedure for the patients is not limited to a particular technique and
module. This approach will allow the diagnosis of the patients to be multidimensional and patent
centred so that the challenges or mis- diagnoses and over- diagnoses can be overcome and
optimal care can be provided to the mental patients optimally and successfully without any
discrimination or labeling. Along with that, other counter diagnosis techniques like the
idiographic approach or dimensional spectrum based diagnostic approaches can also be
incorporated in the regular manuals like DSM and ICD to improve the specificity and patient
centeredness of the mental health care provided to the patients. I would like to mention here that
this assignment has helped to discover and explore the transitions in the diagnostic tools and the
limitations of use of oversimplified version of diagnostic tools in use for clinical psychology like
the DSM5 or ICD10. This assignment had been an amazing opportunity for me to discover all

9PSYCHIATRIC DIAGNOSTIC CATEGORIES AND ITS IMPACT
the different issues associated with the use of these categorical diagnostic tools and has helped
me acknowledge the need for dimensional counter diagnosis in the clinical psychology.

10PSYCHIATRIC DIAGNOSTIC CATEGORIES AND ITS IMPACT
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(DSM-5®). American Psychiatric Pub.
Anderson, J. L., Sellbom, M., Ayearst, L., Quilty, L. C., Chmielewski, M., & Bagby, R. M.
(2015). Associations between DSM-5 section III personality traits and the Minnesota
Multiphasic Personality Inventory 2-Restructured Form (MMPI-2-RF) scales in a
psychiatric patient sample. Psychological assessment, 27(3), 801.
Bertelli, M. O., Salvador‐Carulla, L., Scuticchio, D., Varrucciu, N., Martinez‐Leal, R., Cooper,
S. A., ... & Munir, K. (2014). Moving beyond intelligence in the revision of ICD‐10:
specific cognitive functions in intellectual developmental disorders. World
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Butcher, J. N., Hooley, J. M., & Mineka, S. M. (2015). Abnormal psychology. Pearson Higher
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Cooper, Z. (2015). Enhanced Cognitive Behavior Treatment: Transdiagnostic Theory and
Treatment. Encyclopedia of Feeding and Eating Disorders, 1-8.
DSM-5 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders. Arlington: American Psychiatric Publishing.
Fairburn, C. G., Bailey-Straebler, S., Basden, S., Doll, H. A., Jones, R., Murphy, R., ... &
Cooper, Z. (2015). A transdiagnostic comparison of enhanced cognitive behaviour

11PSYCHIATRIC DIAGNOSTIC CATEGORIES AND ITS IMPACT
therapy (CBT-E) and interpersonal psychotherapy in the treatment of eating
disorders. Behaviour research and therapy, 70, 64-71.
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
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Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., ... & Wang, P. (2010).
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