Classification systems

Classification systems include categorical, dimensional, and multiaxial types. In the categorical type of classification, each case is allocated to one of several mutually exclusive groups. This simple method is the most suitable one for clinical settings. Categorical systems are usually used in a hierarchical way, so that each case receives only one main diagnosis. Organic psychoses take precedence over functional psychoses, and functional psychoses over neuroses. This can lead to oversimplification of complex cases, and does not take account of 'comorbidity', in which two psychiatric diagnoses (for example, anxiety state and alcohol misuse) or a physical and a psychiatric diagnosis (for example, diabetes and depression) coexist.

In the dimensional type of classification, cases are rated on a continuous scale, or several separate continuous scales, for the characteristic(s) under study, as in, for example, depressed mood.

In the multiaxial type of classification, each case is rated on several separate categorical systems, each measuring a different aspect (for example, psychiatric illness, personality, intelligence).

The two main classification systems in international use, ICD and DSM, will now be summarized. Both systems are due to be published in revised editions shortly.

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