Classification

Psychiatry is the branch of medicine that deals with mental, emotional, and behavioural disorders. In psychiatry, as in other branches of medicine, classification of disease is useful for the following:

• Informing clinical practice. By placing a given patient's disorder into a recognized diagnostic category, the clinician is able to make an appropriate choice of treatment, and judge the probable future outcome. Using a classification system in this way does not, of course, remove the need to consider and respect those features that are unique to each individual case.

• Communication between professionals. A universally understood classification system permits efficient communication, whether in everyday clinical practice when colleagues are discussing a case, or in the national and international literature.

• A basis for research. Research workers require a classification system in order to investigate the causes, clinical features, natural history, and response to treatment of the various psychiatric disorders.

• Service planning. The type of treatment services required in a given area will depend on the frequency of different disorders within the local population.

Hughes' Outline of Modern Psychiatry, Fifth Edition. David Gill.

© 2007 John Wiley & Sons, Ltd ISBN 9780470033920

However, we must not forget that the existing classifications, in our present, highly imperfect state of knowledge, may be little more than a convenient shorthand, rather than a statement of fundamental scientific truth.

For example, we may say that a patient has a diagnosis of 'F45.4 persistent somatoform pain disorder' under ICD-10 (see below). This may sound very scientific. However, fundamentally, all it means is that the patient has chronic pain, unexplained by physical pathology, with some indication of underlying psychosocial problems. Hence, use of this term should not lead us to delude ourselves that we have a clear understanding of the cause of the patient's problems, let alone a specific effective treatment deriving from it.

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