Li Meixiu (Ellen)

JMS University
Chapter 1. Diagnosis & classification in Psychiatry
• Psychiatry : concerned with the origin, diagnosis,
prevention & treatment of mental disorders
 Psychiatric disorder
• a psychological or behavioral pattern that occurs in
an individual - distress or disability that is not
expected as part of normal development or culture.
cognition / conation / affect
distress / disability / freedom
 Normal mental health
• Health
• Mental health
model: medical / statistical / utopian / subjective
social / process / continuum
 Normality
• Reality orientation
• Self-awareness
• Self –esteem
• Ability
 Classification
• ICD-10 1992
mental & behavoir disorders F00-F99

• DSMIV-TR 2000
Diagnostic & statistical manual of mental disorders
,IV edition ,text revision
 Mental & behavior disorders ICD-10
• F00-F09 organic--symptomatic ,mental disorder
delirium ,dementia ,organic amnestic syndrome
F10-F19 psychoactive substance use
acute intoxication , harmful use ,
dependence syndrome ,psychotic disorders
F20-F29 schizophrenia/schizotypal&delusional disorders
schizophrenia , schizotypal disorder ,persistent
delusional disorders ,acute & transient psychotic
disorders
F31-F39 mood / affective disoders
manic episode ,depressive episode ,bipolar affective
disorder
F40-F48 neurotic , stress-related & somatoform disorder
anxiety disorder , phobic anxiety disorder ,
obsessive –compulsive disorder,somatoform disorders
F50-F59 Behavioral syndromes - physiological
disturbances & physical factors
eating disorder ,non-organic sleep disorders,
sexual dysfunctions
F60-F69Disorder of adult personality & behavior
specific personality disorders, enduring personality
changes,habit & impulse disorders ,gender identity
disorders, sexual preference disorders

F70-F79 Mental retardation

F80-F89 Disorder of psychological development
specific developmental disorder of motor function
specific developmental disorders of scholastic skill

F90-F98 Behavoiral & emotional disorders with onset usually

occurring in childhood & adolescence
hyperkinetic disorders ,conduct disorders ,tic disorders

• F99 Unspecified mental disorder

multi-axial classification
Chapter 2 Psychiatric history & examination
 Interview technique
• Commuinication disturbance
• Informants
• Personal history / premorbid personality
• Observation
• Rapport
• Poor judgement
• Elicit information
• Identification data
aliases,occupation ,residential & office address,
social -economic
• Informants relationship /ability/ source of referral
• Chief complaints
predisposing / precipitating F ,perpetuating / relieving F
• History
cases / therapy / family / personal
 Personal history
• Perinatal / childhood / educational / play /
• puberty / menstrual & obsteric / occupational
/sexual & marital / premorbid personality
 premorbid personality
• Interpersonal relationship
• Use of leisure time
• Predominat mood
• Attitude to self & others
• Attitude to work & responsibility
• Religious beliefs & moral attitudes
• Fantasy life
• Habits
 Examination
• Physical
• Mental status
general
speech
mood & affect
Thought
Perception
Cognition
Insight
judgement
 General appearance & behavior
• General appearance
• Attitude cooperation/ guarded / evasive
• Comprehension
• Gait & posture
• Motor activity
• Social manner & non-verbal behavior
• Rapport
• Hallucinatory behavior
 speech
• Rate & quantity mutism
• Volume & tone
• Flow & rhythm
• Mood & affect
 Thought
• Stream & form
tangentiality / circumstantiality / illogical
• Content
preoccupation
obsession
Phobias
Delusion
 Perception

Hallucination

Illusions & misinterpretations

Depersonalization / derealization

Somatic passivity phenomenon

others
 Cognition (neuropsychiatric)assessment
• Consciousness
• Orientation
• Attention
• Concentration
• Memory
• Intelligence
• Abstract thingking
proverb testing / similarities
 Others
• Investigations
• Formulation
etiological factors ---
• Special interviews
Psychiatry
 AMTS
 What is your age? (1 point)
 What is the time to the nearest hour? (1 point)
 Give the patient an address, and ask him or her to
repeat it at the end of the test. (1 point)
42 West Street
 What is the year? (1 point)