The Classification of Mental Health Disorders

Who Determines the Diagnostic Criteria for a Mental Health Disorder?

The American Psychiatric Association (APA) is responsible for the development of a manual called the Diagnostic and Statistical Manual of Mental Disorders (DSM). To date, there have been five versions of this manual, the most recent released in May 2013. It is the most widely used document in the mental health treatment field and followed by all professionals as they assess the issues facing a patient and determine the diagnosis that will help him or her get effective treatment.

How Are the Diagnostic Criteria for Each Disorder Determined?

Determining the specific diagnostic criteria for all mental health diagnoses is a process that is in constant evolution. There have been five different versions of the DSM and the most recent revision began development more than a year prior to its release. The steps included:

• Three staggered six-week commentary periods from patients, family members, mental health advocates, and mental health professionals over a time frame of two years
• 13 work groups dedicated to exploring potential issues with the DSM-IV and drafting revision proposals
• Introduction of revisions to the psychiatric community and the public to address concerns
• A new round of recommendations and a return to drafting proposals based on feedback

With the goal of taking into consideration the needs of patients and their families while also recognizing the fact that insurance companies utilize this document to determine what will and will not be covered by health insurance policies, the APA works hard to refine the diagnoses to reflect current understanding of mental health disorders and update it to include patient issues and the latest scientific research.

Are There Variations in Degrees of Different Disorders?

Yes. For example, depression may be diagnosed as any one of 14 different types of major depressive disorder. The patient’s experience with different symptoms will determine the specific diagnosis, including:

• Whether or not the disorder is in remission
• If that remission is full or partial
• Whether the patient experienced a single, ongoing episode of depression or multiple episodes
• Whether or not the depression is characterized by psychotic features
• If the symptoms of depression are mild, moderate or severe

Additionally, depression may not signify any depressive disorder at all but instead be determined to be a symptom caused by another disorder like chronic grief or bipolar disorder.

There is a great deal of range and specificity of symptoms within classifications to allow for many different patient experiences in order to better ensure a more effective treatment that is personalized to the needs of each individual.

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