AT the basis for the diagnosis of mental disorders is the principles of good clinical practice, including the objectivity and reliability of the diagnostic study, which ensures the comparability and reproducibility of the diagnostic decisions of psychiatrists who have a different personal level vocational training and work in different countries [ , , , ].

Such objectivity and reliability in modern algorithms diagnostic process is implemented through the use of diagnostic and statistical manuals, guidelines, classifications, which include the International Classification of Disease (ICD) and diagnostic and statistical manual(DSM). The use of classifications and guidelines as diagnostic standards reflects the desire of the -professional community to identify the patient's disorders in accordance with clinical reality, while minimizing the influence of -subjective factors.

Especially great importance overcoming the factor - subjectivism has in psychiatry, where methodologies based on subjective assessment are widely used [ , ].

In addition to standardization, diagnostic manuals and classifications are aimed at solving the following tasks:

Historically, the situation has developed that in the USA the DSM is used, which is developed, updated and implemented by the American Psychiatric Association (APA), and in European countries there is an ICD, the adoption and updating of which is the prerogative of the World Health Organization (WHO). It should be noted that since 1982 the improvement and development of these two classification systems has been going on in concert. Each of the classifications at the same time preserves the traditions of national psychiatric schools.

Thus, since 1994, DSM-IV was used in the USA, during the same period, ICD-10 was introduced in Europe, which has been in force in Ukraine since 1998. The implementation of these two classifications in practical work allowed to achieve some progress towards the standardization of psychiatric diagnosis.

The development of modern neurosciences (genetics, neurochemistry, neuroimaging methods), in combination with the results of clinical, psychopathological and phenomenological studies, contributed to the accumulation of scientific data in favor of the variability of individual characteristics of psychopathological phenomena included in one diagnostic heading of classifications.

The desire to personify diagnostic --and therapeutic process, to reflect in the diagnostic criteria the diversity of psychopathology, the dynamics of disease, the degree of cognitive deficit, the influence of environmental and biological correlates, the response to therapy and many other factors has become a motive for improving and developing existing classification systems [ , ].

Therefore, over the past decade, WHO and APA have been actively preparing new revisions of the DSM and the ICD. This work involved specialists in the field of psychiatry, neurology, neurosciences, public organizations and aid users. The work of numerous expert groups was based on a detailed analysis of evidence in the field of psychopathology, phenomenology, genetics, and neuroimaging. When preparing the classification, experts paid considerable attention to the international compatibility of classifications (DSM and ICD), including the integration of cultural aspects with diagnostic criteria.

In May 2013, the fifth edition of the Diagnostic and Statistical Manual (DSM-5) was published and is being actively implemented and applied in the United States. By that time, the development of ICD-11 was almost completed, but its technical preparation and approval takes some time.

This situation creates difficulties in collecting and transmitting information, in particular in understanding modern diagnostic trends between specialists working on the ICD-10 (they include Ukrainian doctors) and doctors who use DSM-5. Despite the fact that the ICD-10 is a universally recognized diagnostic system, professionals working in the field of mental health, researchers, researchers involved in the field of clinical trials in our country feel an urgent need to understand and practice the content of the updated system of diagnostic criteria contained in the DSM-5.

Table. DSM-5 diagnostic chapters

A comparison of the DSM-5 and ICD-10 diagnostic categories is presented to your attention in this article. At general characteristics DSM-5, it should be noted that it uses a new feature validation, which allowed all forms of pathology to be combined into groups of disorders (spectra), thereby limiting the designation of categorical ranges. It should be emphasized that almost all chapters of the classification have undergone transformation to one degree or another. Such changes are due to the fact that DSM-5 is based not only on the criteria of clinical psychopathology, but also on signs obtained as a result of the development of neurosciences (genetics, neuromorphology, biochemistry, etc.) (table).

The main difference between DSM-5 and previous classifications (DSM-IV and ICD-10) is the transition from the categorical principle of diagnosis to the dimensional one. The methodology for this transition includes: the use of specifiers and subtypes, the combination and separation of disorders, the removal of categories, and the change of terminology.

The inclusion of severity specifiers in the DSM-5 helps to assess clinical picture and to provide information for developing the best treatment strategy, since treatment regimens differ significantly in different degrees of severity.

A comparison of DSM-5 and ICD-10 classification rubrics shows that new rubrics have appeared in DSM-5. - Rubric "Disorders mental development”combines the pathology of the headings “Mental retardation” (F7) and “Impaired psychological development” (F8) of the ICD-10. Aggressive Conditions, Impulsive and Behavioral Disorders includes conditions previously diagnosed under Mature Personality Disorders (F6) and Unspecified Psychiatric Disorders (F99). The DSM-5 Gender Dysphoria section includes Gender Identity Disorders (F64) of the ICD-10.

The rubric "Neurocognitive disorders" contains diagnostic criteria corresponding to various variants of dementia and other organic disorders of the rubric (F0). Thus, the section “Paraphilias” corresponds to the ICD-10 section “Disorders of sexual preference” (F65), and the section “Drug-induced movement disorders and other side effects of pharmacotherapy” includes criteria for diagnosing disorders that developed as side effects. effects of taking antipsychotics and antidepressants (in the ICD-10, these manifestations were included in headings G21, G24, G25 and T43).

Many of the DSM-5 diagnostic chapters are the result of section splitting. In particular, the DSM-5 headings "Bipolar and related disorders" and "Depressive disorders" in the ICD-10 were included in one section "Mood disorders" (F3) of the ICD-10. New diagnostic chapters DSM-5 "Anxiety disorders", "Obsessive-compulsive and related disorders", "Disorders associated with mental trauma and stress", "Mental disorders with a predominance of somatic symptoms and similar conditions" in ICD-10 constituted the section "Neurotic, stress-related and somatoform disorders" (F4).

The next example of disconnection is the chapter on Sleep Disorders. Subtypes of sleep disorders associated with respiratory disturbance are considered in the DSM-5 as separate disorders (obstructive sleep apnea and hypopnea in sleep, central apnea, sleep-related hypoventilation). Combining the diagnostic criteria for ICD-10 G47 and F51 led to the creation of the DSM-5 chapter, Sleep-Wake Disorders. The DSM-5 rubrics Eating and Eating Disorders and Excretion Disorders largely contain the criteria for ICD-10 rubrics F50 and F98.

As a clear example of combining categories, consider autism spectrum disorder, in which specifiers allow you to highlight the degree of intellectual decline, the structure of speech disorders, comorbidities, and loss of acquired skills.

Another example of aggregation is the section on psychoactive substance use (PS) and addictive disorders. The rubric is a combination of two DSM-IV rubrics (substance abuse and dependence). The addition of a severity scale to this rubric makes it possible to diagnose a mild disorder as an abuse, and moderate and severe as a state of substance dependence.

The DSM-5 chapter, Schizophrenia Spectrum Disorders and Other Psychotic Conditions, contains criteria that are presented in ICD-10 under Schizo-Prenia, Schizotypal and Delusional Disorders (F2), and Substance Use Disorders and addictive states” — under the heading “Mental and behavioral disorders due to the use of psychoactive substances” (F1).

The use of specifiers and subtypes in DSM-5 makes it possible to individualize the diagnosis and identify subgroups of signs that are targets of therapeutic intervention, which corresponds to the dimensional orientation of the classification. An example of the introduction of specifiers is the use of the category "with mixed features", which is used to diagnose unipolar and bipolar depression and involves the appointment of specific forms of therapy.

The most revealing subtypes of disorders are presented in the section "Neurocognitive disorders", which corresponds to the section of dementia and organic cerebral pathology in ICD-10. This section presents the etiological subtypes with separate descriptions and criteria for them (Alzheimer's disease, frontotemporal degeneration, Lewy body pathology, vascular pathology, traumatic brain injury, HIV infection, prion infections, Parkinson's disease, Huntington's chorea, etc.) .

Based on a review of the current neuroscience evidence base, taking into account clinical appropriateness, new disorders have been identified in the DSM-5, the main ones being: pathological accumulation; destructive mood dysregulation disorder (DMDD); compulsive overeating; premenstrual dysphoric disorder; restless legs syndrome; behavioral disorder caused by a violation of the fast phase of sleep. Commenting on the clinical significance of the introduction of new disorders, it should be emphasized that new disorders, on the one hand, make it possible to improve diagnosis, and, on the other hand, to avoid the stigmatizing influence of a psychiatric diagnosis. In the case of a growing number of -bipolar disorders (BD) in childhood, clinicians in a certain clinical situation have the opportunity to bring out children with symptoms of constant irritability and impaired social norms outside the BR by including them in the DMDD group.

A lively discussion of experts and professionals was caused by the removal from the DSM-IV of the category of grief reaction, which allowed bereaved people to not be diagnosed with a depressive disorder for two months. The experts decided that in this context there is an underdiagnosis of depression, as a result of which patients do not receive adequate therapy. Therefore, the DSM-5 introduces a descriptive characterization to distinguish between the symptoms of a “normal” and a pathological response to bereavement.

The change in terms in DSM-5 is aimed primarily at destigmatizing psychiatric diagnoses, at "mitigating" psychological consequences arising in patients and their environment after making such diagnoses as "schizophrenia", "mental retardation", "dementia".

The DSM-5 eliminated the term "mental retardation" and replaced it with the term "disability intellectual development". The term “dementia” has been replaced by “neurocognitive disorder”, and instead of “substance abuse” and “substance dependence”, the term “substance use disorders and addictions” is used.

Considering that all sections of the DSM-5 have been transformed during processing, the description of all updated diagnostic criteria is a lengthy process. This article presents changes in the diagnostic criteria for schizophrenia, bipolar and depressive disorders, which are most often used in scientific research and attract the attention of practitioners.

The chapter of DSM-5, which is devoted to schizophrenia spectrum disorders and other psychotic conditions, contains diagnostic criteria for the following forms of pathology:

1. Delusional disorders - 297.1 (F22).

2. Transient psychotic disorders - 298.8 (F23).

3. Schizophreniform disorder - 295.40 (F20.81).

4. Schizophrenia - 295.90 (F20).

5. Schizoaffective disorder - 295.70 (F25.0, F 25.1).

6. Psychotic disorders caused by the use of surfactants and drugs (coding depends on the type of drug used).

7. Psychotic disorders due to other medical conditions (coding depends on the underlying disease).

8. Catatonia associated with other mental disorders - 293.89 (F06.1).

9. Catatonic disorder due to other medical conditions - 293.89 (F06.1).

10. Other schizophrenia spectrum disorders and psychotic disorders - 298.9 (F29).

Main differences between diagnostic criteria for schizophrenia in DSM-5 and ICD-10

The bipolar chapter of the DSM-5 describes the diagnostic criteria for the following disorders:

1. Type I BR - 295.40-295.46.

2. Type II BR - 296.89 (F31.81).

3. Cyclothymic disorders - 301.13 (F34.00).

4. Bipolar and related disorders due to the use of psychoactive substances and drugs (coding depends on the underlying disease).

5. Bipolar and related disorders due to other medical conditions (coding depends on the underlying disease).

6. Other bipolar and related disorders - 296.89 (F31.81).

7. Inaccurate bipolar and related disorders - 296.80 (F31.9).

Comparison of diagnostic criteria for bipolar disorder in DSM-5 and ICD-10

Characteristics of severity, state of remission and the presence of psychotic features qualify in both classifications.

The chapter on depressive disorders of the DSM-5 includes diagnostic criteria for the following disorders:

1. Destructive mood dysregulation disorder - 296.99 (F34.8).

2. Major depressive disorder - 296.20-296.26 (F32.0-32.5, 32.9), 296.30-296.36 (F33.0-F33.42, 33.9).

3. Persistent depressive disorder (Dysthymia) - 300.4 (34.1).

4. Premenstrual dysphoric disorder 625.4 (N94.3).

5. Depressive disorder due to the use of psychoactive substances and drugs (coding depends on the type of drug used).

6. Depressive disorder due to other medical conditions (coding depends on the underlying disease).

7. Other depressive disorders - 311 (F32.8).

8. Unspecified depressive disorders - ---- 311 (32.9).

Analysis of diagnostic criteria for major depressive disorder in DSM-5 and ICD-10

Summarizing the data presented in the article, it should be noted that DSM-5 is based on a dimensional approach, which provides an assessment of each form of pathology in a single continuum "normal-pathology" using numerous specifiers of subtype, severity, course, which makes the diagnosis personalized. The ICD-10 uses a categorical approach to define a pathological disorder as a discrete phenomenon.

The elimination of symptoms of the first Schneider rank, the forms and types of the course of the disease used in the ICD-10, is a difference in the diagnosis of schizophrenia in the DSM-5. It is the DSM-5 diagnostic criteria that include the definition of positive and negative symptoms, social functioning, duration of the disorder, and differential diagnostic criteria. Dynamic specification allows the patient to establish the presence of the first episode, multiple episodes, exacerbation of the condition or the degree of remission. In particular, the assessment of the severity of the condition is carried out on a 5-point scale when determining the main psychopathological dimensions.

Compared to the ICD-10, the diagnostic criteria for BD in DSM-5 are expanded by distinguishing type I BD, introducing a criterion for change in affect with the use of antidepressants, diagnosing BD due to the use of psychoactive substances, drugs and other medical conditions. Diagnostic classifiers allow to assess the individual characteristics of BD (with features of anxious distress; rapid cycles; catatonia; mixed features; atypical features, with a seasonal pattern, with peripartum onset, with psychotic features, congruent or incongruent to mood). Instead of the "mixed episode" category, the specifier "with mixed features" is used.

In order to objectify depressive disorders, the DSM-5 diagnostic criteria for depression provide ample opportunities, which is achieved by introducing new categories (compared to the ICD-10):

1) destructive mood dysregulation disorder (DMDD);

2) persistent depressive disorder (combination of chronic depression and dysthymia);

3) depressive disorder due to the use of psychoactive substances, drugs or other medical conditions.

The basis for the diagnosis of MDD is the definition of two leading symptoms - depressed mood and anhedonia (in ICD-10, "loss of energy" is added to them). The use of specifiers makes it possible to provide individual approach to the diagnosis of MDD, and descriptive criteria to separate "normal" and "pathopsychological response to bereavement."

In addition, acquaintance with the DSM-5 diagnostic criteria for specialists working in the field of mental health in Ukraine opens up wide opportunities for exchanging information and mastering the updated system of diagnostic approaches and criteria.

Literature

Preparation of the ICD-11: the main objectives, principles and stages of the revision of the classification of mental and behavioral disorders /J. M. Reid, V. N. Krasnov, M. A. Kulygina // Social and Clinical Psychiatry. - 2013. - V. 23, No. 4. - S. 56-60.

Reed G. M., Correia J. M., Esparza P. et al. The WPA-WHO global survey of psychiatrists’ uses and attitudes towards mental disorders classification // World Psychiatry. - 2011. - No. 10. - P. 118-131.

Saxena S., Esparza P., Regier D.A. et al. Public health aspects of diagnosis and classification of mental and behavioral disorders. Refining the research agenda for DSM-5 and ICD-11. - Arlington: American Psychiatric Association and World Health Organization, 2012. - R. 217-236.

Wittchen H-U., Beesdo K., Gloster A.T. A new meta-structure of mental disorders: a helpful step into the future or a harmful step back into the past? // Psychol Med. - 2009. - V. 39. - P. 2083-2089.

Andrews G., Goldberg D.P., Krueger R.F. et al. Exploring the feasibility of a meta-structure for DSM-V and ICD-11: could it improve utility and validity? // Psychol Med. - 2009. - V. 39. - Р.1993-2000.

DSM-5: Classification and change criteria / Darrel A. Regier, Emily A. Kuhl, David J. Kupfer // World Psychiatry. - 2013. - V. 12, No. 2. - P. 92-99.

Beyond the DSM and the ICD: introducing "accurate diagnosis" to psychiatry through the use of instant assessment technology / Jim van Os, Philippe Delespaul, Johanna Wigman, Inez Myin-Germeys, Marieke Wichers // World Psychiatry. - 2013. - V. 12, No. 2. - P. 107-110.

Full list Literature, including 17 items, is under revision.

Autism Spectrum Disorder (ASD)- a range of psychological characteristics describing a wide range of abnormal behavior and difficulties in social interaction and communication, as well as severely limited interests and often repetitive behavioral acts.

Included in the "autism spectrum disorder":
- autism (Kanner's syndrome)
- Asperger's syndrome
- childhood disintegrative disorder
- nonspecific pervasive developmental disorder

The Fifth Edition Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5, developed and published by the American Psychiatric Association on May 18, 2013, includes for autism spectrum disorders ( PAC) (Autism Spectrum Disorder, ASD) 299.00 (F84.0) following diagnostic criteria:

A. Persistent impairments in social communication and social interaction in a variety of contexts, presently manifesting or having a history of the following (examples are for illustrative purposes and are not exhaustive, see text):

1. Violations in social-emotional reciprocity; starting, for example, with abnormal social convergence and failures to maintain normal dialogue; to reduce the exchange of interests, emotions, as well as the impact and response; to the inability to initiate or respond to social interactions.
2. Impairments in non-verbal communicative behavior used in social interaction; starting, for example, with poor integration of verbal and non-verbal communication; to an anomaly of eye contact and body language or a violation of the understanding and use of non-verbal communication; to the complete absence of facial expressions or gestures.
3. Violations in the establishment, maintenance and understanding of social relationships; starting, for example, with difficulties in adjusting behavior to different social contexts; to difficulty participating in imaginative games and making friends; to a visible lack of interest in peers.

b. Limited, repetitive patterns of behavior, interests, or activities, as manifested in at least two of the following (examples are provided for illustrative purposes and are not intended to be exhaustive, see text):

1. Stereotypical or repetitive motor movements, speech, or use of objects (eg, simple motor stereotypes, lining up toys or waving objects, echolalia, idiosyncratic phrases).
2. Excessive need for immutability, inflexible adherence to rules or patterns of behavior, ritualized forms of verbal or non-verbal behavior (eg, extreme stress at the slightest change, difficulty shifting attention, inflexible thought patterns, congratulatory rituals, insisting on a fixed route or food).
3. Extremely limited and fixed interests that are anomalous in intensity or direction (e.g., strong attachment to or excessive preoccupation with unusual objects, extremely limited scope occupations and interests or perseveration).
4. Over- or under-reacting to sensory input or unusual interest in sensory aspects of the environment (eg, apparent indifference to pain or environmental temperature, negative reaction to certain sounds or textures, excessive sniffing or touching of objects, fascination with lights or objects in motion) .

Specify the severity:
Severity is based on impaired social interaction and limited, repetitive behaviors (see Table 2).

FROM. Symptoms must be present early in development (but may not become fully apparent until social demands exceed limited capacity, or be masked by learned strategies later in life).

D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of daily functioning.

E. These disorders are not explained by intellectual disabilities (mental retardation) or general developmental delay. Intellectual disability and autism spectrum disorders often coexist; to diagnose comorbidity between autism spectrum disorder and mental retardation, social communication must be below what is expected for the overall level of development.

Note:
Individuals with well-established DSM-IV autism, Asperger's syndrome, or non-specific pervasive developmental disorder (PDD-NOS) under the DSM-V will be diagnosed with an autism spectrum disorder.
Individuals with significant social communication and interaction impairments whose symptoms do not meet the criteria for autism spectrum disorder should undergo a diagnostic evaluation for social communication (pragmatic) disorder (315.39 (F80.89)).

Additionally specify:
With/Without accompanying mental retardation (developmental delay).
With/Without an accompanying defect (speech disorder).
A disorder associated with a medical condition, or genetics, or a known environmental factor. (Coded note: Use additional code(s) to identify associated medical or genetic conditions.)
A disorder associated with impaired development, behavior, mental or other abilities of a neurological nature. (Coded note: Use additional code(s) to identify developmental nervous system mental or behavioral disorders.)
With/Without catatonia(s) (see criteria for catatonia associated with another psychiatric disorder, pp. 119-120, for a definition). (Coded note: use additional code 293.89 of autism-associated catatonia to indicate the presence of concomitant catatonia.)

Table 2. Severities of autism spectrum disorders

Severity	social communication	Limited interests and repetitive behavior
Level 3 "Need in a very substantial support"	Severe violations in verbal and non-verbal social communication skills lead to serious impairments in functioning; extremely limited initiation of social interactions and minimal response to the social initiatives of others. For example, a person with a small set of a few understandable words, occasionally initiating social interaction, and if he initiates, he turns in an unusual form and only to satisfy needs, and responds only to very direct instructions and forms of social communication.	Lack of flexibility in behavior significant difficulty adjusting to change and change, or limited/repetitive behaviors that are very disturbing and make it difficult performance in all areas. Severe stress and / or pronounced difficulty in changing activities or switching attention.
Level 2 "Need in significant support"	Marked impairments in verbal and non-verbal social communication skills; pronounced difficulties in social communication and interaction even with the presence of support; limited initiation of social interactions; and limited or abnormal response to the social initiatives of others. For example, a person who expresses himself in a limited number of phrases and sentences, social interaction is limited to narrow special interests, and oddities are noticeable in the non-verbal form of his communication.	Lack of flexibility in behavior, extreme difficulty adapting to change and change, or limited/repetitive behaviors that occur with sufficient frequency and are noticeable to an outside observer, and also interfere with functioning in various contexts. Marked stress and/or marked difficulty changing activities or shifting attention.
Level 1 "Need in support"	Without support and facilitation, disruptions in social communication lead to noticeable disruptions. Has difficulty initiating social interactions and shows clear examples of atypical or unfortunate reactions to treatment from others. May appear to have a reduced interest in social interactions. For example, a person who is able to speak in full sentences and is sociable, but mutual dialogue with others does not work, and his attempts to establish friendly relations are strange and usually unsuccessful.	Inflexible behavior significantly impedes functioning in one or more contexts. Difficulty switching between activities. Problems with organization and planning hinder independence.

Sources:
1. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, 2013 pp. 50-53.
2. Autism Spectrum Disorder Fact Sheet, 2013, p.1

The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Revised, was published by the American Psychiatric Association in 2000. This paper attempts to evaluate psychiatric illness along five axes.

1. Axis I includes most mental disorders except personality disorders and mental retardation.
2. Axis II includes personality disorders and various degrees of mental retardation.
3. Axis III consists of all concomitant general health disorders that can be observed in a patient with mental disorders (eg, epilepsy, arterial hypertension, gastric ulcer, infectious diseases, etc.).
4. Axis IV covers psychosocial and environmental issues that may complicate diagnostic work and treatment (eg, divorce, trauma, death of a loved one).
5. V axis describes clinicians' assessments of the general level of activity of patients on the Scale overall assessment functional status (GAF), where the level of functionality is rated from 0 to 100.

Axis I diagnoses

(Partial listing with some examples)

Disorders usually first diagnosed in infancy, childhood, or adolescence

• Learning disability.
• Attention deficit hyperactivity disorder.
• Autism.
• Tourette syndrome.

Delirium, dementia, amnestic and other cognitive disorders.

• Delirium caused by alcohol or other psychoactive substances.
• Alzheimer's disease.
• Dementia due to head injury.

Disorders associated with the use of psychoactive substances.

• Alcoholism.
• Abuse of cocaine.
• Abuse of cannabinoids.
• Amphetamine abuse.
• hallucinogenic intoxication.

Schizophrenia and other psychotic disorders

• Schizophrenia

Mood disorders

• clinical depression.
• dysthymic disorder.
• Bipolar disorder of the first type.
• Bipolar II Disorder

Anxiety disorders

• panic disorder.
• Phobia
• Post-traumatic stress disorder.
• Social anxiety disorder.
• Obsessive-compulsive disorder.

Psychosomatic disorders

• somatic disorder.
• Hypochondria.
• conversion disorder.
• Body dysmorphic disorder.

Simulative disorders

Dissociative disorders

• Dissociative identity disorder (split personality)
• dissociative amnesia.
• dissociative fugue.

Sexual and Gender Identity Disorders

• premature ejaculation
• Exhibitionism.
• Pedophilia.
• Fetishism.
• Vaginismus.

Eating Disorders

• Anorexia nervosa.
• Nervous bulimia.

Sleep disorders

• Primary insomnia.
• Somnambulistic disorder.

Impulse Disorders

• Intermittent explosive disorder.
• Kleptomania
• Pathological addiction to gambling.
• Trichotillomania (pulling out hair and eyebrows).

Adjustment Disorders

• With depression.
• With anxiety.

Axis II. Diagnosis of personality disorders

Group A. (Weird, eccentric)

• paranoid personality disorder.
• Schizoid personality disorder.
• Schizotypal personality disorder.

Group B (Dramatic, emotional)

• Antisocial personality disorder.
• Borderline personality disorder.
• Hysterical personality disorder.
• Narcissistic personality disorder.

Group C (Anxious, scared)

• Avoidant personality disorder.
• Dependent personality disorder.
• Obsessive-compulsive personality disorder.

With DSM-III, a multi-axis system was introduced. Patients are classified according to 5 independent parameters (axes). Preparations for the DSM-IV began in 1988 and were completed in 1994. The DSM-IV described 400 mental disorders in 17 categories. It also uses a multi-axis system, just like the DSM-III and DSM-III-R.

The ICD-9-CM (ICD-9-CM) codes were used to codify disorders in the DSM-IV. The next version (DSM-5) specifies two codes: the ICD-9 code -KM and the ICD-10 code -KM for statistical purposes. ICD-10: Clinical modification(ICD-10-KM) differs from the usual ICD-10 also by changed names (for example, hebephrenic schizophrenia in ICD-10-KM is called disorganized schizophrenia, as in the DSM).

Exclusion of homosexuality from the list of mental disorders

DSM-IV-TR

In 2000, a "revised" (English "text revision", literally "text revision") version of the DSM-IV, known as the DSM-IV-TR. The diagnostic categories and the vast majority of specific criteria for diagnosis have remained unchanged. Updated text sections providing Additional information for each diagnosis, as well as some of the diagnostic codes to maintain consistency with the ICD.

DSM-5

Also associated with recent successful psychiatric genome studies that have identified a common gene polymorphism between psychiatric disorders: schizophrenia, bipolar affective disorder, attention deficit hyperactivity disorder, major depressive disorder, and autism spectrum disorder. These states were accepted as the first four chapters of the DSM-5. Similarly, authors have tried to group mental disorders based on advances in neuroscience rather than psychopathology.

Collaboration with WHO and APA in the development of DSM-5

Dates of publications of the diagnostic and statistical manual

see also

Notes

1. Burlachuk L. F. Dictionary-reference book on psychodiagnostics. - 3rd ed. - St. Petersburg. : Piter Publishing House. - S. 126-128. - 688 p. - ISBN 978-5-94723-387-2.
2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) . - Washington, DC: American Psychiatric Publishing, 1980. - P. 380. - 494 p. - ISBN 978-0-521-31528-9.
3. Stuart H. Fighting the stigma caused by mental disorders: past perspectives, present activities, and future directions // World Psychiatry (English)Russian: journal. - 2008. - October (vol. 7, no. 3). - P. 185-188. -

System DSM American psychiatric association - Diagnostic and Statistical Manual of Mental Disorders(Handbook of Diagnostics and Statistics of Mental Disorders) is a rival classification system for mental disorders to the ICD (Original English version: American Psychiatric Association, 1994; German version: American Psychiatric Association, 1996). Recently active DSM IV- Roman numerals indicate the number of revisions - which canceled DSM-III-R(American Psychiatric Association, 1989). DSM IV compiled from extensive expert reports and field research. DSM IV subdivided into 17 main groups (including the group "Other clinically relevant problems"; see Table 6.2), each main group includes units (disorders). For example, the main group of anxiety disorders includes 12 various forms(eg: panic disorder without agoraphobia; other examples can be found in the chapters on Classification and Diagnosis of Functioning Pattern Disorders). Individual units are described in the form of a systematized condensed textbook, the text contains, as a rule, the following items: diagnostic features ( general description disorder pictures), subtypes and/or additional codings, coding rules, belonging symptoms and disorders; special cultural, age and gender characteristics; the frequency of diseases; flow; family distribution pattern; differential diagnosis (but not indications for treatment). The disorders were identified by operational diagnostics. In the English version (American Psychiatric Association, 1994), units of disorders are designated by ICD-9-CM codes and a verbal description (for example, "300.20 Specific Phobia"), in the German version (American Psychiatric Association, 1996) by ICD-9-CM codes, ICD-10 and verbal description (for example, "300.29 (F40.2) Specific phobias").

DSM IV corresponds to ICD-10 in the following paragraphs (given in Table 6.1): purpose of classification, logic of classes, properties of classes, classification unit, basis of classification, data sources, formal accuracy. In some points it differs from ICD-10.

- Scope:DSM-IV- only mental disorders; ICD-10 - all diseases.

- Selection of units: more empirical research oriented (cf. sourcebooks material; Widinger et al., 1994, 1996).

- Definition of units: for definitions DSM IV meets the criteria of the ICD-10 study: operational diagnostics are consistently implemented here. ICD-10 takes into account less explicitly compared to DSM IV that the symptomatology can lead to a decrease in various functions.

- Attribution rules: thanks to operational diagnostics, explicit attribution rules (in ICD-10 - partly implicit, partly explicit). Additionally in DSM IV there is a so-called decision tree which is not in ICD-10. Due to this, the specialist conducting the examination, obviously has graphic scheme to include or exclude individual disorders (see Chapter 37).

Other differences DSM IV from ICD-10:

- Number of versions:DSM IV published in a single version, ICD-10 has several versions (see above).

- Description Form:DSM IV is in the form of textbook text (see above), and ICD-10 contains only general descriptions.

- Multi-Axis Diagnostics: in ICD-10, multi-axis diagnostics is under preparation, in DSM IV this is explicit component. AT DSM IV the following axes are postulated (for an overview of axis categories I and II: see Table 6.2):

Axis I Clinical disorders, other clinically relevant problems (conditions that cannot be attributed to any mental disorder, but give rise to observation or treatment).

Axis II. Personality disorders, mental retardation (in the category of disorders that are diagnosed mainly in infancy, childhood or adolescence).

Axis III. Somatic diseases.

Axis IV. Psychosocial problems and problems related to environment(9 main areas, eg housing or economic issues).

Axis V Global recording of the level of performance (scale with 10 divisions; a period of time related to the current situation, or, for example, highest level for at least 2 months in the past year).

Axes I, II, III contain the official DSM IV diagnoses; axes IV and V are optional, they are used for special clinical and research purposes. Along the axes from I to IV there can be various gradations. The multi-axis approach enables complex diagnostics, which also takes into account psychosocial aspects. FROM psychological point of view, however, axes IV and V seem too global and one-sided to differentiate between psychosocial conditions. So, for example, overload factors without taking into account coping are only informative to a limited extent. So far, these axes have not been used in clinical or research projects.

- Diagnostic differences: detailed differences appear in some diagnoses: identical in ICD-10 and DSM IV concepts do not always have identical content. Therefore, it is necessary to indicate exactly which system is used for diagnostics.

Despite all the differences, between the ICD-10 and DSM IV there is a clear convergence. The methods of examination given in section 2.5 partly allow one to put the ICD- and DSM-diagnoses, so it becomes possible to compare results in different systems.