'Diagnosis' is a word origin Greek, already used in ancient medicine with the meaning of 'recognition'. With the diagnosis is in fact to recognize the signs, taken as evidence for the assessment of specific faculty, or the overall framework of personality (in this case we speak of 'psychological diagnosis'), or symptoms of altered functions due to nosological entities that are known in broad outline the course and outcome.
In an attempt to provide uniform diagnostic criteria in psychiatry, American Psychiatric Association published the Diagnostic and Statistical Manual (DSM), in order to develop new methods of classification and a new glossary that could be really universal.
This is a handbook currently more than 370 mental disorders, describing them according to prevalence of certain symptoms (mostly those observed in the behavior of the individual, but there are references to the ego structure and personality). Given its scientific origin of a statistical nature, is considered one of the most reliable to diagnose a mental disorder, and therefore widely used as a reference for choosing a particular treatment, especially medication.
The first edition of the Manual (DSM-I) dates back to 1952, and was drafted by the American Psychiatric Association (APA). Over the years this book has been enhanced and enriched with references to the current development of psychological research in many fields, but also with new definitions of mental disorders: its latest edition, dating from 1994 (DSM-IV) classifies a number of mental disorders equal to three times that of the first edition. (The DSM V will be released in 2011).
Politically, the DSM is a very important because it determines the boundary between normality and pathology, indicates what needs to be treated and how.
Given the importance of such an instrument is to assume a level of scientific culture worldwide, the DSM is the subject of several critical issues that challenge especially cold statistics, that can hardly be found in an individual, with his personal history.
Its structure follows a multiaxial system: disorder divided into five axes, as follows:
Axis I: clinical disorders characterized by the property to be temporary or not "structural"
Axis II: personality disorders and mental retardation. Disorders stable and unlikely to be returned to a structural condition "pre-morbid"
AXIS III: General medical conditions
AXIS IV: psychosocial and environmental problems
AXIS V: Global assessment of functioning
To give some examples, the DSM part in ' AXIS I disorders such as schizophrenia and other forms of psychosis, Axis II disorders but are collected such as borderline personality or the paranoid.
Generally the DSM requires a cut-off, a minimum number of symptoms collected in order to make a correct diagnosis.
Usually the DSM requires a minimum period of presence of symptoms in order to make a diagnosis (something a few months). Other exclusion criteria include age of onset of the disorder (for personality disorders such as the onset in adolescence is required) and a differential diagnosis to diseases that may share the same symptoms
In Europe, often using Alternatively, the ICD is the latest version of the diagnostic criteria of the Organisation World Health Organization, it concerns the classification of all medical illnesses, not just psychiatric.
We see such a case of 'schizoid personality' according to the DSM IV and ICD.
DSM IV
A subject is called 'schizoid' if it has at least four of the following symptoms:
1. The subject feels no desire or pleasure to have close relationships with other people, including family
2. Almost always prefers solitary activities or relationships that involve the entire surface.
3. It has little or no interest in real relationships and sexual experiences.
4. Do not test or pleasure in almost any business.
5. Lacks close friends or confidants in addition to first-degree relatives.
6. It seems emotionally indifferent to criticism or praise.
7. Demonstrates "cold" emotional detachment or emotional flatness.
ICD
In this classification the "schizoid personality disorder" is defined as the symptomatic picture characterized by the continuous presence of at least three of the following symptoms:
1. Emotional coldness, detachment or reduced affectivity.
2. Limited ability to express both positive and negative feelings towards others.
3. Significant preference for solitary activities or lack of commitment to participatory.
4. Lack (or reduced number) of friends or close relationships, and lack of desire to have.
5. Marked indifference to praise or criticism.
6. The subject is not derived any pleasure from any activity or Qasi.
7. Indifference to social conventions and behavioral standards.
8. Excessive worries or fantasies toward introspective thoughts.
9. Little desire for sexual experiences that involved another person.
As we see, in ICD-10 parameters are nine instead of seven in the point A of the DSM IV-TR. The ICD-10 includes two behavioral criteria: indifference to social norms and conventions and the expression of intense emotions on others.
Although the DSM has the merit of creating a unique language and criteria in order to understand, the criticisms are numerous. Not everyone seems an appropriate tool to assess the clinical situation of a person: its structure is strictly statistical, the selection of cut-off is questionable, neglected the subjective characteristics of the patient, the effects of his experience, his personal history .
Other criticisms relate more directly to the ethical dimension: half of the psychiatrists who participated in drafting the latest edition of the DSM has had economic relations (between 1989 and 2004, with roles as a researcher or consultant) with pharmaceutical companies. These are all the psychiatrists who treated the section on mood disorders and psychosis of the manual, definitions of disorders in those years were accompanied by soaring sales of drugs "appropriate." These discoveries have come back into fashion the theme of "diseases created a table" (eg through a simple "shortening" of the cut-off for inclusion in a diagnosis) in recent years to launch new drugs, as the case discussed Attention Disorder treated quickly with the use of a stimulant of the central nervous system, Ritalin.
Sources and Links: Umberto Galimberti, Dictionary of Psychology, De Agostini
Wikipedia
Mind Hacks
'The Dictionary of Disorder' The New Yorker
The 'Bible of mental disorders under fire' - Disinformation
Dr. Giuliana Proietti Ancona
by http://psicolinea.blogspot.com/2007/01/la-diagnosi.html 09/06/2009