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Classification of child and adolescent psychiatric disorders

The present system of classification for child and adolescent psychiatric disorders has focused primarily on symptomatology rather than aetiology. In child psychiatry, organic disorders in which psychiatric disorders arise secondary to physical causes are rare. Multi-axial classification takes into account different aspects of a patient’s disorder and classifies the disorder along different axes giving a composite picture of the condition. The commonly used axes are:

•clinical psychiatric condition; •intellectual level; •specific delays in development; •any medical conditions; •abnormal psychosocial situation.

Classification should not be an end in itself and to be effective should be clinically relevant and aid communication on possible aetiology, treatment and prognosis classification. The two main systems in use are the International Classification of Diseases (ICD) of the World Health Organization and the Statistical Manual (DSM) of the American Psychiatric Association. The DSM-IV and the ICD-10 provide clear descriptive criteria that must be met before a diagnosis can be made. The ICD-10 classification of Behavioural and Emotional Disorders with onset usually occurring in childhood and adolescents is coded separately.

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