Prospects for the classification of mental disorders of children and adolescents

Abstract

Suggestions for classification of mental disorders of children and adolescents in DSM-V and ICD-11 have been made, which differ strongly from the current descriptive approach of dimensional classification. These suggestions even comprise a dichotomized system for health care as well as for scientific purposes. Nevertheless it is obvious that we are far behind an "etiological" classification, so that trade-offs have necessarily to be made in DSM-V and ICD-11. Appropriate proposals concern the strict separation of disorders that are typical for children and adolescents as well as for adults. Furthermore a differentiation of diagnosis for infants, toddlers and preschool children is required in both classification systems. As far as it is relevant for treatment, combined diagnosis in DSM-V and subthreshold diagnosis as well as coding-possibilities for findings in molecular biology should be permitted. As personality disorders should only be diagnosed after the age of 16, it is recommended to dimensionally classify personality traits that are pathognomonic for specific symptom patterns and of prognostic relevance. DSM-V and ICD-11 should allow age-specific information on axis-IV. The article discusses the general question of how relational disorders respectively disturbances should be classified and include furthermore special recommendations concerning ICD and DSM categories.