Chinese Classification of Mental Disorders
Encyclopedia
The Chinese Classification of Mental Disorders (CCMD) (中国精神疾病分类方案与诊断标准), published by the Chinese Society of Psychiatry
Chinese Society of Psychiatry
The Chinese Society of Psychiatry is the largest organization for psychiatrists in China. It publishes the Chinese Classification of Mental Disorders...

 (CSP), is a clinical guide used in China
China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...

 for the diagnosis of mental disorders. It is currently on a third version, the CCMD-3, written in Chinese and English. It is intentionally similar in structure and categorisation to the ICD
ICD
The International Statistical Classification of Diseases and Related Health Problems is a medical classification that provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease...

 and DSM
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...

, the two most well-known diagnostic manuals, though includes some variations on their main diagnoses and around 40 culturally-related diagnoses.

History

The first published Chinese psychiatric classificatory scheme appeared in 1979. A revised classification system, the CCMD-1, was made available in 1981 and further modified in 1984 (CCMD-2-R). The CCMD-3 was published in 2001.

Many Chinese psychiatrists believed the CCMD had special advantages over other manuals, such as simplicity, stability, the inclusion of culture-distinctive categories, and the exclusion of certain Western diagnostic categories. The Chinese translation of the ICD-10
ICD-10
The International Statistical Classification of Diseases and Related Health Problems, 10th Revision is a medical classification list for the coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases, as maintained by the...

 was seen as linguistically complicated, containing very long sentences and awkward terms and syntax (Lee, 2001).

Diagnostic categories

The diagnosis of depression is included in the CCMD, with many similar criteria to the ICD or DSM, with the core having been translated as 'low spirits'. However, Neurasthenia
Neurasthenia
Neurasthenia is a psycho-pathological term first used by George Miller Beard in 1869 to denote a condition with symptoms of fatigue, anxiety, headache, neuralgia and depressed mood...

 is a more central diagnosis. Although also found in the ICD, its diagnosis takes a particular form in China, called 'shenjing shuairuo', which emphasizes somatic
Somatic
The term somatic means 'of the body',, relating to the body. In medicine, somatic illness is bodily, not mental, illness. The term is often used in biology to refer to the cells of the body in contrast to the germ line cells which usually give rise to the gametes...

 (bodily) complaints as well as fatigue or depressed feelings. Neurasthenia is a less stigmatizing diagnosis than depression in China, being conceptually distinct from psychiatric labels, and is said to fit well with a tendency to express emotional issues in somatic terms. The concept of neurasthenia as a nervous system disorder is also said to fit well with the traditional Chinese epistemology of disease causation on the basis of disharmony of vital organs and imbalance of qi
Qi
In traditional Chinese culture, qì is an active principle forming part of any living thing. Qi is frequently translated as life energy, lifeforce, or energy flow. Qi is the central underlying principle in traditional Chinese medicine and martial arts...

.

The diagnosis of Schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...

 is included in the CCMD. It is applied quite readily and broadly in Chinese psychiatry.

Some of the wordings of the diagnosis are different, for example rather than borderline personality disorder
Borderline personality disorder
Borderline personality disorder is a personality disorder described as a prolonged disturbance of personality function in a person , characterized by depth and variability of moods.The disorder typically involves unusual levels of instability in mood; black and white thinking, or splitting; the...

 as in the DSM, or emotionally unstable personality disorder (borderline type) as in the ICD, the CCMD has impulsive personality disorder.

Diagnoses that are more specific to Chinese or Asian culture, though they may also be outlined in the ICD (or DSM glossary section), include:
  • Koro or Genital retraction syndrome: excessive fear of the genitals (and also breasts in women) shrinking or drawing back in to the body.
  • Zou huo ru mo
    Zou huo ru mo (medicine)
    Zou huo ru mo or "qigong deviation" is a Chinese term applied to the results of errors encountered during qigong practice. Those errors are characterized by the perception that there is an uncontrolled flow of qi in the body...

      or qigong deviation : perception of uncontrolled flow of qi
    Qi
    In traditional Chinese culture, qì is an active principle forming part of any living thing. Qi is frequently translated as life energy, lifeforce, or energy flow. Qi is the central underlying principle in traditional Chinese medicine and martial arts...

     in the body.
  • Mental disorders due to superstition
    Superstition
    Superstition is a belief in supernatural causality: that one event leads to the cause of another without any process in the physical world linking the two events....

     or witchcraft
    Witchcraft
    Witchcraft, in historical, anthropological, religious, and mythological contexts, is the alleged use of supernatural or magical powers. A witch is a practitioner of witchcraft...

    .
  • Travelling psychosis
    Psychosis
    Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...



The CCMD-3 retains a category of 'ego-dystonic homosexuality
Ego-dystonic sexual orientation
Ego-dystonic sexual orientation is an ego-dystonic condition characterized by having a sexual orientation or an attraction that is at odds with one's idealized self-image, causing anxiety and a desire to change one's orientation or become more comfortable with one's sexual...

'.

Koro

[[Koro]] or Genital retraction syndrome is a culture-specific syndrome from Southeast Asia in which the patient has an overpowering belief that the genitalia (or nipples in females) is shrinking and will shortly disappear. In China, it is known as shuk yang, shook yong, and suo yang (simplified Chinese: 缩阳; traditional Chinese: 縮陽). This has been associated with cultures placing a heavy emphasis on balance, or on fertility
Fertility
Fertility is the natural capability of producing offsprings. As a measure, "fertility rate" is the number of children born per couple, person or population. Fertility differs from fecundity, which is defined as the potential for reproduction...

 and reproduction.

Zou huo ru mo

Zou huo ru mo
Zou huo ru mo (medicine)
Zou huo ru mo or "qigong deviation" is a Chinese term applied to the results of errors encountered during qigong practice. Those errors are characterized by the perception that there is an uncontrolled flow of qi in the body...

  or "qigong deviation" is a mental condition characterized by the perception that there is uncontrolled flow of qi
Qi
In traditional Chinese culture, qì is an active principle forming part of any living thing. Qi is frequently translated as life energy, lifeforce, or energy flow. Qi is the central underlying principle in traditional Chinese medicine and martial arts...

 in the body. Other complaints include localized pains, headache, insomnia, and uncontrolled spontaneous movements.

See also

  • International Statistical Classification of Diseases and Related Health Problems
    ICD
    The International Statistical Classification of Diseases and Related Health Problems is a medical classification that provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease...

     (ICD) of the World Health Organization
    World Health Organization
    The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

  • Diagnostic and Statistical Manual of Mental Disorders
    Diagnostic and Statistical Manual of Mental Disorders
    The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...

     (DSM) of the American Psychiatric Association
    American Psychiatric Association
    The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...

  • DSM-IV Codes
    DSM-IV Codes
    Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR, is a manual published by the American Psychiatric Association that includes all currently recognized mental health disorders...


External links

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