Concept

Chinese Classification of Mental Disorders

The Chinese Classification of Mental Disorders (CCMD; ), published by the Chinese Society of Psychiatry (CSP), is a clinical guide used in China for the diagnosis of mental disorders. It is on its third version, the CCMD-3, written in Chinese and English. The current edition is very similar to the ICD-10, and is also influenced by the DSM-IV, the two main psychiatric typologies used in the rest of the world. However, it has a unique definition of some disorders, includes an additional 40 or so culturally-related diagnoses, and lacks certain conditions recognised in other parts of the world. The first published Chinese psychiatric classificatory scheme appeared in 1979. A revised classification system, the CCMD-1, was made available in 1981 and was further modified in 1984 (CCMD-2-R), 1989, and 1995. The CCMD-3 was published in 2001. At launch, the CCMD-3 was supplemented with the companion book "Treatment and Nursing of Mental Disorders Relevant to CCMD-3". 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 was seen as linguistically complicated, containing very long sentences, and awkward terms and syntax. A 2014 study found that the ICD-10 was more commonly used by Chinese psychiatrists than the CCMD-3 or DSM-IV. 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 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 (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.

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