The Chinese Classification of Mental Disorders (CCMD; ), published by the

Chinese Society of Psychiatry The Chinese Society of Psychiatry (CSP; ) is the largest organization for psychiatrists in China. It publishes the Chinese Classification of Mental Disorders ("CCMD"), first published in 1985. The CSP also publishes clinical practice guidelines; pr ...

(CSP), is a clinical guide used in

China China, officially the People's Republic of China (PRC), is a country in East Asia. It is the world's List of countries and dependencies by population, most populous country, with a Population of China, population exceeding 1.4 billion, slig ...

for the diagnosis of

mental disorder A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...

s. It is on a third version, the CCMD-3, written in Chinese and English. The current edition is very similar to the

ICD-10 ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms ...

, and is also influenced by the

DSM-IV The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langu ...

, 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.

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), 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.

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 (from the Ancient Greek νεῦρον ''neuron'' "nerve" and ἀσθενής ''asthenés'' "weak") is a term that was first used at least as early as 1829 for a mechanical weakness of the nerves and became a major diagnosis in North A ...

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 Fatigue describes a state of tiredness that does not resolve with rest or sleep. In general usage, fatigue is synonymous with extreme tiredness or exhaustion that normally follows prolonged physical or mental activity. When it does not resolve ...

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 Epistemology (; ), or the theory of knowledge, is the branch of philosophy concerned with knowledge. Epistemology is considered a major subfield of philosophy, along with other major subfields such as ethics, logic, and metaphysics. Epi ...

of disease causation on the basis of disharmony of

vital organ In biology, an organ is a collection of tissues joined in a structural unit to serve a common function. In the hierarchy of life, an organ lies between tissue and an organ system. Tissues are formed from same type cells to act together in a ...

s and imbalance of qi. The diagnosis of

schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social w ...

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 (BPD), also known as emotionally unstable personality disorder (EUPD), is a personality disorder characterized by a long-term pattern of unstable interpersonal relationships, distorted sense of self, and strong ...

as in the DSM, or

emotionally unstable personality disorder Emotions are mental states brought on by neurophysiological changes, variously associated with thoughts, feelings, behavioral responses, and a degree of pleasure or displeasure. There is currently no scientific consensus on a definition. ...

(borderline type) as in the ICD, the CCMD has

impulsive personality disorder Borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD), is a personality disorder characterized by a long-term pattern of unstable interpersonal relationships, distorted sense of self, and strong ...

. Diagnoses that are more specific to Chinese or Asian culture, though they may also be outlined in the ICD (or DSM glossary section), includes: * Koro or Genital retraction syndrome: excessive fear of the

genitals A sex organ (or reproductive organ) is any part of an animal or plant that is involved in sexual reproduction. The reproductive organs together constitute the reproductive system. In animals, the testis in the male, and the ovary in the female, a ...

(and also breasts in women) shrinking or drawing back into the body. * Zou huo ru mo () or qigong deviation (): perception of uncontrolled flow of qi in the body. *Mental disorders due to

superstition A superstition is any belief or practice considered by non-practitioners to be irrational or supernatural, attributed to fate or magic, perceived supernatural influence, or fear of that which is unknown. It is commonly applied to beliefs ...

witchcraft Witchcraft traditionally means the use of magic or supernatural powers to harm others. A practitioner is a witch. In medieval and early modern Europe, where the term originated, accused witches were usually women who were believed to have ...

. *Travelling

psychosis Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavi ...

The CCMD-3 lists several "disorders of sexual preference" including

ego-dystonic homosexuality Ego-dystonic sexual orientation is a highly controversial mental health diagnosis that was included in the American Psychiatric Association's (APA) ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM) from 1980 to 1987 (under the name ...

, but does not recognize

pedophilia Pedophilia ( alternatively spelt paedophilia) is a psychiatric disorder in which an adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children. Although girls typically begin the process of puberty ...

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) are shrinking and will shortly disappear. In China, it is known as shuk yang, shook yong, and suo yang (). This has been associated with cultures placing a heavy emphasis on balance, or on

fertility Fertility is the capability to produce offspring through reproduction following the onset of sexual maturity. The fertility rate is the average number of children born by a female during her lifetime and is quantified demographically. Ferti ...

and

reproduction Reproduction (or procreation or breeding) is the biological process by which new individual organisms – "offspring" – are produced from their "parent" or parents. Reproduction is a fundamental feature of all known life; each individual or ...

Zou huo ru mo

Zou huo ru mo () or "qigong deviation" () is a mental condition characterized by the perception that there is uncontrolled flow of qi in the body. Other complaints include localized pains, headache, insomnia, and uncontrolled spontaneous movements. - Registration required

References

* * * *{{cite journal , vauthors=Zhong J, Leung F , title=Should borderline personality disorder be included in the fourth edition of the Chinese classification of mental disorders? , journal=Chin. Med. J. , volume=120 , issue=1 , pages=77–82 , date=January 2007 , pmid=17254494 , url=http://www.cmj.org/Periodical/LinkIn.asp?journal=Chinese%20Medical%20Journal&linkintype=pubmed&year=2007&vol=120&issue=1&beginpage=77 , access-date=2010-12-26 , archive-url=https://web.archive.org/web/20181003202546/http://www.cmj.org/Periodical/LinkIn.asp?journal=Chinese%20Medical%20Journal&linkintype=pubmed&year=2007&vol=120&issue=1&beginpage=77 , archive-date=2018-10-03 , url-status=dead

External links