Assessing the opinions and experiences of German-speaking psychiatrists regarding necessary changes for the 11th revision of the mental disorders chapter of the international classification of disorders (ICD-11)

2010 ◽  
Vol 25 (8) ◽  
pp. 437-442 ◽  
Author(s):  
J. Zielasek ◽  
H.J. Freyberger ◽  
M. Jänner ◽  
H.P. Kapfhammer ◽  
N. Sartorius ◽  
...  

AbstractWe performed an Internet-based questionnaire survey of the opinions of German-speaking psychiatrists regarding the experiences with the 10th revision of the international classification of mental disorders (chapter F of ICD-10). We received 304 completed questionnaires including more than 500 free-text comments. The responding group was characterized by professionally experienced middle-aged psychiatrists. German-speaking psychiatrists were comparatively content with ICD-10. Most diagnostic categories received a “satisfied” or “very satisfied” rating by the majority of respondents. Negative “goodness of fit” ratings – a possible indicator of the need for revision – were not higher than 50% for any category. Based on free-text entries, neurasthenia was the single diagnostic category most often suggested for deletion in ICD-11. Changes were considered necessary mainly for dementias and personality disorders. Adult attention deficit disorder and narcissistic personality disorder were the two diagnostic categories most frequently suggested to be added as new categories. This study provides valuable information related to perceived clinical utility of the classification, though with a narrow sample. Information about clinicians’ experiences should be combined with scientific evidence for the revision process of ICD-11.

Author(s):  
Timo D. Vloet ◽  
Marcel Romanos

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.


2011 ◽  
Vol 26 (3) ◽  
pp. 159-165 ◽  
Author(s):  
M. Jäger ◽  
S. Haack ◽  
T. Becker ◽  
K. Frasch

AbstractObjectiveSchizoaffective disorder is a common diagnosis in mental health services. The present article aims to provide an overview of diagnostic reliability, symptomatology, outcome, neurobiology and treatment of schizoaffective disorder.MethodLiterature was identified by searches in “Medline” and “Cochrane Library”.ResultsThe diagnosis of schizoaffective disorder has a low reliability. There are marked differences between the current diagnostic systems. With respect to psychopathological symptoms, no clear boundaries were found between schizophrenia, schizoaffective disorder and affective disorders. Common neurobiological factors were found across the traditional diagnostic categories. Schizoaffective disorder according to ICD-10 criteria, but not to DSM-IV criteria, shows a more favorable outcome than schizophrenia. With regard to treatment, only a small and heterogeneous database exists.ConclusionDue to the low reliability and questionable validity there is a substantial need for revision and unification of the current diagnostic concepts of schizoaffective disorder. If future diagnostic systems return to Kraepelin's dichotomous classification of non-organic psychosis or adopt a dimensional diagnostic approach, schizoaffective disorder will disappear from the psychiatric nomenclature. A nosological model with multiple diagnostic entities, however, would be compatible with retaining the diagnostic category of schizoaffective disorder.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
W. Gaebel

In the course of the revision of the International Classification of Mental Disorders (currently 10th revision, hence ICD-10), an international scientific partnership network group was founded by the World Health Organisation (Chair: N. Sartorius, Geneva) in order to review the international scientific evidence of putative significance for the revision of ICD-10 in different language areas.In the course of this project we reviewed several areas of activity that may be of importance for the review process to develop ICD-11. First of all, general questions arise about how a psychiatric classification system should be organized. Will it still depend on classical psychopathological information with additional information from imaging, genetic and laboratory studies, and finally the patient history? An alternative approach is based on functional psychopathology be based on functional neural modules which represent functional activities of the human brain and their disturbances in mental disorders. Another area of debate is whether dimensions rather than categories shall lay a new foundation for the classification of mental disorders. A further issue arises when considering narrative elements of psychiatric history taking. In how far can or should such factors be integrated? All these questions are interwoven with the classical German contributions to psychiatric nosology by Kraepelin and Bleuler, which will be reassessed on the background of these current topics in revising ICD-10.


2000 ◽  
Vol 12 (S1) ◽  
pp. 29-40 ◽  
Author(s):  
Michael Zaudig

“A classification is the reification of an ideological position, of an accepted stand of theory and knowledge. It means creating, defining or confirming boundaries of concepts. These in turn define ourselves, our future and our past…” (Sartorius, 1991). The 10th revision of the International Classification of Diseases (ICD-10), Chapter V on Mental and Behavioral Disorders (World Healthorganization [WHO], 1992, 1993), and the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) have been adapted to the current clinical and scientific knowledge of mental disorders. Because ICD-10 has adapted the primarily descriptive and criteria-related approach from DSM-111, the general structures of both classifications are quite similar. However, complete congruency between ICD-10 and DSM-IV has not yet been reached.


1994 ◽  
Vol 6 (4) ◽  
pp. 66-68
Author(s):  
M.J.A.J.M. Hoes

Gedurende de laatste jaren zijn nieuwe edities van twee grote classificatiesystemen uitgebracht. De American Psychiatric Association heeft in 1994 de vierde editie van de Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) gepubliceerd en de Wereldgezondheids-organisatie in 1991 de tiende editie van de International Classification of Diseases (ICD-10). Van de laatste is hier het vijfde hoofdstuk (V of F) over psychische stoornissen van belang.Vergeleken met de DSM-III (-R) uit 1980 (1987) is de DSM-IV qua structuur niet veranderd. Vergeleken met de DSM-III-R zijn er wel quantitatieve verschillen: 105 veranderde categorieën op as-I, 3 veranderde op as-II, 9 nieuwe voorstellen voor klinische aandacht, 13 nieuwe diagnoses, terwijl 8 classificaties verwijderd zijn en as-IV anders is gestructureerd, naar type belasting in plaats van ernst van belastende factoren.


2014 ◽  
Vol 56 (3) ◽  
pp. 279 ◽  
Author(s):  
Aarón Salinas-Rodríguez ◽  
Betty Manrique-Espinoza ◽  
Gilberto Isaac Acosta-Castillo ◽  
Aurora Franco-Núñez ◽  
Óscar Rosas-Carrasco ◽  
...  

Objetivo. Identificar un punto de corte válido para la Escala de Depresión del Centro de Estudios Epidemiológicos (CES-D) de siete reactivos, que permita clasificar a los adultos mayores según presencia/ausencia de síntomas depresivos clínicamente significativos. Material y métodos. Estudio de tamizaje con 229 adultos mayores residentes de los estados de Morelos y Tlaxcala en México, que fueron parte de la muestra de la Encuesta Nacional de Salud y Nutrición, 2012. Se estimó la sensibilidad y especificidad asociada con el punto de corte seleccionado usando los criterios diagnósticos del ICD-10 (International Classification of Diseases, 10th revision) y del DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition). Resultados. El punto de corte estimado fue CES-D=5. De acuerdo con el ICD-10, los valores obtenidos de sensibilidad y especificidad fueron de 83.3 y 90.2%, y un valor ROC de 87% y, según el DSM-IV, los valores fueron 85, 83.2, y 84%, respectivamente. Conclusiones. La versión abreviada del CES-D puede ser utilizada como una prueba de tamizaje para identificar casos probables de adultos mayores con síntomas depresivos clínicamente significativos.


1991 ◽  
Vol 6 (6) ◽  
pp. 315-322 ◽  
Author(s):  
N Sartorius

SummaryThe chapter dealing with the classification of mental disorders in the Tenth Revision of the International Classification of Diseases (ICD-10) has been developed after consultation with experts in many countries. Each of the categories has been clearly defined so as to facilitate the assignment of diagnoses. The descriptions of categories and the diagnostic guidelines have then been tested in 110 centres located in over 40 countries, and the results have been used to finalize the text. The classification will be issued in several versions - one for statistical purposes, one for clinicians, one for researchers and one for general practitioners. A multiaxial presentation of the classification is being tested at present and will be made available in early 1993. The paper describes the requirements and principles which led to the classification, depicts the process outlined above and gives prospects for the future.


Author(s):  
K. Neumann ◽  
B. Arnold ◽  
A. Baumann ◽  
C. Bohr ◽  
H. A. Euler ◽  
...  

Zusammenfassung Hintergrund Sprachtherapeutisch-linguistische Fachkreise empfehlen die Anpassung einer von einem internationalen Konsortium empfohlenen Änderung der Nomenklatur für Sprachstörungen im Kindesalter, insbesondere für Sprachentwicklungsstörungen (SES), auch für den deutschsprachigen Raum. Fragestellung Ist eine solche Änderung in der Terminologie aus ärztlicher und psychologischer Sicht sinnvoll? Material und Methode Kritische Abwägung der Argumente für und gegen eine Nomenklaturänderung aus medizinischer und psychologischer Sicht eines Fachgesellschaften- und Leitliniengremiums. Ergebnisse Die ICD-10-GM (Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Revision, German Modification) und eine S2k-Leitlinie unterteilen SES in umschriebene SES (USES) und SES assoziiert mit anderen Erkrankungen (Komorbiditäten). Die USES- wie auch die künftige SES-Definition der ICD-11 (International Classification of Diseases 11th Revision) fordern den Ausschluss von Sinnesbehinderungen, neurologischen Erkrankungen und einer bedeutsamen intellektuellen Einschränkung. Diese Definition erscheint weit genug, um leichtere nonverbale Einschränkungen einzuschließen, birgt nicht die Gefahr, Kindern Sprach- und weitere Therapien vorzuenthalten und erkennt das ICD(International Classification of Disease)-Kriterium, nach dem der Sprachentwicklungsstand eines Kindes bedeutsam unter der Altersnorm und unterhalb des seinem Intelligenzalter angemessenen Niveaus liegen soll, an. Die intendierte Ersetzung des Komorbiditäten-Begriffs durch verursachende Faktoren, Risikofaktoren und Begleiterscheinungen könnte die Unterlassung einer dezidierten medizinischen Differenzialdiagnostik bedeuten. Schlussfolgerungen Die vorgeschlagene Terminologie birgt die Gefahr, ätiologisch bedeutsame Klassifikationen und differenzialdiagnostische Grenzen zu verwischen und auf wertvolles ärztliches und psychologisches Fachwissen in Diagnostik und Therapie sprachlicher Störungen im Kindesalter zu verzichten.


2021 ◽  
Vol 11 (5) ◽  
pp. e612-e619
Author(s):  
Ali G. Hamedani ◽  
Leah Blank ◽  
Dylan P. Thibault ◽  
Allison W. Willis

ObjectiveTo determine the effect of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) coding transition on the point prevalence and longitudinal trends of 16 neurologic diagnoses.MethodsWe used 2014–2017 data from the National Inpatient Sample to identify hospitalizations with one of 16 common neurologic diagnoses. We used published ICD-9-CM codes to identify hospitalizations from January 1, 2014, to September 30, 2015, and used the Agency for Healthcare Research and Quality's MapIt tool to convert them to equivalent ICD-10-CM codes for October 1, 2015–December 31, 2017. We compared the prevalence of each diagnosis before vs after the ICD coding transition using logistic regression and used interrupted time series regression to model the longitudinal change in disease prevalence across time.ResultsThe average monthly prevalence of subarachnoid hemorrhage was stable before the coding transition (average monthly increase of 4.32 admissions, 99.7% confidence interval [CI]: −8.38 to 17.01) but increased after the coding transition (average monthly increase of 24.32 admissions, 99.7% CI: 15.71–32.93). Otherwise, there were no significant differences in the longitudinal rate of change in disease prevalence over time between ICD-9-CM and ICD-10-CM. Six of 16 neurologic diagnoses (37.5%) experienced significant changes in cross-sectional prevalence during the coding transition, most notably for status epilepticus (odds ratio 0.30, 99.7% CI: 0.26–0.34).ConclusionsThe transition from ICD-9-CM to ICD-10-CM coding affects prevalence estimates for status epilepticus and other neurologic disorders, a potential source of bias for future longitudinal neurologic studies. Studies should limit to 1 coding system or use interrupted time series models to adjust for changes in coding patterns until new neurology-specific ICD-9 to ICD-10 conversion maps can be developed.


2017 ◽  
Vol 52 (5) ◽  
pp. 425-434 ◽  
Author(s):  
Bo Bach ◽  
Martin Sellbom ◽  
Mathias Skjernov ◽  
Erik Simonsen

Objective: The five personality disorder trait domains in the proposed International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition are comparable in terms of Negative Affectivity, Detachment, Antagonism/Dissociality and Disinhibition. However, the International Classification of Diseases, 11th edition model includes a separate domain of Anankastia, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model includes an additional domain of Psychoticism. This study examined associations of International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domains, simultaneously, with categorical personality disorders. Method: Psychiatric outpatients ( N = 226) were administered the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Interview and the Personality Inventory for DSM-5. International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition trait domain scores were obtained using pertinent scoring algorithms for the Personality Inventory for DSM-5. Associations between categorical personality disorders and trait domains were examined using correlation and multiple regression analyses. Results: Both the International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models showed relevant continuity with categorical personality disorders and captured a substantial amount of their information. As expected, the International Classification of Diseases, 11th edition model was superior in capturing obsessive–compulsive personality disorder, whereas the Diagnostic and Statistical Manual of Mental Disorders, 5th edition model was superior in capturing schizotypal personality disorder. Conclusion: These preliminary findings suggest that little information is ‘lost’ in a transition to trait domain models and potentially adds to narrowing the gap between Diagnostic and Statistical Manual of Mental Disorders, 5th edition and the proposed International Classification of Diseases, 11th edition model. Accordingly, the International Classification of Diseases, 11th edition and Diagnostic and Statistical Manual of Mental Disorders, 5th edition domain models may be used to delineate one another as well as features of familiar categorical personality disorder types. A preliminary category-to-domain ‘cross walk’ is provided in the article.


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