scholarly journals Classification in psychiatry: ICD–10 v. DSM–IV

1999 ◽  
Vol 175 (3) ◽  
pp. 205-209 ◽  
Author(s):  
Michael B. First ◽  
Harold Alan Pincus

The editorial by Andrews et al (1999) usefully calls attention to issues of compatibility between diagnostic classification systems but we believe that the editorial greatly overstates the compatibility problem as well as its implications. The article begins with the suggestion that the DSM–IV authors' position is to downplay the differences between DSM–IV and ICD–10. After stating that the American Psychiatric Association “felt sufficiently confident to publish a DSM–IV International Version in which the DSM–IV criteria are listed against the ICD–10 codes”, the authors go on to report concordances between the classifications for the main mental disorders as ranging from a low of 33% (for substance harmful use or abuse) to 87% (for dysthymia), with an overall concordance of only 68%. The authors conclude that if this “unnecessary dissonance between the classification systems continues, patients, researchers and clinicians will be all the poorer”. Although we acknowledge that there are a number of differences between the two systems, the authors fail to assess fully the sources, significance and solutions for this compatibility problem.

2011 ◽  
Vol 26 (S2) ◽  
pp. 90-90
Author(s):  
I. Pajević ◽  
M. Hasanović

IntroductionCurrent valid classification systems (ICD-10 and DSM-IV) of the alcohol-induced disorders include: acute intoxication, pathological intoxication, alcohol withdrawal syndrome, psychotic disorder with delusions or hallucinations, delirium tremens, amnesic syndrome, mood disorders and anxiety disorders caused by alcohol consumption (only in DSM-IV) and sexual dysfunction.AimTo consider adequacy of existing classifications of alcohol dependency and to offer more adequate suggestion for ICD-11 and DSM-V.MethodologyAuthors compared and analyzed the diagnostic criteria that are offered in the current classifications for these disorders.ResultsThere are many similarities and many differences between existing diagnostic criteria's. The former name of the DSM-IV (Substance related disorders, which include Alcohol related disorders) is inappropriate since it excludes other related disorders. Another important issue that is currently a subject of extensive discussions in the process of finalizing the DSM-V refers to the current distinction terms abuse and alcohol dependence. Scientific documents about the criteria of abuse and dependence in clinical samples and samples from the general population suggest that the DSM-IV criteria for abuse and dependence can be considered as part of a one-dimensional structure, thus for DSM-V it could be combined into a single disorder, with two criteria to make a diagnosis.ConclusionIt is expected that the principles adopted by the WHO during the preparation for ICD-11, which includes bridging the differences between ICD and DSM and the introduction of the person centered integrative diagnosis (PID) will be an important step forward in understanding and distinction among alcohol induced mental disorders.


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.


1998 ◽  
Vol 28 (2) ◽  
pp. 159-176 ◽  
Author(s):  
Henk Lamberts ◽  
Kathryn Magruder ◽  
Roger G. Kathol ◽  
Harold A. Pincus ◽  
Inge Okkes

Background: Primary care physicians traditionally have a strong interest in the mental health of their patients. Three classification systems are available for them to diagnose, label, and classify mental disorders: 1) The ICD-10 approach with three options, 2) The DSM-IV approach with two options, and 3) the ICPC approach with two options. This article lists important similarities and differences between the systems to help potential users choose the option that best meets their needs. Methods: Definitions for depressive disorder, anxiety disorder, and somatization disorder are compared on five characteristics of classification: 1. the domain, 2. the scope, 3. the nature of the definitions, 4. focus on episodes of care, and 5. clinical guidelines. Results: Primary care physicians and psychiatrists have different perspectives, reflected in different classifications. Each system has specific possibilities and limitations with regard to the diagnosis of mental disorders. For common mental disorders it is possible, however, to choose codes from one system while maintaining compatibility with the other two. Comparability as to the diagnostic content of the different classes, however, is more difficult to establish. The available classification systems give both primary care physicians and psychiatrists options to diagnose, label, and to classify mental disorders from their own perspective, but once a system has been chosen the clinical comparability of a patient with the same diagnosis in other systems is limited. Conclusion: Compatibility among systems can be optimized by strictly following a number of rules. The conversion between ICPC and ICD-10 (and consequently DSM-IV) allows simultaneous use of ICPC and ICD-10 as a classification and DSM-IV as the standard nomenclature. This is of particular interest for computer based patient records in primary care. The clinical comparability of the same diagnosis in different systems however is limited by the characteristics of the different system.


2005 ◽  
Vol 17 (s1) ◽  
pp. S17-S26 ◽  
Author(s):  
Edmond Chiu

A brief review of classification in psychiatry from Kraepelin to ICD-10 and DSM-IV reveals that the categorical paradigm inherent in these nosological systems has certain inadequacies when applied to dementia specifically and cognitive impairment in general. There are “outcasts” from these two systems that, with the rapid advances in an understanding of cognitive disorders, expose significant limitations in them. As and when they are revised, serious consideration of a different view, accepting a dimensional paradigm, would contribute to a more inclusive and clinically relevant nosology for dementia and cognitive disorders.


2013 ◽  
pp. 1023-1042

F00-F09 Organic, including symptomatic mental disorders F10–F19 Mental and behavioural disorders due to psychoactive substance abuse F20–F29 Schizophrenia, schizotypal, and delusional disorders F30–F39 Mood (affective) disorders F40–F49 Neurotic, stress-related, and somatoform disorders F50–F59 Behavioural syndromes associated with physiological disturbance and physical factors F60–F69 Disorders of adult personality and behaviour...


2009 ◽  
Vol 195 (5) ◽  
pp. 382-390 ◽  
Author(s):  
Michael B. First

BackgroundDifferences in the ICD–10 and DSM–IV definitions for the same disorder impede international communication and research efforts. The forthcoming parallel development of DSM–V and ICD–11 offers an opportunity to harmonise the two classifications.AimsThis paper aims to facilitate the harmonisation process by identifying diagnostic differences between the two systems.MethodDSM–IV–TR criteria sets and the ICD–10 Diagnostic Criteria for Research were compared and categorised into those with identical definitions, those with conceptually based differences and those in which differences are not conceptually based and appear to be unintentional.ResultsOf the 176 criteria sets in both systems, only one, transient tic disorder, is identical. Twenty-one per cent had conceptually based differences and 78% had non-conceptually based differences.ConclusionsHarmonisation of criteria sets, especially those with non-conceptually based differences, should be prioritised in the DSM–V and ICD–11 development process. Prior experience with the DSM–IV and ICD–10 harmonisation effort suggests that for the process to be successful steps should be taken as early as possible.


2018 ◽  
Vol 48 (2) ◽  
pp. 76-86 ◽  
Author(s):  
Jennie Shepheard ◽  
Elsa Lapiz ◽  
Carla Read ◽  
Terri J Jackson

Background: The Council of Australian Governments has focused the attention of health service managers and state health departments on a list of hospital-acquired complications (HACs) proposed as the basis of funding adjustments for poor quality of hospital inpatient care. These were devised for the Australian Commission on Safety and Quality in Health Care as a subset of their earlier classification of hospital-acquired complications (CHADx) and designed to be used by health services to monitor safety performance for their admitted patients. Objective: To improve uptake of both classification systems by clarifying their purposes and by reconciling the ICD-10-AM code sets used in HACs and the Victorian revisions to the CHADx system (CHADx+). Method: Frequency analysis of individual clinical codes with condition onset flag (COF 1) included in both classification systems using the Victorian Admitted Episodes Dataset for 2014/2015 ( n = 2,623,275 separations). Narrative description of the resulting differences in definition of “adverse events” embodied in the two systems. Results: As expected, a high proportion of ICD-10-AM codes used in the HACs also appear in CHADx+, and given the wider scope of CHADx+, it uses a higher proportion of all COF 1 diagnoses than HACs (82% vs. 10%). This leads to differing estimates of rates of adverse events: 2.12% of cases for HACs and 11.13% for CHADx+. Most CHADx classes (70%) are not covered by the HAC system; discrepancies result from the exclusion from HACs of several major CHADx+ groups and from a narrower definition of detailed HAC classes compared with CHADx+. Case exclusion criteria in HACs (primarily mental health admissions) resulted in a very small proportion of discrepancies (0.13%) between systems. Discussion: Issues of purpose and focus of these two Australian systems, HACs for clinical governance and CHADx+ for local quality improvement, explain many of the differences between them, and their approach to preventability, and risk stratification. Conclusion: A clearer delineation between these two systems using routinely coded hospital data will assist funders, clinicians, quality improvement professionals and health information managers to understand discrepancies in case identification between them and support their different information needs.


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