scholarly journals The Use of ICD-10 for Diagnosing Mental Disorders In Russia, According to National Statistics and a Survey of Psychiatrists' Experience

10.17816/cp69 ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 35-44
Author(s):  
Ivan A. Martynikhin

Purpose and methods. In order to assess the specifics of practical use of the ICD-10 Diagnostic Guidelines by Russian psychiatrists, official national statistics on the prevalence of a number of mental disorders in Russia in 2019 were compared with the results of meta-analyses of international epidemiological studies of these disorders. In addition, a number of items in the online psychiatrists' survey, relating to the diagnosis of schizophrenia, were analysed; 807 Russian psychiatrists took part in the online survey. Results. Analysis of national statistics showed that domestic clinicians diagnose some mental disorders significantly less often than might be expected, according to data obtained by international epidemiological studies. The number of cases of bipolar affective disorder registered in Russia is 90150 times less than that for the prevalence of this disorder, according to meta-analyses of epidemiological studies; for depression, the result is 5070 times; for anxiety disorders, the number is 2550 times, and for autism, it is 30 times. Instead of the above disorders, diagnoses of organic non-psychotic mental disorders and schizophrenia might have been used unreasonably often. Between 2005 and 2019, diagnosis of childhood autism changed significantly (an increase of more than 100%), while the frequency of diagnosing other mental disorders remained unchanged. The results of the online survey also showed largely perfunctory use of the ICD-10 Diagnostic Guidelines, with a third of respondents reporting never checking the diagnostic schedules, and another third doing so from time to time. In addition, the low estimates given by survey participants regarding practical utility of the ICD-10 Diagnostic Guidelines, along with a large percentage of respondents who do not directly use diagnostic criteria in their work, indicate the need to improve the clinical usefulness of the diagnostic guidelines in the latest revision of the ICD, including convenience of use in practice. Conclusion. The results of analysis of the Russian national mental health service statistic indicate that at least some diagnostic categories are not used by Russian psychiatrists exactly as ICD-10 suggests. The revealed discrepancy between the principles of diagnostics observed by domestic clinicians and international criteria may interfere with the use of evidence-based treatment algorithms, negatively affecting the quality of psychiatric care. In light of the upcoming transition to ICD-11 and in order to unify approaches to the diagnosis of mental disorders in our country, it is necessary to update and improve educational programmes for psychiatrists.

10.17816/cp80 ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 23-34
Author(s):  
Maya A. Kulygina ◽  
Timur S. Syunyakov ◽  
Ilya A. Fedotov ◽  
George P. Kostyuk

Background. ICD-11 implementation will start in early 2022 in WHO member countries, including Russia. This process should be preceded not only by the official translation and wide distribution of ICD-11 statistical classification and diagnostic guidelines but also by clinicians training. For recent years ICD-11 development and innovations in the diagnosis of mental disorders were in the focus of attention of mental health professionals in all over the world. Objectives. This online survey aimed to identify the current views of the Russian psychiatric community on the upcoming implementation of ICD-11. Methods. A survey was composed in a Google form and circulated through the website of the Russian Society of Psychiatrists and other professional networks. Statistical and narrative analysis was provided. The sample was represented by 148 psychiatrists working in inpatient or outpatient clinical settings. Results. Expectations for the classification of mental disorders reported by the respondents were wider than the current purpose of ICD-10. In general, the Russian psychiatrists expressed their interests to forthcoming ICD-11 implementation. Positive attitudes to ICD-11 innovations were associated with the familiarity with the ICD-11 draft. Conservative or negative views were related to longer years of clinical experience. Early carrier psychiatrists were more practically oriented than old school clinicians. Conclusion. This survey may help to promote the ICD-11 by focusing on its advantages for clinical practice and develop targeted training programs.


Author(s):  
Sally-Ann Cooper

Mental disorders are common in people with intellectual disability, with a reported point prevalence of 36% in children and young people (including challenging behaviours), and 40.9% in adults (or 28.3% excluding challenging behaviours). People with intellectual disability experience all types of mental disorders, some more commonly than the general population, e.g. autism, attention-deficit hyperactivity disorder, schizophrenia, bipolar affective disorder, and dementia. Challenging behaviours are also common, and have no clear general population equivalent. Multi-morbidity of mental and physical disorders is typical. Mental disorder assessments are complex due to multi-morbidity and polypharmacy, in addition to impairments in communication, understanding, vision, and hearing, and the need to work with family and paid carers as well as the person with intellectual disability. Mental disorder classificatory systems have been developed for people with intellectual disability, in view of under-reporting when using general population manuals: DC-LD was designed to complement ICD-10, and DM-ID 2 to interpret DSM-5.


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.


2010 ◽  
Vol 197 (5) ◽  
pp. 411-412 ◽  
Author(s):  
Dheeraj Rai ◽  
Petros Skapinakis ◽  
Nicola Wiles ◽  
Glyn Lewis ◽  
Ricardo Araya

SummaryIn a representative sample of the UK population we found that common mental disorders (as a group and in ICD–10 diagnostic categories) and subthreshold psychiatric symptoms at baseline were both independently associated with new-onset functional disability and significant days lost from work at 18-month follow-up. Subthreshold symptoms contributed to almost half the aggregate burden of functional disability and over 32 million days lost from work in the year preceding the study. Leaving these symptoms unaccounted for in surveys may lead to gross underestimation of disability related to psychiatric morbidity.


2011 ◽  
Vol 26 (S2) ◽  
pp. 1668-1668
Author(s):  
I.E. Kupriyanova

Objective of investigationTo study structure of borderline neuro-mental disorders in women with breast cancer with subsequent development of therapeutic and psychopreventive activities.Material and methodsWe examined 102 women. At the first stage we have analyzed the role of constitutional-biological, social and psychogenic factors in formation and subsequent clinical dynamic of borderline neuro-mental disorders. Classification of psychiatric diagnosis was conducted according to ICD-10. During diagnosis we used the following diagnostic categories: for neurotic disorders (F41–48) and for personality disorders (F60). Results: Women with neurotic disorders reliably predominated, and namely - mixed anxiety and depressive reaction (F43.22). At stage I and II patients with pre-nosological disorder predominated (asthenic variant with predominance of mental fatigue) (22,73% and 24,14%, respectively), and at stage III - with dysthymic variant of pre-nosological disorder (18,18%). At stage II of breast cancer we have diagnosed mixed anxiety and depressive disorder (F41.2) (3,45%).ConclusionMedico-biological block included early diagnosis of revealed psychopathological disorders at pre-hospital stage; identification of profile of the personality and level of mental health during stay in hospital. Psychopharmacotherapeutic block consisted of individual therapeutic programs for women with various level of mental health. Social block based on organization of system of rehabilitation, including work with patients in the hospital, joint observation with cancer therapist for a half of the year, participation of patients in an open psychotherapeutic group.


2016 ◽  
Vol 33 (S1) ◽  
pp. S612-S612
Author(s):  
A. Veraksa ◽  
A. Egorov

Acute psychotic states (APS) usually are diagnosed as schizophrenia spectrum and affective disorders and make up about 45% of cases. The goal of the study was to elucidate the effect of benzodiazepines (BDZ) and valproic acid augmentation in the APS pharmacotherapy. The study was carried out on 102 inpatients diagnosed up to ICD-10 as schizophrenia (n = 24), acute and transient psychotic disorders (n = 40), other mental disorders due to brain damage and dysfunction and to physical disease (n = 17), schizoaffective disorder (n = 12), bipolar affective disorder (n = 9). Patients were randomized into four therapeutic groups:– benzodiazepines (BDZ);– one neuroleptic or combination of one neuroleptic and one BDZ (NBDZ);– combination of valproic acid with BDZ or neuroleptic (VBDZN);– polypragmasy (PP): from two drugs of one group up to four and more drugs at the same time.The mental state of the patients was evaluated daily and estimated before, weekly and after APS termination by BPRS and CGI scale. The APS in all groups lasted from 1 to 50 days (mean 11.4). The shortest duration of APS was In BDZ group – 4.7 days; in VBDZN and NBDZ, the duration was 7.0 and 7.4 days (P < 0.05); in PP group, the treatment lasted 24.5 days (P < 0.001). Before therapy, average BPRS rate was 43.5 ± 8.1, CGI – 6.2 ± 0.8; after APS, BPRS was 18.9 ± 2.1, CGI – 1.1 ± 0.3. All rates did not differ among subgroups. APS therapy by BDZ and its combination with neuroleptics and valproic acid was effective compared to the polypragmasy.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2021 ◽  
Vol 12 ◽  
Author(s):  
Kelly Lin ◽  
Yanni Li ◽  
Eugene Du Toit ◽  
Lauren Wendt ◽  
Jing Sun

Background: Increased prevalence of mental disorders has become a significant public health concern. Recent studies have linked nutrition to depression and anxiety, suggesting that dietary changes or nutritional supplementation may be beneficial in improving mental disorders. Polyphenols have anti-inflammatory and antioxidant properties that may counteract physiological changes in depression and anxiety. This study examined the effectiveness of polyphenol supplementation in improving depression, anxiety and quality of life (QoL).Methods: Randomized controlled trials in English and with polyphenol supplementation as the intervention were searched. The primary outcome was depression, and secondary outcomes were anxiety and QoL. Only studies of at least moderate quality based on the Physiotherapy Evidence Database tool were included. Comprehensive systematic review and meta-analysis were then used to determine the effect of polyphenol supplementations on improving depression, anxiety and quality of life (QoL) in patients with depression.Results: Nineteen studies with 1,523 participants were included; 18 studies (n = 1,523) were included in the depression meta-analysis, and 5 (n = 188) and 6 (n = 391) in the QoL and anxiety meta-analyses, respectively. Twelve of the 18 studies found significant improvements in depression with polyphenol use, while the meta-analyses results also indicated that polyphenol supplementation significantly improved depression score as compared to control conditions (MD: −2.280, 95% CI: −1.759, −0.133, I2 = 99.465). Although subgroup analyses were conducted a significantly high heterogeneity was still found amongst subgroups. Only 2 of the 5 studies found significant improvements in QoL following polyphenol supplementation and meta-analyses found that polyphenol use did not benefit QoL (MD: −1.344, p &lt; 0.05, I2 = 55.763). For anxiety, 5 of the 6 studies found significant reductions in depression score following polyphenol use but meta-analyses found no significant differences in anxiety score (MD: −0.705, CI: −1.897, 0.487, I2 = 84.06) between polyphenol supplementation and control.Conclusion: The results suggest that polyphenol supplementation is effective in improving depression. Physical illness may act as a risk factor that worsens depression, suggesting the need for preventative supplementation to improve depression. Polyphenol types may have varying effects, which suggests that different populations with depression may benefit from different polyphenols.


2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Miss Suhailah Ali ◽  
Fiona Charlson

Abstract Background Decades worth of epidemiological studies, synthesised by systematic reviews and meta-analyses, have consistently shown that people with severe mental disorders (SMD) have a higher risk of mortality compared to the general population, which has not improved over time. One of the major limitations of previous reviews is the use of meta-analytic models to synthesise mortality estimates without taking into account potential sources of heterogeneity. Methods A systematic review of studies examining mortality in people with schizophrenia and bipolar disorder compared to the general population was conducted. Estimates of all-cause and cause-specific mortality were calculated using meta-regression models to quantify and adjust for the effects of covariates, including both study-level and population-level factors. Results A total of 76 studies were included in the analyses. The adjusted relative risk for all-cause mortality in schizophrenia was 2.80 (95% CI 2.30 to 3.41) and 2.33 (95%CI 2.01 to 2.71) for bipolar disorder. Mortality was elevated in each cause of death examined, across both unnatural and natural causes. Some heterogeneity was explained by age and sex. Conclusions The mortality gap for people with SMD compared to the general population remains unchanged. Most of the heterogeneity between studies could not be accounted for by the covariates included in our analyses. Key messages More work needs to be done towards understanding the causal factors underlying excess mortality in people with SMD in order to achieve more equitable health outcomes.


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.


2017 ◽  
Vol 22 (3) ◽  
pp. 159-166 ◽  
Author(s):  
Bastianina Contena ◽  
Stefano Taddei

Abstract. Borderline Intellectual Functioning (BIF) refers to a global IQ ranging from 71 to 84, and it represents a condition of clinical attention for its association with other disorders and its influence on the outcomes of treatments and, in general, quality of life and adaptation. Furthermore, its definition has changed over time causing a relevant clinical impact. For this reason, a systematic review of the literature on this topic can promote an understanding of what has been studied, and can differentiate what is currently attributable to BIF from that which cannot be associated with this kind of intellectual functioning. Using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria, we have conducted a review of the literature about BIF. The results suggest that this condition is still associated with mental retardation, and only a few studies have focused specifically on this condition.


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