CLASSIFICATION AND DIAGNOSIS OF SCHIZOPHRENIA OR OTHER PRIMARY PSYCHOTIC DISORDERS: CHANGES FROM ICD-10 TO ICD-11 AND IMPLEMENTATION IN CLINICAL PRACTICE

Mortality And Morbidity ◽

Critical Elements ◽

Icd 10

From January 2022, the WHO member countries shall start implementing the mortality and morbidity statistics (MMS) version of the eleventh revision of the International Classification of Diseases (ICD-11). Regarding mental, behavioural or neurodevelopmental disorders, there are substantial changes from ICD-10 to ICD-11. The subchapter for schizophrenia or other primary psychotic disorders has changed due to a revised structure, new diagnostic criteria, and the introduction of dimensional elements (i.e., course and symptom qualifiers). The aim of this manuscript is twofold. First, we review changes from ICD-10 to ICD- 11 in the classification and diagnosis of schizophrenia or other primary psychotic disorders, including findings from recent field studies. Second, we provide an overview of approaches to the implementation of ICD-11 in clinical practice. Critical elements for transition from ICD-10 to ICD 11 include the use of digital tools, education and training, stakeholder involvement, national adaptations, and continuous evaluation.

ICD-11: an international classification of diseases for the twenty-first century

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01534-6 ◽

2021 ◽

Vol 21 (S6) ◽

Author(s):

James E. Harrison ◽

Stefanie Weber ◽

Robert Jakob ◽

Christopher G. Chute

Keyword(s):

Biomedical Ontology ◽

Semantic Knowledge ◽

Remote Access ◽

World Health ◽

Mortality And Morbidity ◽

Icd 10

Abstract Background The International Classification of Diseases (ICD) has long been the main basis for comparability of statistics on causes of mortality and morbidity between places and over time. This paper provides an overview of the recently completed 11th revision of the ICD, focusing on the main innovations and their implications. Main text Changes in content reflect knowledge and perspectives on diseases and their causes that have emerged since ICD-10 was developed about 30 years ago. Changes in design and structure reflect the arrival of the networked digital era, for which ICD-11 has been prepared. ICD-11’s information framework comprises a semantic knowledge base (the Foundation), a biomedical ontology linked to the Foundation and classifications derived from the Foundation. ICD-11 for Mortality and Morbidity Statistics (ICD-11-MMS) is the primary derived classification and the main successor to ICD-10. Innovations enabled by the new architecture include an online coding tool (replacing the index and providing additional functions), an application program interface to enable remote access to ICD-11 content and services, enhanced capability to capture and combine clinically relevant characteristics of cases and integrated support for multiple languages. Conclusions ICD-11 was adopted by the World Health Assembly in May 2019. Transition to implementation is in progress. ICD-11 can be accessed at icd.who.int.

What’s Happened to Paraphrenia? The Modernity of Emil Kraepelin’s Thinking

European Psychiatry ◽

10.1016/s0924-9338(09)71417-8 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

L. Pelizza ◽

F. Bonazzi

Keyword(s):

Psychotic Disorders ◽

Diagnostic Category ◽

Delusional Disorder ◽

Systematic Research ◽

Diagnostic And Statistical Manual ◽

Icd 10 ◽

Dsm Iv

Paraphrenia is a psychotic disorder described by Kraepelin in 1913. He formulated this concept to define a group of patients who exhibited symptoms characteristic of dementia praecox (marked delusions with or without hallucinations), but with minimal disturbances of emotion and volition, and much less personality deterioration. after the publication of Mayer"s prognostic research in 1921 (which studied the outcomes of 78 paraphrenic patients reported by Kraepelin), the view to differentiate paraphrenia from schizophrenia was considered to be unfounded in Germany. Paraphrenia is now diagnosed relatively infrequently and is not listed in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) or International Classification of Diseases (ICD-10). However, it appears that some psychiatrists recognize the illness but label it "atypical psychosis", "schizoaffective disorder," or "delusional disorder" for lack of a better diagnostic category.Virtually no systematic research on paraphrenia has been conducted in the past 60 years. We describe a 30-year-old man affected by sistematic paraphrenia, according to the neo-Kraepelinian description of paraphrenia proposed by Ravindran et al. in 1999 (description compatible with the formats of DSM-IV and ICD-10). Using a questionnaire adapted from this description, our case of paraphrenia were distinguished from those of schizophrenia and delusional disorder. in conclusion, It is possible to define and recognize paraphrenia, because it is a viable diagnostic entity. as in the days of Kraepelin, the problems concerning paraphrenia cannot be neglected when considering the classification of psychotic disorders.

The ICD-11 Field Trial: Creating a Large Dually Coded Database

10.21203/rs.3.rs-505934/v1 ◽

2021 ◽

Author(s):

Cathy A Eastwood ◽

Danielle A Southern ◽

Shahreen Khair ◽

Chelsea Doktorchik ◽

William A Ghali ◽

...

Keyword(s):

Field Trial ◽

Field Testing ◽

Future Research ◽

Data Set ◽

Mortality And Morbidity ◽

Icd 10

Abstract ObjectiveNew codes developed in the International Classification of Diseases, 11th Revision for Mortality and Morbidity Statistics (ICD-11) needed testing. Field-testing involves real-world application of the new codes to examine data quality. This paper describes the field trial methods to create a dually coded database to field test ICD-11 against ICD-10-CA (a Canadian modification of the International Classification of Diseases, Tenth Revision), and a reference standard data set of diagnoses. ResultsA random sample of discharge records previously coded using ICD-10-CA was selected. Nurses re-examined these entire charts for specific conditions and patient safety events. Clinical coders re-coded the same charts using ICD-11 codes. Inpatients discharged from hospitals in Calgary, Alberta, were identified and a dually coded database was created (n=2897). Inter-rater reliability and coding time improved with ICD-11 coding experience. Clinical coder comments enabled content to be improved in the ICD-11 browser, Coding Tool, and ICD-11 Reference Guide. This paper describes the field trial, database creation methods, and contributions for ICD-11 improvement. Crucial future research will use this database to test ICD-11 before implementation in Canada.

Angststörungen – von der ICD-10 zur ICD-11

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie ◽

10.1024/1422-4917/a000768 ◽

2020 ◽

pp. 1-5

Author(s):

Timo D. Vloet ◽

Marcel Romanos

Keyword(s):

Mental Disorders ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

Dsm 5 ◽

Icd 10

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.

Depression

10.1093/oso/9780198801900.003.0004 ◽

2017 ◽

Author(s):

Philip Cowen

Keyword(s):

Behavioural Therapy ◽

Historical Background ◽

Cognitive Behavioural ◽

Icd 10 ◽

Diagnosis And Classification ◽

Modern Experience ◽

Symptoms And Signs

This chapter discusses the symptomatology, diagnosis, and classification of depression. It begins with a brief historical background on depression, tracing its origins to the classical term ‘melancholia’ that describes symptoms and signs now associated with modern concepts of the condition. It then considers the phenomenology of the modern experience of depression, its diagnosis in the operational scheme of ICD-10 (International Classification of Diseases, tenth edition), and current classificatory schemes. It looks at the symptoms needed to meet the criteria for ‘depressive episode’ in ICD-10, as well as clinical features of depression with ‘melancholic’ features or ‘somatic depression’ in ICD-10. It also presents an outline of the clinical assessment of an episode of depression before concluding with an overview of issues that need to be taken into account when addressing approaches to treatment, including cognitive behavioural therapy and the administration of antidepressants.

Neue Terminologie für Sprachentwicklungsstörungen?

Monatsschrift Kinderheilkunde ◽

10.1007/s00112-021-01148-2 ◽

2021 ◽

Author(s):

K. Neumann ◽

B. Arnold ◽

A. Baumann ◽

C. Bohr ◽

H. A. Euler ◽

...

Keyword(s):

International Classification Of Disease ◽

Diagnostik Und Therapie ◽

Icd 10

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.

Validation of ICD-10-CM codes for injuries complicating pregnancy, childbirth and the puerperium: a medical record review

Injury Prevention ◽

10.1136/injuryprev-2019-043512 ◽

2021 ◽

Vol 27 (Suppl 1) ◽

pp. i9-i12

Author(s):

Anna Hansen ◽

Dana Quesinberry ◽

Peter Akpunonu ◽

Julia Martin ◽

Svetla Slavova

Keyword(s):

Emergency Department ◽

Medical Record ◽

Medical Record Review ◽

Full Sample ◽

Emergency Department Data ◽

Icd 10 ◽

Record Review

IntroductionThe purpose of this study was to estimate the positive predictive value (PPV) of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for injury, poisoning, physical or sexual assault complicating pregnancy, childbirth and the puerperium (PCP) to capture injury encounters within both hospital and emergency department claims data.MethodsA medical record review was conducted on a sample (n=157) of inpatient and emergency department claims from one Kentucky healthcare system from 2015 to 2017, with any diagnosis in the ICD-10-CM range O9A.2-O9A.4. Study clinicians reviewed medical records for the sampled cases and used an abstraction form to collect information on documented presence of injury and PCP complications. The study estimated the PPVs and the 95% CIs of O9A.2-O9A.4 codes for (1) capturing injuries and (2) capturing injuries complicating PCP.ResultsThe estimated PPV for the codes O9A.2-O9A.4 to identify injury in the full sample was 79.6% (95% CI 73.3% to 85.9%) and the PPV for capturing injuries complicating PCP was 72.0% (95% CI 65.0% to 79.0%). The estimated PPV for an inpatient principal diagnosis O9A.2-O9A.4 to capture injuries was 90.7% (95% CI 82.0% to 99.4%) and the PPV for capturing injuries complicating PCP was 88.4% (95% CI 78.4% to 98.4%). The estimated PPV for any mention of O9A.2-O9A.4 in emergency department data to capture injuries was 95.2% (95% CI 90.6% to 99.9%) and the PPV for capturing injuries complicating PCP was 81.0% (95% CI 72.4% to 89.5%).DiscussionThe O9A.2-O9A.4 codes captured high percentage true injury cases among pregnant and puerperal women.

Impact of ICD-9 to ICD-10 Coding Transition on Prevalence Trends in Neurology

Neurology Clinical Practice ◽

10.1212/cpj.0000000000001046 ◽

2021 ◽

Vol 11 (5) ◽

pp. e612-e619

Author(s):

Ali G. Hamedani ◽

Leah Blank ◽

Dylan P. Thibault ◽

Allison W. Willis

Keyword(s):

Time Series ◽

Status Epilepticus ◽

Interrupted Time Series ◽

Disease Prevalence ◽

Rate Of Change ◽

Icd 10

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.

Validation of ICD-10 codes shows intracranial venous thrombosis incidence to be higher than previously reported

Health Information Management Journal ◽

10.1177/1833358318819105 ◽

2018 ◽

Vol 49 (1) ◽

pp. 58-61 ◽

Cited By ~ 2

Author(s):

Joel D Handley ◽

Hedley CA Emsley

Keyword(s):

Positive Predictive Value ◽

Cerebral Infarction ◽

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Coding System ◽

Icd 10 ◽

In Pregnancy

Background: Intracranial venous thrombosis (ICVT) accounts for around 0.5% of all stroke cases. There have been no previously published studies of the International Classification of Diseases, Tenth Edition (ICD-10) validation for the identification of ICVT admissions in adults. Objective: The aims of this study were to validate and quantify the performance of the ICD-10 coding system for identifying cases of ICVT in adults and to derive an estimate of incidence. Method: Administrative data were collected for all patients admitted to a regional neurosciences centre over a 5-year period. We searched for the following ICD-10 codes at any position: G08.X (intracranial and intraspinal phlebitis and thrombophlebitis), I67.6 (non-pyogenic thrombosis of intracranial venous system), I63.6 (cerebral infarction due to cerebral venous thrombosis, non-pyogenic), O22.5 (cerebral venous thrombosis in pregnancy) and O87.3 (cerebral venous thrombosis in the puerperium). Results: Sixty-five admissions were identified by at least one of the relevant ICD-10 codes. The overall positive predictive value (PPV) for confirmed ICVT from all of the admissions combined was 92.3% (60 out of 65) with the results for each code as follows: G08.X 91.5% (54 of 59), O22.5 100% (4 of 4), I67.6 100% (1 of 1), I63.6 100% (1 of 1) and O87.3 100% (1 of 1). There were 40 unique cases of ICVT over a 5-year period giving an annual incidence of ICVT of 5 per million. Conclusions: All codes gave a high PPV. Implications for practice: As demonstrated in previous studies, the incidence of ICVT may be higher than previously thought.

Adverse drug events identified in hospitalized patients in Brazil by International Classification of Diseases (ICD-10) code listings

Cadernos de Saúde Pública ◽

10.1590/0102-311x00222417 ◽

2018 ◽

Vol 34 (12) ◽

Cited By ~ 3

Author(s):

Ana Cristina Martins ◽

Fabíola Giordani ◽

Lusiele Guaraldo ◽

Gianni Tognoni ◽

Suely Rozenfeld

Keyword(s):

Public Health ◽

Adverse Drug Events ◽

Hospitalized Patients ◽

Administrative Databases ◽

National Database ◽

Icd 10

Studies of adverse drug events (ADEs) are important in order not to jeopardize the positive impact of pharmacotherapy. These events have substantial impact on the population morbidity profiles, and increasing health system operating costs. Administrative databases are an important source of information for public health purposes and for identifying ADEs. In order to contribute to learning about ADE in hospitalized patients, this study examined the potential of applying ICD-10 (10th revision of the International Classification of Diseases) codes to a national database of the public health care system (SIH-SUS). The study comprised retrospective assessment of ADEs in the SIH-SUS administrative database, from 2008 to 2012. For this, a list of ICD-10 codes relating to ADEs was built. This list was built up by examining lists drawn up by other authors identified by bibliographic search in the MEDLINE and LILACS and consultations with experts. In Brazil, 55,604,537 hospital admissions were recorded in the SIH-SUS, between 2008 and 2012, of which 273,440 (0.49%) were related to at least one ADE. The proportions and rates seem to hold constant over the study period. Fourteen out of 20 most frequent ADEs were identified in codes relating to mental disorders. Intoxications figure as the second most frequently recorded group of ADEs in the SIH-SUS, comprising 76,866 hospitalizations. Monitoring of ADEs in administrative databases using ICD-10 codes is feasible, even in countries with information systems under construction, and can be an innovative tool to complement drug surveillance strategies in place in Brazil, as well as in others countries.