Changes from ICD-10 to ICD-11 and future directionsin psychiatric classification

Abstract

This article provides a brief overview of the changes from ICD-10 to ICD-11 regarding the classification of mental, behavioral, or neurodevelopmental disorders. These changes include a new chapter structure, new diagnostic categories, changes in diagnostic criteria, and steps towards dimensionality. Additionally, we review evaluative field studies of ICD-11, which provide preliminary evidence for higher reliability and clinical utility of ICD-11 compared with ICD-10. Despite the extensive revision process, changes from ICD-10 to ICD-11 were relatively modest in that both systems are categorical, classifying mental phenomena based on self-reported or clinically observable symptoms. Other recent approaches to psychiatric nosology and classification (eg, neurobiology-based or hierarchical) are discussed. To meet the needs of different user groups, we propose expanding the stepwise approach to diagnosis introduced for some diagnostic categories in ICD-11, which includes categorical and dimensional elements.

Childhood Depression Can Impair Learning

“…The CDI was presented by Kovacs in 1983, the first instrument designed to study the symptoms of depression in childhood. It consists of a self-assessment scale with 27 items, in order to identify the depressive symptoms in individuals from 7 to 17 years old and has been widely used since then (Gaebel et al, 2020;Stein et al, 2020). The DSM-V (2013) is a reference for psychiatric diagnoses, and knowledge of its criteria for the diagnosis of depressive disorders is essential.…”

“…Among such symptoms, a total of 10 bring depressive moods; marked decrease in interest or pleasure in activities; reduced power of concentration or maintenance of attention or marked difficulty in making decisions; low self-esteem or excessive or inadequate guilt; lack of hope for the future; frequent thoughts of death or ideation or suicide attempt; significant disturbances in sleep or excessive sleep; changes in appetite or weight; agitation or psychomotor retardation; and decrease in energy or fatigue. Depending on the number of episodes, as well as the intensity of how they occur (i.e., whether they are medium, moderate or severe) (Stein et al, 2020), a gradual range of depression disorders is created, thus characterizing its new dimensional approach (which brings it closer to DSM) (Gaebel et al, 2020;Stein et al, 2020).…”

Clusters, lines and webs—so does my patient have psychosis? reflections on the use of psychiatric conceptual frameworks from a clinical vantage point

“…However, such distinctive, defining characteristics are rarely established with any clarity. Due to this rationale the ICD-11 abandoned traditional sub-categories of schizophrenia, finding insufficient evidence for their predictive or treatment validity, and adopted instead a set of dimensional symptom specifiers (positive, negative, depressive, manic, psychomotor, and cognitive symptoms) rated on a four-point severity scale applied across all diagnostic categories in the group ‘Schizophrenia or other primary psychotic disorders’ [ 29 ]. This approach represents a major rupture both from the ideal type and prototype approaches, as different patients diagnosed with schizophrenia may well display entirely different symptom profiles, leaving the overarching conceptual construct difficult to grasp.…”

Optimizing multi-domain hematologic biomarkers and clinical features for the differential diagnosis of unipolar depression and bipolar depression

“…[1] In the international classification system of mental disorders International Classification of Diseases 10th edition (ICD -10) and the American classification system American Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV), mood disorders mainly include: major depressive disorder, bipolar disorder, persistent mood disorder and cyclothymic disorder, etc. [2] However, in the new classification standard of the fifth edition of DSM (DSM-V) [3], the mood disorder is regarded as two independent categories, including bipolar and bipolar related disorders, as well as depressive disorder. Accordingly, the ICD-11 [4] will also be revised to be synchronized with DSM-V.…”