ICD-10 VersusDSM-5on Cultural Issues

Abstract

Mental health practitioners in the United States often use two classification systems for mental disorders, namely, the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). A critical issue when diagnosing people with mental disorders is to ensure that cultural variables do not potentially explain the presentation of symptoms. A fundamental difference between the two classification systems is that the ICD is mute regarding the need to consider such variables in this context of diagnosing people with mental disorders, whereas the DSM-5 does alert mental health practitioners that they should not make a diagnosis in this context without considering the cultural variables potentially affecting the assessment and diagnosis of such disorders. This difference between the two classification systems is illustrated with a sample of mental disorders in both systems.

Concurrent and convergent validity of culture-specific psychopathology syndromes among Cambodian adolescents

“…Although DSM-5 (APA, 2013) and ICD-10 (WHO, 1992) were designed to identify pathologies universal across the human species, it has been argued that ethnocentric assumptions underlying both of these diagnostic systems may prevent a truly comprehensive understanding of psychopathology among different cultural groups (La Roche et al, 2015). Notably, although the DSM-5 (which appears more inherently connected to Western psychiatric standards than the ICD) includes specific sections considering the role of culture in the development of psychopathology, ICD-10's cultural consideration is smaller (Paniagua, 2018). The absence of cultural consideration in ICD-10 has led to efforts to redress this issue in the upcoming ICD-11 (Gureje et al, 2020).…”

Culture‑Bound Syndromes and Cultural Concepts of Distress in Psychiatry

“…However, some syndromes such as Latah, Koro and Dhat are mentioned in the "Other specified neurotic disorders" section. 12…”

Conundrum of the Critiques Related to Culture Bound Syndromes and the Way Forward

“…Differences in the emotional, symptomatic, and contextual aspects of cultural syndromes signal different comorbid relationships with psychiatric diagnosis or even lack of such a relationship. 8, 10 Proponents of CBS being a separate entity put forward the viewpoints that if cultural syndromes are incorporated into descriptive oriented classificatory systems, it would lead to the loss of their unique individual meaning from a cultural perspective, as the international classificatory systems have rigid (phenomenological) boundaries of the disorders to enable research and clinical practice. This might also lead to exclusion of culturally influenced alternative variants of these disorders.…”

“…This might also lead to exclusion of culturally influenced alternative variants of these disorders. 10 Further, the criteria of classification of CBS have been changing over time, 7 which makes the debate unending and add on new controversy every time.…”