Use of the ICD-10 Classification in Psychiatry: An International Survey

H, Müssigbrodt; Michels, Rolf; Malchow, C.P.; Dilling, Horst; Munk‐Jørgensen, P.; Bertelsen, Aksel

doi:10.1159/000029127

Cited by 35 publications

(24 citation statements)

References 7 publications

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“…The ICD-10 F2 diagnoses cover 1/4 of all diagnoses given to Danish in-and outpatients over the last 5 years. A similar proportion was observed in an international survey with F20.0 'paranoid schizophrenia' as number 1 among the 10 most frequently used diagnostic categories, which covered 40% of the diagnoses [4].…”

Section: Introductionsupporting

confidence: 77%

Schizophrenia and Related Disorders: Experience with Current Diagnostic Systems

Bertelsen¹

2002

Psychopathology

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Schizophrenia and related disorders include a variety of psychotic disorders in the major classification systems, ICD-10 and DSM-IV, with only partial concordance between the two systems. They both rely on demonstrated reliability, but which disorders are the most valid still has to be determined. Particularly for the ICD-10 disorders, only few studies examining external validity have appeared. Disorders of uncertain validity include ‘schizo-affective disorders’ which in ICD-10 contain the DSM-IV psychotic mood disorders with first-rank symptoms or bizarre delusions; ICD-10 ‘schizotypal disorder’ which in DSM-IV is a personality disorder; the ICD-10 ‘acute and transient psychotic disorders’ and the DSM-IV ‘brief psychotic disorder’. Concerning diagnostic criteria, the reliability and validity of Schneiderian first-rank symptoms, ‘bizarre’ delusions and the Bleulerian ‘negative’ symptoms have been questioned. Validity studies in these areas are needed before it will be possible to provide major reconstructions for future diagnostic systems. One may hope that, eventually, one common worldwide psychiatric classification will be available.

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Section: Introductionsupporting

confidence: 77%

Schizophrenia and Related Disorders: Experience with Current Diagnostic Systems

Bertelsen¹

2002

Psychopathology

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“…In an earlier paper, we published the results of a nonsystematic inquiry about diagnoses in various countries and centres [4], in which we found some significant differences in the use of the ICD-10 diagnostic classification. The question was raised whether additional axes, e.g.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Psychiatric ICD-10 Diagnoses in Denmark and Germany

Lange

Munk‐Jørgensen²,

Bertelsen³

et al. 2002

Psychopathology

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A dataset of psychiatric ICD-10 diagnoses from the Danish case register concerning psychiatric hospitals was compared with a sample of psychiatric diagnoses from 27 psychiatric hospitals in Germany. The comparison shows a higher proportion of F1 diagnoses in the German dataset and a difference in the coding of alcohol dependence and harmful use. Some further differences in the groups F0–F6 are demonstrated and some of them are discussed. The most frequent diagnoses found in both datasets but in different sequence are alcohol dependence syndrome and paranoid schizophrenia and, in third place, adjustment disorder. Various aspects of the problem of rarely used diagnoses are discussed.

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“…In this way, the diagnoses are considered as a yes/no distinction, with no room in the rubric for gradations of a disorder (Silverman & Krueger, 2014), yet a real possibility exists that a patient would not receive needed services. Moreover, diagnostic thresholds utilized in the categorical approach often are arbitrary, while the variability both above and below diagnostic thresholds can be clinically meaningful (Kessler et al, 2003) and does not mirror the way practicing clinicians use the categories in everyday practice (Kim & Ahn, 2002;Mussigbrodt et al, 2000;Reed, Mendonca Correia, Esparza, Saxena, & Maj, 2011).…”

Section: The Need For Rdocmentioning

confidence: 99%

Operationalizing NIMH Research Domain Criteria (RDoC) in naturalistic clinical settings

Sharp¹,

Fowler²,

Salas³

et al. 2016

Bulletin of the Menninger Clinic

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Recently, the National Institute of Mental Health (NIMH) introduced the Research Domain Criteria (RDoC) initiative to address two major challenges facing the field of psychiatry: (1) the lack of new effective personalized treatments for psychiatric disorders, and (2) The need for RDoCEffective treatments and policies are lacking for adolescents and adults with serious mental illness (SMI; i.e., treatment refractory neuropsychiatric disorders). Because tightly controlled efficacy studies restrict the capacity to provide personalized care, they may also restrict treatment response. Moreover, health insurance and public sector mental healthcare systems rarely allow for more than very brief psychiatric hospitalizations to focus primarily on stabilization. Thus, the majority of people with SMI are not afforded the time in treatment necessary to understand and treat their complex clinical symptoms and functional impairments.Offering personalized care means recognizing that for reasons of genetic makeup and personal history, people respond differentially to specific treatments and that poor response to one treatment does not necessarily imply poor response to another, or deny the possibility of potentiation through combinations of multimodal treatments over time.In addition to the challenges facing personalized clinical care for SMI, the publication of the 5 th edition of the Diagnostic and Statistical Manual for Mental Disorders in 2013 by the American Psychiatric Association was preceded by controversy and contentious debate (Regier, 2007a(Regier, , 2007bSaunders, 2006;Widiger & Simonsen, 2005). Despite the hopes that the practice of psychiatric diagnosis would be revolutionized, the knowledge base in the field was not judged sufficient to justify moving beyond the established tradition of diagnosing mental disorders based on clinical observation and patients' phenomenological symptom reports. In addition, the polythetic and dichotomous (categorical) diagnostic system was, for the most part, retained. In psychiatry (unlike other disciplines in medicine) we rely solely on the patient's subjective report, and on clinical observation, for diagnosis and treatment planning. In other words one could say that in psychiatry the disease is diagnosed as the symptom. Thus anxiety, for instance, is both the 4 4 diagnosis and its symptom. In general medicine, by contrast, when a patient presents with excessive thirst and frequent restroom breaks, the physician might order a blood glucose level test to confirm or dispute a diagnosis of diabetes, acknowledging that the behavioral phenotype (excessive thirst and frequent restroom breaks) may be associated with a variety of underlying conditions and that a direct mapping of subjective patient report to pathophysiology may clarify the disorder. In psychiatry, when a patient presents with anger outbursts, affective instability, a history of suicide attempts, alcohol abuse and relationship problems, he/she meets five out of nine DSM-5 criteria for borderline personality disorde...

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Use of the ICD-10 Classification in Psychiatry: An International Survey

Cited by 35 publications

References 7 publications

Schizophrenia and Related Disorders: Experience with Current Diagnostic Systems

Schizophrenia and Related Disorders: Experience with Current Diagnostic Systems

Comparison of Psychiatric ICD-10 Diagnoses in Denmark and Germany

Operationalizing NIMH Research Domain Criteria (RDoC) in naturalistic clinical settings

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