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Gureje O. The ICD-11 CDDR: benefits to health systems and clinical care. World Psychiatry 2024; 23:447-448. [PMID: 39279385 PMCID: PMC11403161 DOI: 10.1002/wps.21250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2024] Open
Affiliation(s)
- Oye Gureje
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Alcohol and Drug Abuse, University of Ibadan, Ibadan, Nigeria
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2
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Maj M. Scientific validation of the ICD-11 CDDR. World Psychiatry 2024; 23:358-359. [PMID: 39279399 PMCID: PMC11403167 DOI: 10.1002/wps.21226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2024] Open
Affiliation(s)
- Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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3
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Richardson C, Robson A, Sood L, Ferrier IN, Owen A. Mortality in the Victorian asylum: was it so high? Standardised Mortality Rate compared with historical methods. HISTORY OF PSYCHIATRY 2024:957154X241269206. [PMID: 39118302 DOI: 10.1177/0957154x241269206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Mortality is closely linked to age, sex, and social and historical context. Standardised Mortality Rates (SMR) address these contextual factors by comparing mortality in a population under study with that in people of the same age and sex, the same period in history and from a similar cultural context. We use records from the Hatton Asylum and contemporaneous census data in order to calculate SMR in the asylum population, showing rates that were about 2.5 times greater than the population at the time. This is much lower than crude mortality rates, which we calculated as being more than seven times greater than in the population. The SMR method may enable a more meaningful understanding of mortality in asylums or other institutions.
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Affiliation(s)
| | | | | | | | - Andy Owen
- Coventry and Warwickshire Partnership Trust, UK
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Stausberg J, Vogel U. Coding Diagnoses from the Electronic Death Certificate with the 11th Revision of the International Statistical Classification of Diseases and Related Health Problems: An Exploratory Study from Germany. Healthcare (Basel) 2024; 12:1214. [PMID: 38921328 PMCID: PMC11203020 DOI: 10.3390/healthcare12121214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
The 11th Revision of the International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD-11) will replace its predecessor as international standard for cause-of death-statistics. The digitization of healthcare is a main motivation for its introduction. In parallel, the replacement of the paper-based death certificate with an electronic format is under evaluation. At the moment, the death certificate is used in paper-based format with ICD-10 for coding in Germany. To be prepared for the switch to ICD-11, the compatibility between ICD-11 and the electronic certificate should be assured. Objectives were to check the appropriateness of diagnosis-related information found on death certificates for an ICD-11 coding and to describe enhancements to the certificate's structure needed to fully utilize the strengths of ICD-11. As part of an exploratory test of a respective application, information from 453 electronic death certificates were provided by one local health authority. From a sample of 200 certificates, 433 diagnosis texts were coded into the German version of ICD-11. The appropriateness of the results as well as the further requirements of ICD-11, particularly with regard to post-coordination, were checked. For 430 diagnosis texts, 649 ICD-11 codes were used. Three hundred and sixty two diagnosis texts were rated as appropriately represented through the coding result. Almost all certificates contained diagnosis texts that lacked details required by ICD-11 for a precise coding. The distribution of diseases was very similar between ICD-10 and ICD-11 coding. A few gaps in ICD-11 were identified. Information requested by ICD-11 for a mandatory post-coordination were almost entirely absent from the death certificates. The structure and content of the death certificate are currently not well prepared for an ICD-11 coding. Necessary information was frequently missing. The line-oriented structure of death certificates has to be supplemented with a more flexible approach. Then, the semantic knowledge base of ICD-11 should better guide the content related input fields of a future electronic death certificate.
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Affiliation(s)
- Jürgen Stausberg
- Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), Faculty of Medicine, University Duisburg-Essen, 45122 Essen, Germany
| | - Ulrich Vogel
- Federal Institute for Drugs and Medical Devices, 53175 Bonn, Germany;
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5
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Bachem R, Maercker A, Levin Y, Köhler K, Willmund G, Bohus M, Koglin S, Roepke S, Schoofs N, Priebe K, Wülfing F, Schmahl C, Stadtmann MP, Rau H, Augsburger M. Assessing complex PTSD and PTSD: validation of the German version of the International Trauma Interview (ITI). Eur J Psychotraumatol 2024; 15:2344364. [PMID: 38687289 PMCID: PMC11062267 DOI: 10.1080/20008066.2024.2344364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 04/08/2024] [Indexed: 05/02/2024] Open
Abstract
Background: With the introduction of the ICD-11 into clinical practice, the reliable distinction between Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) becomes paramount. The semi-structured clinician-administered International Trauma Interview (ITI) aims to close this gap in clinical and research settings.Objective: This study investigated the psychometric properties of the German version of the ITI among trauma-exposed clinical samples from Switzerland and Germany.Method: Participants were 143 civilian and 100 military participants, aged M = 40.3 years, of whom 53.5% were male. Indicators of reliability and validity (latent structure, internal reliability, inter-rater agreement, convergent and discriminant validity) were evaluated. Confirmatory factor analysis (CFA) and partial correlation analysis were conducted separately for civilian and military participants.Results: Prevalence of PTSD was 30% (civilian) and 33% (military) and prevalence of CPTSD was 53% (civilians) and 21% (military). Satisfactory internal consistency and inter-rater agreement were found. In the military sample, a parsimonious first-order six-factor model was preferred over a second-order two-factor CFA model of ITI PTSD and Disturbances in Self-Organization (DSO). Model fit was excellent among military participants but no solution was supported among civilian participants. Overall, convergent validity was supported by positive correlations of ITI PTSD and DSO with DSM-5 PTSD. Discriminant validity for PTSD symptoms was confirmed among civilians but low in the military sample.Conclusions: The German ITI has shown potential as a clinician-administered diagnostic tool for assessing ICD-11 PTSD and CPTSD in primary care. However, further exploration of its latent structure and discriminant validity are indicated.
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Affiliation(s)
- Rahel Bachem
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | - Yafit Levin
- School of Social Work, Ariel University, Ariel, Israel
| | - Kai Köhler
- Bundeswehr Center for Military Mental Health, Berlin, Germany
| | - Gerd Willmund
- Bundeswehr Center for Military Mental Health, Berlin, Germany
| | - Martin Bohus
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
| | - Stefanie Koglin
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Roepke
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Nikola Schoofs
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Kathlen Priebe
- Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Felix Wülfing
- Department of Psychiatry and Neurosciences, Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim / Heidelberg University, Mannheim, Germany
| | - Manuel P. Stadtmann
- Eastern Switzerland University of Applied Sciences, Competence Centre for Mental Health, St. Gallen, Switzerland
| | - Heinrich Rau
- Bundeswehr Center for Military Mental Health, Berlin, Germany
| | - Mareike Augsburger
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
- Klenico Health AG, University of Zurich startup, Zürich, Switzerland
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6
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Stańczykiewicz B, Bogudzińska B, Kowalski K, Misiak B. The association between depression and the cortisol awakening response is moderated by loneliness in men from a non-clinical sample. Psychoneuroendocrinology 2024; 160:106924. [PMID: 38086318 DOI: 10.1016/j.psyneuen.2023.106924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/02/2024]
Abstract
Previous studies investigating cortisol levels in people with depression or depressive symptoms have provided mixed findings. It has been suggested that the difficulty to generalize findings across studies in this field might be related to interindividual variability in experiencing depressive symptoms in terms of clinical and social contexts. Therefore, in the present study we aimed to test the association of morning cortisol levels and depressive symptoms in a non-clinical sample of young men taking into consideration the level of perceived loneliness. We hypothesized that the level of loneliness might moderate the association between morning cortisol levels and depressive symptoms. A total of 102 participants (aged 29.9 ± 5.0 years) completed questionnaires measuring the levels of depressive and anxiety symptoms, perceived stress, and loneliness. Cortisol levels were determined in four morning samples of saliva. There were significant positive correlations of the cortisol awakening response (CAR) and the mean increase in cortisol levels during the measurement period (MnInc) with the levels of depressive symptoms and loneliness. Moreover, a significant association of the depressive symptoms by loneliness interaction with the CAR and the MnInc was found. Specifically, the correlation of depressive symptoms with the CAR and the MnInc appeared to be significant and negative at high levels of loneliness. No significant association between depressive symptoms and the CAR was observed in men with low levels of loneliness. There were no significant associations of depressive symptoms, loneliness and the depressive symptoms by loneliness interaction with cortisol levels at awakening. In conclusion, findings from the present study indicate the importance of social contexts in understanding the association between altered activity of the hypothalamic-pituitary-adrenal axis and depressive symptoms in men.
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Affiliation(s)
- Bartłomiej Stańczykiewicz
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Wroclaw, Poland.
| | - Bogna Bogudzińska
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Kowalski
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Wroclaw, Poland
| | - Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
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7
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Dominke C, Fischer AM, Grimmer T, Diehl-Schmid J, Jahn T. CERAD-NAB and flexible battery based neuropsychological differentiation of Alzheimer's dementia and depression using machine learning approaches. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:221-248. [PMID: 36320158 DOI: 10.1080/13825585.2022.2138255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
Depression (DEP) and dementia of the Alzheimer's type (DAT) represent the most common neuropsychiatric disorders in elderly patients. Accurate differential diagnosis is indispensable to ensure appropriate treatment. However, DEP can yet mimic cognitive symptoms of DAT and patients with DAT often also present with depressive symptoms, impeding correct diagnosis. Machine learning (ML) approaches could eventually improve this discrimination using neuropsychological test data, but evidence is still missing. We therefore employed Support Vector Machine (SVM), Naïve Bayes (NB), Random Forest (RF) and conventional Logistic Regression (LR) to retrospectively predict the diagnoses of 189 elderly patients (68 DEP and 121 DAT) based on either the well-established Consortium to Establish a Registry for Alzheimer's Disease neuropsychological assessment battery (CERAD-NAB) or a flexible battery approach (FLEXBAT). The best performing combination consisted of FLEXBAT and NB, correctly classifying 87.0% of patients as either DAT or DEP. However, all accuracies were similar across algorithms and test batteries (83.0% - 87.0%). Accordingly, our study is the first to show that common ML algorithms with their default parameters can accurately differentiate between patients clinically diagnosed with DAT or DEP using neuropsychological test data, but do not necessarily outperform conventional LR.
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Affiliation(s)
- Clara Dominke
- Division Clinical Neuropsychology, Department of Psychology, Ludwig-Maximilians-University, Munich, Germany
| | - Alina Maria Fischer
- School of Medicine, Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Timo Grimmer
- School of Medicine, Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Janine Diehl-Schmid
- School of Medicine, Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
- Centre for Geriatric Medicine, Kbo-Inn-Salzach-Klinikum, Wasserburg am Inn, Germany
| | - Thomas Jahn
- Division Clinical Neuropsychology, Department of Psychology, Ludwig-Maximilians-University, Munich, Germany
- School of Medicine, Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
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Lee H, Kim S. Impact of the ICD-11 on the accuracy of clinical coding in Korea. HEALTH INF MANAG J 2023; 52:221-228. [PMID: 35614871 DOI: 10.1177/18333583221095147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: ICD-11 was officially released at the World Health Assembly on 25 May 2019. Objective: To find effective ways to increase the accuracy of coding for diagnostic terms in Korea for a stable transition from Korean modification of ICD-10 (7th Revision of Korean Classification of Disease, KCD-7) to ICD-11. Method: A total of 27 skilled Korean health information managers performed KCD-7 and ICD-11 coding simultaneously (line coding [56]; case coding [17]). Accuracy rates and percentage agreements were calculated, and granularity and difficulty of the ICD-11 were rated by participants. Results: The average accuracy rate of line coding was 71.6 % in ICD-11 and 80.2% in KCD-7, which was similar to results in other studies. The mean percentage agreements for ICD-11 and KCD-7 for line coding were 64.2% and 72.1%, respectively; while for case coding it was 15.3% and 26.6%. Selection criteria for the case scenarios may have influenced the low agreements in case coding. Cluster coding, changes of terms in ICD-11 and removal of codes used in ICD-10 contributed to low agreement in ICD-11 (46.6% of participants reported that granularity of ICD-11 was similar to ICD-10, while 36.9% reported that ICD-11 had finer granularity). In terms of difficulty, 15.3% of participants found line coding difficult and 10.9% found case coding difficult. Conclusion: Provision of more detailed reference guidelines and efficient training for coding professionals by the World Health Organization would enable ICD-11 to be an excellent tool for gathering relevant information about diseases in Korea.
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Affiliation(s)
- Hyunkyung Lee
- Resource Management Office, Kunsan American Airbase Hospital, Kunsan Air Base, Korea
| | - Sukil Kim
- Department of Preventive Medicine, College of Medicine, The Catholic University, Seoul, Korea
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9
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Misiak B, Samochowiec J, Kowalski K, Gaebel W, Bassetti CLA, Chan A, Gorwood P, Papiol S, Dom G, Volpe U, Szulc A, Kurimay T, Kärkkäinen H, Decraene A, Wisse J, Fiorillo A, Falkai P. The future of diagnosis in clinical neurosciences: Comparing multiple sclerosis and schizophrenia. Eur Psychiatry 2023; 66:e58. [PMID: 37476977 PMCID: PMC10486256 DOI: 10.1192/j.eurpsy.2023.2432] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/12/2023] [Accepted: 06/14/2023] [Indexed: 07/22/2023] Open
Abstract
The ongoing developments of psychiatric classification systems have largely improved reliability of diagnosis, including that of schizophrenia. However, with an unknown pathophysiology and lacking biomarkers, its validity still remains low, requiring further advancements. Research has helped establish multiple sclerosis (MS) as the central nervous system (CNS) disorder with an established pathophysiology, defined biomarkers and therefore good validity and significantly improved treatment options. Before proposing next steps in research that aim to improve the diagnostic process of schizophrenia, it is imperative to recognize its clinical heterogeneity. Indeed, individuals with schizophrenia show high interindividual variability in terms of symptomatic manifestation, response to treatment, course of illness and functional outcomes. There is also a multiplicity of risk factors that contribute to the development of schizophrenia. Moreover, accumulating evidence indicates that several dimensions of psychopathology and risk factors cross current diagnostic categorizations. Schizophrenia shares a number of similarities with MS, which is a demyelinating disease of the CNS. These similarities appear in the context of age of onset, geographical distribution, involvement of immune-inflammatory processes, neurocognitive impairment and various trajectories of illness course. This article provides a critical appraisal of diagnostic process in schizophrenia, taking into consideration advancements that have been made in the diagnosis and management of MS. Based on the comparison between the two disorders, key directions for studies that aim to improve diagnostic process in schizophrenia are formulated. All of them converge on the necessity to deconstruct the psychosis spectrum and adopt dimensional approaches with deep phenotyping to refine current diagnostic boundaries.
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Affiliation(s)
- Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | | | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, LVR-Klinikum Düsseldorf, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
- WHO Collaborating Centre on Quality Assurance and Empowerment in Mental Health, DEU-131, Düsseldorf, Germany
| | - Claudio L. A. Bassetti
- Department of Neurology, Inselspital, Bern University Hospital, University Bern, Switzerland
- Interdisciplinary Sleep-Wake-Epilepsy-Center, Inselspital, Bern University Hospital, University Bern, Bern, Switzerland
| | - Andrew Chan
- Department of Neurology, Inselspital, Bern University Hospital, University Bern, Switzerland
| | - Philip Gorwood
- Université Paris Cité, INSERM, U1266 (Institute of Psychiatry and Neuroscience of Paris), Paris, France
- CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| | - Sergi Papiol
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Institute of Psychiatric Phenomics and Genomics, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, B-2610Antwerp, Belgium
- Multiversum Psychiatric Hospital, B-2530Boechout, Belgium
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, 60126Ancona, Italy
| | - Agata Szulc
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Tamas Kurimay
- Department of Psychiatry, St. Janos Hospital, Budapest, Hungary
| | | | - Andre Decraene
- European Federation of Associations of Families of People with Mental Illness (EUFAMI), Leuven, Belgium
| | - Jan Wisse
- Century House, Wargrave Road, Henley-on-Thames, OxfordshireRG9 2LT, UK
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstraße 7, 80336Munich, Germany
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10
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Karvelis P, Paulus MP, Diaconescu AO. Individual differences in computational psychiatry: a review of current challenges. Neurosci Biobehav Rev 2023; 148:105137. [PMID: 36940888 DOI: 10.1016/j.neubiorev.2023.105137] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/04/2023] [Accepted: 03/14/2023] [Indexed: 03/23/2023]
Abstract
Bringing precision to the understanding and treatment of mental disorders requires instruments for studying clinically relevant individual differences. One promising approach is the development of computational assays: integrating computational models with cognitive tasks to infer latent patient-specific disease processes in brain computations. While recent years have seen many methodological advancements in computational modelling and many cross-sectional patient studies, much less attention has been paid to basic psychometric properties (reliability and construct validity) of the computational measures provided by the assays. In this review, we assess the extent of this issue by examining emerging empirical evidence. We find that many computational measures suffer from poor psychometric properties, which poses a risk of invalidating previous findings and undermining ongoing research efforts using computational assays to study individual (and even group) differences. We provide recommendations for how to address these problems and, crucially, embed them within a broader perspective on key developments that are needed for translating computational assays to clinical practice.
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Affiliation(s)
- Povilas Karvelis
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, USA; Oxley College of Health Sciences, The University of Tulsa, Tulsa, OK, USA
| | - Andreea O Diaconescu
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada; Department of Psychology, University of Toronto, Toronto, ON, Canada
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11
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Associations of neurodevelopmental risk factors with psychosis proneness: Findings from a non-clinical sample of young adults. Compr Psychiatry 2023; 123:152385. [PMID: 36931184 DOI: 10.1016/j.comppsych.2023.152385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 03/19/2023] Open
Abstract
Psychotic disorders often develop as the continuum of subclinical symptoms that include hallucination-like and delusion-like experiences, and are commonly referred to as psychotic-like experiences (PLEs). To date, a number of neurodevelopmental risk factors of psychosis have been detected, yet their mutual interplay remains unknown. Therefore, we aimed to investigate the additive association of childhood trauma history, reading disabilities and symptoms of attention-deficit/hyperactivity disorder (ADHD) with psychosis proneness. A total of 3000 young adults (58.3% females, aged 18-35 years) with a negative history of psychiatric treatment were recruited to the cross-sectional study through computer-assisted web interview. Self-reports were administered to measure childhood trauma history, ADHD symptoms and reading disabilities. Linear regression analyses revealed significant main associations of childhood trauma history and reading disabilities with higher levels of PLEs. There were no significant main associations of ADHD with the level of PLEs. However, the associations of all possible interactions between neurodevelopmental risk factors with the level of PLEs were significant. Our findings suggest that childhood trauma history and reading disabilities may additively increase a risk of psychosis. The present findings bring new implications for early intervention strategies in psychosis and posit the rationale of recording the accumulation of neurodevelopmental vulnerabilities in clinical practice.
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12
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Hofman A, Lier I, Ikram MA, van Wingerden M, Luik AI. Uncovering psychiatric phenotypes using unsupervised machine learning: A data-driven symptoms approach. Eur Psychiatry 2023; 66:e27. [PMID: 36804948 PMCID: PMC10044296 DOI: 10.1192/j.eurpsy.2023.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Current categorical classification systems of psychiatric diagnoses lead to heterogeneity of symptoms within disorders and common co-occurrence of disorders. We investigated the heterogeneous and overlapping nature of symptom endorsement in a population-based sample across three of the most common categories of psychiatric disorders: depressive disorders, anxiety disorders, and sleep-wake disorders using unsupervised machine learning approaches. METHODS We assessed a total of 43 symptoms in a discovery sample of 6,602 participants of the population-based Rotterdam Study between 2009 and 2013, and in a replication sample of 3,005 participants between 2016 and 2020. Symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, the Hospital Anxiety and Depression Scale, and the Pittsburgh Sleep Quality Index. Hierarchical clustering analysis was applied on test items and participants to investigate common patterns of symptoms co-occurrence, and further quantitatively investigated with clustering methods to find groups that may represent similar psychiatric phenotypes. RESULTS First, clustering analyses of the questionnaire items suggested a three-cluster solution representing clusters of "mixed" symptoms, "depressed affect and nervousness", and "troubled sleep and interpersonal problems". A highly similar clustering solution was independently established in the replication sample. Second, four groups of participants could be separated, and these groups scored differently on the item clusters. CONCLUSIONS We identified three clusters of psychiatric symptoms that most commonly co-occur in a population-based sample. These symptoms clustered stable over samples, but across the topics of depression, anxiety, and poor sleep. We identified four groups of participants that share (sub)clinical symptoms and might benefit from similar prevention or treatment strategies, despite potentially diverging, or lack of, diagnoses.
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Affiliation(s)
- Amy Hofman
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Isabelle Lier
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marijn van Wingerden
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, The Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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13
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Inter-Rater Reliability between Structured and Non-Structured Interviews Is Fair in Schizophrenia and Bipolar Disorders-A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2023; 13:diagnostics13030526. [PMID: 36766632 PMCID: PMC9914275 DOI: 10.3390/diagnostics13030526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/25/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
We aimed to find agreement between diagnoses obtained through standardized (SDI) and non-standardized diagnostic interviews (NSDI) for schizophrenia and Bipolar Affective Disorder (BD). METHODS A systematic review with meta-analysis was conducted. Publications from 2007 to 2020 comparing SDI and NSDI diagnoses in adults without neurological disorders were screened in MEDLINE, ISI Web of Science, and SCOPUS, following PROSPERO registration CRD42020187157, PRISMA guidelines, and quality assessment using QUADAS-2. RESULTS From 54231 entries, 22 studies were analyzed, and 13 were included in the final meta-analysis of kappa agreement using a mixed-effects meta-regression model. A mean kappa of 0.41 (Fair agreement, 95% CI: 0.34 to 0.47) but high heterogeneity (Î2 = 92%) were calculated. Gender, mean age, NSDI setting (Inpatient vs. Outpatient; University vs. Non-university), and SDI informant (Self vs. Professional) were tested as predictors in meta-regression. Only SDI informant was relevant for the explanatory model, leaving 79% unexplained heterogeneity. Egger's test did not indicate significant bias, and QUADAS-2 resulted in "average" data quality. CONCLUSIONS Most studies using SDIs do not report the original sample size, only the SDI-diagnosed patients. Kappa comparison resulted in high heterogeneity, which may reflect the influence of non-systematic bias in diagnostic processes. Although results were highly heterogeneous, we measured a fair agreement kappa between SDI and NSDI, implying clinicians might operate in scenarios not equivalent to psychiatry trials, where samples are filtered, and there may be more emphasis on maintaining reliability. The present study received no funding.
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von Mücke-Heim IA, Urbina-Treviño L, Bordes J, Ries C, Schmidt MV, Deussing JM. Introducing a depression-like syndrome for translational neuropsychiatry: a plea for taxonomical validity and improved comparability between humans and mice. Mol Psychiatry 2023; 28:329-340. [PMID: 36104436 PMCID: PMC9812782 DOI: 10.1038/s41380-022-01762-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/09/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023]
Abstract
Depressive disorders are the most burdensome psychiatric disorders worldwide. Although huge efforts have been made to advance treatment, outcomes remain unsatisfactory. Many factors contribute to this gridlock including suboptimal animal models. Especially limited study comparability and replicability due to imprecise terminology concerning depressive-like states are major problems. To overcome these issues, new approaches are needed. Here, we introduce a taxonomical concept for modelling depression in laboratory mice, which we call depression-like syndrome (DLS). It hinges on growing evidence suggesting that mice possess advanced socioemotional abilities and can display non-random symptom patterns indicative of an evolutionary conserved disorder-like phenotype. The DLS approach uses a combined heuristic method based on clinical depression criteria and the Research Domain Criteria to provide a biobehavioural reference syndrome for preclinical rodent models of depression. The DLS criteria are based on available, species-specific evidence and are as follows: (I) minimum duration of phenotype, (II) significant sociofunctional impairment, (III) core biological features, (IV) necessary depressive-like symptoms. To assess DLS presence and severity, we have designed an algorithm to ensure statistical and biological relevance of findings. The algorithm uses a minimum combined threshold for statistical significance and effect size (p value ≤ 0.05 plus moderate effect size) for each DLS criterion. Taken together, the DLS is a novel, biologically founded, and species-specific minimum threshold approach. Its long-term objective is to gradually develop into an inter-model validation standard and microframework to improve phenotyping methodology in translational research.
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Affiliation(s)
- Iven-Alex von Mücke-Heim
- grid.419548.50000 0000 9497 5095Max Planck Institute of Psychiatry, Molecular Neurogenetics, Munich, Germany ,grid.419548.50000 0000 9497 5095Department of Translational Research, Max Planck Institute of Psychiatry, Munich, Germany ,grid.4372.20000 0001 2105 1091International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Lidia Urbina-Treviño
- grid.419548.50000 0000 9497 5095Max Planck Institute of Psychiatry, Molecular Neurogenetics, Munich, Germany
| | - Joeri Bordes
- grid.4372.20000 0001 2105 1091International Max Planck Research School for Translational Psychiatry, Munich, Germany ,grid.419548.50000 0000 9497 5095Max Planck Institute of Psychiatry, Neurobiology of Stress Resilience, Munich, Germany
| | - Clemens Ries
- grid.419548.50000 0000 9497 5095Max Planck Institute of Psychiatry, Molecular Neurogenetics, Munich, Germany ,grid.4372.20000 0001 2105 1091International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Mathias V. Schmidt
- grid.419548.50000 0000 9497 5095Max Planck Institute of Psychiatry, Neurobiology of Stress Resilience, Munich, Germany
| | - Jan M. Deussing
- grid.419548.50000 0000 9497 5095Max Planck Institute of Psychiatry, Molecular Neurogenetics, Munich, Germany
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15
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Chakrabarti S. Bipolar disorder in the International Classification of Diseases-Eleventh version: A review of the changes, their basis, and usefulness. World J Psychiatry 2022; 12:1335-1355. [PMID: 36579354 PMCID: PMC9791613 DOI: 10.5498/wjp.v12.i12.1335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/07/2022] [Accepted: 11/22/2022] [Indexed: 12/16/2022] Open
Abstract
The World Health Organization’s 11th revision of the International Classification of Diseases (ICD-11) including the chapter on mental disorders has come into effect this year. This review focuses on the “Bipolar or Related Disorders” section of the ICD-11 draft. It describes the benchmarks for the new version, particularly the foremost principle of clinical utility. The alterations made to the diagnosis of bipolar disorder (BD) are evaluated on their scientific basis and clinical utility. The change in the diagnostic requirements for manic and hypomanic episodes has been much debated. Whether the current criteria have achieved an optimum balance between sensitivity and specificity is still not clear. The ICD-11 definition of depressive episodes is substantially different, but the lack of empirical support for the changes has meant that the reliability and utility of bipolar depression are relatively low. Unlike the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), the ICD-11 has retained the category of mixed episodes. Although the concept of mixed episodes in the ICD-11 is not perfect, it appears to be more inclusive than the DSM-5 approach. Additionally, there are some uncertainties about the guidelines for the subtypes of BD and cyclothymic disorder. The initial results on the reliability and clinical utility of BD are promising, but the newly created diagnostic categories also appear to have some limitations. Although further improvement and research are needed, the focus should now be on facing the challenges of implementation, dissemination, and education and training in the use of these guidelines.
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Affiliation(s)
- Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, UT, India
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16
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Disorders Specifically Associated With Stress in ICD-11. CLINICAL PSYCHOLOGY IN EUROPE 2022; 4:e9711. [PMID: 36760318 PMCID: PMC9881111 DOI: 10.32872/cpe.9711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/12/2022] [Indexed: 12/16/2022] Open
Abstract
Background After almost three decades of ICD-10 use for diagnostic purposes, the World Health Organization has conducted a systematic and elaborate evaluation to revise the classification of mental disorders in this system. This revision resulted in the 11th version (ICD-11), introduced in 2022. As one new feature, the ICD-11 forms a new grouping of mental disorders specifically associated with stress. Method The current review presents an overview of the diagnostic features and cultural specifications of disorders specifically associated with stress. This grouping includes posttraumatic stress disorder and complex posttraumatic stress disorder, prolonged grief disorder, adjustment disorder, as well as two diagnoses for children, reactive attachment disorder and disinhibited social engagement disorder. Results Overall, there is evidence for the improved clinical utility and applicability of these disorders. The disorders have been defined in a parsimonious way by few features, but they suffice for scientific purposes as well. Conclusion However, more research is needed to evaluate assessments for the diagnoses and diagnostic features in the ICD-11.
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17
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Castagnini A, Foldager L, Caffo E, Berrios GE. The predictive validity and outcome of ICD-10 and DSM-5 short-lived psychotic disorders: a review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 2022; 272:1157-1168. [PMID: 34988647 DOI: 10.1007/s00406-021-01356-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 11/08/2021] [Indexed: 11/30/2022]
Abstract
The ICD-10 Classification of Mental and Behavioural Disorders introduced the category of 'acute and transient psychotic disorders' (ATPDs) encompassing polymorphic, schizophrenic and predominantly delusional subtypes, and the forthcoming ICD-11 revision has restricted it to polymorphic psychotic disorder, while the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) listed 'brief psychotic disorder' (BPD). To assess the predictive validity and outcome of ATPDs and BPD, relevant papers in English, French and German were searched in PubMed and Web of Science. Where possible meta-analysis of prognostic validators (diagnostic stability, course, outcome and response to treatment) was conducted. Fifty studies published between January 1993 and July 2019 were found. The clinical and functional outcome of ATPDs proved better than in schizophrenia and related disorders, but mortality risk is high, particularly suicide, and treatment trials provide little evidence. Meta-analysis of 25 studies (13,507 cases) revealed that 55% (95% CI 49-62) do not change diagnosis, 25% (95% CI 20-31) converted into schizophrenia and related disorders, and 12% (95% CI 7-16) into affective disorders on average over 6.3 years. Subgroup meta-analysis estimated prospective consistency of polymorphic psychotic disorder (55%; 95% CI 52-58) significantly greater than that of the ATPD subtypes with schizophrenic (OR 1.7; 95% CI 1.4-2.0) and predominantly delusional (OR 1.3; 95% CI 1.1-1.5) symptoms. Moreover, the diagnostic stability of BPD (13 studies; 294 cases) was 45% (95% CI 32-50) over a mean 4.2 years. Although these findings indicate that short-lived psychotic disorders have little predictive validity, significant differences among the ATPD subtypes support the revised ICD-11 ATPD category.
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Affiliation(s)
- Augusto Castagnini
- School of Child Neuropsychiatry, University of Modena and Reggio Emilia, Modena, Italy.
| | - Leslie Foldager
- Health Research Unit, Department of Animal Science, Aarhus University, Tjele, Denmark.,Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Ernesto Caffo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - German E Berrios
- Department of Psychiatry and Robinson College, University of Cambridge, Cambridge, UK
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18
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Kalmady SV, Paul AK, Narayanaswamy JC, Agrawal R, Shivakumar V, Greenshaw AJ, Dursun SM, Greiner R, Venkatasubramanian G, Reddy YCJ. Prediction of Obsessive-Compulsive Disorder: Importance of Neurobiology-Aided Feature Design and Cross-Diagnosis Transfer Learning. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:735-746. [PMID: 34929344 DOI: 10.1016/j.bpsc.2021.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/25/2021] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Machine learning applications using neuroimaging provide a multidimensional, data-driven approach that captures the level of complexity necessary for objectively aiding diagnosis and prognosis in psychiatry. However, models learned from small training samples often have limited generalizability, which continues to be a problem with automated diagnosis of mental illnesses such as obsessive-compulsive disorder (OCD). Earlier studies have shown that features incorporating prior neurobiological knowledge of brain function and combining brain parcellations from various sources can potentially improve the overall prediction. However, it is unknown whether such knowledge-driven methods can provide a performance that is comparable to state-of-the-art approaches based on neural networks. METHODS In this study, we apply a transparent and explainable multiparcellation ensemble learning framework EMPaSchiz (Ensemble algorithm with Multiple Parcellations for Schizophrenia prediction) to the task of predicting OCD, based on a resting-state functional magnetic resonance imaging dataset of 350 subjects. Furthermore, we apply transfer learning using the features found effective for schizophrenia to OCD to leverage the commonality in brain alterations across these psychiatric diagnoses. RESULTS We show that our knowledge-based approach leads to a prediction performance of 80.3% accuracy for OCD diagnosis that is better than domain-agnostic and automated feature design using neural networks. Furthermore, we show that a selection of reduced feature sets can be transferred from schizophrenia to the OCD prediction model without significant loss in prediction performance. CONCLUSIONS This study presents a machine learning framework for OCD prediction with neurobiology-aided feature design using resting-state functional magnetic resonance imaging that is generalizable and reasonably interpretable.
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Affiliation(s)
- Sunil Vasu Kalmady
- Alberta Machine Intelligence Institute, Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada; Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.
| | - Animesh Kumar Paul
- Alberta Machine Intelligence Institute, Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada
| | - Janardhanan C Narayanaswamy
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Rimjhim Agrawal
- Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Venkataram Shivakumar
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Andrew J Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Serdar M Dursun
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Russell Greiner
- Alberta Machine Intelligence Institute, Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada; Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ganesan Venkatasubramanian
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
| | - Y C Janardhan Reddy
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
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19
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Gaebel W, Salveridou-Hof E. Reinventing schizophrenia: Updating the construct - Primary schizophrenia 2021 - The road ahead. Schizophr Res 2022; 242:27-29. [PMID: 35033393 DOI: 10.1016/j.schres.2021.12.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 02/06/2023]
Affiliation(s)
- Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-Klinikum Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany; WHO Collaborating Centre on Quality Assurance and Empowerment in Mental Health DEU-131, LVR-Klinikum Düsseldorf, Germany.
| | - Eva Salveridou-Hof
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-Klinikum Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany; WHO Collaborating Centre on Quality Assurance and Empowerment in Mental Health DEU-131, LVR-Klinikum Düsseldorf, Germany
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20
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Robles R, de la Peña FR, Medina-Mora ME, de Los Dolores Márquez-Caraveo ME, Domínguez T, Juárez F, Rojas AG, Sarmiento-Hernández EI, Feria M, Sosa L, Aguerre RE, Ortiz S, Real T, Rebello T, Sharan P, Reed GM. ICD-11 Guidelines for Mental and Behavioral Disorders of Children and Adolescents: Reliability and Clinical Utility. Psychiatr Serv 2022; 73:396-402. [PMID: 34433288 DOI: 10.1176/appi.ps.202000830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE ICD-11 clinical guidelines for mental and behavioral disorders must be tested in clinical settings to guarantee their usefulness worldwide. The purpose of this study was to evaluate interrater reliability and clinical utility of the ICD-11 guidelines for children and adolescents in assessing and diagnosing mood, anxiety, and fear-related disorders; attention-deficit hyperactivity disorder (ADHD); and disruptive behavioral disorder (DBD). METHODS Children and adolescents ages 6-17 from two specialized settings in Mexico City were interviewed. Each was interviewed by a pair of psychiatrists (interviewer and observer), who independently codified established diagnoses and evaluated the clinical utility of the guidelines with each participant. Kappa values were calculated to determine the level of general diagnostic correlation between the two clinicians. RESULTS A total of 25 psychiatrists evaluated 52 children and adolescents. Kappa values between clinicians ranged from 0.46 to 0.53 for mood, anxiety, and fear-related disorders and for ADHD; the kappa value was 0.81 for DBD guidelines. Over 80% of psychiatrists reported that the guidelines, qualifiers, and descriptions of developmental presentations were quite useful. CONCLUSIONS ICD-11 guidelines for mental and behavioral disorders of children and adolescents demonstrated mostly moderate interrater reliability and strong interrater reliability in the case of DBD. A large proportion of clinicians regarded the guidelines as quite useful clinical tools.
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Affiliation(s)
- Rebeca Robles
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - Francisco R de la Peña
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - María Elena Medina-Mora
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - María Elena de Los Dolores Márquez-Caraveo
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - Tecelli Domínguez
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - Francisco Juárez
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - Armida Granados Rojas
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - Emmanuel Isaías Sarmiento-Hernández
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - Miriam Feria
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - Liz Sosa
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - Romina E Aguerre
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - Silvia Ortiz
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - Tania Real
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - Tahilia Rebello
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - Patrap Sharan
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
| | - Geoffrey M Reed
- Centro de Investigación en Salud Mental Globa (Robles, Medina-Mora, Domínguez, Real), Unidad de Fomento a la Investigación (de la Peña), Dirección de Investigaciones Epidemiológicas y Psicosociales (Domínguez, Juárez), and Clínica de la Adolescencia, Dirección de Servicios Clínicos (Feria, Sosa, Aguerre), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México; Departamento de Psiquiatría y Salud Mental, Universidad Nacional Autónoma de México, Ciudad de México (Medina-Mora, Ortiz); Departamento de Investigación (de los Dolores Márquez-Caraveo), Departamento de Enseñanza (Rojas), and Direción General (Sarmiento-Hernández), Hospital Psiquiátrico Infantil "Dr. Juan N. Navarro," Ciudad de México; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Rebello, Reed); National Drug Dependence Treatment Centre, World Health Organization Collaborating Centre on Substance Abuse, All India Institute of Medical Sciences, Ansari Nagar, India (Sharan)
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21
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Blair RJR, Mathur A, Haines N, Bajaj S. Future directions for cognitive neuroscience in psychiatry: recommendations for biomarker design based on recent test re-test reliability work. Curr Opin Behav Sci 2022. [DOI: 10.1016/j.cobeha.2022.101102] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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22
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Korwisi B, Garrido Suárez BB, Goswami S, Gunapati NR, Hay G, Hernández Arteaga MA, Hill C, Jones D, Joshi M, Kleinstäuber M, López Mantecón AM, Nandi G, Papagari CSR, Rabí Martínez MDC, Sarkar B, Swain N, Templer P, Tulp M, White N, Treede RD, Rief W, Barke A. Reliability and clinical utility of the chronic pain classification in the 11th Revision of the International Classification of Diseases from a global perspective: results from India, Cuba, and New Zealand. Pain 2022; 163:e453-e462. [PMID: 34393200 DOI: 10.1097/j.pain.0000000000002379] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/11/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Chronic pain affects 1 in 5 persons and contributes substantially to the global burden of disease. The 11th Revision of the International Classification of Diseases (ICD-11) includes a comprehensive classification of chronic pain. The aim of this ecological implementation field study was to evaluate the classification's interrater reliability and clinical utility in countries with different income levels. The study was conducted in 4 pain clinics in Cuba, India, and New Zealand. Twenty-one clinicians used the ICD-11 to diagnose and code n = 353 patients with chronic pain. Of these, 111 were assessed by 2 clinicians, and Fleiss' kappa was calculated to establish interrater reliability for any diagnosis assigned to ≥15 patients. The clinicians rated the clinical utility of all diagnoses. The interrater reliability could be calculated for 11 diagnoses. It was substantial for 10 diagnoses and moderate for 1 (kappa: 0.596-0.783). The mean clinical utility of the ICD-11 chronic pain diagnoses was rated as 8.45 ± 1.69/10. Clinical utility was rated higher for ICD-11 than for the commonly used classification systems (P < 0.001, η2 = 0.25) and differed between all centers (P < 0.001, η2 = 0.60). The utility of the ICD-11 diagnoses was rated higher than the commonly used diagnoses in Dunedin and Havana, and no difference was found in Kolkata and Hyderabad. The study showed the high interrater reliability of the new chronic pain diagnoses. The perceived clinical utility of the diagnoses indicates their superiority or equality compared with the classification systems currently used in pain clinics. These results suggest the global applicability of the classification in specialized pain treatment settings.
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Affiliation(s)
- Beatrice Korwisi
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Bárbara Beatriz Garrido Suárez
- Department of Pharmacology, Institute of Marine Science (ICIMAR), Havana, Cuba
- Pain Clinic, Hospital 10 de Octubre, Havana, Cuba
| | - Subrata Goswami
- ESI Institute of Pain Management, ESI Hospital Sealdah, Kolkata, India
| | | | - Ginea Hay
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | | | - Charlotte Hill
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | - David Jones
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | | | - Maria Kleinstäuber
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
- Department of Psychological Medicine, Otago Medical School-Dunedin Campus, University of Otago, Dunedin, New Zealand
| | - Ana Marta López Mantecón
- Pain Clinic, Hospital 10 de Octubre, Havana, Cuba
- Rheumatological Disease Reference Centre, Hospital 10 de Octubre, Havana, Cuba
| | - Gargi Nandi
- ESI Institute of Pain Management, ESI Hospital Sealdah, Kolkata, India
| | | | | | - Biplab Sarkar
- ESI Institute of Pain Management, ESI Hospital Sealdah, Kolkata, India
| | - Nicola Swain
- Department of Psychological Medicine, Otago Medical School-Dunedin Campus, University of Otago, Dunedin, New Zealand
| | - Paul Templer
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | - Maartje Tulp
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | - Naomi White
- Persistent Pain Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | - Rolf-Detlef Treede
- Mannheim Center for Translational Neuroscience (MCTN), Department of Neurophysiology, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany
| | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany
| | - Antonia Barke
- Division of Clinical and Biological Psychology, Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Ingolstadt, Germany
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23
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Watson D, Levin-Aspenson HF, Waszczuk MA, Conway CC, Dalgleish T, Dretsch MN, Eaton NR, Forbes MK, Forbush KT, Hobbs KA, Michelini G, Nelson BD, Sellbom M, Slade T, South SC, Sunderland M, Waldman I, Witthöft M, Wright AGC, Kotov R, Krueger RF. Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): III. Emotional dysfunction superspectrum. World Psychiatry 2022; 21:26-54. [PMID: 35015357 PMCID: PMC8751579 DOI: 10.1002/wps.20943] [Citation(s) in RCA: 100] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a quantitative nosological system that addresses shortcomings of traditional mental disorder diagnoses, including arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, substantial heterogeneity within disorders, and diagnostic unreliability over time and across clinicians. This paper reviews evidence on the validity and utility of the internalizing and somatoform spectra of HiTOP, which together provide support for an emotional dysfunction superspectrum. These spectra are composed of homogeneous symptom and maladaptive trait dimensions currently subsumed within multiple diagnostic classes, including depressive, anxiety, trauma-related, eating, bipolar, and somatic symptom disorders, as well as sexual dysfunction and aspects of personality disorders. Dimensions falling within the emotional dysfunction superspectrum are broadly linked to individual differences in negative affect/neuroticism. Extensive evidence establishes that dimensions falling within the superspectrum share genetic diatheses, environmental risk factors, cognitive and affective difficulties, neural substrates and biomarkers, childhood temperamental antecedents, and treatment response. The structure of these validators mirrors the quantitative structure of the superspectrum, with some correlates more specific to internalizing or somatoform conditions, and others common to both, thereby underlining the hierarchical structure of the domain. Compared to traditional diagnoses, the internalizing and somatoform spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and greater clinical applicability. Validated measures are currently available to implement the HiTOP system in practice, which can make diagnostic classification more useful, both in research and in the clinic.
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Affiliation(s)
- David Watson
- Department of Psychology, University of Notre Dame, South Bend, IN, USA
| | | | - Monika A Waszczuk
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | | | - Tim Dalgleish
- Medical Research Council, Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Michael N Dretsch
- US Army Medical Research Directorate - West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, WA, USA
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Miriam K Forbes
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Kelsey A Hobbs
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Giorgia Michelini
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Brady D Nelson
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Martin Sellbom
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Susan C South
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Irwin Waldman
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Michael Witthöft
- Department for Clinical Psychology, Psychotherapy, and Experimental Psychopathology, University of Mainz, Mainz, Germany
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
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24
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Robles-García R, Fresán A, Real T, Domínguez-Martínez T, Rascón ML, Hernández O, Muñoz C, González A, Brunet F, Balaige A, Askevis-Leherpeux F, Medina-Mora ME, Roelandt JL. Accessibility, acceptability, and adequacy of schizophrenia definition according to experts by experience: an ICD-11 field study of patients and relative caregivers in Mexico. PSYCHOSIS 2022. [DOI: 10.1080/17522439.2020.1807591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Rebeca Robles-García
- Global Mental Health Research Center, National Institute of Psychiatry, Mexico City, Mexico
| | - Ana Fresán
- Subdirectorate of Clinical Research, National Institute of Psychiatry, Mexico City, Mexico
| | - Tania Real
- Global Mental Health Research Center, National Institute of Psychiatry, Mexico City, Mexico
| | - Tecelli Domínguez-Martínez
- Directorate of Epidemiological and Psychosocial Research, National Institute of Psychiatry, Mexico City, Mexico
| | - María Luisa Rascón
- Directorate of Epidemiological and Psychosocial Research, National Institute of Psychiatry, Mexico City, Mexico
| | - Omar Hernández
- Psychology Faculty, Nacional Autonomous University of Mexico, Mexico City, Mexico
| | - Carolina Muñoz
- Psychology Faculty, Nacional Autonomous University of Mexico, Mexico City, Mexico
| | - Alejandra González
- Sistema Nacional De Investigadores (Research Assistant), National Council of Science and Technology, Mexico City, Mexico
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25
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Burns SC, Kogan CS, Heyman RE, Foran HM, Smith Slep AM, Dominguez-Martinez T, Grenier J, Matsumoto C, Reed GM. Exploring Mental Health Professionals' Experiences of Intimate Partner Violence-Related Training: Results From a Global Survey. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:124-150. [PMID: 32125216 DOI: 10.1177/0886260520908020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Intimate partner violence (IPV) is a global public health problem that has been shown to lead to serious mental health consequences. Due to its frequent co-occurrence with psychiatric disorders, it is important to assess for IPV in mental health settings to improve treatment planning and referral. However, lack of training in how to identify and respond to IPV has been identified as a barrier for the assessment of IPV. The present study seeks to better understand this IPV-related training gap by assessing global mental health professionals' experiences of IPV-related training and factors that contribute to their likelihood of receiving training. Participants were French-, Spanish-, and Japanese-speaking psychologists and psychiatrists (N = 321) from 24 nations differing on variables related to IPV, including IPV prevalence, IPV-related norms, and IPV-related laws. Participants responded to an online survey asking them to describe their experiences of IPV-related training (i.e., components and hours of training) and were asked to rate the frequency with which they encountered IPV in clinical practice and their level of knowledge and experience related to relationship problems; 53.1% of participants indicated that they had received IPV-related training. Clinicians from countries with relatively better implemented laws addressing IPV and those who encountered IPV more often in their regular practice were more likely to have received training. Participants who had received IPV-related training, relative to those without training, were more likely to report greater knowledge and experience related to relationship problems. Findings suggest that clinicians' awareness of IPV and the institutional context in which they practice are related to training. Training, in turn, is associated with subjective appraisals of knowledge and experience related to relationship problems. Increasing institutional efforts to address IPV (e.g., implementing IPV legislation) may contribute to improved practices with regard to IPV in mental health settings.
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Affiliation(s)
| | | | | | | | | | | | - Jean Grenier
- University of Ottawa, Ontario, Canada
- Montfort Hospital, Ottawa, Ontario, Canada
| | | | - Geoffrey M Reed
- Columbia University, New York City, NY, USA
- World Health Organization, Geneva, Switzerland
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26
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Tam WC. Comparison of adult defendants' forensic psychiatric evaluation in criminal courts between Mainland China and Taiwan China: From law to clinical practice. JOURNAL OF FORENSIC SCIENCE AND MEDICINE 2022. [DOI: 10.4103/jfsm.jfsm_76_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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27
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Fusar-Poli P, Salazar de Pablo G, Rajkumar RP, López-Díaz Á, Malhotra S, Heckers S, Lawrie SM, Pillmann F. Diagnosis, prognosis, and treatment of brief psychotic episodes: a review and research agenda. Lancet Psychiatry 2022; 9:72-83. [PMID: 34856200 DOI: 10.1016/s2215-0366(21)00121-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 03/01/2021] [Accepted: 03/18/2021] [Indexed: 12/25/2022]
Abstract
Brief psychotic episodes represent an intriguing paradox in clinical psychiatry because they elude the standard knowledge that applies to the persisting psychotic disorders such as schizophrenia. This Review describes key diagnostic considerations such as conceptual foundations, current psychiatric classification versus research-based operationalisations, epidemiology, and sociocultural variations; prognostic aspects including the risk of psychosis recurrence, types of psychotic recurrences, other clinical outcomes, prognostic factors; and therapeutic issues such as treatment guidelines and unmet need of care. The advances and challenges associated with the scientific evidence are used to set a research agenda in this area. We conclude that brief psychotic episodes can be reconceptualised within a clinical staging model to promote innovative translational research and improve our understanding and treatment of psychotic disorders.
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Affiliation(s)
- Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK; Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERSAM, Madrid, Spain
| | - Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Álvaro López-Díaz
- University Hospital Virgen Macarena, Seville, Spain; Institute of Biomedicine of Seville, Seville, Spain
| | | | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Frank Pillmann
- WO Center of Psychiatry, Halle, Germany; Martin Luther University, Halle-Wittenberg, Germany
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28
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The latent structure of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD in a general population sample from USA: A factor mixture modelling approach. J Anxiety Disord 2022; 85:102497. [PMID: 34785481 DOI: 10.1016/j.janxdis.2021.102497] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/13/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022]
Abstract
The validity of ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD), as measured by the International Trauma Questionnaire (ITQ; Cloitre et al., 2018) has been supported in many factor analytic and mixture modelling studies. There is, however, a paucity of research investigating the latent structure of the ITQ using factor mixture modelling (FMM). FMM was applied to data collected from a nationally representative sample of U.S. adults (N = 1834). FMM results demonstrated strong support for a two-factor second-order model with four qualitatively distinct latent classes: a 'PTSD class', a 'CPTSD class', a 'DSO' (Disturbances in Self-Organisation) class and a 'low symptoms class'. Sexual abuse increased likelihood of membership to the 'CPTSD' (OR = 3.22) and physical abuse decreased likelihood of membership to the 'PTSD' (OR=0.51). Trauma exposure in adulthood predicted 'PTSD' and 'CPTSD' class membership. The 'CPTSD class' was characterised by higher levels of psychopathological co-morbidities and poorer psychological wellbeing compared to all other classes. Results provide additional support for the validity of PTSD and CPTSD as measured by the ITQ.
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29
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Valle R. Validity, reliability and clinical utility of mental disorders: The case of ICD-11 schizophrenia. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:61-70. [PMID: 35210207 DOI: 10.1016/j.rcpeng.2020.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/09/2020] [Indexed: 06/14/2023]
Abstract
Diagnostic classification systems categorise mental psychopathology in mental disorders. Although these entities are clinical constructs developed by consensus, it has been pointed out that in practice they are usually managed as natural entities and without evaluating aspects related to their nosological construction. The objectives of the study are to review a) the conceptualisation of mental disorders, b) the indicators of validity, reliability and clinical utility, and c) the values of these indicators in ICD-11 schizophrenia. The results show that mental disorders are conceptualised as discrete entities, like the diseases of other areas of medicine; however, differences are observed between these diagnostic categories in clinical practice. The reliability and clinical utility of mental disorders are adequate; however, the validity is not yet clarified. Similarly, ICD-11 schizophrenia demonstrates adequate reliability and clinical utility, but its validity remains uncertain. The conceptualisation of psychopathology in discrete entities may be inadequate for its study, therefore dimensional and mixed models have been proposed. The indicators of validity, reliability and clinical utility enable us to obtain an accurate view of the nosological state of mental disorders when evaluating different aspects of their nosological construction.
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Affiliation(s)
- Rubén Valle
- Centro de Investigación en Epidemiología Clínica y Medicina Basada en Evidencias, Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Peru; DEIDAE de Adultos y Adultos Mayores, Instituto Nacional de Salud Mental Honorio Delgado-Hideyo Noguchi, Lima, Peru.
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30
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Nestgaard Rød Å, Schmidt C. Complex PTSD: what is the clinical utility of the diagnosis? Eur J Psychotraumatol 2021; 12:2002028. [PMID: 34912502 PMCID: PMC8667899 DOI: 10.1080/20008198.2021.2002028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 10/07/2021] [Indexed: 11/11/2022] Open
Abstract
Background The diagnosis of complex posttraumatic stress disorder (CPTSD) was included in the 11th revised edition of the International Classification of Diseases (ICD-11). CPTSD shares trauma-specific symptoms with its sibling disorder PTSD but is additionally characterized by disturbances of the individual's self-organization (DSO). The clinical utility of the CPTSD diagnosis has yet to be thoroughly investigated. Objective The current study aimed to examine the clinical utility of the CPTSD diagnosis, considering the upcoming implementation of ICD-11 in clinical practice. Method International field studies, construct- and validity analyses leading up to the inclusion in ICD-11 are reviewed, and the diagnostic measures; International Trauma Questionnaire (ITQ) and International Trauma Interview (ITI) are presented. Also, the relationship between CPTSD and borderline personality disorder (BPD) is elaborated in an independent analysis, to clarify their differences in clinical relevance to treatment. Treatment implications for CPTSD are discussed with reference to existing guidelines and clinical needs. Results The validation of ITQ and ITI contributes to the cementation of CPTSD in further clinical practice, providing qualified assessment of the construct, with intended informative value for both clinical communication and facilitation of treatment. CPTSD is found distinguishable from both PTSD and BPD in empirical studies, while the possibility of comorbid BPD/PTSD cases being better described as CPTSD is acknowledged. Practitioners need to employ well-established methods developed for PTSD, while considering additional DSO-symptoms in treatment of CPTSD. Conclusions The inclusion of CPTSD in ICD-11 may potentially facilitate access to more tailored treatment interventions, as well as contribute to increased research focus on disorders specifically associated with stress. The clinical utility value of this additional diagnosis is expected to reveal itself further after ICD-11 is implemented in clinical practice in 2022 and onwards. Yet, CPTSD's diagnostic inclusion gives future optimism to assessing and treating complex posttraumatic stress symptoms.
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Affiliation(s)
- Åshild Nestgaard Rød
- Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Casper Schmidt
- Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
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Kogan CS, Maj M, Rebello TJ, Keeley JW, Kulygina M, Matsumoto C, Robles R, Huang J, Zhong N, Chakrabarti S, Figueira ML, Stein DJ, Strakowski SM, Garcia-Pacheco JA, Burns S, Montoya M, Andrade L, Ayuso-Mateos JL, Arango I, Balhara YPS, Bryant R, Cournos F, Porto JAD, Meyer TD, Medina-Mora ME, Gureje O, First MB, Gaebel W, Khoury B, Krasnov VN, de Jesus Mari J, Maruta T, Pike KM, Roberts MC, Sharan P, Zhao M, Reed GM. A global field study of the international classification of diseases (ICD-11) mood disorders clinical descriptions and diagnostic guidelines. J Affect Disord 2021; 295:1138-1150. [PMID: 34706426 DOI: 10.1016/j.jad.2021.08.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/18/2021] [Accepted: 08/21/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND We report results of an internet-based field study evaluating the diagnostic guidelines for ICD-11 mood disorders. Accuracy of clinicians' diagnostic judgments applying draft ICD-11 as compared to the ICD-10 guidelines to standardized case vignettes was assessed as well as perceived clinical utility. METHODS 1357 clinician members of the World Health Organization's Global Clinical Practice Network completed the study in English, Spanish, Japanese or Russian. Participants were randomly assigned to apply ICD-11 or ICD-10 guidelines to one of eleven pairs of case vignettes. RESULTS Clinicians using the ICD-11 and ICD-10 guidelines achieved similar levels of accuracy in diagnosing mood disorders depicted in vignettes. Those using the ICD-11 were more accurate in identifying depressive episode in recurrent depressive disorder. There were no statistically significant differences detected across classifications in the accuracy of identifying dysthymic or cyclothymic disorder. Circumscribed problems with the proposed ICD-11 guidelines were identified including difficulties differentiating bipolar type I from bipolar type II disorder and applying revised severity ratings to depressive episodes. Clinical utility of ICD-11 bipolar disorders was found to be significantly lower than for ICD-10 equivalent categories. LIMITATIONS Standardized case vignettes were manipulated to evaluate specific changes. The degree of accuracy of clinicians' diagnostic judgments may not reflect clinical decision-making with patients. CONCLUSIONS Alignment of the ICD-11 with current research appears to have been achieved without sacrificing diagnostic accuracy or clinical utility though specific training may be necessary as ICD-11 is implemented worldwide. Areas in which the ICD-11 guidelines did not perform as intended resulted in further revisions.
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Affiliation(s)
- Cary S Kogan
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier Pvt., Vanier Building, Ottawa, Ontario K1N 6N5, Canada.
| | - Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Tahilia J Rebello
- Global Mental Health Program, Columbia University and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, 800 W. Franklin Street, P.O. Box 842018, Richmond, VA, 23284-2018, USA
| | - Maya Kulygina
- Moscow Research Institute of Psychiatry, Poteshnaya 3, 107076, Moscow, Russian Federation
| | - Chihiro Matsumoto
- National Study Coordinator for ICD-11 Field Studies, ICD-11 Committee, Japanese Society of Psychiatry and Neurology, Hongo-Yumicho Building, 2-38-4, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Rebeca Robles
- Instituto Nacional de Psiquiatría 'Ramón de la Fuente', WHO Collaborating Centre on Addictions and Mental Health, Calzada Mexico-Xochimilco 101, Tlalpan, ZC 14370, Ciudad de México, Mexico
| | - Jingjing Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, WHO Collaborating Centre for Research and Training in Mental Health, 600 Wan Ping Nan Rd., Shanghai, 200030, People's Republic of China
| | - Na Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, WHO Collaborating Centre for Research and Training in Mental Health, 600 Wan Ping Nan Rd., Shanghai, 200030, People's Republic of China
| | - Subho Chakrabarti
- Dept. Of Psychiatry, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, - 160012, India
| | - Maria Luisa Figueira
- Department of Psychiatry, Faculty of Medicine, University of Lisbon, 1699, Lisboa Codex, Portugal
| | - Dan J Stein
- Department of Psychiatry, University of Cape Town and Groote Schuur Hospital, J-Block, Anzio Road, Observatory 7925, South Africa
| | - Stephen M Strakowski
- Dell Medical School, University of Texas at Austin, Health Learning Building, 1501 Red River St., Austin, Texas, 78712, USA
| | - José A Garcia-Pacheco
- Centro de Investigación y Docencia Económica, Carr. México-Toluca 3655, Santa Fe, Altavista, Álvaro Obregón, 01210, Ciudad de México, México
| | - Samantha Burns
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier Pvt., Vanier Building, Ottawa, Ontario K1N 6N5, Canada
| | - Madeline Montoya
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier Pvt., Vanier Building, Ottawa, Ontario K1N 6N5, Canada
| | - Laura Andrade
- Institute of Psychiatry, School of Medicine, University of São Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, 01246903, Brazil
| | - José L Ayuso-Mateos
- Department of Psychiatry, Universidad Autonoma de Madrid; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Instituto de Investigación Sanitaria La Princesa, Madrid, Spain
| | - Ivan Arango
- Instituto Nacional de Psiquiatría 'Ramón de la Fuente', WHO Collaborating Centre on Addictions and Mental Health, Calzada Mexico-Xochimilco 101, Tlalpan, ZC 14370, Ciudad de México, Mexico
| | - Yatan Pal Singh Balhara
- National Drug Dependence Treatment Center and Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | | | - Francine Cournos
- Departments of Epidemiology and Psychiatry, Columbia University Medical Center, 722 West 168th St, 10032, New York, NY
| | - José Alberto Del Porto
- Department of Psychiatry, Universidade Federal de São Paulo, Rua Borges Lagoa 570 - 1° andar, Vila Clementino- São Paulo-SP, 04038-000, Brazil
| | - Thomas D Meyer
- Faillace Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas HSC at Houston, 1941 East Road, Houston, Texas, 77054, USA
| | - Maria-Elena Medina-Mora
- The Health Management Center, Seitoku University, 550 Iwase, Matsudo City, Chiba Prefecture, 271-8555, Japan
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, University College Hospital, PMB, 5116 Ibadan, Nigeria
| | - Michael B First
- Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, 722 West 168th St, 10032, New York, NY
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, WHO Collaborating Centre for Quality Assurance and Empowerment in Mental Health, Bergische Landstr. 2, 40629, Düsseldorf, Germany
| | - Brigitte Khoury
- Department of Psychiatry, American University of Beirut Medical Center, P.O. Box 11-0236 - Riad El Solh 1107 2020 Beirut, Lebanon
| | - Valery N Krasnov
- Moscow Research Institute of Psychiatry, Poteshnaya 3, 107076, Moscow, Russian Federation
| | - Jair de Jesus Mari
- Department of Psychiatry, Universidade Federal de São Paulo, Rua Borges Lagoa 570 - 1° andar, Vila Clementino- São Paulo-SP, 04038-000, Brazil
| | - Toshimasa Maruta
- The Health Management Center, Seitoku University, 550 Iwase, Matsudo City, Chiba Prefecture, 271-8555, Japan
| | - Kathleen M Pike
- Global Mental Health Program, Columbia University and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Michael C Roberts
- University of Kansas, Clinical Child Psychology Program, Dole Human Development Center, Lawrence, KS, 66045, USA
| | - Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, WHO Collaborating Centre for Research and Training in Mental Health, 600 Wan Ping Nan Rd., Shanghai, 200030, People's Republic of China
| | - Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA, and Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
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Ede MO, Okeke CI, Igbo JN, Aye E. Testing the efficacy of group cognitive-behavioral therapy for pathological internet use among undergraduates in Nigeria. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2021; 45:e20210348. [PMID: 34842397 PMCID: PMC9991421 DOI: 10.47626/2237-6089-2021-0348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 11/18/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The aim of this study was to examine the effect of group cognitive-behavioral therapy (GCBT) on pathological internet use (PIU). METHOD The study applied a group randomized controlled trial design to assign participants to intervention and control groups. A total of 40 college students aged 18 to 30 who were pathological internet users (PIUs) participated in this study and were randomly assigned to treatment and control groups. Participants completed a self-report scale entitled the Problematic Internet Use Scale (PIUS) at three time points. The intervention lasted 8 weeks. The data collected were statistically analyzed using repeated-measures analysis of variance (ANOVA). RESULTS The results showed that GCBT has significant efficacy, decreasing the symptoms of PIU among the GCBT participants compared to those in the control group and that the improvements were maintained at follow-up. We also found a significant interaction effect by time for PIU. CONCLUSION From the study findings, we can conclude that GCBT has significant benefit for mitigating the severity of PIU in college students. Therefore, mental health professionals are encouraged to explore the benefits of GCBT in treating symptoms associated with PIU in school settings and beyond.
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Affiliation(s)
- Moses Onyemaechi Ede
- Department of Education FoundationsFaculty of EducationUniversity of the Free StateBloemfonteinSouth Africa Department of Education Foundations, Faculty of Education, University of the Free State, Bloemfontein, South Africa.
| | - Chinedu Ifedi Okeke
- Department of Education FoundationsFaculty of EducationUniversity of the Free StateBloemfonteinSouth Africa Department of Education Foundations, Faculty of Education, University of the Free State, Bloemfontein, South Africa.
| | - Janet N. Igbo
- Department of Educational FoundationsFaculty of EducationUniversity of NigeriaNsukkaEnuguNigeria Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State, Nigeria.
| | - Eucharia Aye
- Department of Educational FoundationsFaculty of EducationUniversity of NigeriaNsukkaEnuguNigeria Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State, Nigeria.
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Gaebel W. Auf dem Weg zur ICD-11. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2021; 49:413-415. [PMID: 34766832 DOI: 10.1024/1422-4917/a000836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Wolfgang Gaebel
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, LVR-Klinikum Düsseldorf/Klinken der Heinrich-Heine-Universität Düsseldorf
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Provenzani U, Salazar de Pablo G, Arribas M, Pillmann F, Fusar-Poli P. Clinical outcomes in brief psychotic episodes: a systematic review and meta-analysis. Epidemiol Psychiatr Sci 2021; 30:e71. [PMID: 35698876 PMCID: PMC8581951 DOI: 10.1017/s2045796021000548] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 12/25/2022] Open
Abstract
AIMS Patients with brief psychotic episodes (BPE) have variable and fluctuating clinical outcomes which challenge psychiatric care. Our meta-analysis aims at providing a comprehensive summary of several clinical outcomes in this patient group. METHODS A multistep systematic PRISMA/MOOSE-compliant literature search was performed for articles published from inception until 1st March 2021. Web of Science database was searched, complemented by manual search of original articles reporting relevant outcomes (psychotic recurrence, prospective diagnostic change or stability, remission, quality of life, functional status, mortality and their predictors) for patients diagnosed with acute and transient psychotic disorders (ATPD), brief psychotic disorders (BPD), brief intermittent psychotic symptoms (BIPS) and brief limited intermittent psychotic symptoms (BLIPS). Random-effects methods and Q-statistics were employed, quality assessment with Newcastle-Ottawa Scale, assessment of heterogeneity with I2 index, sensitivity analyses (acute polymorphic psychotic disorders, APPD) and multiple meta-regressions, assessment of publication bias with funnel plot, Egger's test and meta-regression (psychotic recurrence and sample size). RESULTS A total of 91 independent articles (n = 94 samples) encompassed 37 ATPD, 24 BPD, 19 BLIPS and 14 BIPS samples, totalling 15 729 individuals (mean age: 30.89 ± 7.33 years, mean female ratio: 60%, 59% conducted in Europe). Meta-analytical risk of psychotic recurrence for all BPE increased from 15% (95% confidence interval (CI) 12-18) at 6 months, 25% (95% CI 22-30) at 12 months, 30% (95% CI 27-33) at 24 months and 33% (95% CI 30-37) at ⩾36 months follow-up, with no differences between ATPD, BPD, BLIPS and BIPS after 2 years of follow-up. Across all BPE, meta-analytical proportion of prospective diagnostic stability (average follow-up 47 months) was 49% (95% CI 42-56); meta-analytical proportion of diagnostic change (average follow-up 47 months) to schizophrenia spectrum psychoses was 19% (95% CI 16-23), affective spectrum psychoses 5% (95% CI 3-7), other psychotic disorders 7% (95% CI 5-9) and other (non-psychotic) mental disorders 14% (95% CI 11-17). Prospective diagnostic change within APPD without symptoms of schizophrenia was 34% (95% CI 24-46) at a mean follow-up of 51 months: 18% (95% CI 11-30) for schizophrenia spectrum psychoses and 17% (95% CI 10-26) for other (non-psychotic) mental disorders. Meta-analytical proportion of baseline employment was 48% (95% CI 38-58), whereas there were not enough data to explore the other outcomes. Heterogeneity was high; female ratio and study quality were negatively and positively associated with risk of psychotic recurrence, respectively. There were no consistent factor predicting clinical outcomes. CONCLUSIONS Short-lived psychotic episodes are associated with a high risk of psychotic recurrences, in particular schizophrenia spectrum disorders. Other clinical outcomes remain relatively underinvestigated. There are no consistent prognostic/predictive factors.
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Affiliation(s)
- U. Provenzani
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - G. Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - M. Arribas
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - F. Pillmann
- AWO Center of Psychatry, Halle, Germany
- Martin Luther University Halle-Wittenberg, Halle, Germany
| | - P. Fusar-Poli
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Outreach and Support in South London (OASIS) service, South London and Maudsley NHS Foundation Trust, London, UK
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Gaebel W, Stricker J, Kerst A. Changes from ICD-10 to ICD-11 and future directions in psychiatric classification
. DIALOGUES IN CLINICAL NEUROSCIENCE 2021; 22:7-15. [PMID: 32699501 PMCID: PMC7365296 DOI: 10.31887/dcns.2020.22.1/wgaebel] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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.
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Affiliation(s)
- Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-Klinikum Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany; WHO Collaborating Centre for Quality Assurance and Empowerment in Mental Health, Düsseldorf, Germany
| | - Johannes Stricker
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-Klinikum Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany; WHO Collaborating Centre for Quality Assurance and Empowerment in Mental Health, Düsseldorf, Germany
| | - Ariane Kerst
- Department of Psychiatry and Psychotherapy, Medical Faculty, LVR-Klinikum Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany; WHO Collaborating Centre for Quality Assurance and Empowerment in Mental Health, Düsseldorf, Germany
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Fusar‐Poli P, Correll CU, Arango C, Berk M, Patel V, Ioannidis JP. Preventive psychiatry: a blueprint for improving the mental health of young people. World Psychiatry 2021; 20:200-221. [PMID: 34002494 PMCID: PMC8129854 DOI: 10.1002/wps.20869] [Citation(s) in RCA: 184] [Impact Index Per Article: 61.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Preventive approaches have latterly gained traction for improving mental health in young people. In this paper, we first appraise the conceptual foundations of preventive psychiatry, encompassing the public health, Gordon's, US Institute of Medicine, World Health Organization, and good mental health frameworks, and neurodevelopmentally-sensitive clinical staging models. We then review the evidence supporting primary prevention of psychotic, bipolar and common mental disorders and promotion of good mental health as potential transformative strategies to reduce the incidence of these disorders in young people. Within indicated approaches, the clinical high-risk for psychosis paradigm has received the most empirical validation, while clinical high-risk states for bipolar and common mental disorders are increasingly becoming a focus of attention. Selective approaches have mostly targeted familial vulnerability and non-genetic risk exposures. Selective screening and psychological/psychoeducational interventions in vulnerable subgroups may improve anxiety/depressive symptoms, but their efficacy in reducing the incidence of psychotic/bipolar/common mental disorders is unproven. Selective physical exercise may reduce the incidence of anxiety disorders. Universal psychological/psychoeducational interventions may improve anxiety symptoms but not prevent depressive/anxiety disorders, while universal physical exercise may reduce the incidence of anxiety disorders. Universal public health approaches targeting school climate or social determinants (demographic, economic, neighbourhood, environmental, social/cultural) of mental disorders hold the greatest potential for reducing the risk profile of the population as a whole. The approach to promotion of good mental health is currently fragmented. We leverage the knowledge gained from the review to develop a blueprint for future research and practice of preventive psychiatry in young people: integrating universal and targeted frameworks; advancing multivariable, transdiagnostic, multi-endpoint epidemiological knowledge; synergically preventing common and infrequent mental disorders; preventing physical and mental health burden together; implementing stratified/personalized prognosis; establishing evidence-based preventive interventions; developing an ethical framework, improving prevention through education/training; consolidating the cost-effectiveness of preventive psychiatry; and decreasing inequalities. These goals can only be achieved through an urgent individual, societal, and global level response, which promotes a vigorous collaboration across scientific, health care, societal and governmental sectors for implementing preventive psychiatry, as much is at stake for young people with or at risk for emerging mental disorders.
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Affiliation(s)
- Paolo Fusar‐Poli
- Early Psychosis: Interventions and Clinical‐detection (EPIC) Lab, Department of Psychosis StudiesInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK,OASIS Service, South London and Maudsley NHS Foundation TrustLondonUK,Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | - Christoph U. Correll
- Department of PsychiatryZucker Hillside Hospital, Northwell HealthGlen OaksNYUSA,Department of Psychiatry and Molecular MedicineZucker School of Medicine at Hofstra/NorthwellHempsteadNYUSA,Center for Psychiatric NeuroscienceFeinstein Institute for Medical ResearchManhassetNYUSA,Department of Child and Adolescent PsychiatryCharité Universitätsmedizin BerlinBerlinGermany
| | - Celso Arango
- Department of Child and Adolescent PsychiatryInstitute of Psychiatry and Mental Health, Hospital General Universitario Gregorio MarañónMadridSpain,Health Research Institute (IiGSM), School of MedicineUniversidad Complutense de MadridMadridSpain,Biomedical Research Center for Mental Health (CIBERSAM)MadridSpain
| | - Michael Berk
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin UniversityBarwon HealthGeelongVICAustralia,Department of PsychiatryUniversity of MelbourneMelbourneVICAustralia,Orygen Youth HealthUniversity of MelbourneMelbourneVICAustralia,Florey Institute for Neuroscience and Mental HealthUniversity of MelbourneMelbourneVICAustralia
| | - Vikram Patel
- Department of Global Health and Social MedicineHarvard University T.H. Chan School of Public HealthBostonMAUSA,Department of Global Health and PopulationHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - John P.A. Ioannidis
- Stanford Prevention Research Center, Department of MedicineStanford UniversityStanfordCAUSA,Department of Biomedical Data ScienceStanford UniversityStanfordCAUSA,Department of Epidemiology and Population HealthStanford UniversityStanfordCAUSA
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Rebello TJ, Kulygina MA, Krasnov VN, Pike KM, Reed GM. Engagement of Russian Mental Health Professionals in the Development of WHO's ICD-11. CONSORTIUM PSYCHIATRICUM 2021; 2:17-22. [PMID: 39070738 PMCID: PMC11272319 DOI: 10.17816/cp79] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 12/19/2022] Open
Abstract
The World Health Organization (WHO) has officially approved the next version of its global diagnostic system, the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11). Processes to implement the ICD-11 are now underway. Developing the ICD-11 chapter on Mental, Behavioural and Neurodevelopmental Disorders, in line with WHO's core priorities to enhance the clinical utility, reliability, and global applicability of the guidelines, necessitated a large-scale scientifically-rigorous research program. Such a program of global field studies engaged mental health professionals from across the world, with substantial contributions from clinicians in the Russian Federation. This paper systematically highlights the substantive roles played by Russian clinicians in all steps of development of the mental, behavioural, and neurodevelopmental disorder guidelines, including their participation in the following: 1) early formative field studies that informed the organizing principles and overarching structure of the ICD-11; 2) large-scale online studies that used a case-controlled methodology to evaluate the guideline's clinical utility and the accuracy with which the new ICD-11 guidelines could be applied by global clinicians; 3) an online network of mental health professionals who provided direct feedback on the ICD-11 to WHO (also known as the Global Clinical Practice Network, www.globalclinicalpractice.net) with over 16,000 members from 160 countries, and with the Russian Federation being in the top five most represented countries in the network; 4) clinic-based field studies that tested the reliability and clinical utility of the ICD-11 diagnostic guidelines; and 5) development and participation in training programs that prepare clinicians in implementing the diagnostic guidelines in clinical settings. In these many ways, Russian clinicians have substantively and directly contributed to efforts to maximize the clinical usefulness, consistency, acceptability, and applicability of the ICD-11's mental, behavioural, and neurodevelopmental disorder guidelines. This substantial engagement of clinicians will conceivably facilitate the adoption and use of the guidelines by clinicians in the Russian Federation and other Russian-speaking countries, as the ICD-11 is implemented over the coming years.
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Maercker A. Development of the new CPTSD diagnosis for ICD-11. Borderline Personal Disord Emot Dysregul 2021; 8:7. [PMID: 33641675 PMCID: PMC7919312 DOI: 10.1186/s40479-021-00148-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/25/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The diagnosis of complex post-traumatic stress disorder (CPTSD) was proposed several decades ago by scientist-practitioners, almost parallel to the first description of the diagnosis of post-traumatic stress disorder (PTSD). In the previous International Classification of Diseases, version 10 (ICD-10) issued by the World Health Organization (WHO), this symptom constellation was termed 'enduring personality change after catastrophic experience'. This diagnosis has not been clinically influential, nor has it been subjected to much research. Thus, in a multi-stage process of ICD-11 development, the diagnosis of CPTSD was developed. METHODS This paper provides a review of the historical lines of development that led to the CPTSD diagnosis, as well as the results since the ICD-11 publication in 2018. RESULTS The CPTSD diagnosis comprises the core symptoms of the - newly, narrowly defined - PTSD diagnosis, the three symptom groups of affective, relationship, and self-concept changes. The diagnosis is clinically easy to use in accordance with the WHO development goals for the ICD-11 and has shown good psychodiagnostic properties in various studies, including good discrimination from personality disorder with borderline pattern. CONCLUSION The scholarly use of the new diagnosis has resulted in an increasing number of published studies on this topic in the diagnostic and therapeutic fields.
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Affiliation(s)
- Andreas Maercker
- Department of Psychology, Division Psychopathology and Clinical Intervention, University of Zurich, Binzmühlestr. 14/17, 8044, Zurich, Switzerland.
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Killikelly C, Merzhvynska M, Zhou N, Stelzer EM, Hyland P, Rocha J, Ben-Ezra M, Maercker A. Examination of the New ICD-11 Prolonged Grief Disorder Guidelines Across Five International Samples. CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e4159. [PMID: 36397782 PMCID: PMC9667123 DOI: 10.32872/cpe.4159] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/30/2020] [Indexed: 12/20/2022] Open
Abstract
Background Prolonged grief disorder (PGD) is a new disorder included in the 11th edition of the International classification of diseases (ICD-11). An important remit of the new ICD-11 is the global applicability of the mental health disorder guidelines or definitions. Although previous definitions and descriptions of disordered grief have been assessed worldwide, this new definition has not yet been systematically validated. Method Here we assess the validity and applicability of core items of the ICD-11 PGD across five international samples of bereaved persons from Switzerland (N = 214), China (N = 325); Israel (N = 544), Portugal (N = 218) and Ireland (N = 830). Results The results confirm that variation in the diagnostic algorithm for PGD can greatly impact the rates of disorder within and between international samples. Different predictors of PGD severity may be related to sample differences. Finally, a threshold for diagnosis of clinically relevant PGD symptoms using a new scale, the International Prolonged Grief Disorder Scale (IPGDS), in three samples was confirmed. Conclusions Although this study was limited by lack of questionnaire data points across all five samples, the findings for the diagnostic threshold and algorithm iterations have implications for clinical use of the new ICD-11 PGD criteria worldwide.
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Affiliation(s)
- Clare Killikelly
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | | | - Ningning Zhou
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Eva-Maria Stelzer
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Jose Rocha
- Instituto Universitário de Ciências da Saúde, Gandra, Portugal
| | | | - Andreas Maercker
- Department of Psychology, University of Zurich, Zurich, Switzerland
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Roche GC, Fung P, Ransing R, Noor IM, Shalbafan M, El Hayek S, Koh EBY, Gupta AK, Kudva KG. The state of psychiatric research in the Asia Pacific region. Asia Pac Psychiatry 2021; 13:e12432. [PMID: 33145988 DOI: 10.1111/appy.12432] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 10/10/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION This study aims to review recent scientific publications and research output in the field of psychiatry, from a series of countries in the Asia-Pacific region (Australia, India, Indonesia, Iran, Lebanon, Malaysia, and Nepal), with a view to identify themes and similarities across regions, as well as to examine the barriers and challenges in mental health research faced by countries in the region. METHODS Seven psychiatrists from seven countries reviewed recent published and ongoing research in psychiatry in their respective nations, with respect to themes, as well as any barriers or challenges faced by mental health researchers. RESULTS While the seven nations included in this review vary in terms of research capabilities and economic development level, they share many similarities both in terms of research direction, and with regards to challenges faced. Limitations in the form of sociocultural differences from the West, and a lack of funding were some of the barriers identified. DISCUSSION Mental health research in the region has been progressing well. However, more varied research in the form of qualitative or economic studies are lacking, as are multi-center studies. The similar issues that nations face with regards to research could perhaps benefit from collaborative efforts and initiatives for the furtherance of research in the region.
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Affiliation(s)
- Glen Cedric Roche
- Department of Psychological Medicine, Changi General Hospital, Singapore
| | - Paul Fung
- Paramatta Mission, Parramatta, New South Wales, Australia.,Health Education and Training Institute Higher Education, North Paramatta, New South Wales, Australia
| | - Ramdas Ransing
- Department of Psychiatry, BKL Walawalkar Rural Medical College, Ratnagiri, Maharashtra, India
| | - Isa Multazam Noor
- Department of Psychiatry, Dr. Soeharto Heerdjan Mental Hospital, Jakarta, Indonesia
| | - Mohammadreza Shalbafan
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Samer El Hayek
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Eugene Boon Yau Koh
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Kundadak Ganesh Kudva
- Early Psychosis Intervention Programme and East Region, Institute of Mental Health, Singapore
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de Vries ALC, Beek TF, Dhondt K, de Vet HCW, Cohen-Kettenis PT, Steensma TD, Kreukels BPC. Reliability and Clinical Utility of Gender Identity-Related Diagnoses: Comparisons Between the ICD-11, ICD-10, DSM-IV, and DSM-5. LGBT Health 2021; 8:133-142. [PMID: 33600259 DOI: 10.1089/lgbt.2020.0272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Purpose: The World Health Organization general assembly approved the 11th revision of the International Classification of Diseases (ICD) in 2019 which will be implemented in 2022. Gender identity-related diagnoses were substantially reconceptualized and removed from the mental health chapter so that the distress criterion is no longer a prerequisite. The present study examined reliability and clinical utility of gender identity-related diagnoses of the ICD-11 in comparison with the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5, ICD-10, and DSM-IV. Methods: Sixty-four health care providers assessed six videos of two children, two adolescents, and two adults referred for gender incongruence. Each provider rated one pair of videos with three of the four classification systems (ICD-11, DSM-5, ICD-10, and DSM-IV-TR). This resulted in 72 ratings for the adolescent and adult diagnoses and 59 ratings for the children's diagnoses. Results: Interrater agreement rates for each instrument ranged from 65% to 79% for the adolescence/adulthood diagnoses and from 67% to 94% for the childhood diagnoses and were comparable regardless of the system used. Only agreement rates for ICD-11 were significantly better than those for DSM-5 for both age categories. Clinicians evaluated all four systems as convenient and easy to use. Conclusion: In conclusion, both classification systems (DSM and ICD) and both editions (DSM-IV and DSM-5 and ICD-10 and ICD-11) of gender identity-related diagnoses seem reliable and convenient for clinical use.
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Affiliation(s)
- Annelou L C de Vries
- Department of Child and Adolescent Psychiatry and Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Titia F Beek
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Karlien Dhondt
- Center for Sexology and Gender, Pediatric Gender Clinic, Ghent University Hospital, Ghent, Belgium
| | - Henrica C W de Vet
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Peggy T Cohen-Kettenis
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Thomas D Steensma
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - Baudewijntje P C Kreukels
- Department of Medical Psychology, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
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First MB, Gaebel W, Maj M, Stein DJ, Kogan CS, Saunders JB, Poznyak VB, Gureje O, Lewis-Fernández R, Maercker A, Brewin CR, Cloitre M, Claudino A, Pike KM, Baird G, Skuse D, Krueger RB, Briken P, Burke JD, Lochman JE, Evans SC, Woods DW, Reed GM. An organization- and category-level comparison of diagnostic requirements for mental disorders in ICD-11 and DSM-5. World Psychiatry 2021; 20:34-51. [PMID: 33432742 PMCID: PMC7801846 DOI: 10.1002/wps.20825] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In 2013, the American Psychiatric Association (APA) published the 5th edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In 2019, the World Health Assembly approved the 11th revision of the International Classification of Diseases (ICD-11). It has often been suggested that the field would benefit from a single, unified classification of mental disorders, although the priorities and constituencies of the two sponsoring organizations are quite different. During the development of the ICD-11 and DSM-5, the World Health Organization (WHO) and the APA made efforts toward harmonizing the two systems, including the appointment of an ICD-DSM Harmonization Group. This paper evaluates the success of these harmonization efforts and provides a guide for practitioners, researchers and policy makers describing the differences between the two systems at both the organizational and the disorder level. The organization of the two classifications of mental disorders is substantially similar. There are nineteen ICD-11 disorder categories that do not appear in DSM-5, and seven DSM-5 disorder categories that do not appear in the ICD-11. We compared the Essential Features section of the ICD-11 Clinical Descriptions and Diagnostic Guidelines (CDDG) with the DSM-5 criteria sets for 103 diagnostic entities that appear in both systems. We rated 20 disorders (19.4%) as having major differences, 42 disorders (40.8%) as having minor definitional differences, 10 disorders (9.7%) as having minor differences due to greater degree of specification in DSM-5, and 31 disorders (30.1%) as essentially identical. Detailed descriptions of the major differences and some of the most important minor differences, with their rationale and related evidence, are provided. The ICD and DSM are now closer than at any time since the ICD-8 and DSM-II. Differences are largely based on the differing priorities and uses of the two diagnostic systems and on differing interpretations of the evidence. Substantively divergent approaches allow for empirical comparisons of validity and utility and can contribute to advances in the field.
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Affiliation(s)
- Michael B First
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Dan J Stein
- Department of Psychiatry, University of Cape Town and South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
| | - Cary S Kogan
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - John B Saunders
- Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, QLD, Australia
| | - Vladimir B Poznyak
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Roberto Lewis-Fernández
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Andreas Maercker
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Chris R Brewin
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Marylene Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, USA
| | - Angelica Claudino
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Kathleen M Pike
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Gillian Baird
- Newcomen Centre, Evelina Children's Hospital, Guys & St. Thomas NHS Foundation Trust, London, UK
| | - David Skuse
- Brain and Behaviour Science Unit, Institute of Child Health, University College London, London, UK
| | - Richard B Krueger
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jeffrey D Burke
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - John E Lochman
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | | | - Douglas W Woods
- Offiice of the Provost and Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Geoffrey M Reed
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
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Ma C, Wang Z, Li C, Lu J, Long J, Li R, Wu Q, Jiang H, Du J, Li R, Wang P, Ma L, Li H, Hui S, Zhao W, Zhong N, Zhao M. The Clinical Consistency and Utility of ICD-11 Diagnostic Guidelines for Gaming Disorder: A Field Study Among the Chinese Population. Front Psychiatry 2021; 12:781992. [PMID: 35002801 PMCID: PMC8729903 DOI: 10.3389/fpsyt.2021.781992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/18/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: As a new category proposed in the International Classification of Diseases (11th Revision) (ICD-11), the reliability and clinical utility of ICD diagnostic guidelines for gaming disorder (GD) in the Chinese population have not been studied. The purpose of this field study is to clarify the reliability, clinical utility, and cultural applicability of ICD diagnostic guidelines for GD in China and its comparability with Internet GD (IGD) in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5). Methods: Participants included 21 paired clinical raters consisting of seven psychiatrists and 200 gaming players aged from 15 to 18 years with different risk levels of Internet addiction based on the scores of Young's Internet Addiction Test. Each participant received a semi-structured face-to-face interview by paired clinical raters at the same time. Then clinical raters made the diagnosis and filled the clinical utility questionnaire independently according to the diagnostic guidelines for GD in both ICD-11 and DSM-5. Results: The diagnostic consistency coefficient (kappa value) between the paired clinical raters was 0.545 (0.490-0.600, p < 0.001) and 0.622 (0.553-0.691, p < 0.001) for ICD-11 and DSM-5 diagnostic guidelines, respectively, for GD. The diagnostic consistency was 0.847 (0.814-0.880, p < 0.001) between GD in ICD-11 and IGD in DSM-5. Meanwhile, 86.7% of responses that agreed with the ICD-11 diagnostic guidelines for GD provided enough detailed implementation characteristics and showed good overall clinical applicability (86.0%), specificity (94.4%), usefulness (84.1%), and acceptable cultural adaptation (74.8%). GD in ICD-11 was slightly more accepted than IGD in DSM-5 (p < 0.001), while the clinical efficiency of ICD-11 was inferior to that of DSM-5 (p < 0.001). Conclusion: This study indicates that the ICD-11 diagnostic guidelines for GD have acceptable clinical reliability and high consistency with IGD in DSM-5. Their clinical applicability and cultural adaption are comparable with those of DSM-5. Although the guidelines still need to be adjusted for better implementation in China, this is already a great step committed to reducing the serious consequences caused by excessive gaming behaviors through effective identification and normative diagnosis, especially for adolescents.
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Affiliation(s)
- Chenyi Ma
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhe Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chuanwei Li
- The Affiliated Guangji Hospital of Soochow University, Jiangsu, China
| | - Jing Lu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang Long
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruihua Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qianying Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Runji Li
- UCLA College of Letters and Science, University of California, Los Angeles, Los Angeles, CA, United States
| | - Peiyan Wang
- Lulong Vocational and Technical Education Center, Qinhuangdao, China
| | - Limin Ma
- Lulong Vocational and Technical Education Center, Qinhuangdao, China
| | - Hongwei Li
- Lulong Vocational and Technical Education Center, Qinhuangdao, China
| | - Shuqin Hui
- Lulong Vocational and Technical Education Center, Qinhuangdao, China
| | - Wenli Zhao
- Lulong Vocational and Technical Education Center, Qinhuangdao, China
| | - Na Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China.,Chinese Academy of Sciences (CAS), Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences (CAS), Shanghai, China
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44
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Schultze-Lutter F, Meisenzahl E, Michel C. [Psychotic disorders in ICD-11: the revisions]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2020; 49:453-462. [PMID: 33287579 DOI: 10.1024/1422-4917/a000777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Psychotic disorders in ICD-11: the revisions Abstract. This article provides an overview of the main changes to the chapter "Schizophrenia or Other Primary Psychotic Disorders" (6A2) from ICD-10 to ICD-11 and compares them with the psychosis chapter of DSM-5. These changes include abandoning the classical subtypes of Schizophrenia as well as of the special significance of Schneider's first-rank symptoms, resulting in the general requirement of two key features (one must be a positive symptom) in the definition of "Schizophrenia" (6A20) and the allowance for bizarre contents in "Delusional Disorder" (6A24), which now includes "Induced Delusional Disorder" (F24). Further introduced are the focus on the current episode, the restriction of "Acute and Transient Psychotic Disorder" (6A23) to the former Polymorphic Disorder Without Schizophrenic Symptoms (F23.0), the diagnosis of delusional "Obsessive-Compulsive or Related Disorders" (6B2) exclusively as Obsessive-Compulsive Disorders, the specification of "Schizoaffective Disorder" (6A21), and the formulation of a distinct subchapter "Catatonia" (6A4) for the assessment of catatonic features in the context of several disorders. In analogy to DSM-5, ICD-11 now includes the optional category "Symptomatic Manifestations of Primary Psychotic Disorders" (6A25) for the dimensional quantification of symptoms. Again, developmental aspects remain unattended in in the ICD-11-definitions of psychotic disorders.
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Affiliation(s)
- Frauke Schultze-Lutter
- Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland.,Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Bern, Schweiz.,Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | - Eva Meisenzahl
- Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Chantal Michel
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Bern, Schweiz
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The revision of the categories of mood, anxiety and stress-related disorders in the ICD-11: a perspective from the Arab region. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-0017-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The World Health Organization estimates that 75% of patients with mental and substance use disorders in low- and middle-income countries do not have access to the care needed. In the Arab World, approximately 100–140 million people suffer from at least one psychiatric disorder. One main criticism of classification systems has been their lack of cultural sensitivity. The International Classification of Diseases, 11th edition aims to improve clinical utility of psychiatric classification across cultures. Mood, anxiety and stress-related disorders are the most common psychiatric manifestations and the most impacted by cultural factors.
Main body
Relying on rigorous field testing, including in three Arab countries, clinically meaningful changes have been introduced in the International Classification of Diseases 11. These include new disorders such as complex post-traumatic stress disorder and prolonged grief disorder. In classifying mood episodes, the pattern of symptoms over time is emphasized. Disorders associated with anxiety provide the basis for a new grouping separate from obsessive-compulsive-related disorders. Lastly, culture and its impact are incorporated into each diagnostic grouping.
Conclusions
This latest version of the International Classification of Diseases prioritizes addressing gaps in the validity and reliability of psychiatric classification. The methodology adopted in this latest revision is encouraging and opens the way to truly global collaboration on refining psychiatric diagnoses and practice.
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Fortune N, Short S, Madden R. Building a statistical classification: A new tool for classification development and testing. ACTA ACUST UNITED AC 2020. [DOI: 10.3233/sji-200633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Statistical classifications are essential for collecting consistent data that can be compared over space and time. However, a publicly-documented body of practice concerning how to undertake the development and testing of a statistical classification is currently lacking. What aspects of the classification should be tested during the development process? How do we judge whether the classification is fit-for-purpose? How should problems and shortcomings be identified so that they can be remedied? To fill this gap, we drew on existing, authoritative sources to develop an analytic structure for use in the development and testing of statistical classifications. It consists of two components: (1) a statistical classification development and testing framework reflecting the required features of a statistical classification; and (2) a 4-tier model representing the main elements that make up a statistical classification, to use as a heuristic structure within which to locate issues identified and consider how they can be addressed. In this paper, we outline the development of the framework and model, and reflect on their application in testing a draft classification of health interventions. We propose this analytic structure as a new tool to support those engaged in the development of statistical classifications.
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Valle R. Validity, Reliability and Clinical Utility of Mental Disorders: The Case of ICD-11 Schizophrenia. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 51:S0034-7450(20)30084-6. [PMID: 33735020 DOI: 10.1016/j.rcp.2020.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/18/2020] [Accepted: 09/09/2020] [Indexed: 06/12/2023]
Abstract
Diagnostic classification systems categorise mental psychopathology in mental disorders. Although these entities are clinical constructs developed by consensus, it has been pointed out that in practice they are usually managed as natural entities and without evaluating aspects related to their nosological construction. The objectives of the study are to review a) the conceptualisation of mental disorders, b) the indicators of validity, reliability and clinical utility, and c) the values of these indicators in ICD-11 schizophrenia. The results show that mental disorders are conceptualised as discrete entities, like the diseases of other areas of medicine; however, differences are observed between these diagnostic categories in clinical practice. The reliability and clinical utility of mental disorders are adequate; however, the validity is not yet clarified. Similarly, ICD-11 schizophrenia demonstrates adequate reliability and clinical utility, but its validity remains uncertain. The conceptualisation of psychopathology in discrete entities may be inadequate for its study, therefore dimensional and mixed models have been proposed. The indicators of validity, reliability and clinical utility enable us to obtain an accurate view of the nosological state of mental disorders when evaluating different aspects of their nosological construction.
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Affiliation(s)
- Rubén Valle
- Centro de Investigación en Epidemiología Clínica y Medicina Basada en Evidencias, Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Perú; DEIDAE de Adultos y Adultos Mayores, Instituto Nacional de Salud Mental Honorio Delgado-Hideyo Noguchi, Lima, Perú.
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Ede MO, Omeje JC, Ncheke DC, Agah JJ, Chinweuba NH, Amoke CV. Assessment of the Effectiveness of Group Cognitive Behavioural Therapy in Reducing Pathological Gambling. J Gambl Stud 2020; 36:1325-1339. [PMID: 33037961 DOI: 10.1007/s10899-020-09981-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 12/17/2022]
Abstract
Pathological gambling is a developmental disorder usually associated with a continuous loss of control over gambling; it also involves a preoccupation with gambling and with obtaining money for the same purpose of gambling, irrational thinking, and a continuation of the behaviour despite being aware of its adverse consequences. This study examined the effectiveness of group cognitive-behavioural therapy (GCBT) on pathological gambling among Nigerian students. The study used a group randomised controlled trial design to assign participants to intervention and control groups. A total of 40 undergraduate students, aged 18-30, were classified as pathological gamblers (participants) in this study. Participants completed self-report scales titled South oaks gambling screen and Gambling Symptom Assessment Scale at three-time points. The intervention lasted for 8 weeks. The data collected were statistically analysed using repeated-measures ANOVA. Results revealed that GCBT has a significant effect in decreasing the symptoms of pathological gambling among the participants in GCBT compared to those in the control group and that the improvements were maintained at follow-up. The study concluded that group cognitive-behavioural therapy is impactful therapy in reducing pathological gambling among students. It has also validated the effectiveness of cognitive-behavioural therapy in altering erroneous thoughts and replacing it with a better alternative realistic way of thinking.
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Affiliation(s)
- Moses Onyemaechi Ede
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State, Nigeria.
| | - Joachim C Omeje
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Damian Chijioke Ncheke
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State, Nigeria.
| | - John J Agah
- Department of Science Education, Faculty of Education, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Ngozi H Chinweuba
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Chijioke Virgilus Amoke
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State, Nigeria
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Kogan CS, Stein DJ, Rebello TJ, Keeley JW, Chan KJ, Fineberg NA, Fontenelle LF, Grant JE, Matsunaga H, Simpson HB, Thomsen PH, van den Heuvel OA, Veale D, Grenier J, Kulygina M, Matsumoto C, Domínguez-Martínez T, Stona AC, Wang Z, Reed GM. Accuracy of diagnostic judgments using ICD-11 vs. ICD-10 diagnostic guidelines for obsessive-compulsive and related disorders. J Affect Disord 2020; 273:328-340. [PMID: 32560926 DOI: 10.1016/j.jad.2020.03.103] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/28/2020] [Accepted: 03/28/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND We report results of an internet-based field study evaluating the diagnostic guidelines for the newly introduced ICD-11 grouping of obsessive-compulsive and related disorders (OCRD). We examined accuracy of clinicians' diagnostic judgments applying draft ICD-11 as compared to the ICD-10 diagnostic guidelines to standardized case vignettes. METHODS 1,717 mental health professionals who are members of the World Health Organization's Global Clinical Practice Network completed the study in Chinese, English, French, Japanese, Russian or Spanish. Participants were randomly assigned to apply ICD-11 or ICD-10 guidelines to one of nine pairs of case vignettes. RESULTS Participants using ICD-11 outperformed those using ICD-10 in correctly identifying newly introduced OCRD, although results were mixed for differentiating OCRD from disorders in other groupings largely due to clinicians having difficulty differentiating challenging presentations of OCD. Clinicians had difficulty applying a three-level insight qualifier, although the 'poor to absent' level assisted with differentiating OCRD from psychotic disorders. Brief training on the rationale for an OCRD grouping did not improve diagnostic accuracy suggesting sufficient detail of the proposed guidelines. LIMITATIONS Standardized case vignettes were manipulated to include specific characteristics; the degree of accuracy of clinicians' diagnostic judgments about these vignettes may not generalize to application in routine clinical practice. CONCLUSIONS Overall, use of the ICD-11 guidelines resulted in more accurate diagnosis of case vignettes compared to the ICD-10 guidelines, particularly in differentiating OCRD presentations from one another. Specific areas in which the ICD-11 guidelines did not perform as intended provided the basis for further revisions to the guidelines.
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Affiliation(s)
- Cary S Kogan
- School of Psychology, Faculty of Social Sciences, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON K1N 6N5, Canada.
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town Dept of Psychiatry & Neuroscience Institute, Groote Schuur Hospital, J-Block, Anzio Road, Observatory 7925, Cape Town, South Africa.
| | - Tahilia J Rebello
- Global Mental Health Program, Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, Mailman School of Public Health, 722 West 168th, Floor R2, R-233, New York, NY 10032, USA.
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St, Box 842018, Richmond, VA 23284, USA.
| | - K Jacky Chan
- School of Psychology, Faculty of Social Sciences, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON K1N 6N5, Canada.
| | - Naomi A Fineberg
- Highly Specialized Obsessive Compulsive and Related Disorders Service, Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, UK; Postgraduate Medical School, University of Hertfordshire, Hatfield, UK; University of Cambridge School of Clinical Medicine, Cambridge, UK.
| | - Leonardo F Fontenelle
- Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; "D'Or' Institute for Research and Education, Rio de Janeiro, RJ, Brazil; School of Psychological Sciences, Monash University, Melbourne, Australia.
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
| | - Hisato Matsunaga
- Department of Neuropsychiatry, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya Hyogo, Japan.
| | - H Blair Simpson
- College of Physicians and Surgeons, Columbia University, New York, NY, USA; Anxiety Disorders Clinic and the Center for OCD and Related Disorders, New York State Psychiatric Institute, New York, NY, USA.
| | - Per Hove Thomsen
- Department for Child and Adolescent Psychiatry, Aarhus University Hospital, Skejby, Aarhus, Denmark.
| | - Odile A van den Heuvel
- Amsterdam University Medical Centers, Vrije Universiteit, Department of Psychiatry and Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, the Netherlands.
| | - David Veale
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Center for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, London, UK.
| | - Jean Grenier
- Institut du Savoir Montfort - Hôpital Montfort and Université d'Ottawa, Ottawa, Ontario, Canada.
| | - Mayya Kulygina
- Alekseev Mental Health Clinic, No. 1, Education Centre, Moscow, Russian Federation.
| | - Chihiro Matsumoto
- National Study Coordinator for ICD-11 Field Studies, ICD-11 Committee, Japanese Society of Psychiatry and Neurology, Hongo-Yumicho Building, 2-38-4, Hongo, Bunkyo-ku, Tokyo 113-0033. Japan.
| | - Tecelli Domínguez-Martínez
- Center for Research on Global Mental Health, Direction of Epidemiology and Psychosocial Research, National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, Mexico.
| | - Anne-Claire Stona
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore.
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, PR China.
| | - Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA; Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.
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Pavlichenko AV, Kulygina MA, Kostyuk GP. [Schizophrenia and other psychotic disorders in ICD-11 and DSM-5: evolution of the concepts and current status]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:5-12. [PMID: 32729685 DOI: 10.17116/jnevro20201200625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The concepts of schizophrenia and other primary psychotic disorders have been changed a lot since their beginnings more than century ago due to many factors such as the dominance of a certain hypothesis during a particular period of time, the development of new clinical research and specific treatments as well as different understanding of the boundaries between mental disorders. It was appeared the diagnosis of schizophrenia spectrum disorders which still based only on clinical symptoms. Whether psychotic disorders can be better represented dimensionally or categorically remains a challenging question. Regarding schizophrenia and other primary psychotic disorders, there are some important changes in DSM-5 and ICD-11 concerning the use of quantitative assessment of psychopathological domains, course of psychosis and remission as well as giving more attention to cognitive issues. The main differences between these classifications are the structure of corresponding sections and different criteria of some disorders. Before the ICD-11 implementation in 2022 into clinical practice, it is highly recommended to conduct a set of trainings for clinicians along with the comments to Diagnostic guidelines for Schizophrenia and other primary psychotic disorders.
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Affiliation(s)
- A V Pavlichenko
- Alekseev Psychiatric Clinical Hospital No. 1, Moscow, Russia
| | - M A Kulygina
- Alekseev Psychiatric Clinical Hospital No. 1, Moscow, Russia
| | - G P Kostyuk
- Alekseev Psychiatric Clinical Hospital No. 1, Moscow, Russia
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