1
|
Chessa A, Sentissi O. [ICD-11: New revision and impact of this classification in psychiatry]. L'ENCEPHALE 2024; 50:329-338. [PMID: 38092593 DOI: 10.1016/j.encep.2023.10.003] [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: 06/12/2023] [Revised: 09/26/2023] [Accepted: 10/27/2023] [Indexed: 05/31/2024]
Abstract
OBJECTIVES After more than 20 years of work, the World Health Organization's efforts have culminated in the adoption of the 11th revision of the International Classification of Diseases (ICD-11). The process has been guided by the principles of global applicability, scientific validity, and clinical utility. The update of the chapter on mental, behavioral, and neurodevelopmental disorders (MBND) within the ICD-11 has generated widespread interest worldwide. This has raised various questions about the status of mental disorder nosology, changes to diagnostic guidelines, and the potential implications for clinical practice. METHODS We conducted a narrative analysis of the literature in four different languages to track the various stages of the ICD-11 revision and to highlight the major changes. We searched databases such as PubMed, EMBASE, MEDLINE, and Google Scholar, and consulted the official websites of the WHO, APA, and UNICEF. A total of 79 articles from 40 different editorials and websites were analyzed and included in this study. RESULTS The new chapters on mental disorders in the ICD-11 include 21 groups, as opposed to the 11 in the ICD-10. The changes aim to align the diagnoses with those of the DSM-5 and introduce a new chapter structure, new diagnostic categories, modifications to diagnostic criteria, and advancements in dimensionality. For the first time in the history of the ICD, sleep and wakefulness disorders, as well as disorders related to sexual health, have been addressed in separate chapters of the international classification. Four new diagnoses have been added: complex post-traumatic stress disorder (PTSD), gaming disorder, prolonged grief disorder, and compulsive sexual behavior which replaces "excessive sexual activity" in the ICD-10. Moreover, the ICD-11 revision has brought about a fundamental change in the clinical conceptualization of addictive behaviors, introducing a distinction between substance use disorders and addictive behaviors. The criteria for many existing conditions have been revised, particularly those related to bipolar disorders, eating disorders, and gender identity disorders. CONCLUSIONS The revision process for mental, behavioral, and neurodevelopmental disorders in the ICD-11 has witnessed unprecedented participation in the history of mental disorder classification. These changes could have a significant impact on clinical practice in psychiatry. However, it is crucial to examine the advantages and limitations of this new classification compared to previous versions.
Collapse
Affiliation(s)
- Ambra Chessa
- Département de psychiatrie, service de psychiatrie adulte, CAPPI jonction, hôpitaux universitaires Genève, 35, rue des Bains, 1205 Genève, Suisse
| | - Othman Sentissi
- Département de psychiatrie, service de psychiatrie adulte, CAPPI jonction, hôpitaux universitaires Genève, 35, rue des Bains, 1205 Genève, Suisse.
| |
Collapse
|
2
|
Lemay KR, Kogan CS, Rebello T, Keeley JW, Bhargava R, Buono S, Cooray S, Ginige P, Kishore MT, Kommu JVS, Recupero M, Roy A, Sharan P, Reed GM. Implementation of the International Classification of Diseases 11th revision behavioural indicators for disorders of intellectual development with co-occurring autism spectrum disorder. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024. [PMID: 38733333 DOI: 10.1111/jir.13146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/20/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND The classification of mental, behavioural and neurodevelopmental disorders in the World Health Organization's International Classification of Diseases 11th revision (ICD-11) includes a comprehensive set of behavioural indicators (BIs) within the neurodevelopmental disorders grouping. BIs can be used to assess the severity of disorders of intellectual development in situations in which standardised measures of intellectual functioning and adaptive behaviours are not available or feasible. This international study examines the implementation characteristics of the BIs and compares them to standardised measures for assessing the severity of intellectual impairment and adaptive behaviours in disorders of intellectual development and autism spectrum disorder (ASD). The clinical utility of the ICD-11 and the fidelity of its application in international clinical settings were also assessed. METHODS A total of 116 children and adolescents (5-18 years old) with a suspected or established diagnosis of disorders of intellectual development were included across four sites [Italy (n = 18), Sri Lanka (n = 19) and two sites in India (n = 79)]. A principal component analysis was conducted to evaluate the application of the ICD-11 guidance for combining severity levels. RESULTS Assessment using the BIs showed a higher proportion of individuals classified with mild severity, whereas the standardised measures indicated a higher proportion of severe ratings. Additionally, individuals with co-occurring ASD tended to have more severe impairments compared with those without ASD, as indicated by both BIs and standardised measures. Overall, the BIs were considered clinically useful, although more time and consideration were required when applying the guidelines for individuals with a co-occurring disorder of intellectual development and ASD. The principal component analysis revealed one principal component representing overall disorders of intellectual development severity levels. CONCLUSIONS The ICD-11 BIs can be implemented as intended in international clinical settings for a broad range of presentations of individuals with neurodevelopmental disorders. Use of the BIs results in similar severity diagnoses to those made using standardised measures. The BIs are expected to improve the reliability of severity assessments in settings where appropriate standardised measures for intellectual and adaptive behaviours are not available or feasible.
Collapse
Affiliation(s)
- K R Lemay
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - C S Kogan
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - T Rebello
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Department of Psychiatry, Research Foundation for Mental Hygiene, New York, NY, USA
| | - J W Keeley
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - R Bhargava
- Department of Psychiatry and National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - S Buono
- Department of Psychology, Oasi Research Institute-IRCCS, Troina, Italy
| | - S Cooray
- Faculty of Psychiatry of Learning Disability, Royal College of Psychiatrists, London, UK
| | - P Ginige
- Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - M T Kishore
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - J V S Kommu
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - M Recupero
- Department of Psychology, Oasi Research Institute-IRCCS, Troina, Italy
| | - A Roy
- Coventry and Warwickshire Partnership NHS Trust, Birmingham, UK
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - P Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - G M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| |
Collapse
|
3
|
Hyland P, Redican E, Karatzias T, Shevlin M. Assessing the validity and reliability of the International Anxiety Questionnaire and the International Depression Questionnaire in two bereaved national samples. Clin Psychol Psychother 2023. [PMID: 37776046 DOI: 10.1002/cpp.2917] [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: 06/29/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023]
Abstract
The International Anxiety Questionnaire (IAQ) and International Depression Questionnaire (IDQ) are self-report measures of ICD-11 Generalized Anxiety Disorder (ICD-11 GAD) and ICD-11 Single Episode Depressive Disorder (ICD-11 DD). This study tested the psychometric properties of these scales in two samples of bereaved adults from the United Kingdom and the Republic of Ireland. Confirmatory factor analysis (CFA) was used to test the combined dimensionality and measurement invariance of the IAQ and IDQ across the United Kingdom (n = 1012) and Irish (n = 1011) samples. Differential item functioning (DIF) was tested using multiple indicator multiple cause (MIMIC) modelling while convergent validity was also assessed. CFA results supported a correlated two-factor model in both samples. The MIMIC model showed that the IDQ item "Had recurrent thoughts of death or suicide" showed DIF and the effect was small. Internal reliability of the scales were high and convergent validity was supported. The prevalence of ICD-11 GAD was 18.6% and 16.1% and ICD-11 DD was 13.8% and 10.5% in the United Kingdom and Irish samples, respectively. Findings of the study provide support for the validity, measurement invariance, and reliability of the IAQ and IDQ among two bereaved national samples.
Collapse
Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Enya Redican
- School of Psychology, Ulster University, Ulster, UK
| | - Thanos Karatzias
- School of Health & Social Care, Napier University, Edinburgh, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Ulster, UK
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Bandeira M, Graham MA, Ebersöhn L. The significance of feeling safe for resilience of adolescents in sub-Saharan Africa. Front Psychol 2023; 14:1183748. [PMID: 37663363 PMCID: PMC10469746 DOI: 10.3389/fpsyg.2023.1183748] [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: 03/10/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Adolescents in sub-Saharan Africa (SSA) are exposed to several challenges and risk factors, linked to historical legacies. Sub-Saharan Africa has one of the highest rates of poverty and inequality in the world, is one of the regions most negatively affected by climate change, performs poorly on many health measures, and has high rates of different forms of violence, especially gender-based violence. These contextual challenges impact adolescent mental health outcomes, preventing them to access resilience-enabling pathways that support positive outcomes despite adversity. This study aimed to contribute to knowledge generation on resilience of young people in the understudied SSA region by investigating which variables directly (or indirectly) affect the resilience of adolescents. Methods Purposive sampling was used to collect quantitative survey data from 3,312 adolescents (females = 1,818; males = 1,494) between the ages of 12 and 20 years, participating in interventions implemented by a non-governmental organization, the Regional Psychosocial Support Initiative. Data were collected in Angola (385, 11.6%), Eswatini (128, 3.9%), Kenya (390, 11.8%), Lesotho (349, 10.5%), Mozambique (478, 14.4%), Namibia (296, 8.9%), South Africa (771, 23.3%), Uganda (201, 6.1%), and Zambia (314, 9.5%). The survey collected data on socio-demographic status, resilience (CYRM-R), depression (PHQ-9), self-esteem (Rosenberg Self-Esteem Scale) and feelings of safety (self-developed scale). Mental health was defined as lower levels of depression, higher levels of self-esteem and higher levels of feeling safe. A mediation analysis was conducted to investigate the relationship between the predictors (the socio-demographic variables) and the output (resilience), with the mediators being depression, self-esteem and feeling safe (which all link to mental health). Results This study contributes to a gap in knowledge on country-level comparative evidence on significant predictors that impact resilience outcomes (directly or indirectly) for adolescents in sub-Saharan African countries. The results indicate that, when considering all countries collectively, feeling safe is the only predictor that has a significant direct effect on overall resilience and personal resilience, but not on caregiver resilience. When considering each country separately, feeling safe has a direct effect on overall, personal and caregiver resilience for all countries; but not for South Africa and Mozambique. Discussion The results provide evidence on which to craft youth development interventions by measuring mediators (depression, self-esteem and feeling safe) and resilience for adolescents in sub-Saharan Africa. The overall results of the present paper point toward a contextually relevant pathway to supporting their resilience, namely, the need to systemically target the creation and/or strengthening of structures that enable adolescents to feel safe.
Collapse
Affiliation(s)
- Monica Bandeira
- Centre for the Study of Resilience and Department of Educational Psychology University of Pretoria, Pretoria, South Africa
| | - Marien A. Graham
- Department of Science, Mathematics and Technology Education, University of Pretoria, Pretoria, South Africa
| | - Liesel Ebersöhn
- Centre for the Study of Resilience and Department of Educational Psychology University of Pretoria, Pretoria, South Africa
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Hualparuca-Olivera L, Caycho-Rodríguez T. Diagnostic accuracy of severity measures of ICD-11 and DSM-5 personality disorder: clarifying the clinical landscape with the most up-to-date evidence. Front Psychiatry 2023; 14:1209679. [PMID: 37324826 PMCID: PMC10265646 DOI: 10.3389/fpsyt.2023.1209679] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
With the implementation of new dimensional models of personality disorder (PD) in the DSM-5 and ICD-11, several investigators have developed and evaluated the psychometric properties of measures of severity. The diagnostic accuracy of these measures, an important cross-cultural metric that falls between validity and clinical utility, remains unclear. This study aimed to analyze and synthesize the diagnostic performance of the measures designed for both models. For this purpose, searches were carried out using three databases: Scopus, PubMed, and Web of Science. Studies that presented sensitivity and specificity parameters for cut-off points were selected. There were no restrictions on the age and gender of the participants nor on the reference standard used or the settings. Study quality and synthesis were assessed using QUADAS-2 and MetaDTA software, respectively. Twelve studies were eligible covering self-reported and clinician-rated measures based on the ICD-11 and DSM-5 PD severity models. A total of 66.7% of the studies showed a risk of bias in more than 2 domains. The 10th and 12th studies provided additional metrics, resulting in a total of 21 studies for evidence synthesis. Adequate overall sensitivity and specificity (Se = 0.84, Sp = 0.69) of these measures were obtained; however, the cross-cultural performance of specific cut-off points could not be assessed due to the paucity of studies on the same measure. Evidence suggests that patient selection processes should mainly be improved (avoid case-control design), use adequate reference standards, and avoid only reporting metrics for the optimal cut-off point.
Collapse
|
8
|
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.
Collapse
Affiliation(s)
- Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, UT, India
| |
Collapse
|
9
|
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: 3] [Impact Index Per Article: 1.5] [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
| |
Collapse
|
10
|
Gureje O, Ojagbemi A. Applicability and future status of schizophrenia as a construct in Africa. Schizophr Res 2022; 242:52-55. [PMID: 35151534 DOI: 10.1016/j.schres.2022.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 10/19/2022]
Affiliation(s)
- Oye Gureje
- Department of Psychiatry, University of Ibadan, Nigeria; Department of Psychiatry, Stellenbosch University, South Africa.
| | - Akin Ojagbemi
- Department of Psychiatry, University of Ibadan, Nigeria
| |
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
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.
Collapse
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.
| |
Collapse
|
13
|
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
| |
Collapse
|
14
|
Sandini C, Zöller D, Schneider M, Tarun A, Armondo M, Nelson B, Amminger PG, Yuen HP, Markulev C, Schäffer MR, Mossaheb N, Schlögelhofer M, Smesny S, Hickie IB, Berger GE, Chen EY, de Haan L, Nieman DH, Nordentoft M, Riecher-Rössler A, Verma S, Thompson A, Yung AR, McGorry PD, Van De Ville D, Eliez S. Characterization and prediction of clinical pathways of vulnerability to psychosis through graph signal processing. eLife 2021; 10:59811. [PMID: 34569937 PMCID: PMC8476129 DOI: 10.7554/elife.59811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/09/2021] [Indexed: 11/21/2022] Open
Abstract
Causal interactions between specific psychiatric symptoms could contribute to the heterogenous clinical trajectories observed in early psychopathology. Current diagnostic approaches merge clinical manifestations that co-occur across subjects and could significantly hinder our understanding of clinical pathways connecting individual symptoms. Network analysis techniques have emerged as alternative approaches that could help shed light on the complex dynamics of early psychopathology. The present study attempts to address the two main limitations that have in our opinion hindered the application of network approaches in the clinical setting. Firstly, we show that a multi-layer network analysis approach, can move beyond a static view of psychopathology, by providing an intuitive characterization of the role of specific symptoms in contributing to clinical trajectories over time. Secondly, we show that a Graph-Signal-Processing approach, can exploit knowledge of longitudinal interactions between symptoms, to predict clinical trajectories at the level of the individual. We test our approaches in two independent samples of individuals with genetic and clinical vulnerability for developing psychosis. Novel network approaches can allow to embrace the dynamic complexity of early psychopathology and help pave the way towards a more a personalized approach to clinical care.
Collapse
Affiliation(s)
- Corrado Sandini
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Daniela Zöller
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.,Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.,Center for Contextual Psychiatry, Research Group Psychiatry, Department of Neuroscience, KU Leuven, Leuven, Belgium
| | - Anjali Tarun
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Marco Armondo
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland
| | - Barnaby Nelson
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Paul G Amminger
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.,Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - Hok Pan Yuen
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Connie Markulev
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Monica R Schäffer
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.,Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - Monika Schlögelhofer
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - Stefan Smesny
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University Vienna, Vienna, Austria
| | - Ian B Hickie
- Department of Psychiatry, University Hospital Jena, Jena, Germany
| | | | - Eric Yh Chen
- Child and Adolescent Psychiatric Service of the Canton of Zurich, Zurich, Switzerland
| | - Lieuwe de Haan
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | - Dorien H Nieman
- Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | | | | | - Swapna Verma
- Institute of Mental Health, Singapore, Singapore
| | - Andrew Thompson
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.,Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, United Kingdom.,North Warwickshire Early Intervention in Psychosis Service, Conventry and Warwickshire National Health Service Partnership Trust, Coventry, United Kingdom
| | - Alison Ruth Yung
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.,Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Patrick D McGorry
- Orygen, Parkville, Australia.,The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Dimitri Van De Ville
- Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.,Department of Genetic Medicine and Development, University of Geneva School of Medicine, Geneva, Switzerland
| |
Collapse
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
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.
Collapse
|
17
|
Kulygina MA, Syunyakov TS, Fedotov IA, Kostyuk GP. Toward ICD-11 Implementation: Attitudes and Expectations of the Russian Psychiatric Community. CONSORTIUM PSYCHIATRICUM 2021; 2:23-34. [PMID: 39070735 PMCID: PMC11272316 DOI: 10.17816/cp80] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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
Background ICD-11 implementation will start in early 2022 in WHO member countries, including Russia. This process should be preceded not only by the official translation and wide distribution of ICD-11 statistical classification and diagnostic guidelines but also by clinicians' training. For recent years ICD-11 development and innovations in the diagnosis of mental disorders were in the focus of attention of mental health professionals in all over the world. Objectives This online survey aimed to identify the current views of the Russian psychiatric community on the upcoming implementation of ICD-11. Methods A survey was composed in a Google form and circulated through the website of the Russian Society of Psychiatrists and other professional networks. Statistical and narrative analysis was provided. The sample was represented by 148 psychiatrists working in inpatient or outpatient clinical settings. Results Expectations for the classification of mental disorders reported by the respondents were wider than the current purpose of ICD-10. In general, the Russian psychiatrists expressed their interests to forthcoming ICD-11 implementation. Positive attitudes to ICD-11 innovations were associated with the familiarity with the ICD-11 draft. Conservative or negative views were related to longer years of clinical experience. Early carrier psychiatrists were more practically oriented than 'old school' clinicians. Conclusion This survey may help to promote the ICD-11 by focusing on its advantages for clinical practice and develop targeted training programs.
Collapse
|
18
|
Zhuo C, Cheng L, Li G, Xu Y, Jing R, Li S, Zhang L, Lin X, Zhou C. COMT-Val158Met polymorphism modulates antipsychotic effects on auditory verbal hallucinations and temporal lobe gray matter volumes in healthy individuals-symptom relief accompanied by worrisome volume reductions. Brain Imaging Behav 2021; 14:1373-1381. [PMID: 30712251 PMCID: PMC7572342 DOI: 10.1007/s11682-019-00043-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Investigation of auditory verbal hallucinations (AVHs) in schizophrenics is complicated by psychiatric symptoms. Investigating healthy individuals with AVHs (H-AVHs) can obviate such confounding factors. The objective of this study was to explore the effects of antipsychotic treatment on AVHs and gray matter volumes (GMVs) in H-AVH subjects and whether such are effects are influenced by COMT-Val158Met genotype. Magnetic resonance imaging (MRI) and genotyping studies were completed for 42 H-AVH subjects and 42 well-matched healthy controls (HCs). COMT-Met/Met homozygotes (158th codon) were identified as COMT-Met genotype; COMT-Met/Val heterozygotes and COMT-Val/Val homozygotes were identified as COMT-Val genotype. Data were compared across groups (H-AVH vs. HC, and between genotypes) with two-sample t-tests. The H-AVH COMT-Met group showed a stronger response to antipsychotic treatment than the H-AVH COMT-Val group (p < 0.001). Both H-AVH genotype groups exhibited temporal lobe GMV reductions after treatment, and relative to their respective genotype-matched HC groups. Antipsychotic treatment effects in H-AVH subjects were influenced by COMT-Val158Met genotype and associated with widespread GMV reductions. These findings provide clues for further exploration of treatment targets for AVHs. Treatment associated GMV reductions, however, raise concerns about use of antipsychotics in H-AVH subjects.
Collapse
Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatric-Neuroimaging-Genetics and Morbidity Laboratory (PNGC-Lab), Tianjin Mental Health Center, Mental Health Teaching Hospital, Nankai University Affiliated Anding Hospital, Tianjin Medical University, Tianjin, 300222, China. .,Department of Psychiatry, Institute of Mental Healthy, Genetic Lab, Jining Medical University, Jining, 272191, China. .,Department of Psychiatry, College of Basic Medical Research, Tianjin Medical University, Tianjin, 300000, China. .,Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, 030001, China. .,Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China. .,Department of Psychiatry, Shanxi Medical University, Taiyuan, 030000, China.
| | - Langlang Cheng
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China
| | - Gongying Li
- Department of Psychiatry, Institute of Mental Healthy, Genetic Lab, Jining Medical University, Jining, 272191, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, 030001, China.,Department of Psychiatry, Shanxi Medical University, Taiyuan, 030000, China
| | - Rixing Jing
- Department of Pattern Recognition, China National Key Laboratory, Institute of Automation, Chinese Academy of Sciences, Beijing, 100191, China.,Department of Pattern Recognition, University of Chinese Academy of Sciences, Beijing, 100191, China
| | - Shen Li
- Department of Psychiatry, College of Basic Medical Research, Tianjin Medical University, Tianjin, 300000, China
| | - Li Zhang
- GHM Institute of CNS Regeneration, Jinan University, Guangzhou, 510632, Guangdong Province, China
| | - Xiaodong Lin
- Department of Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou, 325000, China.
| | - Chunhua Zhou
- Department of Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
| |
Collapse
|
19
|
Evans SC, Roberts MC, Guler J, Keeley JW, Reed GM. Taxonomy and utility in the diagnostic classification of mental disorders. J Clin Psychol 2021; 77:1921-1936. [PMID: 33638149 DOI: 10.1002/jclp.23125] [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: 05/05/2020] [Revised: 12/24/2020] [Accepted: 01/21/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE One strategy for improving the clinical utility of mental health diagnostic systems is to better align them with how clinicians conceptualize psychopathology in practice. This approach was used in International Classification of Diseases 11th Revision (ICD-11) development, but its underlying assumption-a link between taxonomic "fit" and clinical utility-remains untested. METHODS Using data from global mental health clinician samples (combined N = 5404), we investigated the association between taxonomic fit and clinical utility in mental disorder categories. RESULTS The overall association between fit and utility was positive (r = 0.19) but statistically not different from zero (95% confidence interval [CI]: -0.06, 0.43) in this small sample (N = 39 ICD/DSM categories). However, a positive association became clear after correcting for outliers (r = 0.34 [0.05, 0.58] or higher). Further insights were apparent for specific diagnoses given their locations in the scatterplot. CONCLUSIONS Results suggest a positive link between taxonomic fit and clinical utility in mental disorder diagnoses, highlighting future research directions.
Collapse
Affiliation(s)
- Spencer C Evans
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Michael C Roberts
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA
| | - Jessy Guler
- Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.,Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| |
Collapse
|
20
|
Pinto da Costa M, Ng RMK, Reed GM. International classification systems: views of early career psychiatrists. World Psychiatry 2021; 20:148-149. [PMID: 33432759 PMCID: PMC7801856 DOI: 10.1002/wps.20834] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Mariana Pinto da Costa
- Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
- Hospital de Magalhaes Lemos, Porto, Portugal
| | - Roger M K Ng
- Department of Psychiatry, Kowloon Hospital, Hong Kong, Hong Kong
| | - Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- World Health Organization, Geneva, Switzerland
| |
Collapse
|
21
|
Luciano M, Steardo L, Sampogna G, Caivano V, Ciampi C, Del Vecchio V, Di Cerbo A, Giallonardo V, Zinno F, De Fazio P, Fiorillo A. Affective Temperaments and Illness Severity in Patients with Bipolar Disorder. MEDICINA-LITHUANIA 2021; 57:medicina57010054. [PMID: 33435391 PMCID: PMC7826695 DOI: 10.3390/medicina57010054] [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] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 11/18/2022]
Abstract
Background and objectives: Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and the highest suicide rate. Although affective temperaments can impact on BD long-term outcome, their role remains poorly investigated. The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to assess the relation between affective temperaments and severity of clinical picture in a sample of patients with BD. Materials and Methods: A total of 199 patients have been recruited in the outpatients units of two university sites. Patients’ psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments. Results: Predominant cyclothymic and irritable temperaments are associated to higher number of relapses, poorer quality of life, higher rates of aggressive behaviors, and suicide attempts. Conversely, the predominant hyperthymic disposition was a protective factor for several outcome measures, including relapse rate, severity of anxiety, depressive and manic symptoms, suicidality, and earlier age at onset. One limitation of the present study is that the recruitment took place in two university sites; therefore, our findings cannot be fully generalized to the whole community of BD patients. Other limitations are the lack of a control group and the cross-sectional design of the study. Conclusions: The early identification of affective temperaments can help clinicians to identify those BD patients who are more likely to show a poor long-term outcome. An early screening of affective temperaments can be useful to develop targeted integrated pharmacological and psychosocial interventions.
Collapse
Affiliation(s)
- Mario Luciano
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80132 Naples, Italy; (L.S.J.); (G.S.); (V.C.); (C.C.); (V.D.V.); (A.D.C.); (V.G.); (F.Z.); (A.F.)
- Correspondence: ; Tel.: +39-0815666516 or +39-3490730150
| | - Luca Steardo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80132 Naples, Italy; (L.S.J.); (G.S.); (V.C.); (C.C.); (V.D.V.); (A.D.C.); (V.G.); (F.Z.); (A.F.)
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, 88100 Catanzaro, Italy;
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80132 Naples, Italy; (L.S.J.); (G.S.); (V.C.); (C.C.); (V.D.V.); (A.D.C.); (V.G.); (F.Z.); (A.F.)
| | - Vito Caivano
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80132 Naples, Italy; (L.S.J.); (G.S.); (V.C.); (C.C.); (V.D.V.); (A.D.C.); (V.G.); (F.Z.); (A.F.)
| | - Carmen Ciampi
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80132 Naples, Italy; (L.S.J.); (G.S.); (V.C.); (C.C.); (V.D.V.); (A.D.C.); (V.G.); (F.Z.); (A.F.)
| | - Valeria Del Vecchio
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80132 Naples, Italy; (L.S.J.); (G.S.); (V.C.); (C.C.); (V.D.V.); (A.D.C.); (V.G.); (F.Z.); (A.F.)
| | - Arcangelo Di Cerbo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80132 Naples, Italy; (L.S.J.); (G.S.); (V.C.); (C.C.); (V.D.V.); (A.D.C.); (V.G.); (F.Z.); (A.F.)
| | - Vincenzo Giallonardo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80132 Naples, Italy; (L.S.J.); (G.S.); (V.C.); (C.C.); (V.D.V.); (A.D.C.); (V.G.); (F.Z.); (A.F.)
| | - Francesca Zinno
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80132 Naples, Italy; (L.S.J.); (G.S.); (V.C.); (C.C.); (V.D.V.); (A.D.C.); (V.G.); (F.Z.); (A.F.)
| | - Pasquale De Fazio
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, 88100 Catanzaro, Italy;
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “L. Vanvitelli”, 80132 Naples, Italy; (L.S.J.); (G.S.); (V.C.); (C.C.); (V.D.V.); (A.D.C.); (V.G.); (F.Z.); (A.F.)
| |
Collapse
|
22
|
Golpira R, Azadmanjir Z, Zarei J, Hashemi N, Meidani Z, Vahedi A, Bakhshandeh H, Fakharian E, Sheikhtaheri A. Evaluation of the implementation of International Classification of Diseases, 11th revision for morbidity coding: Rationale and study protocol. INFORMATICS IN MEDICINE UNLOCKED 2021. [DOI: 10.1016/j.imu.2021.100668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
23
|
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.
Collapse
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
| |
Collapse
|
24
|
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.
Collapse
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
| |
Collapse
|
25
|
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.
Collapse
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
| |
Collapse
|
26
|
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.
Collapse
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.
| |
Collapse
|
27
|
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.
Collapse
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.
| |
Collapse
|
28
|
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.
Collapse
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
| |
Collapse
|
29
|
Evaluation of the International Classification of Diseases-11 chronic pain classification: study protocol for an ecological implementation field study in low-, middle-, and high-income countries. Pain Rep 2020; 5:e825. [PMID: 32656459 PMCID: PMC7318717 DOI: 10.1097/pr9.0000000000000825] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/17/2020] [Accepted: 04/25/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction The purpose of the present ecological implementation field study is to evaluate the new classification of chronic pain as implemented in the 11th revision of the International Classification of Diseases (ICD-11) with regard to clinical utility and interrater reliability. To evaluate the classification in a variety of settings, the study will be implemented in different low-, middle-, and high-income countries. Methods The study will be conducted in 2 phases. Participating pain clinics of the first phase are located in India, Cuba, and New Zealand. Two or more clinicians per study center will use the ICD-11 classification of chronic pain to diagnose 75 to 100 consecutive new chronic pain patients per center. A structured classification algorithm will guide the diagnostic process. Interrater reliability will be analyzed for the first 20 consecutive new patients per center. Before the coding, a training workshop will introduce the clinicians to the new classification. The main outcome parameter of the ecological implementation field study is clinical utility. More specifically, this entails clinical utility ratings, interrater reliability, as well as the exhaustiveness of the classification and the mutual exclusiveness of the new chronic pain categories. Differences between countries with different cultural backgrounds and income levels will be analyzed. Perspective The ecological implementation field study presented here will be implemented in several countries with different income levels. This increases the generalizability of the results and allows initial insight into the global applicability of the new chronic pain classification. A positive evaluation can facilitate the implementation of the classification.
Collapse
|
30
|
Affiliation(s)
- Francesco Perris
- WHO Collaborating Centre for Research and Training in Mental Health, University of Campania L. Vanvitelli, Naples, Italy
| |
Collapse
|
31
|
Kotov R, Jonas KG, Carpenter WT, Dretsch MN, Eaton NR, Forbes MK, Forbush KT, Hobbs K, Reininghaus U, Slade T, South SC, Sunderland M, Waszczuk MA, Widiger TA, Wright AGC, Zald DH, Krueger RF, Watson D. Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): I. Psychosis superspectrum. World Psychiatry 2020; 19:151-172. [PMID: 32394571 PMCID: PMC7214958 DOI: 10.1002/wps.20730] [Citation(s) in RCA: 135] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is a scientific effort to address shortcomings of traditional mental disorder diagnoses, which suffer from arbitrary boundaries between psychopathology and normality, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. This paper synthesizes evidence on the validity and utility of the thought disorder and detachment spectra of HiTOP. These spectra are composed of symptoms and maladaptive traits currently subsumed within schizophrenia, other psychotic disorders, and schizotypal, paranoid and schizoid personality disorders. Thought disorder ranges from normal reality testing, to maladaptive trait psychoticism, to hallucinations and delusions. Detachment ranges from introversion, to maladaptive detachment, to blunted affect and avolition. Extensive evidence supports the validity of thought disorder and detachment spectra, as each spectrum reflects common genetics, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, biomarkers, and treatment response. Some of these characteristics are specific to one spectrum and others are shared, suggesting the existence of an overarching psychosis superspectrum. Further research is needed to extend this model, such as clarifying whether mania and dissociation belong to thought disorder, and explicating processes that drive development of the spectra and their subdimensions. Compared to traditional diagnoses, the thought disorder and detachment spectra demonstrated substantially improved utility: greater reliability, larger explanatory and predictive power, and higher acceptability to clinicians. Validated measures are available to implement the system in practice. The more informative, reliable and valid characterization of psychosis-related psychopathology offered by HiTOP can make diagnosis more useful for research and clinical care.
Collapse
Affiliation(s)
- Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Katherine G Jonas
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | | | - Michael N Dretsch
- Walter Reed Army Institute of Research, US Army Medical Research Directorate - West, Silver Spring, MD, USA
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Miriam K Forbes
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Kelsie T Forbush
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Kelsey Hobbs
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
- ESRC Centre for Society and Mental Health, King's College London, London, UK
- Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance Abuse, 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 Abuse, University of Sydney, Sydney, NSW, Australia
| | - Monika A Waszczuk
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Thomas A Widiger
- Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - Aidan G C Wright
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - David H Zald
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - David Watson
- Department of Psychology, University of Notre Dame, South Bend, IN, USA
| |
Collapse
|
32
|
Valle R. Schizophrenia in ICD-11: Comparison of ICD-10 and DSM-5. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020; 13:95-104. [PMID: 32336596 DOI: 10.1016/j.rpsm.2020.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 11/15/2019] [Accepted: 01/22/2020] [Indexed: 10/24/2022]
Abstract
The conceptualization of schizophrenia has changed from its initial conception in the 19th century to the recent publication of the ICD-11. The changes incorporated in this latest version were made based on the evaluation of the current ICD, the available scientific evidence, and the consensus reached by its developers. In this paper we describe the conceptualization changes (diagnostic criteria and specifiers) of ICD-11 schizophrenia with respect to those of ICD-10 and DSM-5. The changes found are discussed based on the scientific literature published in Medline, Scopus and Scielo until July 2019 and the information on the Wordl Health Organization and American Psychiatric Association websites. Given that the diagnosis of schizophrenia is based on the diagnostic criteria of the diagnostic classification systems, it is important to know the changes made in its conceptualization and the evidence supporting such modifications.
Collapse
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.
| |
Collapse
|
33
|
Accuracy of diagnostic classification and clinical utility assessment of ICD-11 compared to ICD-10 in 10 mental disorders: findings from a web-based field study. Eur Arch Psychiatry Clin Neurosci 2020; 270:281-289. [PMID: 31654119 DOI: 10.1007/s00406-019-01076-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/09/2019] [Indexed: 12/16/2022]
Abstract
In this web-based field study, we compared the diagnostic accuracy and clinical utility of 10 selected mental disorders between the ICD-11 Clinical Descriptions and Diagnostic Guidelines (CDDG) and the ICD-10 CDDG using vignettes in a sample of 928 health professionals from all WHO regions. On average, the ICD-11 CDDG displayed significantly higher diagnostic accuracy (71.9% for ICD-11, 53.2% for ICD-10), higher ease of use, better goodness of fit, higher clarity, and lower time required for diagnosis compared to the ICD-10 CDDG. The advantages of the ICD-11 CDDG were largely limited to new diagnoses in ICD-11. After limiting analyses to diagnoses existing in ICD-11 and ICD-10, the ICD-11 CDDG were only superior in ease of use. The ICD-11 CDDG were not inferior in diagnostic accuracy or clinical utility compared to the ICD-10 CDDG for any of the vignettes. Diagnostic accuracy was consistent across WHO regions and independent of participants' clinical experience. There were no differences between medical doctors and psychologists in diagnostic accuracy, but members of other health professions had greater difficulties in determining correct diagnoses based on the ICD-11 CDDG. In sum, there were no differences in diagnostic accuracy for diagnoses existing in ICD-10 and ICD-11, but the introduction of new diagnoses in ICD-11 has improved the diagnostic classification of some clinical presentations. The favourable clinical utility ratings of the ICD-11 CDDG give reason to expect a positive evaluation by health professionals in the implementation phase of ICD-11. Yet, training in ICD-11 is needed to further enhance the diagnostic accuracy.
Collapse
|
34
|
Sampogna G, Del Vecchio V, Giallonardo V, Luciano M, Fiorillo A. Diagnosis, Clinical Features, and Therapeutic Implications of Agitated Depression. Psychiatr Clin North Am 2020; 43:47-57. [PMID: 32008687 DOI: 10.1016/j.psc.2019.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Agitated "unipolar" depression is a clinical entity characterized by excitement together with depressed mood during the same episode. The clinical picture of agitated "unipolar" depression is characterized by a depressed and anxious mood with inner, psychic agitation, whereas motor agitation may or may not be present. Some investigators have conceptualized this disorder as a mixed affective state, laying on the bipolar disorder spectrum, but controversies still persist. The diagnosis of agitated "unipolar" depression has important prognostic and therapeutic implications, with many clinicians reporting difficulties to adequately diagnose and treat it.
Collapse
Affiliation(s)
- Gaia Sampogna
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie, Naples 80138, Italy.
| | - Valeria Del Vecchio
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie, Naples 80138, Italy
| | - Vincenzo Giallonardo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie, Naples 80138, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie, Naples 80138, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie, Naples 80138, Italy
| |
Collapse
|
35
|
Reed GM, Medina-Mora ME. A Clinically Useful, Globally Applicable, Science-based Classification. Arch Med Res 2020; 50:556-557. [PMID: 32062188 DOI: 10.1016/j.arcmed.2019.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | | |
Collapse
|
36
|
Onofa L, Odunleye M, Kola L, Gureje O. Reliability and Clinical Utility of ICD-11 Diagnostic Guidelines for Severe Mental Disorders in Nigeria. Arch Med Res 2020; 50:535-542. [PMID: 32032925 DOI: 10.1016/j.arcmed.2020.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 01/15/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND An essential foundation for global mental health is the development of reliable, clinically useful and globally applicable diagnostic classification of mental disorders. AIM This study is aimed at assessing the inter-rater reliability and clinical utility of the proposed diagnostic guidelines for severe mental disorders in the eleventh edition of the International Classification of Diseases and Related Health Problems (ICD-11) in Nigeria. METHOD The study was conducted in Nigeria at 2 mental health facilities as part of a 13 country project coordinated by the World Health Organization. Following training, 32 clinician raters assessed the reliability and clinical utility of the proposed diagnostic guidelines for schizophrenia and other primary psychotic disorders, mood disorders, anxiety and fear-related disorders, and disorders specifically associated with stress. Using SPSS version 21, analysis of data was conducted at the Data Coordinating Center (DCC), Columbia University. RESULTS For reliability, estimates of intraclass κ coefficients for diagnoses ranged between 0.71 (Schizoaffective disorder) and 0.93 (Schizophrenia). In ratings of the clinical utility, the guidelines were perceived as easy to use, corresponding accurately to patients' presentations (i.e. having satisfactory goodness-of-fit), clearly understandable, and as providing useful guidance on distinguishing a disorder from normality and from other mental disorders. CONCLUSION Overall, the reliability of the diagnostic guidelines was good in Nigeria, ranging from substantial to almost perfect. Utility ratings were generally satisfactory. The results support the suitability of the ICD-11 diagnostic guidelines for implementation at a worldwide level.
Collapse
Affiliation(s)
- Lucky Onofa
- Federal Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria
| | - Mayokun Odunleye
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Lola Kola
- WHO Collaborating Centre of Research and Training in Mental Health, Neuroscience and Substances Abuse, Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Oye Gureje
- WHO Collaborating Centre of Research and Training in Mental Health, Neuroscience and Substances Abuse, Department of Psychiatry, University of Ibadan, Ibadan, Nigeria.
| |
Collapse
|
37
|
Rebello TJ, Keeley JW, Kogan CS, Sharan P, Matsumoto C, Kuligyna M, Domínguez-Martínez T, Stona AC, Grenier J, Huang J, Zhong N, Stein DJ, Emmelkamp P, Chakrabarti S, Andrews HF, Reed GM. Anxiety and Fear-Related Disorders in the ICD-11: Results from a Global Case-controlled Field Study. Arch Med Res 2020; 50:490-501. [PMID: 32018071 DOI: 10.1016/j.arcmed.2019.12.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 12/17/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND This article reports the results of one of a series of global field studies implemented by the World Health Organization (WHO) to evaluate the accuracy, clinical utility, and global applicability of the new diagnostic guidelines for Mental, Behavioural and Neurological Disorders included in the next version of WHO's International Classification of Diseases (ICD-11). AIMS OF THE STUDY The purpose of this study was to compare the diagnostic accuracy and clinical utility ratings of global clinicians implementing the ICD-11 diagnostic guidelines for Anxiety and Fear-Related Disorders, relative to those applying ICD-10 guidelines. The study also aimed to identify elements of the guidelines that required further refinement or clarification. METHODS 1840 global mental health professionals registered with WHO's Global Clinical Practice Network completed the study in one of six study languages. Participants were randomly assigned to apply either the ICD-11 or ICD-10 guidelines to diagnose standardized case vignettes, and to rate the clinical utility of their assigned guidelines. RESULTS ICD-11's diagnostic accuracy and clinical utility were equivalent or superior to that of ICD-10. Global clinicians were significantly more accurate in diagnosing Generalized Anxiety Disorder, Specific Phobia and adult cases of Separation Anxiety Disorder when using ICD-11 and provided high clinical utility ratings for these disorders. Clinicians also found the ICD-11 guidelines easy to use, clear, and a good fit to patients they see in their clinical practice. However, clinicians had difficulty with distinguishing the boundary between disorder and normality for subthreshold cases of anxiety, and also with applying the new ICD-11 guidelines on panic attacks. CONCLUSIONS The new diagnostic guidelines for Anxiety Disorders in ICD-11 can be applied in an acceptably consistent manner by global clinicians and perform as well or better than the previous guidelines for ICD-10. Study findings also helped identify aspects of the ICD-11 guidelines that required refinement prior to their publication and areas that should be emphasized in training programs.
Collapse
Affiliation(s)
- Tahilia J Rebello
- Department of Psychiatry and WHO Collaborating Centre for Research and Capacity Building in Global Mental Health, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Cary S Kogan
- Department of Psychology, University of Ottawa, Ottawa, Canada
| | - Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Chihiro Matsumoto
- ICD-11 Committee, Japanese Society of Psychiatry and Neurology, Tokyo, Japan
| | - Maya Kuligyna
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | | | - Anne-Claire Stona
- Lee Kong Chian School of Medicine, Nanyang Technological Univerity, Singapore
| | - Jean Grenier
- Institut du savoir Montfort, Montfort Hospital & University of Ottawa, Ottawa, Canada
| | - Jingjing Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Na Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Dan J Stein
- SA MRC Unit of Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Paul Emmelkamp
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Howard F Andrews
- Departments of Biostatistics and Psychiatry and New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
| | - Geoffrey M Reed
- Department of Psychiatry and WHO Collaborating Centre for Research and Capacity Building in Global Mental Health, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.
| |
Collapse
|
38
|
Luciano M, Sampogna G, Del Vecchio V, Giallonardo V, Palummo C, Pocai B, Steardo L, Zinno F, Rebello T, Reed GM, Fiorillo A. The Italian ICD-11 field trial: clinical utility of diagnostic guidelines for schizophrenia and related disorders. Int J Ment Health Syst 2020; 14:4. [PMID: 31998405 PMCID: PMC6979076 DOI: 10.1186/s13033-020-0338-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/13/2020] [Indexed: 11/10/2022] Open
Abstract
Background The 11th revision of the International Classification of Diseases and Related Disorders (ICD-11) has been released. In order to test the clinical consistency and the clinical utility of the proposed guidelines the World Health Organization (WHO) has carried out the Ecological Implementation Field Studies in various countries. In this paper the results of the Italian field trials on the clinical utility of the ICD-11 diagnostic guideline concerning schizophrenia and related disorders will be presented. Methods In Italy, field trials have been carried out at the Department of Psychiatry of the University of Campania “L. Vanvitelli”. All patients showing any psychotic symptom and referring to the outpatient and inpatient units have been recruited. Patients were interviewed by two clinicians with whom they had not had any prior clinical contact. At the end of each interview, clinicians were asked to complete 12 questions about the clinical utility of the diagnostic guidelines as applied to each patient. Results Fourteen clinicians and 100 patients have been involved. The ICD-11 clinical guidelines were perceived as easy to use, with an adequate goodness of fit, clear and understandable and with an adequate level of details and specificity to describe the essential features of the diagnoses. Clinicians rated very positively their usefulness in describing the threshold between patient’s disorder and normality. Despite still very positive, the guidelines have been perceived as less useful to select a treatment, to assess patients’ prognosis and to communicate with other mental health professionals. Conclusions The 11th revision of the chapter on Mental, Behavioural and Neurodevelopmental Disorders has made substantive changes to the conceptualization of mental disorders which could have impacted on their reliability and clinical utility. Results of the Italian field studies, in line with those reported by the international sample, highlight that ICD-11 has been rated as highly clinically useful by participating clinician, more than the ICD-10. This could be considered a good reason to be optimistic about the implementation of the ICD-11 among global clinicians. Trial registration The study has been approved by the Ethical Review Board of the University of Campania “L. Vanvitelli” (N. 416, 2016)
Collapse
Affiliation(s)
- Mario Luciano
- WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gaia Sampogna
- WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy
| | - Valeria Del Vecchio
- WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy
| | - Vincenzo Giallonardo
- WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy
| | - Carmela Palummo
- WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy
| | - Benedetta Pocai
- WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy
| | - Luca Steardo
- 2Dipartimento di Scienze della Salute, Università della Magna Graecia, Catanzaro, Italy
| | - Francesca Zinno
- WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy
| | - Tahilia Rebello
- 3WHO Collaborating Centre for Capacity Building and Training in Global Mental Health, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY USA
| | - Geoffrey M Reed
- 3WHO Collaborating Centre for Capacity Building and Training in Global Mental Health, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY USA
| | - Andrea Fiorillo
- WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy
| |
Collapse
|
39
|
Stein DJ, Szatmari P, Gaebel W, Berk M, Vieta E, Maj M, de Vries YA, Roest AM, de Jonge P, Maercker A, Brewin CR, Pike KM, Grilo CM, Fineberg NA, Briken P, Cohen-Kettenis PT, Reed GM. Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies. BMC Med 2020; 18:21. [PMID: 31983345 PMCID: PMC6983973 DOI: 10.1186/s12916-020-1495-2] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/09/2020] [Indexed: 12/16/2022] Open
Abstract
An update of the chapter on Mental, Behavioral and Neurodevelopmental Disorders in the International Classification of Diseases and Related Health Problems (ICD) is of great interest around the world. The recent approval of the 11th Revision of the ICD (ICD-11) by the World Health Organization (WHO) raises broad questions about the status of nosology of mental disorders as a whole as well as more focused questions regarding changes to the diagnostic guidelines for specific conditions and the implications of these changes for practice and research. This Forum brings together a broad range of experts to reflect on key changes and controversies in the ICD-11 classification of mental disorders. Taken together, there is consensus that the WHO's focus on global applicability and clinical utility in developing the diagnostic guidelines for this chapter will maximize the likelihood that it will be adopted by mental health professionals and administrators. This focus is also expected to enhance the application of the guidelines in non-specialist settings and their usefulness for scaling up evidence-based interventions. The new mental disorders classification in ICD-11 and its accompanying diagnostic guidelines therefore represent an important, albeit iterative, advance for the field.
Collapse
Affiliation(s)
- Dan J. Stein
- SA Medical Research Council Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Peter Szatmari
- Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto, Toronto, ON Canada
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Michael Berk
- Deakin University, IMPACT, the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health and the Centre for Youth Mental Health, Parkville, Australia
- Florey Institute for Neuroscience and Mental Health, Parkville, Australia
- Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Eduard Vieta
- Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia Spain
| | - Mario Maj
- Department of Psychiatry, University of Campania ‘L. Vanvitelli’, Naples, Italy
| | - Ymkje Anna de Vries
- Department of Developmental Psychology, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, Groningen, The Netherlands
| | - Annelieke M. Roest
- Department of Developmental Psychology, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, Groningen, The Netherlands
| | - Peter de Jonge
- Department of Developmental Psychology, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, Groningen, The Netherlands
| | - Andreas Maercker
- Department of Psychology – Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
| | - Chris R. Brewin
- Research Deparment of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Kathleen M. Pike
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY USA
| | - Carlos M. Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Naomi A. Fineberg
- Hertfordshire Partnership University NHS Foundation Trust and University of Hertfordshire, Welwyn Garden City, UK
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine & Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | - Geoffrey M. Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY USA
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| |
Collapse
|
40
|
Abstract
In psychiatry, the information conveyed by diagnosis (i.e., the "type" to which the individual patient is reconducted) is in itself insufficient for therapeutic and prognostic purposes. Hence the need for a more detailed characterization of the individual case, with a special focus on the assessment of low-order and high-order psychopathological dimensions, the evaluation of the severity of the clinical picture, the assessment of the stage of development of the disorder, and the exploration of a series of antecedent and concomitant variables. We should start to promote the construction and validation of tools guiding the clinician systematically in this characterization, trying to incorporate in this effort elements of the approaches that are currently presented as "alternative" to the ICD and DSM.
Collapse
Affiliation(s)
- Mario Maj
- Department of Psychiatry, University of Campania L. Vanvitelli, Largo Madonna delle Grazie, 80138 Naples, Italy
| |
Collapse
|
41
|
Maalouf FT, Alamiri B, Atweh S, Becker AE, Cheour M, Darwish H, Ghandour LA, Ghuloum S, Hamze M, Karam E, Khoury B, Khoury SJ, Mokdad A, Meho LI, Okasha T, Reed GM, Sbaity E, Zeinoun P, Akl EA. Mental health research in the Arab region: challenges and call for action. Lancet Psychiatry 2019; 6:961-966. [PMID: 31327707 DOI: 10.1016/s2215-0366(19)30124-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/19/2019] [Accepted: 03/20/2019] [Indexed: 12/16/2022]
Abstract
Although mental disorders are a leading cause of disability in the Arab region, which includes 5·54% of the global population, Arab countries produce only 1·0% of the global output of peer-reviewed publications in mental health research. Various stakeholders, including Arab mental health researchers, institutional and funding agency officials, and international research collaborators, convened to identify challenges faced by Arab mental health researchers and propose an evidence-informed call for action. Challenges identified include prevalent stigma and low awareness, conflict and war, scarce institutional and funding resources, inadequate publishing opportunities, insufficient training in mental health research, and shortage of reliable and valid assessment tools. The proposed action plan includes ways of addressing stigma and spreading awareness, increasing collaborative efforts, building research infrastructure, strengthening the mental health workforce, and translating research findings into a call to action on societal and governmental levels. The proposed action plan could provide a roadmap for Arab mental health researchers and research institutions, which might ultimately increase research productivity in the Arab region and close the gap between Arab countries and the rest of the world.
Collapse
Affiliation(s)
- Fadi T Maalouf
- Division of Child and Adolescent Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Bibi Alamiri
- Al-Manara, Kuwait Center for Mental Health, Kuwait
| | - Samir Atweh
- Department of Neurology, American University of Beirut, Beirut, Lebanon
| | - Anne E Becker
- Department of Global Health and Social Medicine, Harvard Medical School Cambridge, MA, USA
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - Hala Darwish
- Hariri School of Nursing, Abu-Haidar Neuroscience Institute, American University of Beirut, Beirut, Lebanon
| | - Lilian A Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Suhaila Ghuloum
- Hamad Medical Corporation, Weill Cornell Medicine, Doha, Qatar
| | - Mouin Hamze
- National Council for Scientific Research, Beirut, Lebanon
| | - Elie Karam
- Department of Psychiatry and Clinical Psychology, St Georges Hospital University Medical Center, Beirut, Lebanon
| | - Brigitte Khoury
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Samia J Khoury
- Hariri School of Nursing, Abu-Haidar Neuroscience Institute, American University of Beirut, Beirut, Lebanon; Department of Neurology, American University of Beirut, Beirut, Lebanon
| | - Ali Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Lokman I Meho
- University Libraries, American University of Beirut, Beirut, Lebanon
| | - Tarek Okasha
- Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Eman Sbaity
- Department of Surgery, American University of Beirut, Beirut, Lebanon
| | - Pia Zeinoun
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon; Department of Psychology, American University of Beirut, Beirut, Lebanon
| | - Elie A Akl
- Department of Internal Medicine, American University of Beirut Medical Center, Riad-El-Solh, Beirut, Lebanon.
| |
Collapse
|
42
|
Affiliation(s)
- Benedetta Pocai
- WHO Collaborating Center for Research and Training in Mental Health, Naples, Italy
| |
Collapse
|
43
|
Saunders JB, Degenhardt L, Reed GM, Poznyak V. Alcohol Use Disorders in ICD‐11: Past, Present, and Future. Alcohol Clin Exp Res 2019; 43:1617-1631. [DOI: 10.1111/acer.14128] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 05/31/2019] [Indexed: 01/16/2023]
Affiliation(s)
- John B. Saunders
- Centre for Youth Substance Abuse Research University of Queensland Brisbane QLD Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre University of New South Wales Sydney NSW Australia
| | - Geoffrey M. Reed
- Department of Psychiatry Columbia University Vagelos College of Physicians and Surgeons New York NY USA
- Department of Mental Health and Substance Abuse World Health Organization Geneva Switzerland
| | - Vladimir Poznyak
- Department of Mental Health and Substance Abuse World Health Organization Geneva Switzerland
| |
Collapse
|
44
|
Bakker GM. A new conception and subsequent taxonomy of clinical psychological problems. BMC Psychol 2019; 7:46. [PMID: 31291999 PMCID: PMC6617608 DOI: 10.1186/s40359-019-0318-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/12/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND A taxonomy of the objects of study, theory, assessment, and intervention is critical to the development of all clinical sciences. Clinical psychology has been conceptually and administratively dominated by the taxonomy of an adjacent discipline - psychiatry's Diagnostic and statistical manual of mental disorders (DSM). Many have called for a 'paradigm shift' away from a medical nosology of diseases toward clinical psychology's own taxonomy of clinical psychological problems (CPPs), without being able to specify what is to be listed and classified. MAIN TEXT An examination of DSM's problems for clinical psychology, especially its lack of clinical utility, and a search for the essence of CPPs in what clinical psychologists actually do, leads to the proposal that: The critical psychological-level phenomenon underlying CPPs is the occurrence of 'problem-maintaining circles' (PMCs) of causally related cognitions, emotions, behaviours, and/or stimuli. This concept provides an empirically-derived, theory-based, treatment-relevant, categorical, essentialist, parsimonious, and nonstigmatizing definition of CPPs. It distinguishes psychological problems in which PMCs have not (yet?) formed, and which may respond to 'counseling', clinical psychological problems in which active PMCs require clinical intervention, and psychopathological problems which are unlikely to be 'cured' by PMC-breaking alone. CONCLUSION A subsequent classification and coding system of PMCs is proposed, and expected benefits to research, communication, and the quality of case formulation in clinical psychology are described, reliant upon a development effort of some meaningful fraction of that which has been devoted to the DSM.
Collapse
Affiliation(s)
- Gary M Bakker
- School of Medicine, University of Tasmania, Locked Bag 1377, Launceston, Tasmania, 7250, Australia.
| |
Collapse
|
45
|
Fuss J, Lemay K, Stein DJ, Briken P, Jakob R, Reed GM, Kogan CS. Public stakeholders' comments on ICD-11 chapters related to mental and sexual health. World Psychiatry 2019; 18:233-235. [PMID: 31059633 PMCID: PMC6502458 DOI: 10.1002/wps.20635] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Johannes Fuss
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Ham-burg-Eppendorf, Hamburg, Germany
| | - Kyle Lemay
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Dan J. Stein
- Department of Psychiatry, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Peer Briken
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Ham-burg-Eppendorf, Hamburg, Germany
| | - Robert Jakob
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
| | - Geoffrey M. Reed
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland,Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Cary S. Kogan
- School of Psychology, University of Ottawa, Ottawa, Canada
| |
Collapse
|
46
|
Claudino AM, Pike KM, Hay P, Keeley JW, Evans SC, Rebello TJ, Bryant-Waugh R, Dai Y, Zhao M, Matsumoto C, Herscovici CR, Mellor-Marsá B, Stona AC, Kogan CS, Andrews HF, Monteleone P, Pilon DJ, Thiels C, Sharan P, Al-Adawi S, Reed GM. The classification of feeding and eating disorders in the ICD-11: results of a field study comparing proposed ICD-11 guidelines with existing ICD-10 guidelines. BMC Med 2019; 17:93. [PMID: 31084617 PMCID: PMC6515596 DOI: 10.1186/s12916-019-1327-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/16/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) International Classification of Diseases and Related Health Problems (ICD) is used globally by 194 WHO member nations. It is used for assigning clinical diagnoses, providing the framework for reporting public health data, and to inform the organization and reimbursement of health services. Guided by overarching principles of increasing clinical utility and global applicability, the 11th revision of the ICD proposes major changes that incorporate empirical advances since the previous revision in 1992. To test recommended changes in the Mental, Behavioral, and Neurodevelopmental Disorders chapter, multiple vignette-based case-controlled field studies have been conducted which examine clinicians' ability to accurately and consistently use the new guidelines and assess their overall clinical utility. This manuscript reports on the results from the study of the proposed ICD-11 guidelines for feeding and eating disorders (FEDs). METHOD Participants were 2288 mental health professionals registered with WHO's Global Clinical Practice Network. The study was conducted in Chinese, English, French, Japanese, and Spanish. Clinicians were randomly assigned to apply either the ICD-11 or ICD-10 diagnostic guidelines for FEDs to a pair of case vignettes designed to test specific clinical questions. Clinicians selected the diagnosis they thought was correct for each vignette, evaluated the presence of each essential feature of the selected diagnosis, and the clinical utility of the diagnostic guidelines. RESULTS The proposed ICD-11 diagnostic guidelines significantly improved accuracy for all FEDs tested relative to ICD-10 and attained higher clinical utility ratings; similar results were obtained across all five languages. The inclusion of binge eating disorder and avoidant-restrictive food intake disorder reduced the use of residual diagnoses. Areas needing further refinement were identified. CONCLUSIONS The proposed ICD-11 diagnostic guidelines consistently outperformed ICD-10 in distinguishing cases of eating disorders and showed global applicability and appropriate clinical utility. These results suggest that the proposed ICD-11 guidelines for FEDs will help increase accuracy of public health data, improve clinical diagnosis, and enhance health service organization and provision. This is the first time in the revision of the ICD that data from large-scale, empirical research examining proposed guidelines is completed in time to inform the final diagnostic guidelines.
Collapse
Affiliation(s)
- Angélica M Claudino
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Rua Major Maragliano, 241, São Paulo, SP, 04017-030, Brazil.
| | - Kathleen M Pike
- Department of Psychiatry, Columbia University, Vagelos College of Physicians and Surgeons, Unit 9 Room 5808, 1051 Riverside Drive, New York, NY, 10032, USA.
| | - Phillipa Hay
- Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Locked Bag 1797, Penrith South, 2751, NSW Campbelltown, Australia
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St, Box 842018, Richmond, VA, 23284, USA
| | - Spencer C Evans
- Department of Psychology, Harvard University, 33 Kirkland St, 1040 William James Hall, Cambridge, MA, 02138, USA
| | - 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
| | - Rachel Bryant-Waugh
- Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust, Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, 30 Guilford St, London, WC1N 1EH, UK
| | - Yunfei Dai
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, People's Republic of China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, 200030, People's Republic of China
| | - 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
| | - Cecile Rausch Herscovici
- International Life Sciences Institute (ILSI, Argentina), J. Salguero 2745, Buenos Aires, 1425, CABA, Argentina
| | - Blanca Mellor-Marsá
- Department of Psychiatry, Faculty of Medicine, Universidad Autónoma de Madrid, Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental, 2ª Planta Norte, Calle del Prof Martín Lagos, s/n, 28040, Madrid, Spain
| | - Anne-Claire Stona
- Ministry for Solidarity and Health, Avenue Duquesne, 75350, Paris, France
| | - Cary S Kogan
- School of Psychology, Faculty of Social Sciences, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON, K1N 6N5, Canada
| | - Howard F Andrews
- Departments of Biostatistics and Psychiatry and New York State Psychiatric Institute, Columbia University, Vagelos College of Physicians and Surgeons, Unit 47, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Palmiero Monteleone
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy.,Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, via Allende, Baronissi, 84081, Salerno, Italy
| | - David Joseph Pilon
- Nova Scotia Health Authority, Dalhousie University, LeMarchant Place, 2nd Floor, Rm 2121, 1246 LeMarchant Street, Halifax, NS, B3H 4R2, Canada
| | - Cornelia Thiels
- Department of Social Studies, University of Applied Sciences Bielefeld, Kissinger Str. 14, D-12157, Berlin, Germany
| | - Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India
| | - Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 35, P.C. 123, Al Khoud, Muscat, Sultanate of Oman
| | - Geoffrey M Reed
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.,Department of Psychiatry, Columbia University, Vagelos College of Physicians and Surgeons, Unit 9 Room 5816, 1051 Riverside Drive, New York, NY, 10032, USA
| |
Collapse
|
47
|
Stieglitz RD, Jäger M. Status und Zukunft psychiatrischer Klassifikationssysteme. VERHALTENSTHERAPIE 2019. [DOI: 10.1159/000497783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Psychiatrische Klassifikationssysteme werden seit jeher kontrovers diskutiert. Kritikpunkte beziehen sich auf konzeptuelle, methodische und anwendungsbezogene Aspekte. In den letzten Jahren wurden zur Lösung dieser Probleme neue Ansätze wie Research Domain Criteria oder Hierarchical Taxonomy of Psychopathology vorgeschlagen. Diese werden vermutlich jedoch erst in Jahren nutzbare Ergebnisse liefern. Existierende Ansätze und Konzepte wie multiaxiale Klassifikation, multimodale Diagnostik, Clinimetrics oder Evidence-Based Assessment können jedoch bereits jetzt genutzt werden, um bestehende Schwächen auszugleichen.
Collapse
|
48
|
Zhuo C, Xu Y, Zhang L, Jing R, Zhou C. The Effect of Dopamine Antagonist Treatment on Auditory Verbal Hallucinations in Healthy Individuals Is Clearly Influenced by COMT Genotype and Accompanied by Corresponding Brain Structural and Functional Alterations: An Artificially Controlled Pilot Study. Front Genet 2019; 10:92. [PMID: 30894870 PMCID: PMC6414462 DOI: 10.3389/fgene.2019.00092] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/29/2019] [Indexed: 11/29/2022] Open
Abstract
Few studies have been conducted to explore the influence of the catechol-o-methyltransferase (COMT) genotype on the severity of and treatment efficacy on auditory verbal hallucination (AVH) symptoms in healthy individuals with AVHs (Hi-AVHs). We hypothesized that the efficacy of dopamine antagonist treatment on AVHs in Hi-AVHs may be influenced by their COMT genotype and may be accompanied by corresponding brain alterations. To preliminarily investigate and test our hypothesis in an artificially controlled pilot study, we enrolled 42 Hi-AVHs as subjects and used magnetic resonance imaging and genetic methods to explore the basis brain features to investigate whether the efficacy of dopamine antagonist treatment on AVHs in Hi-AVH subjects was influenced by their COMT genotype or not. We found that COMT-met genotype subjects’ treatment response was better than that of COMT-val subjects. Although COMT-met genotype subjects demonstrated an increase in global functional connectivity density (gFCD) but no difference on gray matter volume (GMV) compared to COMT-val genotype subjects at baseline, notably, we found that both groups demonstrated gFCD and GMV reduction after treatment, but the reduction was more widespread in COMT-met genotype subjects than in COMT-val genotype subjects. This is the first study to report that Hi-AVH subjects’ baseline brain functional features are influenced by their COMT genotypes and that the COMT-met genotype subjects exhibit better responses to dopamine antagonists but have more widespread GMV and gFCD reduction than subjects with the COMT-val genotype. Despite several limitations, these findings may provide auxiliary information to further explain the mechanisms of AVHs and provide a clue for scholars to further explore specific treatment targets for AVHs in Hi-AVH subjects or in schizophrenia patients.
Collapse
Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC-Lab), Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, China.,Department of Psychiatry, College of Basic Medical Science, Tianjin Medical University, Tianjin, China.,Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China.,Department of Psychiatry, Institute of Mental Health, Jining Medical University, Jining, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Li Zhang
- GHM Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Rixing Jing
- Department of Pattern Recognition, China National Key Laboratory, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Department of Pattern Recognition, University of Chinese Academy of Sciences, Beijing, China
| | - Chunhua Zhou
- Department of Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, China
| |
Collapse
|
49
|
Affiliation(s)
- G S Malhi
- Northern Clinical School, The University of Sydney, Sydney, NSW, Australia.,Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - L Irwin
- Northern Clinical School, The University of Sydney, Sydney, NSW, Australia.,Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| | - T Outhred
- Northern Clinical School, The University of Sydney, Sydney, NSW, Australia.,Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia
| |
Collapse
|
50
|
Reed GM, First MB, Kogan CS, Hyman SE, Gureje O, Gaebel W, Maj M, Stein DJ, Maercker A, Tyrer P, Claudino A, Garralda E, Salvador‐Carulla L, Ray R, Saunders JB, Dua T, Poznyak V, Medina‐Mora ME, Pike KM, Ayuso‐Mateos JL, Kanba S, Keeley JW, Khoury B, Krasnov VN, Kulygina M, Lovell AM, de Jesus Mari J, Maruta T, Matsumoto C, Rebello TJ, Roberts MC, Robles R, Sharan P, Zhao M, Jablensky A, Udomratn P, Rahimi‐Movaghar A, Rydelius P, Bährer‐Kohler S, Watts AD, Saxena S. Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders. World Psychiatry 2019; 18:3-19. [PMID: 30600616 PMCID: PMC6313247 DOI: 10.1002/wps.20611] [Citation(s) in RCA: 305] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Following approval of the ICD-11 by the World Health Assembly in May 2019, World Health Organization (WHO) member states will transition from the ICD-10 to the ICD-11, with reporting of health statistics based on the new system to begin on January 1, 2022. The WHO Department of Mental Health and Substance Abuse will publish Clinical Descriptions and Diagnostic Guidelines (CDDG) for ICD-11 Mental, Behavioural and Neurodevelopmental Disorders following ICD-11's approval. The development of the ICD-11 CDDG over the past decade, based on the principles of clinical utility and global applicability, has been the most broadly international, multilingual, multidisciplinary and participative revision process ever implemented for a classification of mental disorders. Innovations in the ICD-11 include the provision of consistent and systematically characterized information, the adoption of a lifespan approach, and culture-related guidance for each disorder. Dimensional approaches have been incorporated into the classification, particularly for personality disorders and primary psychotic disorders, in ways that are consistent with current evidence, are more compatible with recovery-based approaches, eliminate artificial comorbidity, and more effectively capture changes over time. Here we describe major changes to the structure of the ICD-11 classification of mental disorders as compared to the ICD-10, and the development of two new ICD-11 chapters relevant to mental health practice. We illustrate a set of new categories that have been added to the ICD-11 and present the rationale for their inclusion. Finally, we provide a description of the important changes that have been made in each ICD-11 disorder grouping. This information is intended to be useful for both clinicians and researchers in orienting themselves to the ICD-11 and in preparing for implementation in their own professional contexts.
Collapse
Affiliation(s)
- Geoffrey M. Reed
- Department of Mental Health and Substance AbuseWorld Health OrganizationGenevaSwitzerland,Department of PsychiatryColumbia University Medical CenterNew YorkNYUSA
| | - Michael B. First
- Department of PsychiatryColumbia University Medical CenterNew YorkNYUSA,New York State Psychiatric InstituteNew YorkNYUSA
| | - Cary S. Kogan
- School of PsychologyUniversity of OttawaOttawaONCanada
| | - Steven E. Hyman
- Stanley Center for Psychiatric ResearchBroad Institute of Harvard and Massachusetts Institute of TechnologyCambridgeMAUSA
| | - Oye Gureje
- Department of PsychiatryUniversity of IbadanIbadanNigeria
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical FacultyHeinrich‐Heine UniversityDüsseldorfGermany
| | - Mario Maj
- Department of PsychiatryUniversity of Campania “L. Vanvitelli”NaplesItaly
| | - Dan J. Stein
- Department of PsychiatryUniversity of Cape Town, and South African Medical Research Council Unit on Risk and Resilience in Mental DisordersCape TownSouth Africa
| | | | - Peter Tyrer
- Centre for Mental HealthImperial CollegeLondonUK
| | - Angelica Claudino
- Department of PsychiatryUniversidade Federal de São Paulo (UNIFESP/EPM)São PauloBrazil
| | | | - Luis Salvador‐Carulla
- Research School of Population HealthAustralian National UniversityCanberraACTAustralia
| | - Rajat Ray
- National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - John B. Saunders
- Centre for Youth Substance Abuse ResearchUniversity of QueenslandBrisbaneQLDAustralia
| | - Tarun Dua
- Department of Mental Health and Substance AbuseWorld Health OrganizationGenevaSwitzerland
| | - Vladimir Poznyak
- Department of Mental Health and Substance AbuseWorld Health OrganizationGenevaSwitzerland
| | | | - Kathleen M. Pike
- Department of PsychiatryColumbia University Medical CenterNew YorkNYUSA
| | - José L. Ayuso‐Mateos
- Department of PsychiatryUniversidad Autonoma de Madrid; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Instituto de Investigación Sanitaria La PrincesaMadridSpain
| | | | - Jared W. Keeley
- Department of PsychologyVirginia Commonwealth UniversityRichmondVAUSA
| | - Brigitte Khoury
- Department of PsychiatryAmerican University of Beirut Medical CenterBeirutLebanon
| | - Valery N. Krasnov
- Moscow Research Institute of PsychiatryNational Medical Research Centre for Psychiatry and NarcologyMoscowRussian Federation
| | - Maya Kulygina
- Moscow Research Institute of PsychiatryNational Medical Research Centre for Psychiatry and NarcologyMoscowRussian Federation
| | - Anne M. Lovell
- Institut National de la Santé et de la Recherche Médicale U988ParisFrance
| | - Jair de Jesus Mari
- Department of PsychiatryUniversidade Federal de São Paulo (UNIFESP/EPM)São PauloBrazil
| | | | | | - Tahilia J. Rebello
- Department of PsychiatryColumbia University Medical CenterNew YorkNYUSA,New York State Psychiatric InstituteNew YorkNYUSA
| | - Michael C. Roberts
- Office of Graduate Studies and Clinical Child Psychology ProgramUniversity of KansasLawrenceKSUSA
| | - Rebeca Robles
- National Institute of Psychiatry Ramón de la Fuente MuñizMexico CityMexico
| | - Pratap Sharan
- Department of PsychiatryAll India Institute of Medical SciencesNew DelhiIndia
| | - Min Zhao
- Shanghai Mental Health Center and Department of PsychiatryShanghai Jiao Tong University School of MedicineShanghaiPeople's Republic of China
| | - Assen Jablensky
- Centre for Clinical Research in NeuropsychiatryUniversity of Western AustraliaPerthWAAustralia
| | - Pichet Udomratn
- Department of PsychiatryPrince of Songkla UniversityHat YaiThailand
| | - Afarin Rahimi‐Movaghar
- Iranian National Center for Addiction Studies, Tehran University of Medical SciencesTehranIran
| | - Per‐Anders Rydelius
- Department of Child and Adolescent PsychiatryKarolinska InstituteStockholmSweden
| | | | | | | |
Collapse
|