2012 issue 1

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Volume 21, issue 1

Article from World Psychiatry

The WPA-WHO Global Survey of Psychiatrists’ Attitudes Towards Mental Disorders Classification

Geoffrey M. Reed1, Joāo Mendonça Correia1, Patricia Esparza1, Shenkhar Saxena1, Mario Maj2,3
1. Department of Mental Health and Substance Abuse, World Health Organization, Genewa, Szwajcaria
2. World Psychiatric Association
3. Department of Psychiatry, University of Naples SUN, Neapol, Włochy
Postępy Psychiatrii i Neurologii 2012; 21(1): 7–22
Keywords: mental disorders, classification, International Classification of Diseases (ICD), Diagnostic and Statistical Manual of Mental Disorders (DSM), clinical utility, cross-cultural applicability

Abstract

This article describes the results of the WPA-WHO Global Survey of 4,887 psychiatrists in 44 countries regarding their use of diagnostic classification systems in clinical practice, and the desirable characteristics of a classification of mental disorders. The WHO will use these results to improve the clinical utility of the ICD classification of mental disorders through the current ICD-10 revision process. Participants indicated that the most important purposes of a classification are to facilitate communication among clinicians and to inform treatment and management. They overwhelmingly preferred a simpler system with 100 or fewer categories, and over two-thirds preferred flexible guidance to a strict criteria-based approach. Opinions were divided about how to incorporate severity and functional status, while most respondents were receptive to a system that incorporates a dimensional component. Significant minorities of psychiatrists in Latin America and Asia reported problems with the cross-cultural applicability of existing classifications. Overall, ratings of ease of use and goodness off it for specific ICD-10 categories were fairly high, but several categories were described as having poor utility in clinical practice. This represents an important focus for the ICD revision, as does ensuring that the ICD-11 classification of mental disorders is acceptable to psychiatrists throughout the world.