Scientifically Informed Insider Look at Mental Health: ICD vs DSM

Introduction

• Presentation by Dr. Grande
• Focus on differences between ICD (International Classification of Diseases) and DSM (Diagnostic and Statistical Manual of Mental Disorders)

Use and Purpose of Manuals

• Mental Disorder Definitions: Used for diagnostic purposes
• Classification Benefits: Aids treatment, understanding of causes, prevention, and progression (natural history) of disorders

Communication Among Practitioners

• Provides a common language for mental health professionals
• Facilitates faster and clearer communication (e.g., diagnosing bipolar disorder)
• Highlights challenge: Lack of biological markers for mental disorders unlike physical medicine

Diagnostic and Statistical Manual (DSM)

• History: First published in 1952, DSM-5 released in 2013
• Popularity: Widely used in the United States
• Structure: Operationalized definitions with criteria for disorders
• Inter-rater Reliability: High due to specific criteria
• Research Base: Extensive research available
• Usage Flexibility: Allows clinical discretion despite structured criteria
• Unique Disorders: Includes disorders not in ICD like disruptive mood dysregulation disorder

International Classification of Diseases (ICD)

• History: First edition in 1893, morbidity added in 1948, ICD-10 in 1990, ICD-11 in 2018
• Global Use: Used worldwide, less common in the U.S.
• Content: Covers all disorders, with specific section for mental health
• Diagnosis Approach: Utilizes guidelines instead of strict criteria, leaving more room for interpretation and clinical discretion
• Unique Disorders: Includes some diagnoses not in DSM like complex PTSD, gaming disorder, compulsive sexual behavior disorder
• Personality Disorders: One general diagnosis with ratings, unlike DSM’s categorical system

Key Differences

• Operationalization: DSM uses strict criteria; ICD uses broader guidelines
• Flexibility: ICD allows more clinical interpretation
• Information and Research: DSM provides more detailed information and has a strong research foundation

Preference and Practice

• Personal Preference: Dr. Grande prefers DSM for clarity and abundant research
• Counselor Training: Preference often stems from initial training and widespread usage
• Potential for Change: If DSM were to be replaced by ICD, minimal change expected in U.S. practices

Conclusion

• Both manuals are valuable tools for mental health diagnosis
• Dialogue and differing opinions enrich the understanding of ICD and DSM
• Future potential for merging the two manuals remains unlikely

Final Thoughts

• Engaging in community discussion encouraged for diverse perspectives on ICD and DSM

Dr. Grande emphasizes the importance of understanding these manuals to support effective mental health diagnosis and treatment.