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A comparison of DSM and ICD classifications of mental disorder

  • Peter Tyrer
  • Please note an addendum has been issued for this article.
Summary

Most disorders in medicine are classified using the ICD (initiated in Paris in 1900). Mental and behavioural disorders are classified using the DSM (DSM-I was published in the USA in 1952), but it was not until DSM-III in 1980 that it became a major player. Its success was largely influenced by Robert Spitzer, who welded its disparate elements, and Melvyn Shabsin, who facilitated its acceptance. Spitzer pointed out that most diagnostic conditions in psychiatry were poorly defined, showed poor reliability in test-retest situations, and were temporally unstable. The consequence was that the beliefs of the psychiatrist seemed to matter much more than the characteristics of the patient when it came to classification. Since DSM-III there has been a split between those who adhere to DSM because it is a better research classification and those who adhere to ICD because it allows more clinical discretion in making diagnoses. This article discusses the pros and cons of both systems, and the major criticisms that have been levelled against them.

Learning Objectives

Understand the principles and reasoning behind classification in medicine and psychiatry.

Be able to describe the recent history of psychiatric classification.

Be able to compare DSM and ICD classifications of mental disorder.

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Copyright
Corresponding author
Professor Peter Tyrer, Centre for Mental Health, Department of Medicine, Imperial College London, St Dunstan's Road, London W6 8RP, UK. Email: p.tyrer@imperial.ac.uk
Footnotes
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Declaration of Interest

P.T. is Chair of the ICD-11 Working Group for the Revision of Classification of Personality Disorders and has also been a member of the DSM-ICD Harmonization Coordination Group.

Footnotes
References
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American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). APA.
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn revised) (DSM-III-R) APA.
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). APA.
American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders (4th edn, text revision) (DSM-IV-TR) APA.
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (5th edn) (DSM-5) APA.
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BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
  • URL: /core/journals/bjpsych-advances
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A comparison of DSM and ICD classifications of mental disorder

  • Peter Tyrer
  • Please note an addendum has been issued for this article.
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