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Exploring the feasibility of a meta-structure for DSM-V and ICD-11: could it improve utility and validity?: Paper 1 of 7 of the thematic section: ‘A proposal for a meta-structure for DSM-V and ICD-11’

  • G. Andrews (a1), D. P. Goldberg (a2), R. F. Krueger (a3), W. T. Carpenter (a4), S. E. Hyman (a5), P. Sachdev (a1) and D. S. Pine (a6)...
Abstract
Background

The organization of mental disorders into 16 DSM-IV and 10 ICD-10 chapters is complex and based on clinical presentation. We explored the feasibility of a more parsimonious meta-structure based on both risk factors and clinical factors.

Method

Most DSM-IV disorders were allocated to one of five clusters as a starting premise. Teams of experts then reviewed the literature to determine within-cluster similarities on 11 predetermined validating criteria. Disorders were included and excluded as determined by the available data. These data are intended to inform the grouping of disorders in the DSM-V and ICD-11 processes.

Results

The final clusters were neurocognitive (identified principally by neural substrate abnormalities), neurodevelopmental (identified principally by early and continuing cognitive deficits), psychosis (identified principally by clinical features and biomarkers for information processing deficits), emotional (identified principally by the temperamental antecedent of negative emotionality), and externalizing (identified principally by the temperamental antecedent of disinhibition).

Conclusions

Large groups of disorders were found to share risk factors and also clinical picture. There could be advantages for clinical practice, public administration and research from the adoption of such an organizing principle.

Copyright
Corresponding author
*Address for correspondence: Professor G. Andrews, 299 Forbes Street, Darlinghurst, NSW, Australia2010. (Email: gavina@unsw.edu.au)
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G Andrews , TM Anderson , T Slade , M Sunderland (2008). Classification of anxiety and depressive disorders: problems and solutions. Depression and Anxiety 25, 274281.

G Andrews , DS Pine , MJ Hobbs , TM Anderson , M Sunderland (2009). Neurodevelopmental disorders: Cluster 2 of the proposed meta-structure for DSM-V and ICD-11. Psychological Medicine. doi:10.1017/S0033291709990274.

G Andrews , T Slade , C Issakidis (2002). Deconstructing current comorbidity: data from the Australian National Survey of Mental Health and Well-being. British Journal of Psychiatry 181, 306314.

G Andrews , GW Stewart , A Morris-Yates , PE Holt , AS Henderson (1990). Evidence for a general neurotic syndrome. British Journal of Psychiatry 157, 612.

WT Carpenter Jr., JR Bustillo , GK Thaker , J van Os , RF Krueger , MJ Green (2009). Psychoses: Cluster 3 of the proposed meta-structure for DSM-V and ICD-11. Psychological Medicine. doi:10.1017/S0033291709990286.

BJ Cox , IP Clara , MW Enns (2002). Posttraumatic stress disorder and the structure of common mental disorders. Depression and Anxiety 15, 168171.

DP Goldberg , G Andrews , MJ Hobbs (2009 b). Where should bipolar appear in the meta-structure? Psychological Medicine. doi:10.1017/S0033291709990304.

DP Goldberg , RF Krueger , G Andrews , MJ Hobbs (2009 a). Emotional disorders: Cluster 4 of the proposed meta-structure for DSM-V and ICD-11. Psychological Medicine. doi:10.1017/S0033291709990298.

RE Kendell , A Jablensky (2003). Distinguishing between the validity and utility of psychiatric diagnoses. American Journal of Psychiatry 160, 412.

KS Kendler (1980). The nosologic validity of paranoia (simple delusional disorder). Archives of General Psychiatry 37, 699706.

KS Kendler , CA Prescott , J Myers , MC Neale (2003). The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Archives of General Psychiatry 60, 929937.

RF Krueger (1999). The structure of common mental disorders. Archives of General Psychiatry 56, 921926.

RF Krueger , A Caspi , TE Moffitt , PA Silva (1998). The structure and stability of common mental disorders (DSM-III-R) : a longitudinal-epidemiological study. Journal of Abnormal Psychology 107, 216227.

RF Krueger , YE Chentsova-Dutton , KE Markon , DP Goldberg , JH Ormel (2003). A cross-cultural study of the structure of comorbidity among common psychopathological syndromes in the general health care setting. Journal of Abnormal Psychology 112, 437447.

RF Krueger , SC South (2009). Externalizing disorders: Cluster 5 of the proposed meta-structure for DSM-V and ICD-11. Psychological Medicine. doi:10.1017/S0033291709990328.

E Robins , SB Guze (1970). Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. American Journal of Psychiatry 126, 107111.

P Sachdev , G Andrews , MJ Hobbs , M Sunderland , TM Anderson (2009). Neurocognitive disorders: Cluster 1 of the proposed meta-structure for DSM-V and ICD-11. Psychological Medicine. doi:10.1017/S0033291709990262.

WA Vollebergh , J Iedema , RV Bijl , R de Graaf , F Smit , J Ormel (2001). The structure and stability of common mental disorders: the NEMESIS study. Archives of General Psychiatry 58, 597603.

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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
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