Comparison of ICD 11 vs ICD 10 from Psychiatric Disorders Perspective
TLDRDr. Suresh Badmint discusses the International Classification of Disease (ICD), comparing ICD-11 to its predecessor, ICD-10. He highlights the changes in the classification system, particularly in psychiatric disorders, emphasizing ICD-11's adoption of a lifespan approach and its integration of both categorical and dimensional approaches for diagnosis. Dr. Badmint also notes the addition of new diagnostic subgroups in ICD-11, such as complex PTSD and gaming disorder, and discusses the ongoing effort to bridge the gap between symptom-based classification and neurobiological understanding of mental illnesses.
Takeaways
- 📚 ICD-11 vs ICD-10: The presentation compares the International Classification of Diseases, 11th Revision (ICD-11) with its predecessor, ICD-10, focusing on changes and improvements.
- 👨🏫 Dr. Suresh Badmint, a professor of psychiatry, discusses the classification from a psychiatric disorder perspective, emphasizing the importance of understanding these changes for easier recall.
- 🔍 ICD-11 Browser: The classification system is accessible online, with 26 chapters and two supplementary sections covering all medical illnesses, with psychiatry located in Chapter 6.
- 📈 Chapter Reorganization: ICD-11 reorganizes chapters, promoting psychiatry from Chapter 5 to 6, reflecting a lifespan approach and a shift in the classification of disorders.
- 🌐 Global Clinical Utility: ICD-11 aims for clinical utility that is globally applicable, evidence-based, and user-friendly for healthcare professionals across the world.
- 🤝 Harmonization Efforts: There is an effort to harmonize ICD-11 with the DSM-5, reducing differences and ensuring minor changes for a more consistent classification system.
- 🚀 New Diagnostic Subgroups: ICD-11 introduces new diagnostic subgroups, such as Complex PTSD and Binge Eating Disorder, and removes certain disorders from the child and adolescent category, adopting a lifespan approach.
- 🎯 Dimensional Approach: ICD-11 retains the categorical approach but incorporates a dimensional approach, considering severity, course, and treatment response, providing a more comprehensive diagnostic picture.
- 🧬 Neurobiological Basis: While there is a desire for a classification system based on neurobiology, current understanding is limited, and the symptom-based approach continues to be used for practical purposes.
- 🔄 Dual Classification Systems: The existence of both ICD and DSM classification systems allows for research from different perspectives and can inform policy and insurance decisions.
- 📝 Adoption and Future: ICD-11 is encouraged for adoption due to its promising updates and integration of dimensionality, though it still relies on symptom clusters for classification.
Q & A
What is the main purpose of comparing ICD-11 and ICD-10?
-The main purpose of comparing ICD-11 and ICD-10 is to understand the changes that have occurred in the newer version, ICD-11, and to facilitate easier memorization of the updates in the classification of diseases, particularly from the perspective of psychiatric disorders.
What is the significance of the reorganization of chapters in ICD-11?
-The reorganization of chapters in ICD-11, such as the promotion of psychiatric disorders from Chapter 5 to Chapter 6, reflects a lifespan approach and a shift towards a more comprehensive and evidence-based classification system that is globally applicable and clinically useful.
How does ICD-11 differ from ICD-10 in terms of classification of psychiatric disorders?
-ICD-11 differs from ICD-10 by adopting a more lifespan approach, removing the separate chapter for child and adolescent disorders, and incorporating a dimensional approach alongside the categorical one. It also includes new diagnostic subgroups and restructures some categories, such as combining neurocognitive disorders and adding disorders like gaming disorder and body integrity dysphoria.
What was the goal for the World Health Organization and American Psychiatric Association when planning ICD-11?
-The goal for the World Health Organization and American Psychiatric Association when planning ICD-11 was to create a classification system that is clinically useful, globally applicable, and evidence-based, with an aim to harmonize with the DSM-5 to ensure minor changes and consistency between the two systems.
Why were sleep-wake disorders and sexual health disorders moved to separate chapters in ICD-11?
-Sleep-wake disorders and sexual health disorders were moved to separate chapters in ICD-11 to reflect the understanding that these disorders are not solely mental health and behavioral problems. This change also aimed to decrease the stigma associated with these conditions and to better address their specific health aspects.
How does ICD-11 approach the classification of personality disorders?
-ICD-11 simplifies the classification of personality disorders by removing the previous categorical system and focusing on a description of traits related to interpersonal relationships, self-functioning, behavioral disorders, and cognitive-affective components. It acknowledges that most personality disorders are mixed and rare pure forms are uncommon.
What are some new diagnostic subgroups introduced in ICD-11?
-Some new diagnostic subgroups introduced in ICD-11 include complex PTSD, prolonged grief disorder, binge eating disorder, avoidant/restrictive food intake disorder, body integrity dysphoria, gaming disorder, and compulsive sexual behavior disorder.
How does ICD-11 integrate the dimensional approach into its classification system?
-ICD-11 integrates the dimensional approach by considering severity, course, specific symptoms, and treatment response in addition to the categorical diagnosis. This allows for a more nuanced understanding of conditions and can be particularly useful in research and for tailoring treatment approaches.
What is the current status of the biological versus symptom-based framework for classification in psychiatry?
-Currently, the symptom-based framework continues to be used for classification in psychiatry due to the lack of definitive neurobiological evidence for classification. While research is ongoing, the ICD-11 retains a primarily symptom-based approach but also incorporates elements of the dimensional approach to account for severity and other factors.
Why is it considered beneficial to have both ICD and DSM classification systems?
-Having both ICD and DSM classification systems is beneficial as it allows for a broader perspective in research and policy-making. Each system has its merits and can contribute unique insights. The existence of two systems can help in cross-validation of diagnoses and can facilitate borrowing of ideas and approaches between them, ultimately aiding in the growth and refinement of psychiatric classification over time.
Outlines
📚 Introduction to ICD-11 vs ICD-10
The video begins with Dr. Suresh Badmint introducing the topic of International Classification of Disease (ICD), specifically comparing ICD-11 to its predecessor, ICD-10. He clarifies that the presentation is for academic and training purposes only and not for legal or clinical advice. Dr. Badmint emphasizes the importance of understanding the changes between ICD-10 and ICD-11 for easier recall and application in the field of psychiatry. He provides a brief overview of how to access ICD-11 online and outlines the chapters, highlighting the shift from ICD-10's Chapter 5 to ICD-11's Chapter 6 for mental, behavioral, and neurodevelopmental disorders. The video aims to explain the new classification system from the perspective of psychiatric disorders.
🧠 Changes and Rationale in ICD-11 Classification
Dr. Badmint delves into the reasons behind the changes in ICD-11's classification system, focusing on the shift to a lifespan approach and the reorganization of chapters. He explains that ICD-11 starts with neurodevelopmental disorders and ends with neurocognitive disorders, marking a departure from ICD-10's structure. The new classification is based on etiology, pathophysiology, and phenomenology, aiming to align with other medical conditions. Despite the gap in understanding the neurobiological basis of psychiatric disorders, ICD-11 prioritizes clinical utility, global applicability, and evidence-based practices. The video also touches on the harmonization efforts between ICD-11 and DSM-5, the addition of new subgroups of classification, and the removal of child and adolescent disorders as a separate category in favor of a lifespan approach.
🌟 New Diagnostic Subgroups and Chapter Additions in ICD-11
This section highlights the new diagnostic subgroups and additional chapters introduced in ICD-11. Dr. Badmint mentions the inclusion of conditions like catatonia, bipolar 2 disorder, body dysmorphic disorder, and complex PTSD. He also discusses the renaming and reclassification of certain disorders, such as autism spectrum disorder and attention deficit hyperactivity disorder (ADHD). The video emphasizes the evidence-based approach of ICD-11 and the removal of certain categories from psychiatry chapters, like sleep-wake disorders and sexual health disorders, which are now considered separately. The discussion also covers the addition of gaming disorder and the reclassification of transgender under sexual health disorders, aiming to reduce stigma.
📈 Categorical vs. Dimensional Approach in ICD-11
Dr. Badmint discusses the categorical and dimensional approaches to classification in ICD-11. While the categorical approach is retained for reliability and diagnosis, the dimensional approach is introduced to consider severity, course, and treatment response. This dual approach is intended to aid research and provide a more comprehensive understanding of disorders. The video explains that ICD-11 attempts to integrate both approaches, acknowledging the benefits of having two classification systems (ICD-11 and DSM-5) for different perspectives and research purposes. The discussion also touches on the challenges of creating a classification system based on neurobiology due to the current evidence gap.
🧬 Biological vs. Symptom-Based Framework in ICD-11
In this part, Dr. Badmint addresses the limitations of both symptom-based and biological frameworks for classification in psychiatry. He notes that while the symptom-based approach is practical for primary care and communication, it lacks a solid neurobiological foundation. The video outlines the various units of analysis considered in the biological approach, such as genetics and neurophysiology, but acknowledges that these have not yielded definitive classification criteria. Dr. Badmint expresses hope that future advancements may lead to a neurobiology-based classification system similar to other medical conditions like tuberculosis.
📊 Detailed Classification of Disorders in ICD-11
Dr. Badmint provides a detailed overview of the classification of disorders in ICD-11, including neurodevelopmental disorders, schizophrenia, bipolar disorder, depression, anxiety disorders, obsessive-compulsive and related disorders, disorders specifically associated with stress, dissociative disorders, feeding and eating disorders, elimination and bodily distress disorders, substance use disorders, and personality disorders. He explains the changes in classification, the addition of new disorders, and the removal of certain categories. The video also discusses the dimensional aspects added to the classification, such as specifiers for symptoms, severity, and episodicity, aiming to provide a more nuanced understanding of each disorder.
🚀 Conclusion and Adoption of ICD-11
Concluding the video, Dr. Badmint emphasizes the significant improvements in ICD-11, including the addition of ten new sub-categories and the integration of both categorical and dimensional approaches. He acknowledges the current gap in neurobiological understanding but encourages the adoption of ICD-11 for its promise in contributing to future research and treatment approaches. The video ends with a call for staying updated with the evolving classification systems to ensure the best possible care for patients.
Mindmap
Keywords
💡International Classification of Disease (ICD)
💡Psychiatric Disorders
💡Neurodevelopmental Disorders
💡Categorical Approach
💡Dimensional Approach
💡Harmonization
💡Transgender
💡Personality Disorders
💡Neurobiology
💡Evidence-Based Practices
Highlights
Introduction to the comparison between ICD-10 and ICD-11, focusing on psychiatric disorders.
ICD-11 has a lifespan approach, starting with neurodevelopmental disorders and ending with neurocognitive disorders like dementia.
ICD-11 has 26 chapters and two supplementary sections for all medical illnesses, with psychiatry located in Chapter 6.
The classification in ICD-11 is based on etiology, pathophysiology, and phenomenology, aiming to align with other medical conditions.
ICD-11 emphasizes clinical utility, global applicability, and evidence-based practices.
ICD-11 includes 10 more subgroups of classification chapters compared to ICD-10.
ICD-11 has removed the separate sub-category for child and adolescent disorders, adopting a lifespan approach.
Sleep-wake disorders and sexual health disorders, including transgender health, have been given separate dedicated chapters in ICD-11.
ICD-11 introduces new diagnostic subgroups such as complex PTSD, binge eating disorder, and gaming disorder.
ICD-11 maintains a categorical approach but incorporates dimensionality for certain disorders, considering severity, course, and treatment response.
The rationale behind having both ICD and DSM classification systems is discussed, emphasizing the benefits of different perspectives for research and practice.
ICD-11 includes a new category for mental and behavioral disorders associated with pregnancy, childbirth, and the puerperium.
Personality disorders in ICD-11 are based on functioning, interpersonal relationships, and behavioral aspects, with a simplified classification system.
The transition from ICD-10 to ICD-11 represents a significant update, with the addition of ten different sub-categories and a more comprehensive approach to psychiatric disorders.
The importance of adopting ICD-11 is emphasized for its potential to contribute to future developments in diagnosis and treatment.
Transcripts
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