A global field study of the international classification of diseases (ICD-11) mood disorders clinical descriptions and diagnostic guidelines.

Journal: Journal of affective disorders

Volume: 295

Issue: 

Year of Publication: 2021

Affiliated Institutions:  School of Psychology, University of Ottawa, Jean-Jacques Lussier Pvt., Vanier Building, Ottawa, Ontario KN N, Canada. Electronic address: ckogan@uottawa.ca. Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy. Global Mental Health Program, Columbia University and New York State Psychiatric Institute, Riverside Drive, New York, NY, , USA. Department of Psychology, Virginia Commonwealth University, W. Franklin Street, P.O. Box , Richmond, VA, -, USA. Moscow Research Institute of Psychiatry, Poteshnaya , , Moscow, Russian Federation. National Study Coordinator for ICD- Field Studies, ICD- Committee, Japanese Society of Psychiatry and Neurology, Hongo-Yumicho Building, --, Hongo, Bunkyo-ku, Tokyo, -, Japan. Instituto Nacional de Psiquiatría 'Ramón de la Fuente', WHO Collaborating Centre on Addictions and Mental Health, Calzada Mexico-Xochimilco , Tlalpan, ZC , Ciudad de México, Mexico. Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, WHO Collaborating Centre for Research and Training in Mental Health, Wan Ping Nan Rd., Shanghai, , People's Republic of China. Dept. Of Psychiatry, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, - , India. Department of Psychiatry, Faculty of Medicine, University of Lisbon, , Lisboa Codex, Portugal. Department of Psychiatry, University of Cape Town and Groote Schuur Hospital, J-Block, Anzio Road, Observatory , South Africa. Dell Medical School, University of Texas at Austin, Health Learning Building, Red River St., Austin, Texas, , USA. Centro de Investigación y Docencia Económica, Carr. México-Toluca , Santa Fe, Altavista, Álvaro Obregón, , Ciudad de México, México. School of Psychology, University of Ottawa, Jean-Jacques Lussier Pvt., Vanier Building, Ottawa, Ontario KN N, Canada. Institute of Psychiatry, School of Medicine, University of São Paulo, Av. Dr. Arnaldo, - Cerqueira César, São Paulo, , Brazil. Department of Psychiatry, Universidad Autonoma de Madrid; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Instituto de Investigación Sanitaria La Princesa, Madrid, Spain. National Drug Dependence Treatment Center and Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, , India. School of Psychology, UNSW Sydney, NSW, , Australia. Departments of Epidemiology and Psychiatry, Columbia University Medical Center, West th St, , New York, NY. Department of Psychiatry, Universidade Federal de São Paulo, Rua Borges Lagoa - ° andar, Vila Clementino- São Paulo-SP, -, Brazil. Faillace Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas HSC at Houston, East Road, Houston, Texas, , USA. The Health Management Center, Seitoku University, Iwase, Matsudo City, Chiba Prefecture, -, Japan. Department of Psychiatry, University of Ibadan, WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, University College Hospital, PMB, Ibadan, Nigeria. Department of Psychiatry, Columbia University Medical Center and New York State Psychiatric Institute, West th St, , New York, NY. Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, WHO Collaborating Centre for Quality Assurance and Empowerment in Mental Health, Bergische Landstr. , , Düsseldorf, Germany. Department of Psychiatry, American University of Beirut Medical Center, P.O. Box - - Riad El Solh Beirut, Lebanon. University of Kansas, Clinical Child Psychology Program, Dole Human Development Center, Lawrence, KS, , USA. Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, , India. Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA, and Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.

Abstract summary 

We report results of an internet-based field study evaluating the diagnostic guidelines for ICD-11 mood disorders. Accuracy of clinicians' diagnostic judgments applying draft ICD-11 as compared to the ICD-10 guidelines to standardized case vignettes was assessed as well as perceived clinical utility.1357 clinician members of the World Health Organization's Global Clinical Practice Network completed the study in English, Spanish, Japanese or Russian. Participants were randomly assigned to apply ICD-11 or ICD-10 guidelines to one of eleven pairs of case vignettes.Clinicians using the ICD-11 and ICD-10 guidelines achieved similar levels of accuracy in diagnosing mood disorders depicted in vignettes. Those using the ICD-11 were more accurate in identifying depressive episode in recurrent depressive disorder. There were no statistically significant differences detected across classifications in the accuracy of identifying dysthymic or cyclothymic disorder. Circumscribed problems with the proposed ICD-11 guidelines were identified including difficulties differentiating bipolar type I from bipolar type II disorder and applying revised severity ratings to depressive episodes. Clinical utility of ICD-11 bipolar disorders was found to be significantly lower than for ICD-10 equivalent categories.Standardized case vignettes were manipulated to evaluate specific changes. The degree of accuracy of clinicians' diagnostic judgments may not reflect clinical decision-making with patients.Alignment of the ICD-11 with current research appears to have been achieved without sacrificing diagnostic accuracy or clinical utility though specific training may be necessary as ICD-11 is implemented worldwide. Areas in which the ICD-11 guidelines did not perform as intended resulted in further revisions.

Authors & Co-authors:  Kogan Cary S CS Maj Mario M Rebello Tahilia J TJ Keeley Jared W JW Kulygina Maya M Matsumoto Chihiro C Robles Rebeca R Huang Jingjing J Zhong Na N Chakrabarti Subho S Figueira Maria Luisa ML Stein Dan J DJ Strakowski Stephen M SM Garcia-Pacheco José A JA Burns Samantha S Montoya Madeline M Andrade Laura L Ayuso-Mateos José L JL Arango Ivan I Balhara Yatan Pal Singh YPS Bryant Richard R Cournos Francine F Porto José Alberto Del JAD Meyer Thomas D TD Medina-Mora Maria-Elena ME Gureje Oye O First Michael B MB Gaebel Wolfgang W Khoury Brigitte B Krasnov Valery N VN de Jesus Mari Jair J Maruta Toshimasa T Pike Kathleen M KM Roberts Michael C MC Sharan Pratap P Zhao Min M Reed Geoffrey M GM

Study Outcome 

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Statistics
Citations : 
Authors :  37
Identifiers
Doi : 10.1016/j.jad.2021.08.050
SSN : 1573-2517
Study Population
Male,Female
Mesh Terms
Bipolar Disorder
Other Terms
Classification;Diagnosis;ICD-10;ICD-11;International Classification of Diseases (ICD);Mood disorders
Study Design
Case Study,Cross Sectional Study
Study Approach
Country of Study
Publication Country
Netherlands