Accuracy of diagnostic judgments using ICD-11 vs. ICD-10 diagnostic guidelines for obsessive-compulsive and related disorders.
Journal: Journal of affective disorders
Volume: 273
Issue:
Year of Publication: 2021
Affiliated Institutions:
School of Psychology, Faculty of Social Sciences, Jean-Jacques Lussier, Vanier Hall, Ottawa, ON KN N, Canada. Electronic address: ckogan@uottawa.ca.
SAMRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town Dept of Psychiatry & Neuroscience Institute, Groote Schuur Hospital, J-Block, Anzio Road, Observatory , Cape Town, South Africa. Electronic address: dan.stein@uct.ac.za.
Global Mental Health Program, Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, Mailman School of Public Health, West th, Floor R, R-, New York, NY , USA. Electronic address: Tahilia.Rebello@nyspi.columbia.edu.
Department of Psychology, Virginia Commonwealth University, West Franklin St, Box , Richmond, VA , USA. Electronic address: jwkeeley@vcu.edu.
School of Psychology, Faculty of Social Sciences, Jean-Jacques Lussier, Vanier Hall, Ottawa, ON KN N, Canada. Electronic address: jacky.chan@uottawa.ca.
Highly Specialized Obsessive Compulsive and Related Disorders Service, Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, UK; Postgraduate Medical School, University of Hertfordshire, Hatfield, UK; University of Cambridge School of Clinical Medicine, Cambridge, UK. Electronic address: naomi.fineberg@btinternet.com.
Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; "D'Or' Institute for Research and Education, Rio de Janeiro, RJ, Brazil; School of Psychological Sciences, Monash University, Melbourne, Australia. Electronic address: lfontenelle@gmail.com.
Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA. Electronic address: jgrant@bsd.uchicago.edu.
Department of Neuropsychiatry, Hyogo College of Medicine, - Mukogawa-cho, Nishinomiya Hyogo, Japan. Electronic address: hisa@hyo-med.ac.jp.
College of Physicians and Surgeons, Columbia University, New York, NY, USA; Anxiety Disorders Clinic and the Center for OCD and Related Disorders, New York State Psychiatric Institute, New York, NY, USA. Electronic address: hbs@columbia.edu.
Department for Child and Adolescent Psychiatry, Aarhus University Hospital, Skejby, Aarhus, Denmark. Electronic address: per.hove.thomsen@ps.rm.dk.
Amsterdam University Medical Centers, Vrije Universiteit, Department of Psychiatry and Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, the Netherlands. Electronic address: oa.vandenheuvel@amsterdamumc.nl.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Center for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, London, UK. Electronic address: david.veale@kcl.ac.uk.
Institut du Savoir Montfort - Hôpital Montfort and Université d'Ottawa, Ottawa, Ontario, Canada. Electronic address: jeangrenier@montfort.on.ca.
Alekseev Mental Health Clinic, No. , Education Centre, Moscow, Russian Federation. Electronic address: mkulygina@yandex.ru.
National Study Coordinator for ICD- Field Studies, ICD- Committee, Japanese Society of Psychiatry and Neurology, Hongo-Yumicho Building, --, Hongo, Bunkyo-ku, Tokyo -. Japan. Electronic address: c.matsumoto@outlook.jp.
Center for Research on Global Mental Health, Direction of Epidemiology and Psychosocial Research, National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, Mexico. Electronic address: tecelli.dominguez@gmail.com.
Lee Kong Chian School of Medicine, Nanyang Technological University, Mandalay Road, Singapore. Electronic address: anne.claire.s@gmail.com.
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Wan Ping Nan Road, Shanghai , PR China. Electronic address: wangzhen@smhc.org.cn.
Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, Riverside Drive, New York, NY , USA; Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland. Electronic address: gmr@cumc.columbia.edu.
Abstract summary
We report results of an internet-based field study evaluating the diagnostic guidelines for the newly introduced ICD-11 grouping of obsessive-compulsive and related disorders (OCRD). We examined accuracy of clinicians' diagnostic judgments applying draft ICD-11 as compared to the ICD-10 diagnostic guidelines to standardized case vignettes.1,717 mental health professionals who are members of the World Health Organization's Global Clinical Practice Network completed the study in Chinese, English, French, Japanese, Russian or Spanish. Participants were randomly assigned to apply ICD-11 or ICD-10 guidelines to one of nine pairs of case vignettes.Participants using ICD-11 outperformed those using ICD-10 in correctly identifying newly introduced OCRD, although results were mixed for differentiating OCRD from disorders in other groupings largely due to clinicians having difficulty differentiating challenging presentations of OCD. Clinicians had difficulty applying a three-level insight qualifier, although the 'poor to absent' level assisted with differentiating OCRD from psychotic disorders. Brief training on the rationale for an OCRD grouping did not improve diagnostic accuracy suggesting sufficient detail of the proposed guidelines.Standardized case vignettes were manipulated to include specific characteristics; the degree of accuracy of clinicians' diagnostic judgments about these vignettes may not generalize to application in routine clinical practice.Overall, use of the ICD-11 guidelines resulted in more accurate diagnosis of case vignettes compared to the ICD-10 guidelines, particularly in differentiating OCRD presentations from one another. Specific areas in which the ICD-11 guidelines did not perform as intended provided the basis for further revisions to the guidelines.
Authors & Co-authors:
Kogan Cary S CS
Stein Dan J DJ
Rebello Tahilia J TJ
Keeley Jared W JW
Chan K Jacky KJ
Fineberg Naomi A NA
Fontenelle Leonardo F LF
Grant Jon E JE
Matsunaga Hisato H
Simpson H Blair HB
Thomsen Per Hove PH
van den Heuvel Odile A OA
Veale David D
Grenier Jean J
Kulygina Mayya M
Matsumoto Chihiro C
Domínguez-Martínez Tecelli T
Stona Anne-Claire AC
Wang Zhen Z
Reed Geoffrey M GM
Study Outcome
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