The British Journal of Psychiatry (2009) 195: 382-390. doi: 10.1192/bjp.bp.108.060822
© 2009 The Royal College of Psychiatrists
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SPECIAL ARTICLE

Harmonisation of ICD–11 and DSM–V: opportunities and challenges{dagger}

Michael B. First, MD

New York State Psychiatric Institute, Columbia University Department of Psychiatry, 1051 Riverside Drive – Unit 60, New York, NY 10032, USA. Email: mbf2{at}columbia.edu

Declaration of interest

M. F. consults with pharmaceutical companies to provide diagnostic training for clinical trials. In the past 12 months, he has consulted with AstraZeneca, Eli Lilly, Cephalon, Wyeth, Roche, Novartis, Glaxo SmithKline, Memory Pharmaceuticals and Medavante.

{dagger} See Editorial, pp. 379–381, this issue

Background

Differences in the ICD–10 and DSM–IV definitions for the same disorder impede international communication and research efforts. The forthcoming parallel development of DSM–V and ICD–11 offers an opportunity to harmonise the two classifications.

Aims

This paper aims to facilitate the harmonisation process by identifying diagnostic differences between the two systems.

Method

DSM–IV–TR criteria sets and the ICD–10 Diagnostic Criteria for Research were compared and categorised into those with identical definitions, those with conceptually based differences and those in which differences are not conceptually based and appear to be unintentional.

Results

Of the 176 criteria sets in both systems, only one, transient tic disorder, is identical. Twenty-one per cent had conceptually based differences and 78% had non-conceptually based differences.

Conclusions

Harmonisation of criteria sets, especially those with non-conceptually based differences, should be prioritised in the DSM–V and ICD–11 development process. Prior experience with the DSM–IV and ICD–10 harmonisation effort suggests that for the process to be successful steps should be taken as early as possible.


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