With the help of psychologists, the next version
of the International Classification of Diseases will
have a more behavioral perspective.
BY REBECCA A. CLAY
What’s the world’s most widely used classification system for mental disorders? If you
guessed the Diagnostic and Statistical Manual of Mental Disorders (DSM), you would be wrong.
According to a study of nearly 5,000 psychiatrists in 44 countries sponsored by the World Health
Organization (WHO) and the World Psychiatric Association, more than 70 percent of the world’s
psychiatrists use WHO’s International Classification of Diseases (ICD) most in day-to-day practice
while just 23 percent turn to the DSM. The same pattern is found among psychologists globally,
according to preliminary results from a similar survey of international psychologists conducted by
WHO and the International Union of Psychological Science.
“The ICD is the global standard for health information,” says psychologist Geoffrey M. Reed,
The iCD revision process
PhD, senior project officer in WHO’s Department of Mental Health and Substance Abuse. “It’s
developed as a tool for the public good; it’s not the property of a particular profession or particular
Now WHO is revising the ICD, with the ICD- 11 due to be approved in 2015. With
unprecedented input from psychologists, the revised version’s section on mental and behavioral
disorders is expected to be more psychologist-friendly than ever — something that’s especially
welcome given concerns being raised about the DSM’s own ongoing revision process. (See article
on page 42.) And coming changes in the United States will mean that psychologists will soon need
to get as familiar with the ICD as their colleagues around the world.
Encompassing both mental and physical disorders, the ICD classification system assigns codes used
for health statistics, reimbursement systems and other purposes. The current version, the ICD- 10,
was published in 1992.
The ICD- 11 will see major changes, predicts Reed, who is coordinating revisions to its mental
and behavioral disorders section and participating in revisions to the section on nervous system
diseases. That’s due in part to the fact that it’s not just psychiatrists revising the relevant sections
anymore. For the first time, psychologists and other mental health professionals are also integrally
involved (see “Defining disease worldwide,” June 2010 Monitor).
The result, Reed predicts, is that the publication “will be written from a more behavioral
perspective, not only from a medical perspective.”
Psychologists from around the world are formally participating in the effort. Some are serving
on the international advisory groups for the mental and behavioral disorders and diseases of
the nervous system sections. Others are participating in working groups focused on specific