Towards international agreement on classification

Abstract

Abstract The changes that could be introduced into Chapter V of ICD-9, published in 1978, were comparatively limited because of the conservative policy that applied to all the Chapters of the ICD at that time. Nevertheless, some badly needed improvements were included, such as a better treatment of disorders of childhood and adolescence, and reactions to stress. The Joint Project between the NIMH of the USA and the Division of Mental Health of the WHO was the next major development, with the aim of keeping differences between the forthcoming DSM-IV and Chapter V of ICD-10 to a minimum. This started with literature reviews, leading to a major conference in Copenhagen in 1982, followed by a varied programme of the development of interviewing and rating instruments suitable for use in international cooperative projects. The DIS was expanded into the Composite International Diagnostic Interview (CIDI), the PSE into the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), and the International Personality Disorder Examination (IPDE) schedule was also produced. When a draft of the chapter V of ICD-10 became available, the Joint Project also funded the attendance of several WHO advisors at some meetings of the Task Forces that were preparing DSM-IV. The WHO also produced four mutually compatible versions of Chapter V of the ICD-10; these are i) a very short version for the main ICD-10 volume to go with the other 20 chapters of the whole ICD, ii) the Clinical Descriptions and Diagnostic Guidelines (CDDG), the full clinical version for use by psychiatrists in clinical work, iii) the Diagnostic Criteria for Research (DCR-10), and iv) the Diagnostic and Management Guidelines for Mental Disorders in Primary Care (ICD-10-PHC).