A global clinicians' map of mental disorders to improve ICD-11: Analysing meta-structure to enhance clinical utility
Por:
Roberts M.C., Reed G.M., Medina-Mora M.E., Keeley J.W., Sharan P., Johnson D.K., Mari J.D.J., Ayuso-Mateos J.L., Gureje O., Xiao Z., Maruta T., Khoury B., Robles R., Saxena S.
Publicada:
1 ene 2012
Categoría:
Psychiatry and Mental Health
Resumen:
Enhancing clinical utility is an emphasis of the World Health Organization's development of the mental and behavioural disorders chapter of the next International Classification of Diseases (ICD-11). Understanding how clinicians conceptualize the structure of mental disorders can enable a more clinically intuitive classification architecture that will help professionals find the categories they need more efficiently. This study examined clinicians' conceptualizations of the relationships among mental disorders and the dimensions they use in making these judgements. Psychiatrists and psychologists from 64 countries (n = 1,371), participating in English or Spanish, rated the similarity of mental and behavioural disorders presented as paired comparisons. Data were analysed by multidimensional scaling procedures (INDSCAL) and by analyses of consistency. Participants used three distinctive dimensions to evaluate the similarity among disorders: internalizing versus externalizing, developmental versus adult onset, and functional versus organic. Clinicians' conceptual map of mental disorders was rational and highly stable across profession, language, and country income level. The proposed ICD-11 structure is a moderately better fit with clinicians' conceptual model than either ICD-10 or DSM-IV. Clinician judgements can be used to improve clinical utility of the ICD-11 without sacrificing validity based on a scientific approach to enhancing a logically organized classification meta-structure. © 2012 Institute of Psychiatry.
Filiaciones:
Roberts M.C.:
Clinical Child Psychology Program, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS 66045, United States
Reed G.M.:
Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
Medina-Mora M.E.:
National Institute of Psychiatry Ramón de la Fuente, Mexico, Mexico
Keeley J.W.:
Department of Psychology, Mississippi State University, Starkville, MS, United States
Sharan P.:
Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
Johnson D.K.:
Department of Psychology and Gerontology Center, University of Kansas, Lawrence, KS, United States
Mari J.D.J.:
Department of Psychiatry, Universidade Federal de São Paulo, Brazil
Ayuso-Mateos J.L.:
Department of Psychiatry, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria Princesa, CIBERSAM, Madrid, Spain
Gureje O.:
Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
Xiao Z.:
Shanghai Mental Health Centre, Shanghai Jiaotong University, School of Medicine, Shanghai, China
Maruta T.:
Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
Khoury B.:
Department of Psychiatry, American University of Beirut, Lebanon
Robles R.:
National Institute of Psychiatry Ramón de la Fuente, Mexico, Mexico
Saxena S.:
Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
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