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Dx Revision Watch | Monitoring the development of DSM-5, ICD-11, ICD-10-CM
Site domain and name change
This site originally operated at the domain dsm5watch.wordpress.com under the site name DSM-5 and ICD-11 Watch. On December 22, 2011, I was served with two “cease and desist” letters on behalf of American Psychiatric Association threatening potential legal action under US Trademark Law if I did not meet their demands to immediately cease and desist any and all use of the DSM 5 mark and to remove the DSM 5 mark from my domain name within 10 days. This site now operates at the domain dxrevisionwatch.wordpress.com and under the site name Dx Revision Watch.
Contact
Dx Revision Watch is maintained by UK advocate, Suzy Chapman. To contact please use the Contact page.
Why another site?
The concept for this site developed out of research and awareness raising undertaken throughout 2009 on a sister site around the forthcoming revisions of two important international disease classification systems:
Diagnostic and Statistical Manual of Mental Disorders (DSM) American Psychiatric Association
International Statistical Classification of Diseases and Related Health Problems (ICD) World Health Organization
The American Psychiatric Association should not be confused with the American Psychological Association – both use the acronym ”APA”. Unless otherwise specified, “APA” on this site refers to the American Psychiatric Association.
How does this site work?
This site has been monitoring the revision processes towards DSM-5 and ICD-11, generally, since the beginning of 2010 and endeavours to provide timely updates and content of interest to consumer groups and professionals that are stakeholders in these classification systems.
Key information and resources on Tab pages and Tab child pages. Updates, reports, documents, commentaries, media coverage and other material is posted on the Main page, which displays the 10 most recent postings. Earlier posts can be pulled up from the monthly archives, from Post index or through “Categories.”
Two new international classification systems by 2015
The next edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders will be known as DSM-5. The revision of the current edition, DSM-IV, began in 1999. DSM-5 is now scheduled for publication in May 2013 – a year later than originally planned.
The revision of the current version of the WHO’s International Statistical Classification of Diseases, ICD-10, and the development of the structure of ICD-11 began in 2007. WHO anticipates that ICD-11 will be completed by 2015, though targets for the population of content for the Alpha draft have slipped.
Assuming no further shifts in publication dates, DSM-5 will publish two years in advance of ICD-11.
Diagnostic and Statistical Manual of Mental Disorders (DSM)
Commonly referred to as the “Psychiatrist’s Bible”, the DSM is used by mental health and medical professionals for diagnosing and coding mental disorders. It is also used by medical insurance companies for reimbursement, in medical practices, clinics and hospitals, by social services agencies, government, policy makers, courts, forensics, prisons, drug regulation agencies, pharmaceutical companies and researchers.
Diagnostic criteria defined within DSM determine what is considered a mental health disorder and what is not, what medical treatments individuals receive and which treatments health insurers will authorise funding for. The inclusion or not of a disorder within DSM has revenue implications for pharmaceutical companies seeking licences for new drugs or to expand markets and applications for existing products.
DSM is the primary mental health diagnostic system in the US and is used to a varying extent in other countries. In the UK and some European countries, Chapter V, the Mental and Behavioural Disorders chapter of ICD-10, is also used for diagnosing mental health disorders.
The next edition of DSM will shape international research and influence literature in the fields of psychiatry and psychosomatics for many years to come.
The revision of DSM-IV is being undertaken by a 27 member Task Force, 13 Work Groups and 6 Study Groups.
The names of the members of the 13 Work Groups were released in May 2008, via an APA Press Release, following criticism over lack of transparency. Work Groups also draw on external advisors whose names are not being identified.
It’s been a controversial process. Some of the most vocal critics have been those who had served on the Task Force committees for previous revisions.
Criticism has been voiced by professionals in the field, consumer groups and the media around lack of transparency, potential conflicts of interest from DSM-5 Task Force and Work Group members’ financial links with pharmaceutical companies and a lack of professional diversity and patient representation in the make up of the Work Groups.
There is considerable controversy around the implications for the proposed introduction of new disorder categories and for the lowering of diagnostic thresholds for existing disorders, which may artificially inflate disorder prevalence.
For an overview see Controversial issues for the future DSM-V: Sarah Kamen MA, paper regarding the future revision of the DSM-5, published in the January 2010 Newsletter of the Society for Humanistic Psychology
International Statistical Classification of Diseases (ICD)
The International Statistical Classification of Diseases (ICD) is the international standard diagnostic classification of diseases for use in epidemiology, health management and clinical practice.
ICD is used to classify diseases and other health problems recorded on many types of health and other records, including death certificates and insurance. These records also provide the basis for the compilation of national mortality and morbidity statistics by WHO Member States and are used to monitor health related spending and to inform policy making.
The chapter of ICD-10 which is used for mental health classification is Chapter V: Mental and behavioural disorders. This chapter will be known as “Chapter 5″ in ICD-11.
ICD-10 is being revised through a Steering Group and a number of Topic Advisory Groups (TAGs), under Managing Editors (TAGMEs), with responsibility for recruiting external peer reviewers and experts for reviewing proposals and advising on content. The names of the members of the TAGs are published on the WHO website; the names of external advisers peer reviewing proposals and content are not being disclosed.
The WHO is promoting the development of ICD-11 as an open and transparent process.
Alpha drafting is being carried out via an electronic collaborative authoring platform – the iCAT; a second, publicly viewable version of the initial drafting platform known as the Alpha Browser was launched in May 2011. Registered stakeholders have greater access to content and may submit comment or suggestions via the platform.
Key documentation, style guides, models for the population of content and information on the structure of ICD-11 is being posted on a dedicated, public domain ICD Revision website.
According to the ICD-11 Timeline, the Beta drafting platform is currently scheduled for release in May 2012. At this point it is projected that professional stakeholders and others who register an interest would be given various levels of editing authority and interaction with the platform.
When are the first drafts of DSM-5 and ICD-11 expected?
The APA published its first draft proposals for DSM-5 diagnostic categories and criteria on a dedicated website, on February 10, 2010.
APA webpages for DSM-5 development: DSM-5 Development
The first public review ran from February 10 to April, 20, 2010.
The second public review ran from May 4 to July 15, 2011.
A third and final public review is expected to be released in May 2012, at the latest.
As soon as a date has been finalized for the third public review, I will post a notice on the Main page and also at the top of this page DSM-5 third draft. When the third draft proposals are posted on the DSM-5 Development site for public review I will update with links and information on how to submit stakeholder feedback.
Acording to DSM-5 Task Force Chair, David Kupfer, MD, the specific diagnostic categories that received the most feedback during the second public review and feedback exercise were sexual and gender identity disorders, followed closely by somatic symptom disorders and anxiety disorders.
ICD-11 Alpha Drafting platform has been publicly viewable since May 2011.
ICD-11 Beta Drafting platform is currently scheduled to be publicly viewable in May 2012.
When the ICD-11 Beta platform is launched or if any change to the schedule is announced, or otherwise comes to my attention, I will update on the Main page and at the top of this Tab page ICD-11 drafts.
Continued on Page 2: “Harmonization” of DSM-5 and ICD-10; Timelines; Clinical Modifications of ICD
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