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DSM vs ICD

DIAGNOSTIC & STATISTICAL MANUAL

(American Psychiatric Association)

INTERNATIONAL CLASSIFICATION OF DISEASES & HEALTH-RELATED PROBLEMS

(World Health Organisation)

Current version: DSM-IV-TR (2000)

Current version: ICD-10 (1993)

DSM (1952); DSM-II (1968); DSM-III (1980), DSM-III-R (1987) and DSM-IV (1994)

Originally for collecting statistics – not intended to be a diagnostic tool – mental illnesses not included for many years

DSM/DSM-II emphasised supposed causes; DSM-III/DSM-III-R diagnose on observable syndromes of symptoms – also more specific/detail


DSM-II used single labels; DSM-III/DSM-III-R/DSM-IV use multi-axial system


16 major categories of mental disorder

11 major categories of mental disorder

Schizophrenia & Other Psychotic Disorders

Schizophrenia, Schizotypal & Delusional Disorders

Substance-related Disorders

Mental & Behavioural Disorders Due to Psychoactive Substance Use

Mood Disorders

Mood (Affective) Disorders

Reliability of DSM-III varies from category to category

ICD-10 more reliable than either ICD-9 and DSM-III-R (T W Costello, J T Costello & D A Holmes, 1995)

DSM-IV most reliable?


DSM-IV: low Aetiological Validity

ICD-10: low Aetiological Validity

DSM-IV: Descriptive Validity reduced by Comorbidity

ICD-10: Descriptive Validity low due to prevalence of Comorbidity

Treatment becoming more effective – DSM-IV Predictive Validity fairly good?

ICD-10: Predictive Validity reasonable

Andrews et al (1999) looked at how much DSM-IV agreed with ICD-10. They found:-


An international survey of psychiatrists in 66 countries comparing use of ICD-10 and DSM-IV found the former was more often used for clinical diagnosis while the latter was more valued for research (Juan Mezzich, 2002).


Lahey et al (2006) found good Predictive Validity with regard to social and academic functioning over a 6-year period for children diagnosed with ADHD.