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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 (Costello, Costello & 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

T W Costello, J T Costello & D A Holmes (1995) found ICD-10 to be more reliable than either ICD-9 or DSM-III-R.


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).