Diagnostics discrepancies between ICD-10 and DSM-IV in personality disorders. 2005

A Pérez Urdaniz, and F M Vega Fernández, and N Martín Navarro, and R Molina Ramos, and I Mosqueira Terrón, and V Rubio Larrosa
Hospital Universitario de Salamanca, Salamanca, Spain. perurdan@usuarios.retecal.es

BACKGROUND 50 % of the patients seen in the mental health clinics have personality disorders and their diagnosis is very important to establish the patient's prognosis and treatment. The clinician usually only uses one nosology, the ICD-10 or the DSM-IV and is aware of the differences between them. However, he/she gives preference to his/her favorite nosology. METHODS A total of 248 patients seen in a mental health clinic were included in the study. They were diagnosed of anxiety (n = 121) and depressive (n = 127) disorders, with a mean age of 32.3 years for anxiety disorders and 32.4 years depressive disorders. The International Personality Disorders Examination (IPDE) Screening Questionnaire in its DSM-IV and ICD-10 versions was administered to observe the degree of concordance between the two nosologies. CONCLUSIONS The female population predominated in our sample, these being 35.5 % men with anxiety disorders and 65,5 % women, and 29.10 % men and 70.9 % women with depressive disorders. An observational study was performed by studying the percentage with 3 or more positive items and also percentage with 6 or more positive items. It was observed that the DSM-IV version produced more positive diagnoses and more comorbidity. Thus, it is necessary to consider whether the ICD-10 version subdiagnoses personality disorders or the DSM-IV version gives false positives. The qualitative differences between the ICD-10 and the DSM-IV must also be considered. The ICD-10 does not include narcissistic and schizotypal personality disorders and subdivides the borderline personality disorder into two subcategories, so that a given patient can receive different diagnoses according to the nosology used. CONCLUSIONS In the patient sample studied, diagnostic discrepancies in personality disorders between DSM-IV and ICD-10 are so important that the World Health Organization and the American Psychiatry Association should consider unifying categories and diagnostic criteria of personality disorders in the next nosologies.

UI MeSH Term Description Entries
D010554 Personality Disorders A major deviation from normal patterns of behavior. Avoidant Personality Disorder,Impulse-Ridden Personality,Inadequate Personality,Avoidant Personality Disorders,Impulse Ridden Personality,Personality Disorder,Personality Disorder, Avoidant,Personality Disorders, Avoidant,Personality, Impulse-Ridden,Personality, Inadequate
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D038801 International Classification of Diseases A system of categories to which morbid entries are assigned according to established criteria. Included is the entire range of conditions in a manageable number of categories, grouped to facilitate mortality reporting. It is produced by the World Health Organization (From ICD-10, p1). The Clinical Modifications, produced by the UNITED STATES DEPT. OF HEALTH AND HUMAN SERVICES, are larger extensions used for morbidity and general epidemiological purposes, primarily in the U.S. ICD Code,ICD Codes,ICD-10,ICD-9,International Classification of Disease,ICD-10 Procedure Coding System,ICD-10-CM,ICD-10-PCS,ICD-11,ICD-9-CM,International Classification of Disease Codes,International Statistical Classification of Diseases and Related Health Problems,Code, ICD,Codes, ICD,Disease International Classification,Disease International Classifications,ICD 10 Procedure Coding System
D039721 Diagnostic and Statistical Manual of Mental Disorders Categorical classification of MENTAL DISORDERS based on criteria sets with defining features. It is produced by the American Psychiatric Association. (DSM-IV, page xxii) DSM-IV,DSM-II,DSM-III,DSM-V

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