Selected results from the section psychotherapy/psychosomatics of the ICD-10 research criteria study are discussed. One hundred thirty diagnosticians from 11 psychosomatics centers took part in this section, assessing 16 video-documented patients in case conferences. The results of the study, which were based on 633 diagnostical assessments, demonstrated sufficient chance-corrected interrater reliability coefficients for the majority of the disorders (kappa ranged from 0.22 to 0.99). System-related problems of the ICD-10 approach were identified concerning depressive and psychosomatic disorders. The results are discussed, following some problematical aspects of the concept of comorbidity and multiaxial approaches. Special reference is given to the work group "Operational Psychodynamic Diagnoses' which has produced a multiaxial system covering important psychodynamic variables.