TY - JOUR
T1 - A global clinicians' map of mental disorders to improve ICD-11
T2 - Analysing meta-structure to enhance clinical utility
AU - Roberts, Michael C.
AU - Reed, Geoffrey M.
AU - Medina-Mora, María Elena
AU - Keeley, Jared W.
AU - Sharan, Pratap
AU - Johnson, David K
AU - Mari, Jair De Jesus
AU - Ayuso-Mateos, José Luis
AU - Gureje, Oye
AU - Xiao, Zeping
AU - Maruta, Toshimasa
AU - Khoury, Brigitte
AU - Robles, Rebeca
AU - Saxena, Shekhar
PY - 2012/12/1
Y1 - 2012/12/1
N2 - Enhancing clinical utility is an emphasis of the World Health Organization's development of the mental and behavioural disorders chapter of the next International Classification of Diseases (ICD-11). Understanding how clinicians conceptualize the structure of mental disorders can enable a more clinically intuitive classification architecture that will help professionals find the categories they need more efficiently. This study examined clinicians' conceptualizations of the relationships among mental disorders and the dimensions they use in making these judgements. Psychiatrists and psychologists from 64 countries (n = 1,371), participating in English or Spanish, rated the similarity of mental and behavioural disorders presented as paired comparisons. Data were analysed by multidimensional scaling procedures (INDSCAL) and by analyses of consistency. Participants used three distinctive dimensions to evaluate the similarity among disorders: internalizing versus externalizing, developmental versus adult onset, and functional versus organic. Clinicians' conceptual map of mental disorders was rational and highly stable across profession, language, and country income level. The proposed ICD-11 structure is a moderately better fit with clinicians' conceptual model than either ICD-10 or DSM-IV. Clinician judgements can be used to improve clinical utility of the ICD-11 without sacrificing validity based on a scientific approach to enhancing a logically organized classification meta-structure.
AB - Enhancing clinical utility is an emphasis of the World Health Organization's development of the mental and behavioural disorders chapter of the next International Classification of Diseases (ICD-11). Understanding how clinicians conceptualize the structure of mental disorders can enable a more clinically intuitive classification architecture that will help professionals find the categories they need more efficiently. This study examined clinicians' conceptualizations of the relationships among mental disorders and the dimensions they use in making these judgements. Psychiatrists and psychologists from 64 countries (n = 1,371), participating in English or Spanish, rated the similarity of mental and behavioural disorders presented as paired comparisons. Data were analysed by multidimensional scaling procedures (INDSCAL) and by analyses of consistency. Participants used three distinctive dimensions to evaluate the similarity among disorders: internalizing versus externalizing, developmental versus adult onset, and functional versus organic. Clinicians' conceptual map of mental disorders was rational and highly stable across profession, language, and country income level. The proposed ICD-11 structure is a moderately better fit with clinicians' conceptual model than either ICD-10 or DSM-IV. Clinician judgements can be used to improve clinical utility of the ICD-11 without sacrificing validity based on a scientific approach to enhancing a logically organized classification meta-structure.
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U2 - 10.3109/09540261.2012.736368
DO - 10.3109/09540261.2012.736368
M3 - Article
C2 - 23244613
AN - SCOPUS:84871392371
VL - 24
SP - 578
EP - 590
JO - International Review of Psychiatry
JF - International Review of Psychiatry
SN - 0954-0261
IS - 6
ER -