Category Archives: ICD-11 consultation

Psychologists’ perspectives on the diagnostic classification of mental disorders: Results from the WHO-IUPsyS Global Survey

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Psychologists’ perspectives on the diagnostic classification of mental disorders: Results from the WHO-IUPsyS Global Survey

Post #263 Shortlink:
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http://www.ncbi.nlm.nih.gov/pubmed/23750927
Int J Psychol. 2013 Jun 10. [Epub ahead of print]

Psychologists’ perspectives on the diagnostic classification of mental disorders: Results from the WHO-IUPsyS Global Survey.

Evans SC, Reed GM, Roberts MC, Esparza P, Watts AD, Correia JM, Ritchie P, Maj M, Saxena S.
Source
a Clinical Child Psychology Program, University of Kansas, Lawrence , KS, USA.

Abstract

This study examined psychologists’ views and practices regarding diagnostic classification systems for mental and behavioral disorders so as to inform the development of the ICD-11 by the World Health Organization (WHO). WHO and the International Union of Psychological Science (IUPsyS) conducted a multilingual survey of 2155 psychologists from 23 countries, recruited through their national psychological associations. Sixty percent of global psychologists routinely used a formal classification system, with ICD-10 used most frequently by 51% and DSM-IV by 44%. Psychologists viewed informing treatment decisions and facilitating communication as the most important purposes of classification, and preferred flexible diagnostic guidelines to strict criteria. Clinicians favorably evaluated most diagnostic categories, but identified a number of problematic diagnoses. Substantial percentages reported problems with crosscultural applicability and cultural bias, especially among psychologists outside the USA and Europe. Findings underscore the priority of clinical utility and professional and cultural differences in international psychology. Implications for ICD-11 development and dissemination are discussed.

PMID: 23750927

[PubMed - as supplied by publisher]

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Slide Presentation: Aug 3, 2012

The WHO-IUPsyS Global Survey of Psychologists’ Attitudes Toward Mental Disorders Classification.

Download PDF WHO-IUPsyS Global Survey slides

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More information on this WHO study can be found on Page 7 (3.) of this report:


http://www.apa.org/international/outreach/icd-report-2012.pdf

2012 Annual Report of the International Union of Psychological Science to the American Psychological Association

Revision of World Health Organization’s ICD-10 Mental and Behavioural Disorders

Pierre L.-J. Ritchie, Ph.D., Main Representative to the World Health Organization, International Union of Psychological Science, January, 2013

Click link for PDF document    WHO-IUPsyS ICD Survey Report Report 2012

This report also sets out the responsibilities of ICD Revision working groups, on Page 3 (1.1), and gives some information on the field studies for ICD-11 and ICD11-PHC, on Page 8 (4.)

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The earlier study: WPA-WHO Global Survey of Psychiatrists’ Attitudes Towards Mental Disorders Classification can be downloaded here: 

The WPA-WHO Global Survey of Psychiatrists’ Attitudes Towards Mental Disorders Classification

World Psychiatry 2011;10:118-131

Research report

Geoffrey M Reed,  João Mendonça Correia, Patricia Esparza, Shekhar Saxena, Mario Maj

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Trouble with timelines (1) DSM-5, ICD-10-CM, ICD-11 and ICD-11-CM

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Trouble with timelines (1): DSM-5, ICD-10-CM, ICD-11 and ICD-11-CM

Post #198 Shortlink:
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Update at August 15, 2012: On Page 3, I stated that Steven Hyman, MD, is a DSM-5 Task Force Member and that Dr Hyman chairs the meetings of the  International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders. According to the DSM-5 Development site, Dr Hyman is no longer a member of the DSM-5 Task Force, having served from 2007-2012. I cannot confirm whether Dr Hyman continues involvement with the International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders though his name remains listed on the WHO site page, or on what date or for what reason Dr Hyman stood down from the DSM-5 Task Force.

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While the US health care industry, professional bodies and clinical practices sweat on the announcement of a final rule for ICD-10-CM compliance and speculation continues over the feasibility of leapfrogging from ICD-9-CM to ICD-11, I thought I’d run through the timelines.

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DSM-5: ETA: May 18-22, 2013

Originally slated for publication in May 2012.

In December 2009, the American Psychiatric Association shifted release of DSM-5 to May 2013, in response to slipping targets. With no changes to the published Timeline and no intimation of further delays, I’m assuming DSM-5 remains on target.

The final manual is scheduled for submission to American Psychiatric Publishing by December 31, 2012, for official release, next May, during APA’s 2013 Annual Meeting in San Francisco.

Following closure of the third and final public review on June 15, 2012, draft proposals for disorder descriptions and criteria sets as published on the DSM-5 Development website were frozen. The DSM-5 website will not be updated with any further revisions made by the work groups between June 15 and going to print. Final criteria sets and manual content are under strict embargo until publication [1].

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ICD-10-CM: ETA: Compliance mandatory by October 1, 2013; Final Rule to be announced on CMS’s proposal to delay compliance date to October 1, 2014

The development process for ICD-10-CM is as old as God’s dog.

WHO published ICD-10 in 1992. Twenty years on, while the rest of the world has long since migrated to ICD-10, the US is still waiting to transition from ICD-9-CM to a US specific clinical modification of ICD-10. The US is still using a modification based on WHO’s long since retired, ICD-9, and a code set that is now over 35 years old.

The Tabular List and preliminary crosswalk between ICD-9-CM and ICD-10-CM were posted on the NCHS website for public comment in December 1997. Field testing took place nearly ten years ago, in the summer of 2003.

The proposed rule for the adoption of ICD-10-CM/PCS was published in August 2008 with a proposed compliance date of October 1, 2011. In January 2009, the Department of Health and Human Services (HHS) published a final rule adopting ICD-10-CM/PCS to replace ICD-9-CM in HIPAA transactions, with an effective compliance date of October 1, 2013.

On February 16, 2012, HHS Secretary Kathleen Sibelius announced intent to postpone the compliance date for adoption of ICD-10-CM/PCS codes sets for a further year, to October 1, 2014 to allow more time for providers, payers and vendors to prepare for transition.

Public comment on the proposed rule closed in June. An imminent decision on a final compliance rule is anticipated but no date by which a decision would be announced has been issued.

Annual updated releases of ICD-10-CM and associated documentation have been posted on the CDC website for public viewing since January 2009.

CMS has issued the 2013 release of ICD-10-CM and General Equivalence Mappings (GEMs) which replace the December 2011 release. Until an implementation date is reached, codes in the 2013 release of ICD-10-CM are not currently valid for any purpose or use but are available for public viewing on the CDC website.

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Partial Code freeze for ICD-9-CM and ICD-10-CM

At the September 15, 2010 public ICD-9-CM Coordination and Maintenance Committee Meeting it was announced that the committee had finalized its recommendation to impose a partial code freeze for ICD-9-CM and ICD-10-CM/PCS codes prior to implementation of ICD-10-CM. Partial Code Freeze Announcement [PDF]

October 1, 2011 was the last major update of ICD-10-CM/PCS until October 1, 2014. Between October 1, 2011 and October 1, 2014 proposals for revisions to ICD-10-CM/PCS will be considered only for new diseases/new technology procedures and minor revisions to correct reported errors. Regular (at least annual) updates to ICD-10-CM/PCS will resume on October 1, 2014.

These Partial Code Freeze dates are based on the original compliance date of October 1, 2013. It’s reported that postponement of the requirement for compliance until October 1, 2014 would also push back scheduled ICD-10-CM coding updates.

If the proposed compliance date of October 1, 2014 is instituted, adoption of ICD-10-CM would become mandatory around 18 months after publication of DSM-5. The first regular updates to ICD-10-CM would resume one year post compliance date, that is, from October 1, 2015.

Continued on Page 2

Pages: 1 2 3

Slide presentation: Per Fink: Somatoform disorders – functional somatic syndromes – Bodily distress syndrome (EACLPP lecture, June 2012)

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Slide presentation: Per Fink: Somatoform disorders – functional somatic syndromes – Bodily distress syndrome (EACLPP lecture, June 2012)

Post #197 Shortlink:
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Slide presentation: Per Fink: Somatoform disorders – functional somatic syndromes – Bodily distress syndrome (EACLPP lecture, June 2012)

23 slides in PDF format (i.e. no PowerPoint viewer required)

       EACLPP Per Fink Somatoform Disorders

Aarhus University Hospital

The Research Clinic for Functional Disorders and Psychosomatics

Somatoform disorders – functional somatic syndromes – Bodily distress syndrome.

Need for care and organisation of care in an international perspective – EACLPP Lecture

Prof. Per Fink

MD, Ph.D, Dr.Med.Sc.

www.functionaldisorders.dk

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June 2012 EACLPP Annual Conference*

*The European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) and the European Network of Psychosomatic Medicine (ECPR) have recently merged the two associations to create a new society – the European Association of Psychosomatic Medicine (EAPM).

The Annual Scientific Meeting of the European Association for Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) and the European Conference on Psychosomatic Research (ECPR) was entitled

“Towards a New Agenda: Cross-disciplinary Approach to Psychosomatic Medicine”

The conference was held in the city of Aarhus, Denmark, on 27 – 30 June 2012.

For last year’s conference, a report was published. I will post any report coming out of this year’s conference.

A Conference Abstract document be accessed here:


http://www.eaclpp-ecpr2012.dk/Home/DownloadOral

Selected Extracts:

Page 61 Nagel A

Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf & Schön Klinik Hamburg-Eilbek, Germany, Voigt K Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg- Eppendorf & Schön Klinik Hamburg-Eilbek, Germany

Diagnostic validity of Complex Somatic Symptom Disorder: Which combination of psychological criteria is best suited for DSM-5?

Page 17 Budtz-Lilly A

The Research Unit for General Practice, School of Public Health, Aarhus University, Denmark

Bodily Distress Syndrome: A new diagnosis for functional disorders in primary care

Page 19 Escobar J

Robert Wood Johnson Medical School, New Brunswick, NJ, USA

An Update on DSM-5

Page 32 Fjorback L

Aarhus University Hospital, Research Clinic for Functional Disorders and Psychosomatics

Mindfulness Therapy for Bodily Distress Syndrome – randomized trial, one-year follow-up, active control

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Notes on Fink et al and Bodily Distress Syndrome (BDS)

According to Fink and colleagues, Bodily Distress Syndrome is a unifying diagnosis that encompasses somatization disorder, so-called “medically unexplained symptoms” (MUS), fibromyalgia, irritable bowel syndrome and chronic fatigue syndrome and some other conditions which they consider to be closely related, with a likely shared underlying aetiology.

See paper: Fink P, Schröder A. One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders J Psychosom Res. 2010 May;68(5):415-26.

See article: Per Fink,a Marianne Rosendal b Understanding and Management of Functional Somatic Symptoms in Primary Care: The Concept of Functional Somatic Symptoms

aResearch Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark
bResearch Unit for General Practice, University of Aarhus, Denmark

See Per Fink’s clinical trial for BDS:
http://clinicaltrials.gov/ct2/show/NCT01518647

See BDS clinician/patient manual: Specialised Treatment for Severe Bodily Distress Syndromes (STreSS)

According to a June 2012 EACLPP Conference Abstract, the concept of Bodily Distress Syndrome (BDS) “is expected to be integrated into the upcoming versions of classification systems.”

The potential for inclusion of Bodily Distress Disorder/Syndrome within ICD-11 could have significant implications for patients, globally, who are diagnosed with one of the so-called “functional somatic syndromes.” These proposals require very close monitoring by patient organizations in those countries that will be implementing ICD-11, post 2015.

Research and clinical professionals, patient organizations and their professional advisors can register now with ICD Revision for input into the ongoing drafting process and urge organizations and professionals to engage in this process.

Abstracts, oral presentations, EACLPP Conference: 27 – 30 June 2012, Aarhus University Campus, Aarhus – Denmark


http://www.eaclpp-ecpr2012.dk/Home/DownloadOral

Extracts

Page 17 Budtz-Lilly A

The Research Unit for General Practice, School of Public Health, Aarhus University, Denmark

Bodily Distress Syndrome: A new diagnosis for functional disorders in primary care

Aim: Medically unexplained or functional symptoms and disorders are common in primary care. Empirical research has proposed specific criteria for a new unifying diagnosis for functional disorders and syndromes: Bodily Distress Syndrome (BDS). This new concept is expected to be integrated into the upcoming versions of classification systems.

And from Page 31 of the Conference Abstracts:

Fjorback L

Aarhus University Hospital, Research Clinic for Functional Disorders and Psychosomatics

Mindfulness Therapy for Bodily Distress Syndrome – randomized trial, one-year follow-up, active control

Objective: To conduct a feasibility and efficacy trial of mindfulness therapy in somatization disorder and functional somatic syndromes such as fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome, defined as bodily distress syndrome (BDS)…

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References and related material:

1] Patients with medically unexplained symptoms and somatisation - a challenge for European health care systems: A white paper of the EACLPP Medically Unexplained Symptoms study group by Peter Henningsen and Francis Creed:
http://www.eaclpp.org/working_groups.html


http://www.eaclpp.org/documents/Patientswithmedicallyunexplainedsymptomsandsomatisation_000.doc

2] Creed F, Guthrie E, Fink P, Henningsen P, Rief W, Sharpe M and White. Is there a better term than “Medically unexplained symptoms”? J Psychosom Res: Volume 68, Issue 1, Pages 5-8 January 2010) discusses the deliberations of the EACLPP MUS study group. Editorial also includes references to the DSM and ICD revision processes:
http://www.ncbi.nlm.nih.gov/pubmed/20004295

3] Fink P, Schröder A. One single diagnosis, bodily distress syndrome, succeeded to capture 10 diagnostic categories of functional somatic syndromes and somatoform disorders. J Psychosom Res. 2010 May;68(5):415-26. The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, 8000 Aarhus, Denmark:

http://www.ncbi.nlm.nih.gov/pubmed/20403500

Fink P, Toft T, Hansen MS, Ørnbøl E, Olesen F. Symptoms and syndromes of bodily distress: an exploratory study of 978 internal medical, neurological, and primary care patients. Psychosom Med. 2007 Jan;69(1):30-9.

http://www.ncbi.nlm.nih.gov/pubmed/17244846

Full text:
http://www.psychosomaticmedicine.org/content/69/1/30.full

Fink P, Rosendal, M. Recent developments in the understanding and management of functional somatic symptoms in primary care. Current Opinion in Psychiatry 2008, 21:182–188

Rosendal M, Fink P, Falkoe E, Schou Hansen H, Olesen F. Improving the Classification of Medically Unexplained Symptoms in Primary Care. Eur. J. Psychiat. v.21 n.1 Zaragoza ene.-mar. 2007
Text:
http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-61632007000100004

PDF:
http://scielo.isciii.es/pdf/ejpen/v21n1/improv3.pdf

4] EURASMUS 
http://eurasmus.net/

The multidisciplinary European Research Association for Somatisation and Medically Unexplained Symptoms(EURASMUS) was formed to study the genetic, psychological and physiological mechanisms underlying bodily distress. Co-convenors: Francis Creed, Peter Henningsen

5] Notes from EACLPP Workgroup meeting in Budapest July 2011


http://www.eaclpp.org/working-groups.html

Report from Working group meeting on MUS/somatisation/bodily distress, Budapest July 1st 2011

“…We should find out whether the WHO group for classification of somatic distress and dissociative disorders will provide a better diagnostic system for these disorders.”

6] Article: ‘Heartsinks’ and weird symptoms by Tony Dowell, June 15, 2011.

Article Table: Functional somatic syndromes according to medical speciality:

http://www.nzdoctor.co.nz/media/671495/heartsinks.pdf

Round up: ICD11-PHC, ICD-11 Classification of Mood and Anxiety Disorders, Monograph: Public Health Aspects of Diagnosis and Classification of Mental and Behavioral Disorders, ASHA DSM-5 comments

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Round up: ICD11-PHC; ICD-11 Classification of Mood and Anxiety Disorders; Monograph: Public Health Aspects of Diagnosis and Classification of Mental and Behavioral Disorders; ASHA DSM-5 comments

1] Paper: The primary health care version of ICD-11: the detection of common mental disorders in general medical settings By David P. Goldberg, James J. Prisciandaro, Paul Williams

2] The ICD-11 Classification of Mood and Anxiety Disorders: background and options (Guest Editors: Mario Maj, Geoffrey M. Reed), World Psychiatry, Volume 11, Supplement 1, June 2012

3] Monograph: Public Health Aspects of Diagnosis and Classification of Mental and Behavioral Disorders: Refining the Research Agenda for DSM-5 and ICD-11 By Shekhar Saxena, Patricia Esparza, Darrel A. Regier, Norman Sartorius

4] Submissions to DSM-5 public reviews for drafts one, two and three by The American Speech-Language-Hearing Association

Post #195 Shortlink:
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This post relates to the World Health Organization’s ICD-11 and ICD11-PHC (Primary Care version), both currently under development. It does not apply to the existing ICD-10, ICD10-PHC or to the forthcoming US specific “clinical modification” of ICD-10, known as ICD-10-CM.

Note on ICD10-PHC and ICD11-PHC

The ICD10-PHC (Primary Care version) is a simplified version of the WHO’s International Classification of Diseases (ICD-10) for use in general practice and primary health care settings. This condensed classification system has rough but not exact equivalence to the main ICD-10 classification.

For example, the ICD10-PHC mental and behavioural disorders chapter lists and describes 25 disorders commonly managed within primary care as opposed to circa 450 classified within Chapter V of ICD-10.

A chart showing the grouping of categories adapted from the full ICD-10 version for the existing ICD10-PHC categories can be found here.

The revision of ICD10-PHC, ICD11-PHC, is currently under development.

Professor, Sir David Goldberg, M.D., Emeritus Professor, Institute of Psychiatry, King’s College, London, is a member of the DSM-5 Mood Disorders Work Group. Prof Goldberg also chairs the Consultation Group for Classification in Primary Care that is making recommendations for the mental and behavioural disorders section of ICD11-PHC.

The majority of patients with mental health problems are diagnosed and managed by general practitioners in primary care – not by psychiatrists and mental health specialists. ICD10-PHC is used in developed and developing countries in general medical settings and also used in the training of medical officers, nurses and multi purpose health workers.

Further information on ICD10-PHC and the development of the mental health disorders section of ICD11-PHC can be found in these two documents:

1] Goldberg, D. Guest editorial. A revised mental health classification for use in general medical settings: the ICD11–PHC 1. International Psychiatry, Page 1, February 2011.

http://www.rcpsych.ac.uk/pdf/IPv8n1.pdf

2] 21st Century Global Mental Health by Dr Eliot Sorel, Professor, George Washington University, Washington D.C.
Publication date: August, 2012:
http://www.jblearning.com/catalog/9781449627874/

Page 51, Sample Chapter 2:
http://samples.jbpub.com/9781449627874/Chapter2.pdf

ICD Revision publishes the names and bios of members of the ICD-11 Revision Steering Group, ICD-11 Topic Advisory Groups, and International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders.

But membership of the various sub working groups to the Topic Advisory Groups (TAGs), the names of external peer reviewers recruited by TAG Managing Editors for reviewing proposals and content and the membership of the advisory/consultation groups for the revision of the ICD Primary Care version have not been published by ICD-11 Revision.

The Abstract below lists members of the (WHO) Primary Care Consultation Group for the Revision of ICD-10 Mental and Behavioural Disorders.

1] Paper: The primary health care version of ICD-11: the detection of common mental disorders in general medical settings


http://www.ghpjournal.com/article/S0163-8343(12)00197-1/abstract

The primary health care version of ICD-11: the detection of common mental disorders in general medical settings

26 July 2012

David P. Goldberg, James J. Prisciandaro, Paul Williams

David P. Goldberg
Affiliations Primary Care Consultation Group, World Health Organization; and Institute of Psychiatry, KCL, London, UK

James J. Prisciandaro
Affiliations Department of Psychiatry, Medical University of South Carolina, Charleston SC, USA
Corresponding author.

Paul Williams
Affiliations Health Services & Population Research, Institute of Psychiatry, KCL, London, UK

Received 31 January 2012; accepted 19 June 2012. published online 26 July 2012.
Corrected Proof

Abstract

Background

The primary health care version of the ICD-11 is currently being revised.

Aim
To test two brief sets of symptoms for depression and anxiety in primary care settings, and validate them against diagnoses of major depression and current generalised anxiety made by the CIDI.

Method
The study took place in general medical or primary care clinics in 14 different countries, using the Composite International Diagnostic Interview adapted for primary care (CIDI-PC) in 5,438 patients. The latent structure of common symptoms was explored, and two symptom scales were derived from item response theory (IRT), these were then investigated against research diagnoses.

Results
Correlations between dimensions of anxious, depressive and somatic symptoms were found to be high. For major depression the 5 item depression scale has marked superiority over the usual 2 item scales used by both the ICD and DSM systems, and for anxiety there is some superiority. If the questions are used with patients that the clinician suspects may have a psychological disorder, the positive predictive value of the scale is between 78 and 90%.

Conclusion
The two scales allow clinicians to make diagnostic assessments of depression and anxiety with a high positive predictive value, provided they use them only when they suspect that a psychological disorder is present.

This article is partly based on the work of the World Health Organization (WHO) Primary Care Consultation Group for the Revision of ICD-10 Mental and Behavioural Disorders, of which the first author is Chair. Other members of the group include Michael Klinkman (GP, United States; Vice Chairman); Sally Chan (nurse, Singapore), Tony Dowell (GP, New Zealand) Sandra Fortes (psychiatrist, Brazil), Linda Gask (psychiatrist, UK), KS Jacob (psychiatrist, India), Tai-Pong Lam (GP, Hong Kong), Joseph Mbatia (psychiatrist, Tanzania), Fareed Minhas (psychiatrist, Pakistan), Marianne Rosendal (GP, Denmark), assisted by WHO Secretariat Geoffrey Reed and Shekhar Saxena. The views expressed in this article are those of the authors and, except as specifically noted, are not intended to represent the official policies and positions of the Primary Care Consultation Group or of the WHO.

Competing interests: David Goldberg is a consultant for Ultrasis and advises the World Health Organization and the American Psychiatric Association.

James Prisciandaro and Paul Williams have no competing interests

PII: S0163-8343(12)00197-1

doi:10.1016/j.genhosppsych.2012.06.006

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2] The ICD-11 Classification of Mood and Anxiety Disorders: background and options (Guest Editors: Mario Maj, Geoffrey M. Reed), World Psychiatry, Volume 11, Supplement 1, June 2012

The PDF of this publication is free.

Note regarding references within these commentaries to DSM-5 proposals: Some of these commentaries were written prior to the release of the third DSM-5 draft for public review, in May 2012, and quote draft proposals as they had stood for the second draft.

For example, the commentary Hypochondriasis in ICD-11 by D.J. Stein, on Page 100, sets out in narrative form the DSM-5 Somatic Symptom Disorder Work Group proposals and criteria for Complex Somatic Symptom Disorder as they had stood in May 2011 and are not the most recent iteration.

DSM-5 proposals have not been finalized. Proposals as they stood in May 2012 for the third and final public review may be subject to further change before DSM-5 is published in May 2013. Please refer to the DSM-5 Development website for the most recent proposals and criteria sets for the categories and proposed categories that are discussed in these commentaries.


http://www.wpanet.org/uploads/WPA-WHO_Collaborative_Activities/WP_ICD-11%20Supplement.pdf

July 2012

The ICD-11 Classification of Mood and Anxiety Disorders: background and options (Guest Editors: Mario Maj, Geoffrey M. Reed) World Psychiatry, Volume 11, Supplement 1, June 2012

Contents

The development of the ICD-11 classification of mood and anxiety disorders

M. Maj, G.M. Reed Page 3

How global epidemiological evidence can inform the revision of ICD-10 classification of depression and anxiety disorders

L.H. Andrade, Y.-P. Wang Page 6

Specifiers as aids to treatment selection and clinical management in the ICD classification of mood disorders

D.J. Miklowitz, M.B. First Page 11

Challenges in the implementation of diagnostic specifiers for mood disorders in ICD-11

M.B. First Page 17

Cultural issues in the classification and diagnosis of mood and anxiety disorders

S. Chakrabarti, C. Berlanga, F. Njenga Page 26

Bipolar disorders in ICD-11

S.M. Strakowski Page 31

Changes needed in the classification of depressive disorders: options for ICD-11

E. Paykel, L.H. Andrade, F. Njenga, M.R. Phillips Page 37

Differentiating depression from ordinary sadness: contextual, qualitative and pragmatic approaches

M. Maj Page 43

Severity of depressive disorders: considerations for ICD-11

J.L. Ayuso-Mateos, P. Lopez-García Page 48

Dysthymia and cyclothymia in ICD-11

M.R. Phillips Page 53

Psychotic and catatonic presentations in bipolar and depressive disorders

S. Chakrabarti Page 59

Mixed states and rapid cycling: conceptual issues and options for ICD-11

M. Maj Page 65

How should melancholia be incorporated in ICD-11?

D. Moussaoui, M. Agoub, A. Khoubila Page 69

Postpartum depression and premenstrual dysphoric disorder: options for ICD-11

M.L. Figueira, V. Videira Dias Page 73

Disruptive mood dysregulation with dysphoria disorder: a proposal for ICD-11

E. Leibenluft, R. Uher, M. Rutter Page 77

Generalized anxiety disorder in ICD-11

M.K. Shear Page 82

Agoraphobia and panic disorder: options for ICD-11

D.J. Stein Page 89

Specific and social phobias in ICD-11

P.M.G. Emmelkamp Page 94

Hypochondriasis in ICD-11

D.J. Stein Page 100

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3] Public Health Aspects of Diagnosis and Classification of Mental and Behavioral Disorders: Refining the Research Agenda for DSM-5 and ICD-11

Note: Substantial extracts from this DSM-5 and ICD-11 monograph can be previewed online on the Amazon site via the “LOOKINSIDE!” function. Greater access to preview content is available to Amazon account holders.  Extracts can also be previewed via Google:

Preview via Amazon “LOOKINSIDE!”:

Preview via Google Books:


http://tinyurl.com/DSM5-ICD11-Monograph

Public Health Aspects of Diagnosis and Classification of Mental and Behavioral Disorders: Refining the Research Agenda for Dsm-5 and ICD-11

By Shekhar Saxena, Patricia Esparza, Darrel A. Regier, Norman Sartorius

(c) 2012

Paperback: 303 pages
Publisher: American Psychiatric Publishing; 1 edition (April 30, 2012)

Public Health Aspects of Diagnosis and Classification of Mental and Behavioral Disorders: Refining the Research Agenda for DSM-5 and ICD-11
[Paperback]

Shekhar Saxena (Author), Patricia Esparza (Author), Darrel A. Regier (Author), Benedetto Saraceno (Author), Norman Sartorius (Author)

Shekhar Saxena, M.D.,is Director of the Department of Mental Health and Substance Abuse at the World Health Organization in Geneva, Switzerland.

Patricia Esparza, Ph.D.,is Research Professor and clinical psychologist in the Department of Psychology and Counseling at Webster University in Geneva, Switzerland.

Darrel A. Regier, M.D., M.P.H.,is Director of the American Psychiatric Institute for Research and Education and Director of the Division of Research at the American Psychiatric Association in Arlington, Virginia; and Vice-Chair of the DSM-5 Task Force.

Benedetto Saraceno, M.D.,FRCPsych,is Professor of Psychiatry and Director of the World Health Organization Collaborating Center on Mental Health of the University of Geneva in Geneva, Switzerland.

Norman Sartorius, M.D., Ph.D.,is President of the Association for the Improvement of Mental Health Programs in Geneva, Switzerland.

Book Description
Publication Date: April 30, 2012 | ISBN-10: 0890423490 | ISBN-13:
978-0890423493 | Edition: 1

“Public Health Aspects of Diagnosis and Classification of Mental and Behavioral Disorders: Refining the Research Agenda for DSM-5 and ICD-11″ provides a comprehensive summary of the current state of mental health classification in the United States and internationally, fostering a better understanding of primary research and clinical needs and facilitating the efforts of service planners, researchers and trainees to address current use of psychiatric diagnosis in the public health sector. The volume reflects the proceedings of a research planning conference convened by the APA and World Health Organization (WHO) that focused on public health aspects of the diagnosis and classification of mental disorders. Highly relevant to the ongoing development of DSM-5 and ICD-11, the book includes the background papers prepared and presented by the Conference Expert Groups. The resulting collection: – Discusses the current state of mental illness prevention efforts and the role of public health in supporting them–critical topics, given that development of effective strategies to reduce mental illness around the world depends on the accuracy with which risk and protective factors can be identified, defined, and understood. – Features international perspectives on public health implications of psychiatric diagnosis, classification, and service, providing viewpoints that are broad and more globally relevant. – Views mental health education, and awareness on a macro level, including its impact on social and economic policy, forensics and the legal system, and education. This approach facilitates the continued development of a research base in community health and promotes the establishment of programs for monitoring, treating, and preventing mental illness. – Addresses many fascinating and clinically relevant issues, such as those raised by the concept and the definition of mental disorders and how these impact psychiatric services and practice by individual providers.

This collection should prove useful to the advisory groups, task forces, and working groups for the revision of these two classifications, as well as for researchers in the area of diagnosis and classification, and more generally in public health.

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4] Submissions to DSM-5 public reviews for drafts one, two and three by The American Speech-Language-Hearing Association (ASHA)

The American Speech-Language-Hearing Association (ASHA) represents people with speech, language, and hearing disorders and advocates for services to help them communicate effectively.

ASHA submitted comments during all three DSM-5 draft comment periods:

ASHA submission April 2010 [PDF]; June 2011 [PDF]; June 2012 [PDF]

ASHA Letter sent June 2012 [PDF]

DSM-V Revisions To Move Forward (ASHA Leader article)

all documents available from this page:


http://www.asha.org/SLP/DSM-5/

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Key ICD-11 links and documents

ICD-11 Beta drafting platform  |  Publicly viewable version

WHO ICD Revision  |  Main WHO website: Revision Steering Group and Topic Advisory Groups
ICD-11 Revision site  |  Revision resources [Google site currently unavailable]
ICD-11 Revision site Documents Page  |  Key revision documents and meeting materials  [Google site currently unavailable]

ICD-11 Revision Information  |
ICD-11 Timeline  |

ICD Information Sheet  |

Revision News  |
Steering Group  |
Topic Advisory Groups  |

ICD-11 YouTube Channel  |  Video reports
ICD-11 on Facebook  |
ICD-11 on Twitter  |
ICD-11 Blog  |  Not updated since October 2009

ICD-11 YouTubes collated on Dx Revision Watch ICD-11 YouTubes  |

WHO Publications

ICD-10 Tabular List online Version: 2010  |  International Statistical Classification of Diseases and Related Health Problems 10th Revision Version: 2010, Tabular List of inclusions and Chapter List

ICD-10 Volume 2: Instruction Manual  |  Volume 2 online Version: 2010 PDF Download

ICD-10 for Mental and Behavioural Disorders Diagnostic Criteria for Research  |  PDF download
ICD-10 for Mental and Behavioural Disorders Clinical Descriptions and Diagnostic Guidelines  |  PDF download

ICD-10 Volume 3: The Alphabetical Index  |  WHO does not make ICD-10 Volume 3: The Alphabetical Index available online

About the World Health Organization (WHO)

The WHO Family of International Classifications  

History of ICD

ICD-11 Revision Beta drafting process: stakeholder participation

Posted on by

ICD-11 Revision Beta drafting process: stakeholder participation

Post #194 Shortlink:
http://wp.me/pKrrB-2nw

Information in this report relates to the World Health Organization’s ICD-11, currently under development. It does not apply to the existing ICD-10 or to the forthcoming US specific “clinical modification” of ICD-10, known as ICD-10-CM.

Update at August 2, 2012:

ICD-11 Slide Presentation:     Harrison Slides 2011 PDF 3MB

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Update at August 2, 2012:

Dr Robert J.G. Chalmers, co-chair and managing editor of ICD Revision Dermatology Topic Advisory Group put out a call, yesterday, on the website of the American Academy of Dermatology Association (AAD) for input into the Beta draft for Chapter 12 Diseases of the skin:

An invitation to contribute to the future of dermatology

ICD-11 Update

By Robert J.G. Chalmers

ICD-11 draft is ready for comments and criticism

By Robert J.G. Chalmers, MB, FRCP, August 01, 2012

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When will ICD-11 be ready for dissemination?

Slipping targets

The revision of ICD-10 and development of the structure for ICD-11 began in 2007.

ICD-11 was originally planned to be ready for dissemination by 2012, with the timelines for the revisions of ICD-10 and DSM-IV running more or less in parallel. Source: Archive documents, References [1] [2].

Very early on in the revision process, the ICD-11 dissemination date was extended from 2012 to 2015. In 2009, launch of the Beta draft was timelined for May 2011, with the final draft scheduled for submission to World Health Assembly (WPA) for approval in 2014.

In order to be ready for global implementation in 2015, the technical work on ICD-11 would need to be completed by 2012. Source: Dr Geoffrey Reed, Ph.D., May 2009, via personal correspondence.

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ICD-11 still at the Beta drafting stage

In early 2011, in response to slipping targets for content population and software development, ICD Revision and WHO-FIC were discussing the pros and cons of postponing the launch of a Beta drafting platform until later that year or until May 2012, and whether an interim solution might be to launch “a hybrid model of opening the revision process to public comment and suggestions at the same time not a full scale beta phase with field trials…”

Sources: Slide presentation: ICD Revision Paediatrics Meeting, Ankara, Turkey, February 28 - March 1, 2011;
Report: WHO-FIC Council conference call, February 16, 2011: Page 6: PDF for Report [3]

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Launch of the Beta delayed

The decision was made to delay launching the Beta draft until May 2012. With the Alpha and Beta stages already running a year or more behind 2009 targets, it’s not clear how much time can be allocated for completing the Beta phase and two year field trials period – if the target for a final version for public viewing in 2014 is going to be reached.

According to the ICD-11 Timeline, presentation for World Health Assembly approval has been shifted to May 2015 and in this paper, published in March 2012 by Christopher Chute, MD, (Chair, ICD-11 Revision Steering Group) et al, publication of ICD-11 is now expected “around 2016.”

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“…And just a small detail: who will do all this work?” [4]

ICD-11 is a very ambitious project.

The burden of drafting and liaison is being carried out largely via electronic means between individuals scattered across the globe and in addition to their clinical and academic responsibilities.

Given the scale of the undertaking, its technical complexity, limited funding and human resources, lack of an overall project manager, reported communication problems between WHO, Revision Steering Group, Topic Advisory Group managing editors and members and the amount of work that remains to be completed, I cannot see this vision of WHO’s Bedirhan Üstün reaching fruition by 2016.

There are some interesting comments in this Agenda Appendix (Page 6 of 10) on project funding, lack of resources, project management and lines of communication: ICD-11 April 11 Meeting Agenda

For make-up of the Revision Steering Group (RSG) and the various Topic Advisory Groups (TAGs) see links at end of post. Membership of the various sub working groups to Topic Advisory Groups and the names of external peer reviewers of proposals and content have not been published by ICD-11 Revision.

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Where can the Beta drafting platform be viewed?

ICD Revision Steering Group and the various Topic Advisory Groups that are developing the Beta draft are working on an electronic collaborative authoring platform, called the iCAT, on a password protected server accessible only by WHO classification experts, Revision Steering Group, Topic Advisory Group Managing Editors and revision process IT personnel and software developers. It looks similar to this:

For more views of the iCAT see Slides 20-25 and Slide 39 of this 2011 slide presentation:

ICD-11 Slide Presentation:     Harrison Slides 2011 PDF 3MB

The iCAT platform is more complex than the publicly viewable version of the Beta platform and has a mechanism for recording change histories which tracks additions, deletions and revisions to the draft as ICD chapters are reorganized and new content generated and populated.

Population of content is managed by the Topic Advisory Group (TAG) Managing Editors following review by the Revision Steering Group. Structural changes to the classification, eg changing parent/child relationships and editing the linearizations can only be done by TAG Managing Editors in liaison with WHO classification experts. Source: Drafting Workflow text and chart [MS Word]; Swim Lane Workflow chart [PDF].

The publicly viewable version of the Beta drafting platform, which was launched in May 2012, looks like this:

With no change histories displaying in the public version of the Beta it is difficult for stakeholders to track proposed hierarchical changes to existing categories, changes to the names of parent classes or child categories, proposed introduction of new category terms (and the rationales for these) or proposed retirement of ICD-10 categories.

In the absence of rationales, it cannot be determined whether the disappearance of a category or group of categories is due to error or oversight by Advisory Group Managing Editors or others with editor level access, a temporary absence while a specific chapter section is being reorganized or whether these no longer displaying categories are intended to be subsumed under existing or new categories.

For example, a number of ICD-10 F45 and F48 Somatoform Disorder categories were removed from the Beta draft in early July with no explanation of intention.

Whilst ICD Revision invites interaction with the drafting process, the lack of clear intent on the part of Advisory Group editors and lack of response to requests for clarifications hinder submission of meaningful stakeholder comment and productive interaction with the process.

Caveats

When viewing the Beta draft, be mindful of the Caveats published by ICD Revision; the draft is in a state of flux.

The ICD-11 Beta drafting process is a work in progress over the next two to three years. The Beta draft is updated on a daily basis to reflect the work being carried out on the iCAT platform. Parent terms, category terms and sorting codes assigned to categories are subject to change as chapter reorganization progresses.

The Beta draft can be accessed here:

Beta draft Foundation Component (FC) view:


http://apps.who.int/classifications/icd11/browse/f/en

Beta draft Linearization Morbity (LM) view:


http://apps.who.int/classifications/icd11/browse/l-m/en

For definitions of Synonyms, Inclusions, Exclusions and ICD-11 terminology see the iCAT Glossary.

+++

Who are the stakeholders in ICD?

government service providers
policy makers and policy implementation agencies
health care professionals and practitioners
physician groups, especially primary care physicians
psychiatrists
psychologists
nurses
researchers and clinician academics
lay health care workers (who deliver most of the primary and mental health care in some developing countries)
social workers
patients (aka service users/consumers of health services), their families and carers
advocacy and disability rights organizations
health information managers and coders
health information technology workers
insurers

On its Facebook page, in June, ICD Revision put out a specific call for professionals with backgrounds in the following fields:


http://www.facebook.com/ICD11

Do you have a background in any of the following areas?

Medicine
Nursing
Midwifery
Dentistry
Pharmacy
Health information management (coding, medical records)
Environmental and occupational health and hygiene
Physiotherapy or Physical therapy
Nutrition
Social Sciences
Psychology
Social work and counseling
Epidemiology
Health Policy
Traditional and complementary medicine

WHO is asking experts from all over the world to sign up today to participate in the ICD revision.

www.who.int/classifications/icd11 

+++

How can stakeholders participate in the Beta process?

The public version of the Beta platform can be viewed without registration.

Professional stakeholders and others who register an interest are able to interact with the drafting process and have access to additional content.

Interested stakeholders can register here

Registered stakeholders are permitted to:

• Add comments on and read other stakeholder comments on concepts; title terms; synonyms; inclusion terms, exclusions and other Content Model parameter terms;
• Comment on whether a category is in the right place;
• Comment on whether the category is useful for Primary Care; Research; Clinical;
• Suggest definitions (with source for definition) for a disease or disorder and comment on already populated draft definitions;
• Make proposals to change ICD categories;
• Offer to participate in field trials (for professionals);
• Offer to assist in translating ICD into other languages

Comments left by registered stakeholders are not visible to non registered viewers. Comments cannot be edited or deleted and appear immediately.

Recent comments get aggregated here:


http://apps.who.int/classifications/icd11/browse/Contributions/RecentComments

+++
PDFs of Print Versions for the ICD-11 Beta Morbidity Linearization

Registered users can download individual chapters or the full linearization using the links on this page. These PDF files are updated every few days to reflect the daily revisions to the drafting platform:


http://apps.who.int/classifications/icd11/browse/l-m/en/Printables

 

For more information on how it is envisaged professional and lay stakeholders will interact with the drafting process see:

PowerPoint presentation slides in Posts #70 and #71:

ICD Revision Process Alpha Evaluation Meeting 11 – 14 April 2011: The Way Forward?

ICD Revision Process Alpha Evaluation Meeting documents and PowerPoint slide presentations

ICD-11 Revision Video invitation to participate here: Video invitation to participate

Press Release here announcing launch of Beta drafting platform. Further media coverage here

Specific call for comments from neurology professionals on The Lancet Neurology site here:


http://www.thelancet.com/journals/laneur/article/PIIS1474-4422(12)70125-4/fulltext

+++

Recently issued documents around the Beta drafting process

Frequently Asked Questions About ICD-11

ICD-11 Beta: Expectations, Concerns and Known Issues: Information for Beta Participants


http://www.who.int/classifications/icd/revision/betaexpectations/en/

ICD-11 Known Concerns and Criticisms: Known concerns about the ICD-11 Beta phase


http://www.who.int/classifications/icd/revision/icd11betaknownconcerns.pdf
 

     ICD-11 Beta known concerns

ICD-11 Known Problems and Issues: General known issues


http://www.who.int/classifications/icd/revision/icd11knownissues.pdf
 

     ICD-11 General known issues

+++

The ICD-11 Content Model

ICD Revision says that the most important difference between ICD-10 and ICD-11 will be the Content Model.

In ICD-10, other than Chapter V Mental and behavioral disorders, there are no definitions or other descriptive content associated with ICD categories – just hierarchical lists of diseases arranged by chapter and their ICD codes.

But content in ICD-11 is being populated in accordance with the Content Model Reference Guide and there will be the potential for considerably more content to be included for diseases, disorders and syndromes in ICD-11 than appears in ICD-10, across all chapters:

“Population of the Content Model and the subsequent review process will serve as the foundation for the creation of the ICD-11. The Content Model identifies the basic characteristics needed to define any ICD category through use of multiple parameters.”

The most recently published version of the Content Model Reference Guide is here:

Content Model Reference Guide January 2011  [MS Word]

There are currently 13 defined parameters in the content model to describe a category in ICD. All categories will have an ICD Entity Title, Classification Properties, Textual Definition, Terms and up to 13 parameters described.

Content Model Parameters

  • ICD Entity Title
  • Classification Properties
  • Textual Definitions
  • Terms
  • Body System/Structure Description
  • Temporal Properties
  • Severity of Subtypes Properties
  • Manifestation Properties
  • Causal Properties
  • Functioning Properties
  • Specific Condition Properties
  • Treatment Properties
  • Diagnostic Criteria

Some ICD-11 chapters are more advanced than others for reorganization of categories and population of proposed definitions and text for other parameters.

In setting itself the task of generating, peer reviewing, populating and approving this amount of detail across the entire ICD, one has to question how realistic a goal this is within current timeframes.

“Populating the Content Model is a critical task for the revision. Failure results in failure of delivery of ICD‑11.” [4]

It would not surprise me if at some point before the end of this year, ICD Revision Steering Group announces further delays for the Beta drafting and field trial stages and an extension to the projected dissemination date, or a scaling back of the project if completion of ICD-11 and its several, planned speciality publications, by 2016, is to be viable.

+++

Will ICD-11 be implemented worldwide from 2015/16?

ICD-10 is used in over 100 countries, worldwide. Assuming ICD-11 does meet it schedules, it may still take several years before countries currently using ICD-10 are ready to adopt ICD-11.

Several countries have been authorized by WHO to develop their own “Clinical Modification (CM)” of ICD. Canada uses an adaptation called ICD-10-CA, with a version published for 2009. Germany uses a version called ICD-10-GM. Australia (ICD-10-AM) and Thailand (ICD-10-TM) also use country specific modifications of ICD-10.

The US lags behind the rest of the world and is still using a CM version of ICD based on the ICD-9, which is long since retired by the WHO.

Instead of moving onto ICD-11, once this is completed, the US had scheduled implementation of a clinical modification of ICD-10 called ICD-10-CM, for October 1, 2013. ICD-10-CM has been in development for a considerable number of years.

On April 17, 2012 the Secretary of HHS issued a proposed rule to delay the compliance date for ICD-10-CM and ICD-10-PCS codes sets from October 1, 2013 to October 1, 2014, in order to allow more time for clinical practices and the coding industry to prepare for transitioning from ICD-9-CM to ICD-10-CM.

The public comment period for the proposed rule to delay the compliance date is now closed and comments are in the process of being reviewed. A final rule has yet to be announced. Until a new compliance date has been ratified and the revised implementation date reached, codes in ICD-10-CM are not valid for any purpose or use but can be viewed for free on the CDC website together with other ICD-10-CM documentation.

The US might not anticipate moving on to a clinical modification of ICD-11 before 2020 and possibly later*.

*Source: DHSS Office of Secretary Final Rule document: “We estimated that the earliest projected date to begin rulemaking for implementation of a U.S. clinical modification of ICD–11 would be the year 2020.”

WHO-FIC meeting materials suggest no earlier than 2018 for Canada. Australia is discussing earlier adoption of ICD-11 (or a CM of ICD-11).

Harmonization between ICD-11 and DSM-5

There is already a degree of correspondence between DSM-IV categories and Chapter V of ICD-10. For the next editions, the APA and WHO have committed as far as possible:

“To facilitate the achievement of the highest possible extent of uniformity and harmonization between ICD-11 mental and behavioural disorders and DSM-V disorders and their diagnostic criteria.”

with the objective that

“The WHO and APA should make all attempts to ensure that in their core versions, the category names, glossary descriptions and criteria are identical for ICD and DSM.”

WHO acknowledges that there may be areas where congruency may not be achievable.

With the timelines for DSM-5 and ICD-11 running out of synch (DSM-5 slated for publication in May 2013; ICD-11 still at the Beta drafting stage with a two year period scheduled for completion of its field trials), this may present barriers to harmonization.

In a June 2011 presentation to the International Congress of the Royal College of Psychiatrists, APA President, John M. Oldham, MD, MS, spoke of “Negotiations in progress to ‘harmonize’ DSM-5 with ICD-11 and to ‘retro-fit’ these codes into ICD-10-CM” and that DSM-5 would need “to include ICD-10-CM ‘F-codes’ in order to process all insurance claims beginning October 1, 2011.”

With the three systems: DSM-5 (publication date May 2013), ICD-10-CM (subject to partial code freeze since October 1, 2011 until 2014+ with new compliance date t.b.a.) and ICD-11 (dissemination scheduled for 2015+) set to become potentially more closely aligned, proposals for ICD-11 may have implications for US health care professionals and patient populations who might also consider themselves stakeholders in the ICD-11 development process.

+

References and additional ICD-11 related links and documentation

According to documents [1] and [2], ICD-11 was originally planned for dissemination by 2012, with the timelines for revisions of ICD-10 and DSM-IV running more or less in parallel. By 2008, the completion date for ICD-11 had been extended to 2014. In December 2009, the American Psychiatric Association (APA) announced a shift in the publication date for DSM-5 to May 2013. APA News Release No. 09-65 

1] IUPsyS Mar 08 Agenda Item 25 ICD-10
International Union of Psychological Science COMMITTEE ON INTERNATIONAL RELATIONS ACTION, March 28–30, 2008, Agenda Item No. 25: Revision of the International Classification of Diseases (ICD-10) and Involvement of Psychology

2] Exhibit 1 WHO Letter Aug 07 
Letter Saxena, WHO, to Ritchie, IUPsyS (International Union for Psychological Science), August 2007
Source:
http://www.apa.org/international/governance/cirp/s08agenda25-Exhibit1.pdf
  

3] Pages 5-6: Report, WHO FIC Council conference call, 16 February 2011, PDF format

4] Closing remarks, PowerPoint presentation: “Proposal for the ICD Beta Platform”, Stanford team, 12.04.11, WHO, Geneva.

5] Key document: ICD Revision Project Plan version 2.1 9 July 2010

Key links

ICD-11 Beta drafting platform  |  Publicly viewable version

WHO ICD Revision  |  Main WHO website: Revision Steering Group and Topic Advisory Groups
ICD-11 Revision site  |  Revision resources [Google site currently unavailable]
ICD-11 Revision site Documents Page  |  Key revision documents and meeting materials  [Google site currently unavailable]

ICD-11 Revision Information  |
ICD-11 Timeline  |

ICD Information Sheet  |

Revision News  |
Steering Group  |
Topic Advisory Groups  |

ICD-11 YouTube Channel  |  Video reports
ICD-11 on Facebook  |
ICD-11 on Twitter  |
ICD-11 Blog  |  Not updated since October 2009

ICD-11 YouTubes collated on Dx Revision Watch ICD-11 YouTubes  |

WHO Publications

ICD-10 Tabular List online Version: 2010  |  International Statistical Classification of Diseases and Related Health Problems 10th Revision Version: 2010, Tabular List of inclusions and Chapter List

ICD-10 Volume 2: Instruction Manual  |  Volume 2 online Version: 2010 PDF Download

ICD-10 for Mental and Behavioural Disorders Diagnostic Criteria for Research  |  PDF download
ICD-10 for Mental and Behavioural Disorders Clinical Descriptions and Diagnostic Guidelines  |  PDF download

ICD-10 Volume 3: The Alphabetical Index  |  WHO does not make ICD-10 Volume 3: The Alphabetical Index available online

About the World Health Organization (WHO)

The WHO Family of International Classifications  

History of ICD

Changes to ICD-11 Beta drafting platform: Bodily Distress Disorders (1)

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Changes to ICD-11 Beta drafting platform: Bodily Distress Disorders (1)

Post #190 Shortlink:
http://wp.me/pKrrB-2jB


+++

This four page post is a revised version of content first published on July 2, 2012.

Information in this report relates to proposals for the World Health Organization’s forthcoming ICD-11, currently scheduled for pilot dissemination in 2015+; it does not relate to the existing ICD-10 or to the forthcoming US specific “clinical modification” of ICD-10, known as ICD-10-CM.

Caveat: The ICD-11 Beta drafting process is a work in progress over the next two to three years. The Beta draft is updated on a daily basis. Parent terms, category terms and sorting codes assigned to categories are subject to change as work on chapter reorganization progresses. Images and text in this posting may not reflect the most recently assigned categories and codes. This post reflects the Beta draft as it stood at July 24, 2012. Please also read the ICD-11 Beta Draft Caveats.

This report updates on recent changes to the Somatoform Disorders section of the ICD-11 Beta drafting platform. The Beta drafting platform can be accessed here:

Beta draft Foundation view:


http://apps.who.int/classifications/icd11/browse/f/en

Beta draft Linearization view:


http://apps.who.int/classifications/icd11/browse/l-m/en

+++

How do the Somatoform Disorders categories currently stand in ICD-10?

ICD-10 Tabular List Version: 2010 can be accessed here:
http://apps.who.int/classifications/icd10/browse/2010/en

ICD-10 Chapter V “Somatoform Disorders”

This is the section of ICD-10 that corresponds with the Somatoform Disorders section in DSM-IV. There is a degree of correspondence between current categories for this section of ICD-10 and for DSM-IV, as set out in the (simplified) table, below.

For clinical descriptions and diagnostic guidelines for ICD-10 Somatoform Disorders see Page 129 of the “Blue book”:

ICD-10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines:
http://www.who.int/classifications/icd/en/bluebook.pdf

Current DSM-IV Codes and Categories for Somatoform Disorders and ICD-10 Chapter V Equivalents

[Ed: Neurasthenia is not categorized within DSM-IV.]

Source: Mayou R, Kirmayer LJ, Simon G, Kroenke K, Sharpe M: Somatoform disorders: time for a new approach in DSM-V. Am J Psychiat. 2005;162:847–855.
+++
+++
This screenshot shows how the ICD-11 Beta draft had stood at June 24, 2012:

ICD-11 Beta Draft: Morbidity Linearization view


+++

For ICD-11 Beta draft, the proposal in June 2012 had been to rename ICD-10′s F45 Somatoform Disorders parent category to Bodily Distress Disorders.

Three new proposed terms: 9R0 Mild bodily distress disorder; 9R1 Moderate bodily distress disorder; 9R2 Severe bodily distress disorder were inserted above the 9R3 thru 9R8 legacy categories imported from ICD-10.

ID : http://who.int/icd#F45

05 Mental and behavioural disorders [Chapter V in ICD-10]

[...]

BODILY DISTRESS DISORDERS  [F45 Somatoform Disorders > F40-F48 Neurotic, stress-related and somatoform disorders in ICD-10]

9R0 Mild bodily distress disorder  [New term to ICD]
9R1 Moderate bodily distress disorder   [New term to ICD]
9R2 Severe bodily distress disorder  [New term to ICD]
9R3 Somatization disorder  [F45.0 in ICD-10]
9R4 Undifferentiated somatoform disorder  [F45.1 in ICD-10]
9R5 Somatoform autonomic dysfunction   [F45.3 in ICD-10]
9R6 Persistent somatoform pain disorder  [F45.4 in ICD-10] 
    ›  9R6.1 Persistent somatoform pain disorder
    ›  9R6.2 Chronic pain disorder with somatic and psychological factors  [Not in ICD-10]
9R7 Other somatoform disorders  [F45.8 in ICD-10]
9R8 Somatoform disorder, unspecified  [F45.9 in ICD-10]

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Hypochondriacal disorder, coded at F45.2 in ICD-10, is currently renamed to Illness Anxiety Disorder for ICD-11 Beta draft and relocated under ANXIETY AND FEAR-RELATED DISORDERS:


http://apps.who.int/classifications/icd11/browse/l-m/en#/http%3a%2f%2fwho.int%2ficd%23F45.2

ID : http://who.int/icd#F45.2

9C5  ANXIETY AND FEAR-RELATED DISORDERS

      ›  9C5.6 Illness Anxiety Disorder

Continued on Page Two

Pages: 1 2 3 4

WHO releases ICD-11 Beta drafting platform

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WHO releases ICD-11 Beta drafting platform

Post #170 Shortlink:
http://wp.me/pKrrB-28K

Yesterday, May 14, the World Health Organization (WHO) announced the launch of the ICD-11 Beta drafting platform.

Press Release here and below.

This publicly viewable platform replaces the Alpha drafting platform that has been viewable since mid 2011. ICD-11 Revision Topic Advisory Groups are using a separate drafting platform with greater functionality than the platform launched yesterday.

Interested stakeholders can register for increased access and to interact with the Beta drafting platform.

In terms of functionality, the Beta platform does not appear to incorporate any additional features over the Alpha. 

In terms of population of content, some entities have text populated for Definitions, others are still waiting for provisional definitions. Some entities have very few “Content Model” parameters listed, others have the following: Parents; Definition; Synonyms; Exclusions; Narrower Terms; Causal Mechanisms; Body Site.

It’s not evident how many of the proposed 13 “Content Model” parameters that describe an ICD-11 entity term will eventually be populated for any given entity. The original list of 13 ”Content Model” parameters has been modified since early 2011, but no new documentation has been publicly released that sets out the new parameters.

More information on the Beta drafting platform here:


http://www.who.int/classifications/icd/revision/en/

The International Classification of Diseases 11th Revision is due by 2015

Participate in the ICD Revision

Beta phase participants will have the opportunity to:

• Make Comments
• Make Proposals
• Propose definitions of diseases in a structured way
• Participate in Field Trials
• Assist in translating ICD into other languages

Video invitation to participate
Frequently Asked Questions About ICD-11
ICD Information Sheet

WHO video invitation from Dr Marie-Paule Kieny on ICD-11

For the first time, experts in the public health community who work with patient diagnosis and treatment have an opportunity to contribute to the development of the next version of the ICD. This is WHO’s publication that ensures all aspects of the health community refer to diseases and health conditions in a consistent way.

WHO is calling on experts, health providers and stakeholders from around the world to participate in the 11th revision process. The final ICD-11 will be released in 2015.

With your help, this classification will be more comprehensive than ever before.

 

The Beta drafting platform can be found here:

Linearizations:


http://apps.who.int/classifications/icd11/browse/l-m/en

Foundation Component:


http://apps.who.int/classifications/icd11/browse/f/en
#

User Guide:


http://apps.who.int/classifications/icd11/browse/Help/en

Listing for Chronic fatigue syndrome:


http://apps.who.int/classifications/icd11/browse/f/en#/http%3a%2f%2fwho.int%2ficd%23G93.3

WHO Press Release

May 2102


http://www.who.int/features/2012/international_classification_disease/en/

WHO seeks health experts’ input for 11th International Classification of Diseases

For the first time, experts in the public health community who work with patient diagnosis and treatment have an opportunity to contribute to the development of the next version of the International Classification of Diseases (ICD), which is WHO’s publication that ensures all members of the health community refer to diseases and health conditions in a consistent way.

WHO/Jim Holmes

WHO is releasing the beta version of what will be ICD-11 on a wiki-type platform that allows stakeholder comments to be added after peer review. The final ICD-11 will be released in 2015.

WHO encourages anyone interested to comment to develop a more comprehensive classification.

Foundation for reliable health data

The ICD is the foundation for the identification of health trends and statistics globally. Receiving input from health experts will greatly improve the representation from current medical practice and create insight from a broader diversity of medicine.

“Literally this is what doctors use to diagnose a patient,” says Tevfik Bedirhan Ustun, coordinator in the Department of Health Statistics and Information Systems. “It is how we define the cause of death when a person dies. In research, it is how we classify health problems based on evidence.”

The ICD is the gold standard for defining and reporting diseases and health conditions. It allows the world to compare and share health information using a common language.

In addition to health providers, the ICD is a key tool used by epidemiologists to study disease patterns, insurers, national health programme managers, data collection specialists, and others who track global health progress and how health resources are spent.

ICD-11 innovations

Using advances in information technology, this ICD revision will allow users to collect data on cause of death, advances in science and medicine, emerging diseases and health conditions, and compare information across the globe with more ease and diversity in the service of public health and clinical reporting.

Some of the key new features of the 11th version will include:

• a new chapter on traditional medicine, which constitutes a significant part of health care in many parts of the world;
• it will be ready to use with electronic health records and applications;
• it will updated through the development phase to reflect new knowledge as it is added to the classification; and
• it will be produced in multiple languages through the development phase.

Further coverage:


http://www.dailypioneer.com/nation/65415-who-seeks-inputs-for-key-disease-database.html

WHO seeks inputs for key disease database

Tuesday, 15 May 2012 00:29
Pioneer News Service | New Delhi

The World Health Organisation (WHO) in a maiden initiative has invited experts and users to contribute online to the development of its next version of the International Classification of Diseases (ICD) capturing mortality and morbidity data.

The world’s standard tool provides a picture of the general health of countries and populations and its 11th version is now being developed through an innovative, collaborative process to be released in 2015.

“This is for the first time WHO is calling on experts and users to participate in the revision process through a web-based platform. The outcome will be a classification that is based on user input and needs,” a WHO official said.

Users include physicians, nurses, other providers, researchers, health information managers and coders, health information technology workers, policy-makers, insurers and patient organisations.

WHO will soon be releasing the beta version of what will be ICD-11 on a wiki-type platform that allows stakeholder comments to be added after peer review.

All Member States are expected to use the most current version of the ICD for reporting death and disease statistics (according to the WHO Nomenclature Regulations adopted by the World Health Assembly in 1967), the official added.

Regarding the steps for participating, he elaborated that experts and stakeholders will have to register for a participant account on the web portal which will be open for comments over the next three years and accepted changes will be reflected immediately.

Some of the key new features of the 11th version will include a new chapter on traditional medicine, which constitutes a significant part of health care in many parts of the world and ready to use with electronic health records and applications.

The ICD is translated into 43 languages and is used by all 117 member countries. The ICD holds importance as it provides a common language for reporting and monitoring diseases. This allows the world to compare and share data in a consistent and standard way – between hospitals, regions and countries and over periods of time. It facilitates the collection and storage of data for analysis and evidence-based decision-making, the official said.

What’s new in the ICD-11 Alpha drafting platform? (CFS, PVFS, ME)

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What’s new in the ICD-11 Alpha drafting platform? (CFS, PVFS, ME)

Post #157 Shortlink:
http://wp.me/pKrrB-22h

 

Screenshot: ICD-11 Alpha Browser Foundation view selected, logged in at April 10, 2012:

Chapter 6: Diseases of the nervous system


http://apps.who.int/classifications/icd11/browse/f/en#/http%3a%2f%2fwho.int%2ficd%23G93.3

Apr 09 – 11:02 UTC


 

ICD-11 Beta drafting platform to launch in May?

As reported in previous posts, according to the timeline, the ICD-11 Beta drafting platform is supposed to be launching this May.

ICD-11 Revision Steering Group has yet to announce whether the Beta platform remains on target for a May release and if so, on what date it will be launched – so I cannot give you a date yet.

Like the Alpha Drafting Browser, the Beta drafting platform will be a work in progress – not a final Beta draft. The final Beta isn’t scheduled until 2014, after the ICD-11 field trials have been undertaken.

When it does launch, the Beta platform is intended to be accessible to professionals and the public for viewing.

Registered or logged in users will have greater access to content and will be able to interact with the platform to read comments, comment on proposals and make suggestions, as part of the ongoing drafting process.  

In the meantime, the publicly viewable version of the Alpha drafting platform (known as the ICD-11 Alpha Browser) can still be accessed here:


http://apps.who.int/classifications/icd11/browse/f/en

The various ICD-11 Revision Topic Advisory Groups are carrying out their draft preparation work on a separate, more complex multi-author drafting platform that is accessible only to WHO and ICD Revision personnel.

 

Alpha drafting platform

As before, the publicly viewable version of the Alpha Browser should be viewed with the following caveats in mind:

the Alpha draft is a work in progress; it is incomplete; it may contain errors and omissions; it is in a state of flux and updated daily; textual content, codes and “Sorting labels” are subject to change as chapters are reorganized and content populated; the content has not been approved by Topic Advisory Groups, Revision Steering Group or WHO.

It is possible to register, or sign into the platform using existing accounts with several third party account providers such as Google, Yahoo and myOpenID, for increased access and functionality. Once signed in, Comments and Questions can be read and PDFs of the drafts of the top level linearizations can be downloaded from the Linearization tab.

See the Alpha Browser User Guide for information on how the Alpha Browser functions:


http://apps.who.int/classifications/icd11/browse/Help/en

 

The ICD-11 “Content Model”

ICD-11 will be available in both print and online versions and unlike most chapters of ICD-10, will include descriptive content for ICD terms.

For the online version of ICD-11, all ICD entities will include a definition and a number of additional key descriptive fields – between 7 and 13 pre-defined parameters, populated according to a common “Content Model” (Content Model Reference Guide January 2011).

For example, ICD entity Title, Definition, Synonyms, Narrower Terms, Exclusions, Body Site, Body System, Signs and Symptoms, Causal Mechanisms, and possibly Diagnostic Criteria for some entities.*

*According to the iCAT User Google Group message board, these fields may have been revised since the January 2011 Content Model Reference Guide was published; Content Model parameters in the Beta draft may therefore differ from those currently displaying in the public Alpha drafting platform.

The print version will use a concise version of Definition due to space constraints.

In the Alpha Browser, not all these Content Model parameters display in the Foundation and Linearization views and not all of the parameters that have been listed for individual entities have had their draft text added yet, as some chapters are more advanced for the population of proposed content than others.

So the Alpha draft is still very patchy and many entities have no Definition and little or no other proposed content filled in.

With no “Category Discussion Notes” or “Change history” pop-up windows visible in the public version of the Alpha, the viewer cannot determine the rationales behind the reorganization of terms and hierarchies within the various chapters.

 

Chapter location and hierarchy for CFS, PVFS and (Benign) ME in ICD-11

I have been reporting since June 2010 that the proposals for ICD-11 Alpha Draft, as far as one could determine, appeared to be:

1] That a change of hierarchy had been recorded in a “Category Discussion Note”, dated May 1, 2010, between ICD-10 Title term “Postviral fatigue syndrome” and “Chronic fatigue syndrome”. (“Category Discussion Notes” and “Change History” pop-ups did display in the earlier iCAT version of the Alpha drafting platform.)

You can view a screenshot from June 2010 of that “Change history” record here:


http://dxrevisionwatch.files.wordpress.com/2010/06/change-history-gj92-cfs.png

The Definition field on the “Chronic fatigue syndrome” description panel in the current Alpha Browser is currently blank but in June 2010, the Definition had stood as in this contemporaneous screenshot:


http://dxrevisionwatch.files.wordpress.com/2010/05/2icatgj92cfsdef.png

2] That “Chronic fatigue syndrome” had been designated as an ICD-11 Title term within ICD-11 Chapter 6: Diseases of the nervous system, with the capacity for a Definition and up to 10 additional descriptive parameters.

3] That “Benign myalgic encephalomyelitis” had been specified as an Inclusion term to ICD-11 Title term “Chronic fatigue syndrome” but that the relationships between the three terms, PVFS, (B) ME and CFS had yet to be specified, as in this screenshot from June 2010:


http://dxrevisionwatch.files.wordpress.com/2010/05/2icatgj92cfsterms.png

 

What is currently showing in the Chapter 6 Foundation Component?

It isn’t possible to bring up a discrete ICD Title listing for either “Benign myalgic encephalomyelitis” or “Postviral fatigue syndrome” in either the Foundation Component or the Linearization.

In the Foundation view only, for Chapter 6: Diseases of the nervous system, “Chronic fatigue syndrome” is listed as a Title term with the ICD-10 legacy ID “ID:http://who.int/icd#G93.3″;

the Definition field is currently blank;

a list of terms has recently been added under “Synonyms”;

one term has recently been added under “Narrower Terms”.

(Note: there is a small asterisk at the end of term “Benign myalgic encephalomyelitis” which is listed at the top of the “Synonyms” list. The asterisk “Hover text” reads “This term is an inclusion term in the linearizations.”)

If you want to view the listing directly on the Browser site (note the “Comment” and “Questions” icons which open up pop-up windows next to terms for reading/commenting won’t display unless you have already registered and logged in) go here:

ICD-11 Alpha Browser Foundation view:


http://apps.who.int/classifications/icd11/browse/f/en#/http%3a%2f%2fwho.int%2ficd%23G93.3

ID:http://who.int/icd#G93.3

Chronic fatigue syndrome

Parent(s)

Selected cause is Remainder of diseases of the nervous system in Condensed and selected Infant and child mortality lists
Selected Cause is All other diseases in the Selected General mortality list
Selected cause is Diseases of the nervous system

Definition

This entity does not have a definition at the moment.

Synonyms

Benign myalgic encephalomyelitis *  [Ed: Hover text over asterisk reads: "This term is an inclusion term in the linearizations."]
akureyri
akureyri disease
cfs – chronic fatigue syndrome
chronic fatigue syndrome nos   [Ed: from current proposals for ICD-10-CM, Chapter 18, R53.82]
chronic fatigue, unspecified   [Ed: from current proposals for ICD-10-CM, Chapter 18, R53.82]
epidemic neuromyasthenia
iceland disease
icelandic disease
me – myalgic encephalomyelitis
myalgic encephalomyelitis
myalgic encephalomyelitis syndrome
postviral fatigue syndrome
pvfs – postviral fatigue syndrome

Narrower Terms

neuromyasthenia

Body Site

Entire brain (body structure)
Brain structure (body structure)

Causal Mechanisms

Virus (organism)

 

What’s new in Chapter 5: Mental and behavioural disorders?

As reported in Dx Revision Watch post:
http://wp.me/pKrrB-1Vx
,  the category “Somatoform Disorders” in Chapter 5, Mental and behavioural disorders is currently renamed to “BODILY DISTRESS DISORDERS”, under which currently sit three new child categories:

5M0 Mild bodily distress disorder
5M1 Moderate bodily distress disorder
5M2 Severe bodily distress disorder.

Chapter 5 Linearization view:


http://apps.who.int/classifications/icd11/browse/l-m/en#/http%3a%2f%2fwho.int%2ficd%23F45

Chapter 5 Foundation view:


http://apps.who.int/classifications/icd11/browse/f/en#/http%3a%2f%2fwho.int%2ficd%23F45

(Click on the little grey arrows to display the child categories):

Child categories to parent ”BODILY DISTRESS DISORDERS”:


http://apps.who.int/classifications/icd11/browse/f/en#/http%3a%2f%2fwho.int%2ficd%231905_dd0250d2_e8cd_4c48_a93f_7997cc1c8b07

BODILY DISTRESS DISORDERS

5M0 Mild bodily distress disorder
5M1 Moderate bodily distress disorder
5M2 Severe bodily distress disorder
5M3 Somatization disorder
5M4 Undifferentiated somatoform disorder
5M5 Somatoform autonomic dysfunction
5M6 Persistent somatoform pain disorder
      > 5M6.0 Persistent somatoform pain disorder
      > 5M6.1 Chronic pain disorder with somatic and psycological [sic] factors
5M7 Other somatoform disorders
5M8 Somatoform disorder, unspecified

None of these three new (proposed) categories have had any Definitions or other textual content added to the description panels on the right hand side of the Alpha Browser page since I first reported this change in February.

It is still not possible to determine what disorders ICD-11 intends might be captured by these three new (proposed) terms, should ICD-11 Revision Steering Group and WHO classification experts consider these terms to be valid constructs and approve their progression through to the Beta draft.

Because no “Change Notes” or “Change history” pop-up windows display in this version of the Alpha Drafting browser, it is not possible to determine:

whether ICD-11 is proposing to introduce three new terms – 5M0 Mild bodily distress disorder; 5M1 Moderate bodily distress disorder; 5M2 Severe bodily distress disorder, in addition to retaining existing ICD-10 terms, 5M3 thru 5M8;

how ICD Revision intends to define these (proposed) new terms at 5M0, 5M1, 5M2;

how these three (proposed) new terms would relate to the existing ICD-10 “Somatoform Disorders” categories which remain listed as child categories to “BODILY DISTRESS DISORDERS” (apart from “Hypochondriacal disorder” [ICD-10: F45.2], which is now listed as “5H0.5 Illness Anxiety Disorder” in the ICD-11 Alpha Draft).

(See Page 1 and 2 of my report: “Bodily Distress Disorders” to replace “Somatoform Disorders” for ICD-11?:
http://wp.me/pKrrB-1Vx
  )

 

References:

ICD-11 Revision:
http://www.who.int/classifications/icd/revision/en/

ICD-11 Alpha Browser User Guide:
http://www.who.int/classifications/icd/revision/caveat/en/index.html

Alpha Browser Foundation view:
http://apps.who.int/classifications/icd11/browse/f/en
#
Alpha Browser Linearization view:
http://apps.who.int/classifications/icd11/browse/l-m/en
#
“Bodily Distress Disorders” to replace “Somatoform Disorders” for ICD-11?:
http://wp.me/pKrrB-1Vx

Update on timelines: DSM-5, ICD-11, ICD-10-CM

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Update on timelines: DSM-5, ICD-11, ICD-10-CM

Post #155 Shortlink:
http://wp.me/pKrrB-21N

Update @ April 10, 2012: CMS issues press release – proposes one year delay for ICD-10-CM compliance

See:
http://wp.me/pKrrB-22q
 for press release and full Proposal document

I will update as more information becomes available.

DSM-5

The DSM-5 clinical settings field trials, scheduled to complete by December, last year, but extended in order that more participants might be recruited, were expected to conclude this March. (Source: DSM-5 Disorganization, Disarray, and Delays, Dr Dayle Jones, American Counseling Association, January 3, 2012)

In November, DSM-5 Task Force Vice-chair, Darrel Regier, MD, predicted the pushing back of the final public review and comment period for revised draft diagnostic criteria from January-February to “no later than May 2012,” in response to DSM-5 timeline slippage and delays in completion of the field trials. (Source: APA Answers DSM-5 Critics, Deborah Brauser, November 9, 2011)

The timeline on the DSM-5 Development site was updated to reflect a “Spring” posting of draft diagnostic criteria but thus far, APA has released no firm date for a final public review and feedback exercise in May.

The second release of draft proposals was posted on May 4, last year, with no prior announcement or news release by APA and caught professional bodies, patient organizations and advocates unprepared.

It is hoped that APA will give reasonable notice before releasing their third and final draft – though how much influence professional and public feedback might have at this late stage in the DSM-5 development process is moot.

DSM-5 is slated for publication in May 2013.

Extract from revised Timeline

Spring 2012: Revised draft diagnostic criteria will be posted on http://www.dsm5.org and open to a third public feedback period for 2 months. Feedback will be shared directly with work group members, and further edits to proposals will be made as needed.

The full DSM-5 Timeline (as it stands at April 8, 2012) can be found here.

 

ICD-11

The current timeline schedules presentation of the ICD-11 to the World Health Assembly in May 2015 – a year later than the 2009 timeline.

According to a paper published by Christopher Chute, MD, (Chair, ICD-11 Revision Steering Group) et al, implementation of ICD-11 is now expected around 2016. (Source: Chute CG, Huff SM, Ferguson JA, Walker JM, Halamka JD. There Are Important Reasons For Delaying Implementation Of The New ICD-10 Coding System. Health Aff March 2012 DOI: 10.1377/hlthaff.2011.1258) 

The ICD-11 Beta drafting platform is scheduled to be launched and open to the public this May for comment and interaction. It will be a work in progress – not a final Beta draft. The final Beta draft isn’t scheduled until 2014.

No announcement that the Beta platform remains on target for a May release has been issued by WHO or ICD-11 Revision Steering Group and no date is given on the ICD Revision website for the launch.

The publicly viewable version of the Alpha drafting platform (the ICD-11 Alpha Browser) can be accessed here. The various ICD-11 Revision Topic Advisory Groups work on a separate, more layered multi-author drafting platform.

NB: The Alpha drafting platform is a work in progress. It is incomplete, in a state of flux, updated daily and subject to WHO Caveats.

ICD-11 Alpha Browser User Guide here.

Foundation view here.

Linearization view here.

PDFs of Draft Print versions of the Linearization are available from the Linearization tab to logged in users.

The ICD-11 timeline (as it stands at April 8, 2012) can be found on the WHO website here.

 

ICD-10-CM

Note: ICD-10-CM is the forthcoming US specific “Clinical Modification” of the WHO’s ICD-10. Following implementation of ICD-10-CM, the US is not anticipated to move on to ICD-11, or a Clinical Modification of ICD-11, for a number of years after global transition to ICD-11.

On February 16, Health and Human Services Secretary, Kathleen G. Sebelius, announced HHS’s intent to initiate a process to postpone the date by which certain health care entities have to comply with ICD-10-CM diagnosis and procedure codes. (Source: CMS Public Affairs/HHS Press Release, February 16, 2012)

The final rule adopting ICD-10-CM as a standard was published in January 2009, when a compliance date of October 1, 2013 had been set – a delay of two years from the compliance date initially specified in the 2008 proposed rule.

CMS plans to announce a new ICD-10 implementation date sometime this April, according to CMS Regional Office, Boston. (Source: Healthcare News: CMS targets April for release of new ICD-10-CM/PCS implementation date, March 20, 2012)

It is anticipated that CMS will make an announcement in the Federal Register, take public comment for 60 days, consider feedback on its proposed ruling, then issue a final rule.

For developments on the new ICD-10-CM compliance date, watch the CMS site or sign up for CMS email alerts:
http://www.cms.hhs.gov/Medicare/Coding/ICD10/Latest_News.html

 

Related information:

DSM-5 Development

ICD-11 Revision

ICD10 Watch

Federal Register

CMS Latest News

DHHS Newsroom

ICD-10-CM CDC Site

“Bodily Distress Disorders” to replace “Somatoform Disorders” for ICD-11?

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“Bodily Distress Disorders” to replace “Somatoform Disorders” for ICD-11?

Post #145 Shortlink:
http://wp.me/pKrrB-1Vx

The information in this report relates only to proposals for the WHO’s forthcoming ICD-11; it does not relate to ICD-10 or to the forthcoming US specific “clinical modification” of ICD-10, known as ICD-10-CM.

Codes assigned to ICD-11 Beta draft categories are subject to change as chapter reorganization progresses. Images and text in this posting may not reflect the most recently assigned codes. This post has been updated to reflect the launch of the Beta drafting platform and revisions to codes assigned during the drafting process as they stand at June 24, 2012.

Part One

 

This report contains an important update on proposals for ICD-11 Chapter 5: Mental and behavioural disorders.

In a February 16, 2012 report by Tom Sullivan for Health Care Finance News, Christopher Chute, MD, who chairs the ICD Revision Steering Group, warned of a possible delay for completion of ICD-11 from 2015 to 2016.

The ICD-11 Beta drafting platform was launched in May 2012.

The Beta drafting platform is a publicly viewable browser similar to the Alpha drafting platform that had been in the public domain since May, 2011.

You can view the Beta Drafting Browser here:

Foundation Component view:


http://apps.who.int/classifications/icd11/browse/f/en

Morbidity Linearization view:


http://apps.who.int/classifications/icd11/browse/l-m/en

The Morbidity Linearization is the view that includes (what may be temporarily assigned) sorting codes. These codes are likely to change as chapter organization progresses. Click on the small grey arrows next to the chapters and categories to display parent > child > grandchildren hierarchies. Click on individual terms to display descriptive content in the right hand frame of the Beta Browser.

Textual content for ICD-11 is in the process of being drafted and the population of content for some chapters is more advanced than others. Content for some of the “ICD-11 Content Model” parameters may display: ID legacy code from ICD-10 (where applicable); Parent(s); Definition; Synonyms; Inclusions; Narrower Terms; Exclusions; Body Site; Causal Mechanism; Signs and Symptoms.

(For ICD-11, entities will be defined across all chapters through up to 13 “Content Model” parameters – considerably more descriptive content than in ICD-10 and a significant workload for the Topic Advisory Group members and managers who are generating the content for ICD-11.)

The Beta Browser User Guide is here:


http://apps.who.int/classifications/icd11/browse/Help/en

This page of the User Guide sets out differences between Foundation view and Morbidity Linearization view.

The various ICD Revision Topic Advisory Groups (TAGs) are carrying out their work on a separate, more complex, multi-author drafting platform. On their platform, editing histories and “Category and Discussion Notes” are recorded so the progress of proposals and reorganization of ICD entities can be tracked, as the draft evolves.

For the Beta drafting platform, interested stakeholders may register for increased access and interaction with the drafting process by submitting comments and suggestions on draft content and proposals.

For those registered for increased access, it is possible to download PDFs of drafts for the “Print Versions for the ICD-11 Beta Morbidity Linearization” for all 25 chapters of ICD-11. These are obtainable, once registered and logged in, from the Linearization > Print Versions tab.

Caveats

I’m going to reiterate the ICD-11 Alpha Browser Caveats because it’s important to understand that the ICD-11 Beta draft is a work in progress – not a static document – and is subject to change.

The draft is updated on a (usually) daily basis; when you view the Beta Browser, you are viewing a “snapshot” of how the publicly viewable draft stood at the end of the previous day; not all chapters are as advanced as others for reorganization or population of content; the draft is incomplete and may contain errors and omissions.

The codes and “sorting labels” assigned to ICD parent classes, child and grandchildren terms are subject to change as reorganization of the chapters progresses. The Beta draft has not yet been approved by the Topic Advisory Groups, Revision Steering Group or WHO and proposals for, and content in the draft may not progress to the Beta drafting stage; field trials have not yet been completed – so be mindful of the fact that the draft is in a state of flux.

As it currently stands, the Beta draft lacks clarity; not all textual content will have been generated and uploaded for terms imported from ICD-10 and there may be no definitions or other textual content displaying for proposed new terms.

Two chapters that are a focus of this site are Chapter 5: Mental and behavioural disorders and Chapter 6: Disorders of the nervous system (the Neurology chapter). (ICD-11 is dropping the use of Roman numerals.)

I won’t be reporting on specific categories in Chapter 6 in this post but will do a follow up post for Chapter 6 in a forthcoming post; again, there is a lack of clarity for Chapter 6 and requests for specific clarifications, last year, from the chair of Topic Advisory Group Neurology and the lead WHO Secretariat for TAG Neurology have met with no response.

Continued on Page 2: Somatoform Disorders in ICD-10; Somatoform Disorders to Bodily Distress Disorders for ICD-11?

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