March 31, 2014
Post #305 Shortlink: http://wp.me/pKrrB-3Rm
As no new posts will be added to the site from April, I leave you with my 12 Point Skinny on ICD-11 that I first published in February.
The version below has been updated to reflect changes since February.
A brief summary of how things stand in the Beta drafting platform at March 31, 2014.
If reposting, please repost unedited, with the publication date and source URL:
Dx Revision Watch’s 12 Point Skinny on ICD-11:
1. The ICD-10 terms, PVFS, BME, CFS, are not currently displaying in the public version of the Beta drafting platform under any chapters, either as ICD Title terms, or as Inclusion terms to ICD Title terms, or under Synonyms to ICD Title terms.
2. On Feb 12, 2014, @WHO Twitter admin stated: “Fibromyalgia, ME/CFS are not included as Mental & Behavioural Disorders in ICD-10, there is no proposal to do so for ICD-11″. This position was also confirmed by Mr Gregory Härtl, Head of Public Relations/Social Media, WHO.
3. But WHO/ICD Revision has yet to clarify its intentions for classification of PVFS, BME, CFS within ICD-11, in terms of chapter locations, parent classes (including multiple parentage), hierarchies, definitions etc.
4. Since June 2013, multiple requests have been made to WHO/ICD Revision to explain the reason for the current absence of these terms from the draft and to issue a statement of clarification. On March 18, 2014, a joint letter was sent to key WHO/ICD Revision personnel .
5. Two separate working groups are charged with advising on the revision of the ICD-10 Somatoform disorders section.
6. In 2012, two sets of emerging proposals were published – one for Bodily distress disorder (BDD) and one for Bodily stress syndrome (BSS).
7. In 2012, emerging proposals by the S3DWG (Gureje, Creed’s sub working group) for Bodily distress disorder (BDD) were for an SSD-like psychobehavioural responses construct/criteria .
8. In 2012, emerging proposals by the PCCG (Goldberg’s Primary Care Consultation Group) for Bodily stress syndrome (BSS) drew heavily on a Fink et al BDS-like symptom patterns from body systems construct/criteria, but with some SSD-like psychobehavioural responses tacked on (a mash-up between two divergent constructs) .
9. The current Definition for Bodily distress disorder (BDD), as inserted in the Beta drafting platform,  is based on disorder description wording in the 2012 Gureje, Creed BDD paper, which had described an SSD-like construct .
10. BDD had a child category, Severe bodily distress disorder. This is now removed from the draft. ICD-10′s Somatization disorder has been restored to the draft linearizations as a child category to parent, Bodily distress disorder. Additionally, ICD-10′s F48.0 Neurasthenia has been restored to the draft linearizations, under parent Mental and behavioural disorders.
Seven ICD-10 Somatoform disorders categories (F45.0 – F45.9) plus F48.0 Neurasthenia had previously been proposed to be subsumed by a single new disorder construct, BDD . How these two (now restored) legacy categories from ICD-10 are currently envisaged to relate to any new single disorder framework to replace the Somatoform disorders remains to be clarified.
11. Without full disorder descriptions, criteria, inclusions, exclusions, differential diagnoses etc, there is insufficient information in the public version of the Beta draft to determine the characteristics and criteria for whatever construct is being progressed to field tests, or to determine whether the two advisory groups have reached consensus.
12. ICD-11 Beta is a work in progress, updated daily, not finalized, subject to field test evaluation, not approved by ICD Revision or WHO.
References for 12 Point Skinny on ICD-11:
1. Joint letter signed by Annette Brooke MP, Chair, All Party Parliamentary Group on M.E., Countess of Mar, Chair, House of Lords-led group Forward ME, Dr Charles Shepherd, Medical Adviser of the ME Association, Sonya Chawdhury, Chief Executive, Action for M.E.
2. Creed F, Gureje O. Emerging themes in the revision of the classification of somatoform disorders. Int Rev Psychiatry. 2012 Dec;24(6):556-67. http://www.ncbi.nlm.nih.gov/pubmed/23244611 [Full text behind paywall]
3. Lam TP, Goldberg DP, Dowell AC, Fortes S, Mbatia JK, Minhas FA, Klinkman MS: Proposed new diagnoses of anxious depression and bodily stress syndrome in ICD-11-PHC: an international focus group study. Fam Pract Feb 2013 [Epub ahead of print July 2012]. http://www.ncbi.nlm.nih.gov/pubmed/22843638. Full free text: http://fampra.oxfordjournals.org/content/30/1/76.long
4. ICD-11 Beta drafting platform public version: Bodily distress disorder: http://apps.who.int/classifications/icd11/browse/f/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f767044268
Caveats: The ICD-11 Beta drafting platform is not a static document: it is a work in progress, subject to daily edits and revisions, to field test evaluation and to approval by Topic Advisory Group Managing Editors, the ICD Revision Steering Group and WHO classification experts.
Clarification: Coalition for Diagnostic Rights
A website called Coalition for Diagnostic Rights has recently been launched.
The site includes references to Suzy Chapman and to Dx Revision Watch.
Suzy Chapman/Dx Revision Watch is not associated with or affiliated to the Coalition for Diagnostic Rights website or with any organization associated with that site, and has no responsibility for content published on that site, or published in the name of that site on other platforms.
Dx Revision Watch