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Psychiatric Diagnosis and Classification. Edited by Mario Maj, Wolfgang Gaebel, Juan Jose LoÂpez-Ibor and Norman Sartorius Copyright # 2002, John Wiley & Sons, Ltd. ISBNs: 0±471±49681±2 /Hardback); 0±470±84647±X /Electronic) Psychiatric Diagnosis and Classification Psychiatric Diagnosis and Classification. Edited by Mario Maj, Wolfgang Gaebel, Juan Jose LoÂpez-Ibor and Norman Sartorius Copyright # 2002, John Wiley & Sons, Ltd. ISBNs: 0±471±49681±2 /Hardback); 0±470±84647±X /Electronic) Psychiatric Diagnosis and Classification Edited by Mario Maj University of Naples, Italy Wolfgang Gaebel University of DuÈsseldorf, Germany Juan Jose LoÂpez-Ibor Complutense University of Madrid, Spain Norman Sartorius University of Geneva, Switzerland Psychiatric Diagnosis and Classification. Edited by Mario Maj, Wolfgang Gaebel, Juan Jose LoÂpez-Ibor and Norman Sartorius Copyright # 2002, John Wiley & Sons, Ltd. ISBNs: 0±471±49681±2 /Hardback); 0±470±84647±X /Electronic) Copyright # 2002 by John Wiley & Sons, Ltd., Baffins Lane, Chichester, West Sussex PO19 1UD, UK National 01243 779777 International /+44) 1243 779777 e-mail /for orders and customer service enquiries): [email protected] Visit our Home Page on: http://www.wiley.co.uk or http://www.wiley.com All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except under the terms of the Copyright, Designs and Patents Act 1988 or under the terms of a licence issued by the Copyright Licensing Agency Ltd, 90 Tottenham Court Road, London W1P 0LP, UK, without the permission in writing of the publisher. Other Wiley Editorial Offices John Wiley & Sons, Inc., 605 Third Avenue, New York, NY 10158-0012, USA WILEY-VCH Verlag GmbH, Pappelallee 3, D-69469 Weinheim, Germany John Wiley & Sons Australia, Ltd., 33 Park Road, Milton, Queensland 4064, Australia John Wiley & Sons /Asia) Pte, Ltd., 2 Clementi Loop #02-01, Jin Xing Distripark, Singapore 129809 John Wiley & Sons /Canada), Ltd., 22 Worcester Road, Rexdale, Ontario M9W IL1, Canada Library of Congress Cataloging-in-Publication Data Psychiatric diagnosis and classification / edited by Mario Maj . [et al.]. p. cm. ``Based in part on presentations delivered at the 11th World Congress of Psychiatry /Hamburg, Germany, August 6±11, 1999)'' Includes bibliographical references and index. ISBN 0-471-49681-2 /cased) 1. Mental illnessÐDiagnosisÐCongresses. 2. Mental illnessÐClassificationÐCongresses. I. Maj, Mario, 1953±II. World Congress of Psychiatry /11th: 1999: Hamburg, Germany) RC469. P762 2002 616.890075Ðdc21 2001057370 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 0-471-49681-2 Typeset in 10/12pt Palatino by Kolam Information Services Private Ltd, Pondicherry, India Printed and bound in Great Britain by TJ International Ltd, Padstow, Cornwall, UK This book is printed on acid-free paper responsibly manufactured from sustainable forestry, in which at least two trees are planted for each one used for paper production. Psychiatric Diagnosis and Classification. Edited by Mario Maj, Wolfgang Gaebel, Juan Jose LoÂpez-Ibor and Norman Sartorius Copyright # 2002, John Wiley & Sons, Ltd. ISBNs: 0±471±49681±2 /Hardback); 0±470±84647±X /Electronic) Contents List of Contributors vii Preface ix 1. Criteria for Assessing a Classification in Psychiatry Assen Jablensky and Robert E. Kendell 1 2. International Classifications and the Diagnosis of Mental Disorders: Strengths, Limitations and Future Perspectives T. Bedirhan UÈ stuÈn, Somnath Chatterji and Gavin Andrews 25 3. The American Psychiatric Association /APA) Classification of Mental Disorders: Strengths, Limitations and Future Perspectives Darrel A. Regier, Michael First, Tina Marshall and William E. Narrow 47 4. Implications of Comorbidity for the Classification of Mental Disorders: The Need for a Psychobiology of Coherence C. Robert Cloninger 79 5. Evolutionary Theory, Culture and Psychiatric Diagnosis Horacio Fabrega Jr. 107 6. The Role of Phenomenology in Psychiatric Diagnosis and Classification Josef Parnas and Dan Zahavi 137 7. Multiaxial Diagnosis in Psychiatry Juan E. Mezzich, Aleksandar Janca and Marianne C. Kastrup 163 8. Clinical Assessment Instruments in Psychiatry Charles B. Pull, Jean-Marc Cloos and Marie-Claire Pull-Erpelding 177 9. Psychiatric Diagnosis and Classification in Primary Care David Goldberg, Greg Simon and Gavin Andrews 219 10. Psychiatric Diagnosis and Classification in Developing Countries R. Srinivasa Murthy and Narendra N. Wig 249 Index 281 Acknowledgements 295 Psychiatric Diagnosis and Classification. Edited by Mario Maj, Wolfgang Gaebel, Juan Jose LoÂpez-Ibor and Norman Sartorius Copyright # 2002, John Wiley & Sons, Ltd. ISBNs: 0±471±49681±2 /Hardback); 0±470±84647±X /Electronic) Contributors Gavin Andrews School of Psychiatry, University of New South Wales at St. Vincent's Hospital, 299 Forbes Street, Darlinghurst, NSW 2010, Australia Somnath Chatterji Classification, Assessment, Surveys and Terminology, Department of Evidence for Health Policy, World Health Organization, Geneva, Switzerland C. Robert Cloninger Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 S.Euclid, St. Louis, Missouri 63110±1093, USA Jean-Marc Cloos Centre Hospitalier de Luxembourg, 4, rue BarbleÂ, L-1210 Luxembourg Horacio Fabrega Jr. Department of Psychiatry, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA Michael First NYSPsychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA David Goldberg Institute of Psychiatry, King's College, London, UK Assen Jablensky University Department of Psychiatry and Behavioural Science, University of Western Australia, MRF Building, Level 3, 50 Murray Street, Perth, WA 6000, Australia Aleksandar Janca Department of Psychiatry and Behavioural Science, Univer- sity of Western Australia, Perth, Australia Marianne C. Kastrup International Rehabilitation and Research Center for Torture Victims, Copenhagen, Denmark Robert E. Kendell University Department of Psychiatry and Behavioural Science, University of Western Australia, MRF Building, Level 3, 50 Murray Street, Perth, WA 6000, Australia Tina Marshall Division of Research, American Psychiatric Association, 1400 K Street N.W., Washington, DC 20005, USA Juan E. Mezzich Division of Psychiatric Epidemiology and International Center for Mental Health, Mount Sinai School of Medicine of New York University, New York, USA viii CONTRIBUTORS R. Srinivasa Murthy National Institute of Mental Health, Department of Psychiatry and Neuroscience, Post Bag 2900, Bangalore 56002-9, India William E. Narrow Division of Research, American Psychiatric Association, 1400 K Street N.W., Washington, DC 20005, USA Josef Parnas Department of Psychiatry, Hvidovre Hospital, Brondbyoestervej 160, 2650 Hvidovre, Denmark Charles B. Pull Centre Hospitalier de Luxembourg, 4, rue BarbleÂ, L-1210 Luxembourg Marie-Claire Pull-Erpelding Centre OMSFrancophone de Formation et de ReÂfeÂrence, 4, rue BarbleÂ, L-1210 Luxembourg Darrel A. Regier American Psychiatric Institute for Research and Education, 1400 K Street N.W., Washington, DC 20005, USA Greg Simon Center for Health Studies, Group Health Cooperative, 1730 Minor Ave. #1600, Seattle, WA 98101±1448, USA T. Bedirhan UÈ stuÈ n Classification, Assessment, Surveys and Terminology, Department of Evidence for Health Policy, World Health Organization, Geneva, Switzerland Narendra N. Wig Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India Dan Zahavi Danish Institute for Advanced Studies in the Humanities, Vim- melskaflet 41 A, DK-1161 Copenhagen K, Denmark Psychiatric Diagnosis and Classification. Edited by Mario Maj, Wolfgang Gaebel, Juan Jose LoÂpez-Ibor and Norman Sartorius Copyright # 2002, John Wiley & Sons, Ltd. ISBNs: 0±471±49681±2 /Hardback); 0±470±84647±X /Electronic) Preface The next editions of the two main systems for the diagnosis and classifica- tion of mental disorders, the ICD and the DSM, are not expected before the year 2010. The most frequently alleged reasons for this long interval are: /1) the satisfaction with the performance of the systems as they are now, since they are achieving their goals of improving communication among clini- cians and ensuring comparability of research findings; /2) the concern that frequent revisions of diagnostic systems may undermine their assimilation by clinicians, damage the credibility of our discipline, and hamper the progress of research /by making the comparison between old and new data more difficult, impeding the collection of large patient samples, and requiring a ceaseless update of diagnostic interviews and algorithms); /3) the presentiment that we are on the eve of major research breakthroughs, which may have a significant impact on nosology. There is a further reason, however, for the current hesitation to produce a new edition of the above diagnostic systems, which is seldom made explicit, but is probably not the least important: i.e. the gradually spreading perception that there may have been something incorrect in the assumptions put forward by the neo-Krae- pelinian movement at the beginning of the 1970s, which have guided the development of the modern generation of diagnostic systems. That current diagnostic categories really correspond to discrete natural disease entities is appearing now more and
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