Psychiatric Diagnosis and Classification - ResearchGate
Psychiatric Diagnosis and Classification - ResearchGate
Psychiatric Diagnosis and Classification - ResearchGate
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224 PSYCHIATRIC DIAGNOSIS AND CLASSIFICATION<br />
Table<br />
9.1. Predicted prevalence of ICD-10 mental disorders among consecutive attenders<br />
in 15 centers, showing proportion recognized by physicians in 4 centers after UÈ stuÈ n<br />
<strong>and</strong> Sartorius [10])<br />
ICD-10 diagnosis<br />
Predicted prevalence<br />
%) 15 centers)<br />
Proportion detected by<br />
physicians %)<br />
4 centers) a<br />
Current depression 10.4 60.5<br />
Generalized anxiety<br />
7.9 50.1<br />
disorder<br />
Neurasthenia chronic<br />
5.4 61.1<br />
fatigue)<br />
Harmful use of alcohol 3.3 9.6<br />
Alcohol dependence 2.7 66.6<br />
Somatization disorder 2.7 64.4<br />
Dysthymia 2.1 73.5<br />
Agoraphobia 1.5 65.7<br />
Panic disorder 1.1 59.2<br />
Hypochondriasis 0.8 73.1<br />
Proportion with at least one<br />
diagnosis<br />
24.0 58.8<br />
The 15 centers were Ankara, Athens, Bangalore, Berlin, Groningen, Ibadan, Mainz, Manchester,<br />
Nagasaki, Paris, Rio de Janeiro, Santiago de Chile, Seattle, Shanghai <strong>and</strong> Verona.<br />
a These 4 centers Manchester, Seattle, Verona <strong>and</strong> Bangalore) had somewhat better detection<br />
rates than all 15.<br />
classification of psychological disorders presenting in primary care. We<br />
focus on symptoms <strong>and</strong> disorders most commonly encountered in primary<br />
care: anxiety, depression, <strong>and</strong> unexplained somatic symptoms.<br />
Across different health care systems, primary health providers may range<br />
from physicians with specialist qualifications internists or pediatricians) to<br />
paraprofessionals with quite limited training. Even in developed countries,<br />
physicians may delegate recognition <strong>and</strong> assessment of psychological disorders<br />
to nurses or other clinical staff. A practical primary care classification<br />
system should be appropriate for use by a wide range of health care<br />
providers. As discussed below, the ICD-10 primary care taxonomy is actually<br />
a family of classifications for use by a range of health care providers<br />
a more complexsystem for physicians <strong>and</strong> a simplified system for nonprofessional<br />
or paraprofessional providers). Two primary care modifications<br />
of the DSM system also discussed below) have been adapted for use<br />
by primary care nursing staff.<br />
A classification of mental disorders should both consider the realities of<br />
current primary care practice <strong>and</strong> direct attention toward important shortcomings.<br />
In other words, an appropriate classification system must remain<br />
relevant <strong>and</strong> accessible to primary care providers while emphasizing areas<br />
of need for more specific diagnosis <strong>and</strong> management. Like any good educa-