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Clinical utility of ICD‐11 diagnostic guidelines for high‐burden mental disorders: results from mental health settings in 13 countries |
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| Authors: | Geoffrey M. Reed Jared W. Keeley Tahilia J. Rebello Michael B. First Oye Gureje José Luis Ayuso‐Mateos Shigenobu Kanba Brigitte Khoury Cary S. Kogan Valery N. Krasnov Mario Maj Jair de Jesus Mari Pratap Sharan Dan J. Stein Min Zhao Tsuyoshi Akiyama Howard F. Andrews Elson Asevedo Majda Cheour Tecelli Domínguez‐Martínez Joseph El‐Khoury Andrea Fiorillo Jean Grenier Nitin Gupta Lola Kola Maya Kulygina Itziar Leal‐Leturia Mario Luciano Bulumko Lusu J. Nicolás I. Martínez‐López Chihiro Matsumoto Mayokun Odunleye Lucky Umukoro Onofa Sabrina Paterniti Shivani Purnima Rebeca Robles Manoj K. Sahu Goodman Sibeko Na Zhong Wolfgang Gaebel Anne M. Lovell Toshimasa Maruta Kathleen M. Pike Michael C. Roberts María Elena Medina‐Mora |
| Affiliation: | 1. Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA;2. National Institute of Psychiatry Ramón de la Fuente Mu?iz, Mexico City, Mexico;3. Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA;4. New York State Psychiatric Institute, New York, NY, USA;5. Department of Psychiatry, University of Ibadan, Ibadan, Nigeria;6. Department of Psychiatry, Universidad Autonoma de Madrid;7. Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM);8. Instituto de Investigación Sanitaria La Princesa, Madrid, Spain;9. Department of Neuropsychiatry, Kyushu University, Fukuoka City, Japan;10. Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon;11. School of Psychology, University of Ottawa, Ottawa, ON, Canada;12. Moscow Research Institute of Psychiatry, National Medical Research Centre for Psychiatry and Narcology, Moscow, Russian Federation;13. Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy;14. Department of Psychiatry, Universidade Federal de S?o Paulo, S?o Paulo, Brazil;15. Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India;16. Department of Psychiatry, University of Cape Town and South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa;17. Shanghai Mental Health Center and Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China;18. NTT Medical Center Tokyo, Tokyo, Japan;19. Department of Biostatistics, Columbia University College of Physicians and Surgeons, New York, NY, USA;20. Department of Psychiatry, Tunis Al Manar University and Al Razi Hospital, Tunis, Tunisia;21. Cátedras CONACYT, National Council for Science and Technology, Mexico City, Mexico;22. Institut du Savoir Montfort ‐ H?pital Montfort & Université d'Ottawa, Ottawa, ON, Canada;23. Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India;24. Japanese Society of Psychiatry and Neurology, Tokyo, Japan;25. Department of Psychiatry, University College Hospital, Ibadan, Nigeria;26. Federal Neuropsychiatric Hospital Aro, Abeokuta, Nigeria;27. Institute of Mental Health Research, Royal Ottawa Mental Health Centre, and Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada;28. Pt. Jawahar Lal Nehru Memorial Medical College, Raipur, Chhattisgarh, India;29. Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich‐Heine University, Düsseldorf, Germany;30. Institut National de la Santé et de la Recherche Médicale U988, Paris, France;31. Health Management Center, Seitoku University, Matsudo City, Japan;32. Office of Graduate Studies and Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA |
| Abstract: | In this paper we report the clinical utility of the diagnostic guidelines for ICD‐11 mental, behavioural and neurodevelopmental disorders as assessed by 339 clinicians in 1,806 patients in 28 mental health settings in 13 countries. Clinician raters applied the guidelines for schizophrenia and other primary psychotic disorders, mood disorders (depressive and bipolar disorders), anxiety and fear‐related disorders, and disorders specifically associated with stress. Clinician ratings of the clinical utility of the proposed ICD‐11 diagnostic guidelines were very positive overall. The guidelines were perceived as easy to use, corresponding accurately to patients’ presentations (i.e., goodness of fit), clear and understandable, providing an appropriate level of detail, taking about the same or less time than clinicians’ usual practice, and providing useful guidance about distinguishing disorder from normality and from other disorders. Clinicians evaluated the guidelines as less useful for treatment selection and assessing prognosis than for communicating with other health professionals, though the former ratings were still positive overall. Field studies that assess perceived clinical utility of the proposed ICD‐11 diagnostic guidelines among their intended users have very important implications. Classification is the interface between health encounters and health information; if clinicians do not find that a new diagnostic system provides clinically useful information, they are unlikely to apply it consistently and faithfully. This would have a major impact on the validity of aggregated health encounter data used for health policy and decision making. Overall, the results of this study provide considerable reason to be optimistic about the perceived clinical utility of the ICD‐11 among global clinicians. |
| Keywords: | International Classification of Diseases ICD‐11 diagnosis mental disorders clinical utility ease of use goodness of fit treatment selection assessing prognosis |