Development of DSM-V and ICD-11: Tendencies and potential of new classifications in psychiatry at the current state of knowledge
Article first published online: 23 SEP 2009
© 2009 The Author. Journal compilation © 2009 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences
Volume 63, Issue 5, pages 595–612, October 2009
How to Cite
Möller, H.-J. (2009), Development of DSM-V and ICD-11: Tendencies and potential of new classifications in psychiatry at the current state of knowledge. Psychiatry and Clinical Neurosciences, 63: 595–612. doi: 10.1111/j.1440-1819.2009.02020.x
- Issue published online: 23 SEP 2009
- Article first published online: 23 SEP 2009
- Accepted 13 July 2009.
- categorical classification;
- dimensional classification;
A reason for the necessity to revise ICD-10 and DSM-IV is the increase of knowledge in the past 20 years, especially neurobiological knowledge. But is this increase of knowledge, for example in the field of neurogenetics, of such magnitude that a revision of the psychiatric classification is necessary and promises to be fruitful? The current plans for DSM-V or ICD-11, respectively, focus on different improvements. In this context also the introduction of a purely syndromatic/dimensional approach without including etiopathogenetic hypotheses, is discussed. A switch to such a dimensional approach, which was discussed among others in the DSM-V task force Deconstructing Psychosis, would be the most radical development. It could avoid many theoretical pre-assumptions about causal hypotheses, which are still associated with ICD-10 and DSM-IV. This would indeed increase the validity of psychiatric classification, but it would also reduce the information as compared to traditional diagnostic categories with all the current implications concerning etiopathogenesis, therapy and prognosis. Such a dimensional approach would also mean that the syndromes would have to be assessed in a standardized way for each person seeking help from the psychiatric service system or for each person undergoing psychiatric research. This would have to be a multi-dimensional assessment covering all syndromes existing within different psychiatric disorders. Based on the different aspects that must be considered in this context, a careful revision seems more advisable than a radical change of classification.