The Italian ICD-11 field trial: clinical utility of diagnostic guidelines for schizophrenia and related disorders

Luciano, Mario; Sampogna, Gaia; Vecchio, Valeria Del; Giallonardo, Vincenzo; Palummo, Carmela; Pocai, Benedetta; Steardo, Luca; Zinno, Francesca; Rebello, Tahilia J.; Reed, Geoffrey M.; Fiorillo, Andrea

doi:10.1186/s13033-020-0338-z

Cited by 5 publications

(3 citation statements)

References 48 publications

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“…), b) its implementation into clinical practice, including its goodness of fit, ease of use, and time consumption, and c) its usefulness in determining interventions and as support in clinical assessments (Reed, 2010 , p. 461). The definition also includes whether the use of the diagnostic category leads to improvements in clinical outcomes, both individually and at population level (Reed, 2010 ), and the clinical utility of ICD-11 has since its launch been the subject of several internet-based and clinical field studies (Luciano et al, 2020 ; Peterson et al, 2019 ; Reed et al, 2018 a, 2018 b).…”

Section: Introductionmentioning

confidence: 99%

Complex PTSD: what is the clinical utility of the diagnosis?

Rød

Schmidt

2021

European Journal of Psychotraumatology

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Background The diagnosis of complex posttraumatic stress disorder (CPTSD) was included in the 11th revised edition of the International Classification of Diseases (ICD-11). CPTSD shares trauma-specific symptoms with its sibling disorder PTSD but is additionally characterized by disturbances of the individual’s self-organization (DSO). The clinical utility of the CPTSD diagnosis has yet to be thoroughly investigated. Objective The current study aimed to examine the clinical utility of the CPTSD diagnosis, considering the upcoming implementation of ICD-11 in clinical practice. Method International field studies, construct- and validity analyses leading up to the inclusion in ICD-11 are reviewed, and the diagnostic measures; International Trauma Questionnaire (ITQ) and International Trauma Interview (ITI) are presented. Also, the relationship between CPTSD and borderline personality disorder (BPD) is elaborated in an independent analysis, to clarify their differences in clinical relevance to treatment. Treatment implications for CPTSD are discussed with reference to existing guidelines and clinical needs. Results The validation of ITQ and ITI contributes to the cementation of CPTSD in further clinical practice, providing qualified assessment of the construct, with intended informative value for both clinical communication and facilitation of treatment. CPTSD is found distinguishable from both PTSD and BPD in empirical studies, while the possibility of comorbid BPD/PTSD cases being better described as CPTSD is acknowledged. Practitioners need to employ well-established methods developed for PTSD, while considering additional DSO-symptoms in treatment of CPTSD. Conclusions The inclusion of CPTSD in ICD-11 may potentially facilitate access to more tailored treatment interventions, as well as contribute to increased research focus on disorders specifically associated with stress. The clinical utility value of this additional diagnosis is expected to reveal itself further after ICD-11 is implemented in clinical practice in 2022 and onwards. Yet, CPTSD’s diagnostic inclusion gives future optimism to assessing and treating complex posttraumatic stress symptoms.

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Section: Introductionmentioning

confidence: 99%

Complex PTSD: what is the clinical utility of the diagnosis?

Rød

Schmidt

2021

European Journal of Psychotraumatology

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“…Orienting research toward the clinical characterization of the individual patient should lead to a renewed interest toward a transdiagnostic approach of mental disorders, rather than a categorical one ( 7 ). Indeed, the most recent editions of both ICD and DSM classification systems have tried to include some dimensional aspects—such as for the classification of personality disorders—confirming the need for a comprehensive and balanced evaluation of different psychopathological domains ( 8 , 9 ).…”

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confidence: 99%

Editorial: New trends in psychiatric research: Toward the clinical characterization of the individual case and the personalization of treatments

Sampogna

Falkai

Gondek³

et al. 2022

Front. Psychiatry

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“…A flexible approach has been endorsed, so that the manual can be adapted by clinicians to their clinical routine care [ 9 ][ 22 ]. The feasibility of CDDG has been confirmed by the ICD-11 field trials, which were well received by clinicians and documented a high inter-rater reliability and accuracy of diagnostic categories[ 23 ][ 24 ][ 25 ].…”

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confidence: 99%

The ICD-11 is coming to town! Educational needs, paradigm shifts and innovations in mental health care practice

Fiorillo

Falkai

2021

Eur. Psychiatr.

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Classification systems are essential tools in routine clinical work for providing reliable and clinically useful diagnoses, supporting clinicians and health care workers in identifying patients with higher health needs, and guiding the implementation of the best available care according to the diagnosis [1][2]. In psychiatric practice, classification systems are useful to improve communication among mental health professionals and researchers and to establish widely agreed descriptions of mental disorders, and should not be considered textbooks of psychopathology. Moreover, classification systems offer a framework for education on the most common clinical features of mental disorders through the organization of disorders into discrete diagnostic categories [3][4]. A clear and straightforward classification system can help clinicians to communicate diagnosis to patients and their family members, and to reduce stigma attached to mental disorders. Finally, diagnostic systems facilitate the identification and management of mental disorders in clinical settings and have a significant predictive power [5]. It is understood, however, that they should be complemented by a more detailed clinical characterization of each individual patient [6] [7].The two most widely used classification systems in mental health are the Diagnostic and Statistical Manual of Mental Disorders (DSM), issued by the American Psychiatric Association (APA), and the International Classification of Diseases (ICD), produced by the World Health Organization (WHO). The latest version of the DSM was published in 2013, whereas the 11th revision of the ICD by the WHO has been completed in 2018 and approved by the WHO General Assembly in 2019 [8]. The official reporting of health statistics by Member States to the WHO using the ICD-11 will begin on January 1, 2022 [9].The development of the ICD-11 chapter on mental, behavioral, and neurodevelopmental disorders represents the first major revision of the world's foremost classification of mental disorders, which took nearly 30 years to be completed. In fact, the revision of the ICD-11 represents the biggest global, multidisciplinary, and participative process of revision of a classification system for mental disorders which has ever been implemented [9]. Its development has involved the collaboration among several stakeholders, including some of the most eminent scientists in the field, international scientific associations, and organizations of users and carers [10] [11]. Furthermore, the WHO Global Clinical Practice Network, an international network including more than 16,000 clinicians from 159 countries, has been involved in the field trials of the diagnostic system [9][12]. The ICD-11 is currently being translated in several languages in order to be used in routine clinical practice in different parts of the world [13].Compared with the previous versions, the ICD-11 presents several innovative features, such as the lifespan approach to mental disorders, the inclusion of a dimensional component within a s...

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The Italian ICD-11 field trial: clinical utility of diagnostic guidelines for schizophrenia and related disorders

Cited by 5 publications

References 48 publications

Complex PTSD: what is the clinical utility of the diagnosis?

Complex PTSD: what is the clinical utility of the diagnosis?

Editorial: New trends in psychiatric research: Toward the clinical characterization of the individual case and the personalization of treatments

The ICD-11 is coming to town! Educational needs, paradigm shifts and innovations in mental health care practice

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