DSM-5 and ICD 10

“As an undergraduate student in psychology, I was taught that multiple personalities were a very rare and bizarre disorder. That is all that I was taught on ... It soon became apparent that what I had been taught was simply not true. Not only was I meeting people with multiplicity; these individuals entering my life were normal human beings with much to offer. They were simply people who had endured more than their share of pain in this life and were struggling to make sense of it.”

― Deborah Bray Haddock, The Dissociative Identity Disorder Sourcebook

DSM-5 and ICD-11

Image: "DSM-5" by CCAC North Library

CC BY-NC 2.0



According to the American Psychiatric Association, the organization behind the creation of the DSM, "the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5) is the most widely accepted nomenclature used by clinicians and researchers for the classification of mental disorders" (2013).


The DSM is a guidebook of diagnostic labels and criteria that contains information regarding diagnostic features, associated features, prevalence, development and course, risk and prognostic features, culture-related diagnostic issues, gender-related diagnostic issues, suicide risk, functional consequences, differential diagnoses, and comorbidity. The 5th edition (DSM-5) was released in 2013; before this, the revised 4th edition (DSM-IV-TR) was in use. Though the DSM is created by American psychiatrists and with the US in mind, it is used as a reference by many Western countries.


However, diagnostic coding in the US and other countries does not rely on the DSM but on the International Classification of Diseases (ICD). The ICD is the World Health Organization’s guidebook of diagnostic labels, and it focuses on morbidity, prevalence, and reducing the burden of disease. The 11th edition (ICD-11) was released in 2019.


Despite this, the US has delayed the adaptation of the ICD several times, and many American psychiatrists don't purchase a separate ICD. Many mental health codes are the same between the ICD and DSM, and the DSM provides a list of the ICD codes that are not the same. The DSM is more widely used for mental health diagnoses in Western countries due to being more detailed. The ICD is more often used globally.


The ICD-11 gives a very similar definition for dissociative identity disorder (DID) compared to the DSM-5. However, while the DSM-5 diagnosis other specified dissociative disorder subtype 1 (OSDD-1) covers all DID-like presentations that lack sufficiently differentiated parts or inter-identity amnesia, the ICD-11 diagnosis "Partial DID" is limited to presentations in which dissociated parts engage in very constricted behaviors. The ICD-11 but not DSM-5 differentiates between DID-like presentations in which an individual attributes their experiences to possession by an external entity (possession trance disorder). What is conversion disorder in the DSM-5 is dissociative neurological symptom disorder in the ICD-11. Trance disorder is a separate diagnosis in the ICD-11 but a type of OSDD (OSDD-4) in the DSM-5.

Resources

Accorditional information regarding the differences between the DSM and ICD can be found at the following:


http://www.apapracticecentral.org/update/2013/05-16/frequent-questions.aspx


http://www.dsm5.org/Documents/Understanding%20ICD%2002-21-14%20FINAL.pdf


The ICD-11 is available for free online at:


https://icd.who.int/browse11/l-m/en