In this paper, we propose to define disability operationally and separate it from the disease process in the diagnosis of mental disorders in both ICD and DSM systems.ĭIFFERENT FORMULATION OF DISABILITY IN ICD AND DSMĬompatibility of the ICD and the DSM was already a stated goal of the DSM-II in 1968. This would have the potential to con-found international research and clinical care.
#Functional synonym manual#
Without focused attention on functioning and disabilities, the current revisions of WHO’s International Classification of Diseases (ICD) 3 and APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM) 4 will perpetuate divergence in diagnosing mental disorders. The World Health Organization (WHO) and the American Psychiatric Association (APA) use the construct of disability very differently in their classification systems. More-over, their use in formulating diagnoses of mental disorders is both unclear and inconsistent. Yet the form, frequency and outcome of disabilities in mental disorders are not well-defined or studied scientifically. Using DALYs, the Global Burden of Disease study thus revealed the true magnitude of the long underestimated impact of mental health problems, due to the disability they produce 2.ĭisability in mental disorders is a well-known fact for many clinicians, policy makers and researchers, as well as caregivers and persons with mental illness. However, when “disability” was entered into the equation, as was the case with the disability adjusted life years (DALYs), mental disorders ranked as high as cardiovascular and respiratory diseases, surpassing all malignancies combined, or HIV 1. These disorders had never been put on public health priority lists.
When “disability” was added to public health measures, which had traditionally focused on mortality, it had a “Cinderella effect” on mental disorders.
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