# 05 - Proposed changes to ICD 11

# Proposed changes to ICD-11

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o ICD-10: CDDG (clinical descriptions and diagnostic guidelines) - for clinical, educational and 
service use. It is mainly used by psychiatric practitioners and gives clinical descriptions of each 
disorder together with the diagnostic criteria. 
o ICD-10: DCR (diagnostic criteria for research) contains more restrictive and clearly defined 
clinical features with explicit inclusion, exclusion, and time-course criteria, and is suitable for 
identification of homogeneous patient groups for research purposes. 
o ICD-10: Primary care version - focuses on those disorders prevalent in primary care settings and 
contains broad clinical descriptions, diagnostic flowcharts, and treatment recommendations. 
o ICD 10: Clinical Coding Manual - Short glossary containing the coding together with brief 
descriptions can be used as a quick reference by practitioners, as well as by administrative and 
secretarial staff. It is suitable for clerical workers and for coding purposes. 
Structure of DSM-IV 
While ICD-10 is a wider general medical classification, DSM-IV describes only mental disorders. DSM-IV 
uses a closed, numeric coding system of the form xxx.xx. A single version of DSM-IV is used for both 
clinical and research purposes. DSM takes a descriptive approach, and the characteristic signs and 
symptoms of each disorder should be present before a diagnosis is made. It is neutral and atheoretical 
regarding the causes of mental disorders and does not subscribe to any models of causation of disorders 
such as cognitive theories, learning theories, etc. Its diagnoses are non-hierarchical, which implies that 
more than one diagnosis can be made. An important step included in the development of DSM-IV was the 
attempt to strengthen the reliability of classification. The inter-rater agreement for Axis 1 disorders is very 
high (0.73 and 1.00) and has repeatedly demonstrated greater diagnostic stability over time. 
 
Newer Classification Systems 
Proposed changes to ICD-11 
ICD-11 is under preparation and consultation now and is expected to be released by 2017. Some of the 
significant changes expected in ICD-11 are highlighted below. Note that these are subject to updates and 
revisions. 
x 
Presumed aetiological groupings rather than conventional symptom-based groupings employed 
for placing each disorder in a chapter 
x 
Neurodevelopmental disorders will be set in chapter 1 
x 
Bipolar disorders will be split from depressive disorders and placed in a separate chapter 
x 
Dissociative disorders will be split from stress-induced disorders 
x 
OCD will be separated from anxiety disorders 
x 
Factitious disorders will be placed in a separate chapter 
x 
Conditions related to substance use will be split into various chapters 
x 
No restriction in number of character places when coding the disorders