ICD

• Describe ICD 10 (A01)

  • Section F of ICD-10 groups disorders together based on the different types of symptoms that are present.
  • All disorders are represented by a code that starts with F for the section of ICD-10 that is being used and then a digit to represent the family it belongs to and a second digit to represent a specific disorder. This can then be broken down further with a decimal point to signify a specific type of disorder
  • Annex 1 covers disorders that are being researched but have not yet been classified as an actual disorder such as Seasonal Affective disorder or Narcissistic personality disorder.
  • Annex 2 looks at culture specific disorders, which are disorders that don't easily fit any of the established categories. Some culture bound syndromes can be explained by existing classification but are often described as a local variation of a recognised disorder
• F20-F29 is the code for schizophrenia and delusional disorders
• F50-F59 is the code for behaviours associated with physiological disturbances such as eating disorders
• The code for anorexia nervosa is F50
• The code for Bulimia is F50.3
• Annex 2 example

  Pa-Leng or Frigiophobia (in China/South East Asia) which is characterised by obsessive fear of the cold and winds which are believed to produce fatigue, impotence or death and victims compulsively dress in heavy or excessive clothing. This links to code F40.2, which is a specific phobia.
• A Strength of ICD-10 is that due to this digit form of a coding system clinicians can start with a general diagnosis by identifying the family the symptoms belong to and then move to a more specific diagnosis. Iit also allows the clinician to provide information to another clinician in a more objective, easy and systematic way.
• Supporting and critical evidence for reliability of ICD

  (+) Tarriha et al found that inter-rater reliability for ICD-10 was 0.95 when assessing a clinical sample of opioid users in Iran showing that the system will give a consistent outcome when diagnosing drug dependency.

  (-) Ponizosky using a large scale longitudinal assessing the proportion of people re-diagnosed with SZ and found it was increased by 26%, this shows that the expansion of disorders from ICD9 to ICD10 has not affected the consistency of diagnosis.

  (+) Cheniaux et al had 2 psychiatrists assess 100 in-patients and found that using ICD-10 schizophrenia was more likely to be diagnosed when compared with diagnosis given when DSM-IV was used, suggesting it is not consistent with other classification systems
• Supporting and critical evidence for validity of ICD

  • (+) Pihlajamaa found that ICD-10 was valid as it produced a diagnosis of schizophrenia that matched the diagnosis of other classification systems.
  • (+)Powers et al found that women who had suffered complex post traumatic disorder also had higher levels of alcohol and substance misuse as predicted by ICD 10, showing that ICD 10 does have good predictive validity.
  • (+)Mason found that diagnosis when assessing ICD 10 for 99 SZ patients was a good predictor of their future behaviour 13 years later showing that ICD 10 can be used as an accurate measure of predicting the course of SZ over time.
  • (-)Jansson found issues with the validity of ICD-10 due to it having a different focus in terms of features/ symptoms compared to other diagnosis systems so can't be sure that schizophrenia is being measured.