When it comes to diagnosing a mental disorder, there are two tools that are used most often. These are the DSM and the ICD. DSM stands for Diagnostic Statistic Manual and ICD stands for International Classification of Diseases. It might seem confusing to have two separate criterion-tools when diagnosing mental disorders but they do exist. Today we will take a deeper look into the history of the two tools, the latest versions and try to discern which one is ‘better’.
The ICD has existed since 1900 and was taken over by WHO when it became an official part of the UN, in 1948. The DSM on the other hand was first released in 1952 but only became a relevant force in 1980 with its second revision, DSM-III.
The ICD started in Paris with the attempts of two Frenchmen with the support of the French government. They tried to enlist all the diseases in the world and classify them as well. It is hence no surprise that ICD actually involves various kinds of illnesses rather than specializing in just one branch. You can find cardiovascular, pathological and mental illnesses within it.
DSM, on the other hand, is maintained by the American Psychiatric Association(APA). It is constantly revised and contains only mental disorders. It is hence exclusively used by psychiatrists across the world.
Since DSM had more American origins and was made only for psychiatrists, it didn’t get a lot of attention for its first two versions, DSM-I and DSM-II. It was a big surprise when DSM-III was released in 1980 and tried to define each symptom and disorder included in it. Since then DSM has overtaken ICD as a means for diagnosis of mental disorders.
Presently we are waiting for the 11th version of ICD and are in the 5th form of DSM. ICD-11 will be presented to the UN in 2019 and will be put in effect from 2022.
Which One is Better?
It is a pretty natural question that when we have two different tools, then which one is better? The answer is actually not so simple.
DSM-III gained a lot of popularity because it tried to clearly define each disorder and its diagnostic criteria. It meant that doctors using it were more likely to have the same diagnosis for the same patient. It attempted to remove the vagueness associated with diagnosing disorders.
ICD on the other hand gives important to the clinical judgement of each doctor. The creators believe that a clinician’s opinions should matter as well since they have years of studies and experience behind them. This could lead to two doctors having different diagnoses for the same patient.
DSM has been considered more ‘accurate’ in the recent years but ICD is more accessible compared to DSM. The ICD is available for free download on the internet but DSM generates a huge revenue for the APA and is hence capitalized.
There are various committees trying to reach a harmony point between ICD and DSM. Although, there are very tiny differences between the two, there is a lot of debate around which one is better. Some claim that DSM will ultimately merge with ICD and form a common diagnostic tool. There are others who believe the opposite.
Some even believe that as science progresses, we will have a completely new tool that diagnoses illnesses using fMRIs and neural mapping. It is believed that slowly mental disorders will be considered as disorders of brain circuit and have a known neurological basis. This hypothetical future criteria is called the Research Domain Criteria (RDoC)
One thing is clear; the future of psychology holds a lot of potential and promise. Let us see where our scientists take us as we learn how our own brain works.
Tyrer, P. (2014). A comparison of DSM and ICD classifications of mental disorder. Advances in psychiatric treatment, 20(4), 280-285.