Preparing ICD-11: Can we learn the lessons of DSM-5? Peter Tyrer, Imperial College and Member of DSM-5/ICD-11 Harmonisation Group Manchester, June 28 th 2013

What does DSM stand for? 1. Diagnosis for Simple Minds 2. Diagnosis as a Source of Money Manchester, June 28 th 2013

Summary of the major criticisms of DSM No independent validity Too many diagnoses Too much pharma influence Scientific justification for changes poor Turf wars among Task Forces Weak leadership Summary of the major criticisms of DSM No independent validity Too many diagnoses Too much pharma influence Scientific justification for changes poor Turf wars among Task Forces Weak leadership Manchester, June 28 th 2013

Can ICD-11 do any better? Yes, but only if it: Stops being a sheep Puts more resources into ICD-11 revision Maintains its focus on clinical utility Has the courage to drop redundant diagnoses Manchester, June 28 th 2013

Can ICD-11 do any better? Stops being a sheep Ever since DSM-III the WHO has been on the back foot with regard to mental health classification, and this is sad as ICD is still the formal diagnostic system used everywhere in the world – including the US Manchester, June 28 th 2013

Puts more resources into ICD-11 revision The Royal College of Psychiatrists will be producing four books after publication of ICD-11 to aid research, help in coding, promote better usage and provide case history examples of all categories Manchester, June 28 th 2013

Example of clinical utility DSM-5 has not included personality disorders as even they found the Task Force for personality disorder beyond the pale when they saw its recommendations ICD-11 has one diagnosis for personality disorder, with five groupings: no personality disorder, personality difficulty, mild, moderate and severe personality disorder Manchester, June 28 th 2013

When will you find out if we have succeeded? The Royal College of Psychiatrists will be hosting a conference at the end of 2014 or beginning of 2015 Your will all be invited Manchester, June 28 th 2013