Baron Stefanie, Linden Michael
Research Group Psychosomatic Rehabilitation, Rehabilitation Centre Seehof, Charité University Medicine Berlin, Lichterfelder Allee 55, Teltow/Berlin, Germany.
Eur Arch Psychiatry Clin Neurosci. 2008 Nov;258 Suppl 5:81-5. doi: 10.1007/s00406-008-5013-3.
Diagnoses according to ICD-10 or DSM are conclusions derived from diagnostic algorithms, based on symptoms, but also illness course, history and consequences of the illness state. But, there is only limited consensus about the definitions of the criteria which are the basis of diagnostic algorithms. In DSM there is only a small glossary of technical terms, while ICD does not provide any respective definitions at all. When the diagnostic criteria are unreliable or invalid, then also the diagnostic conclusions must be invalid, even when they are based on strict algorithms. Therefore, standardized definitions for diagnostic criteria are as important as standardized diagnostic algorithms. The ICF, published by WHO in 2001, defines in it's first chapter mental functions which are identical with descriptions of psychopathological terms, if there is a malfunctioning. As definitions of diagnostic criteria are missing in ICD or DSM, the ICF definitions for functions, and thus disorders of functions, are at present the only glossary of illness signs and symptoms. Therefore, the ICF can serve as the basis for diagnostic algorithms in ICD or DSM. Furthermore, illness definitions are, apart from symptoms, also based on illness consequences. These are also defined in ICF as capacities (or disorders of capacity) and participation. Disorders of functions, capacity and participation together can describe targets of treatment. In summary, ICD and ICF as members of the family of WHO classification systems can together provide a common language for the description of health, illness and treatment goals.
根据国际疾病分类第十版（ICD - 10）或精神疾病诊断与统计手册（DSM）进行的诊断是基于症状、疾病进程、病史以及疾病状态后果，通过诊断算法得出的结论。但是，作为诊断算法基础的标准定义，人们仅达成了有限的共识。在DSM中，仅有一个小型的术语表，而ICD根本没有提供任何相关定义。当诊断标准不可靠或无效时，即便诊断结论是基于严格的算法得出的，这些结论也必然是无效的。因此，诊断标准的标准化定义与标准化诊断算法同样重要。世界卫生组织（WHO）于2001年发布的《国际功能、残疾和健康分类》（ICF）在其第一章中定义了精神功能，若存在功能障碍，这些精神功能与精神病理学术语的描述是一致的。由于ICD或DSM中缺少诊断标准的定义，ICF对功能以及功能障碍的定义，目前是唯一的疾病体征和症状术语表。所以，ICF可以作为ICD或DSM中诊断算法的基础。此外，疾病定义除了基于症状外，还基于疾病后果。这些在ICF中也被定义为能力（或能力障碍）和参与。功能、能力和参与方面的障碍共同可以描述治疗目标。总之，ICD和ICF作为WHO分类系统家族的成员，可以共同为描述健康、疾病和治疗目标提供一种通用语言。
