World Psychiatry. 2011 Jun;10(2):118-31. doi: 10.1002/j.2051-5545.2011.tb00034.x.
This article describes the results of the WPA-WHO Global Survey of 4,887 psychiatrists in 44 countries regarding their use of diagnostic classification systems in clinical practice, and the desirable characteristics of a classification of mental disorders. The WHO will use these results to improve the clinical utility of the ICD classification of mental disorders through the current ICD-10 revision process. Participants indicated that the most important purposes of a classification are to facilitate communication among clinicians and to inform treatment and management. They overwhelmingly preferred a simpler system with 100 or fewer categories, and over two-thirds preferred flexible guidance to a strict criteria-based approach. Opinions were divided about how to incorporate severity and functional status, while most respondents were receptive to a system that incorporates a dimensional component. Significant minorities of psychiatrists in Latin America and Asia reported problems with the cross-cultural applicability of existing classifications. Overall, ratings of ease of use and goodness of fit for specific ICD-10 categories were fairly high, but several categories were described as having poor utility in clinical practice. This represents an important focus for the ICD revision, as does ensuring that the ICD-11 classification of mental disorders is acceptable to psychiatrists throughout the world.
本文描述了世界精神病学协会-世界卫生组织对来自 44 个国家的 4887 名精神科医生进行的全球调查结果，内容涉及他们在临床实践中使用诊断分类系统的情况，以及理想的精神障碍分类的特征。世界卫生组织将利用这些结果，通过目前的 ICD-10 修订过程，提高精神障碍 ICD 分类的临床实用性。参与者表示，分类的最重要目的是促进临床医生之间的沟通，并为治疗和管理提供信息。他们压倒性地更喜欢一个有 100 个或更少类别的更简单的系统，超过三分之二的人更喜欢灵活的指导，而不是严格的基于标准的方法。关于如何纳入严重程度和功能状态的意见存在分歧，而大多数受访者对纳入维度成分的系统表示接受。来自拉丁美洲和亚洲的精神科医生中有相当一部分人报告说，现有的分类在跨文化适用性方面存在问题。总体而言，对 ICD-10 特定类别的易用性和拟合度的评价相当高，但有几个类别被描述为在临床实践中实用性较差。这是 ICD 修订的一个重要重点，确保 ICD-11 精神障碍分类在全世界范围内得到精神科医生的认可也是如此。
