The International Classification of Impairments, Disabilities and Handicaps: its usefulness in classifying and understanding biopsychosocial phenomena.

The International Classification of Impairments, Disabilities and Handicaps (ICIDH) was developed because of the growing awareness that ICD-9 failed to reflect many of the problems that people bring to health care systems. The ICIDH was designed to classify the consequences of disease such as the disruption of daily activity and the social disadvantage that accompany illness. However, since its introduction, the ICIDH has largely been ignored by psychiatry, despite its conceptual strength. In particular, it provides a framework for applying the biopsychosocial model and studying the phenomena of mental illness. The latter is an important issue because of clinical psychiatry's inherent weakness in distinguishing between symptoms of disease and the psychosocial consequences, a particular inadequacy of the DSM-III diagnostic criteria. The utility of the ICIDH is shown in the study of the phenomena of panic disorder and agoraphobia, where I conclude that agoraphobia should be classified as a disability/handicap and not a disorder.