Sharan Pratap, Hans Gagan
Consort Psychiatr. 2021 May 25;2(2):7-15. doi: 10.17816/CP67. eCollection 2021.
The challenge of producing a classificatory system that is truly representative of different regions and cultural variations is difficult. This can be conceptualized as an ongoing process, achievable by constant commitment in this regard from various stakeholders over successive generations of the classificatory systems. The objective of this article is to conduct a qualitative review of the process and outcome of the efforts that resulted in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders becoming a global classification. The ICD-11 represents an important, albeit iterative, advance in the classification of mental, behavioural and neurodevelopmental disorders. Significant changes have been incorporated in this regard, such as the introduction of new, culturally-relevant categories, modifications of the diagnostic guidelines, based on culturally informed data and the incorporation of culture-related features for specific disorders. Notwithstanding, there are still certain significant shortcomings and areas for further improvement and research. Some of the key limitations of ICD-11 relate to the paucity of research on the role of culture in the pathogenesis of illnesses. To ensure a classificatory system that is fair, reliable and culturally useful, there is a need to generate empirical evidence on diversity in the form of illnesses, as well as mechanisms that explain these in all the regions of the world. In this review, we try to delineate the various cultural challenges and their influences in the formulation of ICD-11, along with potential shortcomings and areas in need of more improvement and research in this regard.
创建一个能真正代表不同地区和文化差异的分类系统是一项艰巨的挑战。这可以被视为一个持续的过程，需要不同利益相关者在分类系统的连续几代中持续致力于此才能实现。本文的目的是对导致《国际疾病分类第11版》（ICD - 11）中精神、行为和神经发育障碍分类成为全球分类的努力过程和成果进行定性综述。ICD - 11代表了精神、行为和神经发育障碍分类方面一项重要的、尽管是迭代性的进展。在这方面已纳入了重大变化，例如引入了与文化相关的新类别，根据具有文化信息的数据修改诊断指南，以及为特定障碍纳入与文化相关的特征。尽管如此，仍然存在某些重大缺陷以及有待进一步改进和研究的领域。ICD - 11的一些关键局限性与文化在疾病发病机制中的作用研究不足有关。为确保一个公平、可靠且具有文化实用性的分类系统，有必要以疾病形式生成关于多样性的实证证据，以及解释世界所有地区这些情况的机制。在本综述中，我们试图勾勒出ICD - 11制定过程中各种文化挑战及其影响，以及这方面潜在的缺陷和需要更多改进与研究的领域。
