Differences between DSM-5 and ICD-10

There are many mental disorders and problems that exist in the world and that require treatment. Depression and anxiety are some of them, but we can also find others such as schizophrenia, bipolar disorder.

If we know about these disorders it is because they have a name, a diagnostic label that allows us to name the joint presentation of a series of symptoms linked to each other. And sometimes determining what problem the person in question has can be difficult to assess, since different professionals can value different aspects and ignore others.

Fortunately, to overcome this difficulty, some professionals have been carrying out throughout history classification systems for mental disorders, the most widely known and currently used being the DSM-5 and the ICD-10. But despite the fact that these are classification systems with great similarities to each other, they are not the same. What are the main differences between DSM-5 and ICD-10? Let's see it throughout the following article.

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DSM-5 and ICD-10: what are they?

Before going on to talk about the differences between the DSM-5 and the ICD-10, perhaps it would be advisable in First of all, make a brief mention of what these acronyms refer to, known by all psychologists and psychiatrists.

When we talk about DSM-5 we are talking about the fifth edition of the "Diagnostic and Statistical Manual of Mental Disorders", one of the best-known manuals and classification systems for mental disorders and alterations and relevant. This edition was published in 2013 by the American Psychiatric Association (hereinafter APA) through expert consensus and multiple investigations.

This classification system, despite the fact that it is increasingly controversial due to the pathologization of more and more behaviors and modes of functioning and by the accusations of the existence of commercial interests behind the formulation and overdiagnosis of some of these disorders, is one of the most relevant since it offers a framework from which to determine if patients manifest symptoms and criteria of a disorder in such a way that diagnosis and treatment is facilitated both for the professional who attends it and for future interpretations by others professionals.

As for the ICD-10, in this case the acronyms refer to the tenth edition of the "International Classification of Diseases". This is another of the great manuals and classification systems that exist, although this time It does not only analyze mental disorders but the set of all diseases, disorders and alterations that exist. In it, mental disorders only occupy one chapter, the fifth (or F).

It was published in 1992 by the World Health Organization. Although the next edition, the ICD-11, was published in 2018, the truth is that even today it continues to The ICD-10 version is more widely used and is even more widespread, and even the version prior to this one. (ICD-9).

Main differences between DSM-5 and ICD-10

Although DSM-5 and ICD-10 have multiple similarities and include within them psychic/psychiatric problems that are very similar to each other, the truth is that they are two different reference manuals and with several differences to take into account. account. Next we will see some of the clearest differences between the two.

1. Specificity level: mental disorder or general classification of diseases

One of the main aspects in which we can find differential elements between DSM-5 and ICD-10 is found in the fact that while the DSM is a reference manual focused on mental disorders, the ICD is the International Classification of Diseases, including not only the alterations of the psyche but the set of disorders and medical illnesses that can appear in the being human.

So while in the DSM-5 we are only going to find problems and mental disorders, these are only one of the chapters or sections of the ICD-10, which despite the fact that it includes in the Chapter V (or F) to mental disorders also includes any disease or medical problem.

2. different objectives

Despite the fact that both are very useful classification systems in the health field and their contents are highly similar to each other, a difference can be found in the specific objective of each one of them. they.

Although both are diagnostic-oriented, while the DSM aims at a systematic and precise description of the diagnostic criteria and characteristics of a disorder, the ICD is more oriented towards registering and analyzing the present characteristics of the disorder. In this sense, the former is also slightly more precise in its description of the symptoms.

3. Organization that generates them

An also quite relevant difference between both systems is found in the organization that has generated them, as well as the recognition they have.

DSM-5 It has been prepared by the American Psychiatric Association, one of the most relevant American organizations in the world with regard to the study of mental health problems. On the other hand, the ICD-10 has been prepared by the World Health Organization, which has worldwide repercussions.

4. recognition level

Although the DSM-5 is probably the best known classification system and is certainly the most widely used in America, a large majority of psychiatrists in the world and especially in Europe use the ICD-10.

5. Number of large categories

Already within what would be the content or the classification carried out between the different mental disorders, one of the differences that we can find is the number of large sections or categories.

While the ICD-10 incorporates a total of 10 differentiated sections in the chapter dedicated to mental disorders, of of which three are dedicated to childhood disorders, in the DSM we can find a total of 21 large diagnostic categories. It must be borne in mind that we are talking about large groups of disorders, with various disorders existing in the majority of each of the groups.

6. Different disorders or presence of the same disorder with different denominations

Perhaps the most noticeable difference is found in the fact that both DSM-5 and ICD-10 classify psychiatric disorders under different names, include criteria that may be divergent from each other (for example, they may take into account different time periods in which the symptom must occur). There are even some that do not exist directly or are not considered diagnostic entities in one of the classification systems, as is the case with mixed anxiety-depressive disorder.

Most of these differences are not very relevant and refer to the same realities, being highly arbitrary.

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7. Transculturality

Another differential element between the two classifications, and this is something that is even more evident between the DSM-5 and the recent ICD-11, is that despite the fact that both classification systems have Despite useful criticisms, the DSM-5 is based on a Western mindset and culture-based perspective and understanding of the psyche, while in the case of the ICD-10 more account is taken of the existence of different problems more typical of other cultures.

Thus, while in the DSM it is possible that some problems do not fully adjust to the diagnostic criteria due to divergent cultural elements regarding For Westerners, the ICD is more transcultural and allows greater applicability in other regions of the world with different circumstances and ways of understanding the reality.

8. A system... multiaxial?

Throughout their history, both the DSM and the ICD classification systems have used a multiaxial system, with different axes that allow the annotation of different types of problems in such a way that the diagnosis and classification of the various problematic. However, with the arrival of the DSM-5, this feature has gone from being something common to being a differential element.

And it is that the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders has dispensed with the multiaxiality that characterized its previous version (DSM-IVR had a total of five axes), while the ICD-10 maintains three main axes: (clinical diagnosis, disabilities, and contextual elements).