Differences between DSM-5 and ICD-10

Summary of the differences between these medical manuals widely used in psychology and psychiatry.

There are many psychological 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 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. symptoms linked to each other. And sometimes determining what problem the person in question has can be complicated to assess, since different professionals may assess different aspects and ignore others.

Fortunately, in order to overcome this difficulty, some professionals have been developing classification systems for mental disorders throughout history, the best known and currently used being the DSM-5 and the ICD-10. However, despite the fact that these classification systems have great similarities between them, they are not the same. What are the main differences between DSM-5 and ICD-10? Let's take a look at them in the following article.

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

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

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 and most relevant manuals and classification systems of psychic 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, although increasingly controversial due to the pathologization of more and more behaviors and modes of functioning and the accusations of the existence of commercial interests behind the formulation and overdiagnosis of some of these disorders, is one of the most relevant as it provides a framework from which to determine whether patients manifest symptoms and criteria of a particular disorder, so that diagnosis and treatment is facilitated both for the attending professional and for future interpretations by other professionals.

As for the ICD-10, in this case the acronym refers 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 all the diseases, disorders and illnesses that exist. it does not analyze only the mental disorders but the set of all the diseases, disorders and alterations that exist in the world.. In it, mental disorders occupy only one chapter, the fifth (or F).

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

Main differences between DSM-5 and ICD-10

Although DSM-5 and ICD-10 have many similarities and include psychiatric/psychiatric problems very similar to each other, the fact is that they are two different reference manuals with several differences to be taken into account. The following are some of the clearest differences between the two.

1. Level of specificity: mental disorder or general classification of illnesses

One of the main aspects in which we can find differential elements between DSM-5 and ICD-10 lies 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 alterations of the psyche but also the set of medical disorders and diseases that can appear in human beings.

Thus, while in the DSM-5 we will only find mental problems and disordersThese are only one of the chapters or sections of the ICD-10, which although it includes mental disorders in chapter V (or F) also includes any disease or medical problem.

2. Different objectives

Although both are very useful classification systems in the health field and their contents are very similar, a difference can be found in the specific objective of each of them.

Although both are oriented towards diagnosis, 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 recording and analyzing the present characteristics of the disorder.. In this sense, the former is also slightly more precise in its description of symptoms.

3. Organization that generates them

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

The DSM-5 was developed by the American Psychiatric Associationone of the most relevant American organizations in the world regarding the study of mental health problems. On the other hand, the ICD-10 has been elaborated by the World Health Organization, which has worldwide repercussions.

4. Level of recognition

Although the DSM-5 is probably the best known classification system and is undoubtedly the most widely used in America, a large majority of psychiatrists and psychiatrists are not familiar with it, a large majority of psychiatrists in the world and especially in Europe use the ICD-10..

5. Number of major categories

Already within what would be properly the content or the classification made between the different mental disorders, One of the differences that can be found is the number of major sections or categories..

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

6. Different disorders or presence of the same disorder under different names

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

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

7. Transculturality

Another differential element between both classifications, and this is something that is even more evident between the DSM-5 and the recent ICD-11, is that although both classificatory systems have, despite the criticisms they raise, great utility, the DSM-5 is based on a perspective and understanding of the psyche based on Western mentality and culture, while in the case of ICD-10 takes more into account the existence of different problems more typical of other cultures..

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

8. A system... multiaxial?

Throughout their history, both the DSM and the ICD classification systems have used a multi-axial system, with different axes that allow the annotation of different types of problems in such a way as to facilitate the diagnosis and classification of the various problems. However, with the arrival of the DSM-5, this characteristic has gone from being 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 multi-axiality that characterized its previous version (DSM-IVR had a total of five axes), while the ICD-10 maintains three main axes (DSM-IVR had a total of five axes), while ICD-10 maintains three main axes (clinical diagnosis, disabilities and contextual elements): (clinical diagnosis, disabilities and contextual elements).