Experience of a Thai psychiatrist in making ICD-11: focus on acute and transient psychotic disorder

Abstract

Objective: To share the author’s experience as a committee member in the International Classification of Diseases (ICD), eleventh revision (ICD-11), with a focus on acute and transient psychotic disorder (ATPD) and changes from the previous revision.

Methods: Pubmed, ThaiJO, and website databases were searched. The searched terms included acute, brief, transient, psychosis, psychotic disorder, ICD-10, and ICD-11. All published materials as well as the author’s direct experience were reviewed.

Results: The ICD is periodically revised by the World Health Organization (WHO). The last revision was ICD-10, which came out in 1992. In 2006, WHO started to revise the ICD-10 by appointing the International Advisory Group (IAG) and the working groups to classify various diseases for ICD-11. The author, as a member of the Working Group on the Classification of Psychotic Disorders (WGPD), was assigned responsibility for ATPD. In revising ATPD, all academic materials about ATPD were reviewed. Changes of ATPD in the drafts of ICD-11 were proposed to WGPD for discussion and approval. Later, the first draft of ICD-11 came out, then field and a clinic-based studies were conducted to compare the utility of ICD-11 with ICD-10 in disease diagnosis. ATPD in ICD-11 has been improved to make it easier to diagnose by replacing subtypes in ICD-10 with the episode of illness and stage of symptoms.

Conclusion: Psychiatric diagnosis is a dynamic process in which the diagnostic criteria can be changed based on the current evidence. Thai psychiatrists and mental health professionals are encouraged to conduct further research on ATPD across various issues which could lead to the improvement of ATPD diagnosis in the future revisions of the ICD.