COUNTRY REPORT Asian/Pacific Rim psychiatrists’ views on aspects of future classifications Graham Mellsop 1 MD FRANZCP, Aleksandar Janca 2 MD MSc FRCPsych FRANZCP, Carlos León-Andrade 3 MD, Daisy Nga Yan Luk 4 MRCPsych FHKAM(Psychiatry), Helen Fung Kum Chiu 5 FRCPsych FHKAM(Psychiatry), Hinemoa Elder 6 FRANZCP, Naotaka Shinfuku 7 MD PhD, Rees Tapsell 8 FRANZCP, Sivasankaran Balaratnasingam 9 MBBS FRANZCP & Wai Chi Chan 10 MRCPsych FHKAM(Psychiatry) 1 Waikato Clinical School, Peter Rothwell Academic Centre, Hamilton, New Zealand 2 School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia 3 Department of Psychiatry, Metropolitan Hospital, Quito, Ecuador 4 Department of Psychiatry, Prince of Wales Hospital, Hong Kong, China 5 Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China 6 Hauora Waikato, Hamilton, New Zealand 7 Seinan Gakuin University, School of Human Sciences, Fukuoka, Japan 8 Executive Director of Mental Health Division, Waikato, DHB, Hamilton, New Zealand 9 Kimberley Mental Health and Drug Services, Broome, WA, Australia 10 Department of Psychiatry, Shatin Hospital, Hong Kong Correspondence Graham Mellsop MD FRANZCP, Waikato Clinical School, Peter Rothwell Academic Centre, Private Bag 3200, Hamilton 3240, New Zealand. Tel: +64 7 839 8750 Fax: +64 7 839 8712 Email: graham.mellsop@waikatodhb.health.nz Received 24 August 2011 Accepted 19 September 2011 DOI:10.1111/j.1758-5872.2011.00158.x Planning for the next editions of the two most widely used psychiatric classificatory systems has been in progress for a number of years. While much of the debate that has appeared on the relevant World Health Organization (WHO) and American Psychiatric Asso- ciation (APA) websites has been concerned with the placement or wording of tried-and-true or novel categories, there are more fundamental structural issues about which there has been insufficient debate (Kendler and First, 2010). The following brief series of requested viewpoints is intended to instigate or inform such discussion. Research in Asia, the Pacific Rim and elsewhere has already established that frontline psychiatrists hold varied views on which of the current two systems (International Statistical Classification of Diseases and Related Health Problems, 10th Revision [ICD-10] and Diagnostic and Statistical Manual of Mental Disorders, 4th Edition [DSM-IV]) are the most useful, the main purpose of the classificatory systems (e.g. reliable inter-clinician communication), their trans-cultural utility (suboptimal), who they are designed for (all clinical disciplines), and the preferred relationship between systems to be used in primary and specialist care (Mellsop et al., 2008). There remain many ques- tions about which the literature is relatively silent (Mellsop et al., 2007; Suzuki et al., 2010 a & b). One issue on which there is strong agreement is that the classificatory system needs less than 100 diagnostic options. It is also clear that patients and consumers, and family and carers, while they are stakeholders in the implications of diagnostic systems, care little about Official journal of the Pacific Rim College of Psychiatrists Asia-Pacific Psychiatry ISSN 1758-5864 228 Asia-Pacific Psychiatry 3 (2011) 228–234 Copyright © 2011 Blackwell Publishing Asia Pty Ltd