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http://dx.doi.org/10.1037/14862-001
APA Handbook of Clinical Psychology: Vol. 4. Psychopathology and Health, J. C. Norcross, G. R. VandenBos, and D. K. Freedheim (Editors-in-Chief)
Copyright © 2016 by the American Psychological Association. All rights reserved.
C HAPTER 1
CLASSIFICATION OF MENTAL AND
BEHAVIORAL DISORDERS
Geoffrey M. Reed, Rebeca Robles, and Tecelli Domínguez-Martínez
The World Health Organization (WHO) deines a
classiication of diseases as “a system of categories
to which morbid entities are assigned according to
established criteria” (WHO, 1992b, p. 3). WHO’s
International Classification of Diseases and Related
Health Problems (ICD) is by far the most widely used
health classiication worldwide. The widespread
use of the ICD around the world is based on WHO’s
constitutional responsibilities and the obligations
of its 194 member states (WHO, 2014). WHO is a
specialized agency of the United Nations with global
public health responsibilities deined by interna-
tional treaty. Among these are the following: (a)
establishing and revising international nomencla-
tures of diseases, causes of death, and public health
practices; and (b) standardizing diagnostic proce-
dures as necessary. WHO member states, including
the United States, agree to use the ICD as a basis for
reporting health information so that it is internation-
ally comparable. The ICD provides the structural
framework and much of the conceptual basis for
specialty classiications in a variety of areas, includ-
ing oncology, dermatology, dentistry, neurology,
rheumatology, orthopedics, pediatrics, and mental
disorders, including the American Psychiatric Asso-
ciation’s Diagnostic and Statistical Manual of Mental
Disorders (DSM). The ICD also provides the basis
for national government adaptations, such as the
ICD–10 Clinical Modiication (ICD–10 CM), adopted
in the United States as of October 1, 2015.
The classiication of mental disorders contained
in the ICD and other systems derived from it directly
affects psychologists and has profoundly inluenced
the discipline of clinical psychology and other men-
tal health professions. Classiication systems are
used as a basis to deine the impact and prevalence
of mental disorders around the world, to deine
which individuals are entitled to receive mental
health services, for administrative management of
health encounters (e.g., billing and reimbursement),
for the collection and reporting of health informa-
tion based on those encounters, and to deine pro-
fessional scope of practice. Classiication systems are
a foundational aspect of practice, research, educa-
tion, and training in clinical psychology around the
world.
This chapter provides a brief history of mental
disorders classiication, the ICD, and the relation-
ship between the ICD and the DSM. It discusses the
conceptual principles and conventions that underlie
both of these classiication systems and that have
given rise to important criticisms. Although much of
the discussion in this chapter is related to both the
DSM and the ICD, it focuses particularly on WHO’s
current development of the classiication of mental
and behavioral disorders in ICD–11, scheduled for
approval by the World Health Assembly in 2018.
The ICD–11 is less familiar to clinical psychologists
in the United States than similar information about
the DSM–5 (American Psychiatric Association,
2013), about which much has already been writ-
ten. Therefore, this chapter focuses on how WHO’s
global public health priorities are informing the
development of the ICD–11 classiication of mental
disorders and the nature of the diagnostic guidance
provided. The closing section, Future Directions,
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