THE NEW ZEALAND MEDICAL JOURNAL Journal of the New Zealand Medical Association NZMJ 28 November 2008, Vol 121 No 1286; ISSN 1175 8716 Page 30 URL: http://www.nzma.org.nz/journal/121-1286/3373/ ©NZMA General practitioners’ views on the major psychiatric classification systems Steven Lillis, Graham Mellsop, Gaelle Dutu Abstract Aim To understand the views of general practitioners on the utility of diagnostic schema as used by specialist psychiatrists and principles that would increase the value of diagnostic schema to general practitioners. Method A postal survey of 1000 vocationally registered general practitioners in New Zealand Results Diagnostic schema such as the DSM-IV and ICD-10 are seldom used by general practitioners due primarily to their complexity and a lack of familiarity with them. Providing decision support on pharmaceutical treatment, appropriate secondary care referrals and improving communication across the primary/secondary care divide are principles that should guide the development of future diagnostic schema. Integration of schema into existing computerised practice management systems is considered a key success factor. Conclusion Specialist devised schema fit uncomfortably into general practice. There is need for management orientated diagnostic schema that meet the requirements of general practitioners. Systematic community surveys have demonstrated a disease burden of mental health which well exceed the capacity of specialist mental health services, even in the more affluent countries. 1,2 It has been shown that one in three people presenting to their general practitioner (GP) have had a diagnosable mental disorder within the previous year; 3 one-third of those will seek help for their disorder. 4 Recognition of this mismatch between total community psychiatric morbidity and available specialist resources has led to worldwide commitment to increasing the delivery of skilled mental health care within the setting of primary care. 5 Recognition of the clinical profiles of psychiatric morbidity seen in primary care has been limited. The 10 th Edition of the Mental and Behavioural Disorders Section (Chapter V) of the International Classification of Diseases has a primary care version. 6 However, the principles underlying classification of psychiatric morbidity have been specialist driven and no systematic attempts to inform the development of classification that would be useful in primary care in the context of the current developmental work for ICD-11 and DSM-V have been published. Conversely, several studies have been conducted to determine the views of psychiatrists on the utility of current diagnostic schemata. 7,8