The Italian ICD-11 field trial: clinical utility of diagnostic guidelines for schizophrenia and related disorders.

Clinical utility Diagnosis Goodness of fit ICD-11 Schizoaffective disorder Schizophrenia

Journal

International journal of mental health systems
ISSN: 1752-4458
Titre abrégé: Int J Ment Health Syst
Pays: England
ID NLM: 101294224

Informations de publication

Date de publication:
2020
Historique:
received: 19 07 2019
accepted: 13 01 2020
entrez: 31 1 2020
pubmed: 31 1 2020
medline: 31 1 2020
Statut: epublish

Résumé

The 11th revision of the International Classification of Diseases and Related Disorders (ICD-11) has been released. In order to test the clinical consistency and the clinical utility of the proposed guidelines the World Health Organization (WHO) has carried out the Ecological Implementation Field Studies in various countries. In this paper the results of the Italian field trials on the clinical utility of the ICD-11 diagnostic guideline concerning schizophrenia and related disorders will be presented. In Italy, field trials have been carried out at the Department of Psychiatry of the University of Campania "L. Vanvitelli". All patients showing any psychotic symptom and referring to the outpatient and inpatient units have been recruited. Patients were interviewed by two clinicians with whom they had not had any prior clinical contact. At the end of each interview, clinicians were asked to complete 12 questions about the clinical utility of the diagnostic guidelines as applied to each patient. Fourteen clinicians and 100 patients have been involved. The ICD-11 clinical guidelines were perceived as easy to use, with an adequate goodness of fit, clear and understandable and with an adequate level of details and specificity to describe the essential features of the diagnoses. Clinicians rated very positively their usefulness in describing the threshold between patient's disorder and normality. Despite still very positive, the guidelines have been perceived as less useful to select a treatment, to assess patients' prognosis and to communicate with other mental health professionals. The 11th revision of the chapter on Mental, Behavioural and Neurodevelopmental Disorders has made substantive changes to the conceptualization of mental disorders which could have impacted on their reliability and clinical utility. Results of the Italian field studies, in line with those reported by the international sample, highlight that ICD-11 has been rated as highly clinically useful by participating clinician, more than the ICD-10. This could be considered a good reason to be optimistic about the implementation of the ICD-11 among global clinicians.

Sections du résumé

BACKGROUND BACKGROUND
The 11th revision of the International Classification of Diseases and Related Disorders (ICD-11) has been released. In order to test the clinical consistency and the clinical utility of the proposed guidelines the World Health Organization (WHO) has carried out the Ecological Implementation Field Studies in various countries. In this paper the results of the Italian field trials on the clinical utility of the ICD-11 diagnostic guideline concerning schizophrenia and related disorders will be presented.
METHODS METHODS
In Italy, field trials have been carried out at the Department of Psychiatry of the University of Campania "L. Vanvitelli". All patients showing any psychotic symptom and referring to the outpatient and inpatient units have been recruited. Patients were interviewed by two clinicians with whom they had not had any prior clinical contact. At the end of each interview, clinicians were asked to complete 12 questions about the clinical utility of the diagnostic guidelines as applied to each patient.
RESULTS RESULTS
Fourteen clinicians and 100 patients have been involved. The ICD-11 clinical guidelines were perceived as easy to use, with an adequate goodness of fit, clear and understandable and with an adequate level of details and specificity to describe the essential features of the diagnoses. Clinicians rated very positively their usefulness in describing the threshold between patient's disorder and normality. Despite still very positive, the guidelines have been perceived as less useful to select a treatment, to assess patients' prognosis and to communicate with other mental health professionals.
CONCLUSIONS CONCLUSIONS
The 11th revision of the chapter on Mental, Behavioural and Neurodevelopmental Disorders has made substantive changes to the conceptualization of mental disorders which could have impacted on their reliability and clinical utility. Results of the Italian field studies, in line with those reported by the international sample, highlight that ICD-11 has been rated as highly clinically useful by participating clinician, more than the ICD-10. This could be considered a good reason to be optimistic about the implementation of the ICD-11 among global clinicians.

Identifiants

pubmed: 31998405
doi: 10.1186/s13033-020-0338-z
pii: 338
pmc: PMC6979076
doi:

Types de publication

Journal Article

Langues

eng

Pagination

4

Informations de copyright

© The Author(s) 2020.

Déclaration de conflit d'intérêts

Competing interestsThe authors declare that they have no competing interests.

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Auteurs

Mario Luciano (M)

WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy.

Gaia Sampogna (G)

WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy.

Valeria Del Vecchio (V)

WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy.

Vincenzo Giallonardo (V)

WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy.

Carmela Palummo (C)

WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy.

Benedetta Pocai (B)

WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy.

Luca Steardo (L)

2Dipartimento di Scienze della Salute, Università della Magna Graecia, Catanzaro, Italy.

Francesca Zinno (F)

WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy.

Tahilia Rebello (T)

3WHO Collaborating Centre for Capacity Building and Training in Global Mental Health, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY USA.

Geoffrey M Reed (GM)

3WHO Collaborating Centre for Capacity Building and Training in Global Mental Health, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY USA.

Andrea Fiorillo (A)

WHO Collaborating Center for Research and Training in Mental Health, University of Campania "L. Vanvitelli", Naples, Italy.

Classifications MeSH