Reliability and Clinical Utility of ICD-11 Diagnostic Guidelines for Severe Mental Disorders in Nigeria.
Clinical utility
Clinician raters
International Classification of Diseases (ICD-11)
Mental diagnoses
Nigeria
Reliability
Journal
Archives of medical research
ISSN: 1873-5487
Titre abrégé: Arch Med Res
Pays: United States
ID NLM: 9312706
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
24
05
2019
accepted:
15
01
2020
pubmed:
8
2
2020
medline:
21
4
2020
entrez:
8
2
2020
Statut:
ppublish
Résumé
An essential foundation for global mental health is the development of reliable, clinically useful and globally applicable diagnostic classification of mental disorders. This study is aimed at assessing the inter-rater reliability and clinical utility of the proposed diagnostic guidelines for severe mental disorders in the eleventh edition of the International Classification of Diseases and Related Health Problems (ICD-11) in Nigeria. The study was conducted in Nigeria at 2 mental health facilities as part of a 13 country project coordinated by the World Health Organization. Following training, 32 clinician raters assessed the reliability and clinical utility of the proposed diagnostic guidelines for schizophrenia and other primary psychotic disorders, mood disorders, anxiety and fear-related disorders, and disorders specifically associated with stress. Using SPSS version 21, analysis of data was conducted at the Data Coordinating Center (DCC), Columbia University. For reliability, estimates of intraclass κ coefficients for diagnoses ranged between 0.71 (Schizoaffective disorder) and 0.93 (Schizophrenia). In ratings of the clinical utility, the guidelines were perceived as easy to use, corresponding accurately to patients' presentations (i.e. having satisfactory goodness-of-fit), clearly understandable, and as providing useful guidance on distinguishing a disorder from normality and from other mental disorders. Overall, the reliability of the diagnostic guidelines was good in Nigeria, ranging from substantial to almost perfect. Utility ratings were generally satisfactory. The results support the suitability of the ICD-11 diagnostic guidelines for implementation at a worldwide level.
Sections du résumé
BACKGROUND
An essential foundation for global mental health is the development of reliable, clinically useful and globally applicable diagnostic classification of mental disorders.
AIM
This study is aimed at assessing the inter-rater reliability and clinical utility of the proposed diagnostic guidelines for severe mental disorders in the eleventh edition of the International Classification of Diseases and Related Health Problems (ICD-11) in Nigeria.
METHOD
The study was conducted in Nigeria at 2 mental health facilities as part of a 13 country project coordinated by the World Health Organization. Following training, 32 clinician raters assessed the reliability and clinical utility of the proposed diagnostic guidelines for schizophrenia and other primary psychotic disorders, mood disorders, anxiety and fear-related disorders, and disorders specifically associated with stress. Using SPSS version 21, analysis of data was conducted at the Data Coordinating Center (DCC), Columbia University.
RESULTS
For reliability, estimates of intraclass κ coefficients for diagnoses ranged between 0.71 (Schizoaffective disorder) and 0.93 (Schizophrenia). In ratings of the clinical utility, the guidelines were perceived as easy to use, corresponding accurately to patients' presentations (i.e. having satisfactory goodness-of-fit), clearly understandable, and as providing useful guidance on distinguishing a disorder from normality and from other mental disorders.
CONCLUSION
Overall, the reliability of the diagnostic guidelines was good in Nigeria, ranging from substantial to almost perfect. Utility ratings were generally satisfactory. The results support the suitability of the ICD-11 diagnostic guidelines for implementation at a worldwide level.
Identifiants
pubmed: 32032925
pii: S0188-4409(19)30542-9
doi: 10.1016/j.arcmed.2020.01.004
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
535-542Informations de copyright
Copyright © 2020 IMSS. Published by Elsevier Inc. All rights reserved.