Chinese psychiatrists views on global features of CCMD-III, ICD-10 and DSM-IV☆

Abstract 

Objective

To survey psychiatrists’ opinions about psychiatric classification in China, and provide information and suggestions for developing a new version of classificatory system.

Method

The questionnaire about psychiatry classification written by Professor Graham Mellsop, New Zealand, was translated and modified into Chinese. An anonymous field survey of 380 psychiatry professionals was undertaken in Beijing.

Results

A total of 181 questionnaires were eligible for analysis. The Chinese Classification of Mental Disorders version 3 (CCMD-III) is the most commonly used in China (63.8%), then ICD-10 (28.5%) and DSM-IV (7.7%). Half of the respondents (53.0%) agreed that the most important diagnostic classification is for communication among physicians, and then for communication between physician and patient (21.0%). Most professionals (90.0%) agree that classification should include less than 100 diagnostic options. Disagreement presents on cross-culture application of the ICD-10 and DSM-III: 75.1% professionals agreed that they are “useful and reliable regardless of patient ethnicity and culture”, while 46.8% found “sometimes difficult to apply across cultures”, and 35.8% thought classification is “over-embedded in European cultural concepts and values”.

Conclusion

There is a strong trend of convergence and unification of China's diagnostic standards with international standards inevitable. A classification that is less complicated and confused, easy-to-communicate and understand and cross-cultural/nation applicable is expected by most Chinese psychiatrists. Such classification should also be reflective of the advances in understanding of aetiology of disorders and helpful in clinical management.

Keywords: ICD-10, DSM-IV, CCMD-III, Psychiatry classification