Problematic, absent and stigmatizing diagnoses in current mental disorders classifications: Results from the WHO-WPA and WHO-IUPsyS Global Surveys
Open accessAbstract
This study examined English- and Spanish-speaking psychologists’ and psychiatrists’ opinions regarding problematic, absent and stigmatizing diagnoses in current mental disorders classifications (ICD-10 and DSM-IV), and their perceived need for a national classification of mental disorders. Answers to open-ended questions included in WHO-WPA and WHO-IUPsyS surveys were examined using an inductive content-analysis method. A total of 3,222 participants from 35 countries were included. The most problematic diagnostic group was personality disorders, especially among psychiatrists, because of poor validity and lack of specificity. Complex posttraumatic stress disorder was the most frequent diagnosis suggested for inclusion, mainly by psychologists, to better account for the distinct processes and consequences of complex trauma. Schizophrenia was the diagnosis most frequently identified as stigmatizing, particularly by psychiatrists, due to lack of public understanding or knowledge about the diagnosis. Of the 14.4% of participants who perceived a need for a national classification system, two-thirds were from Africa or Latin America. The rationales provided were that mental disorders classifications should consider cultural and socio-historical diversity in the expression of psychopathology, differences in the perception of what is and is not pathological in different nations, and the existence of culture-bound syndromes. Implications for ICD-11 development and dissemination are discussed. Se examinaron las opiniones de psicólogos y psiquiatras de habla inglesa y española acerca de los diagnósticos problemáticos, ausentes y estigmatizantes en la CIE-10 y DSM-IV, y de la necesidad de una clasificación nacional. Se llevó a cabo un análisis de contenido de las preguntas abiertas de las encuestas de WHO-WPA y WHO-IUPsyS. Se incluyeron a 3.222 participantes de 35 países. El grupo diagnóstico considerado más problemático fue trastornos específicos de la personalidad, especialmente entre psiquiatras, por la falta de validez y de especificidad. El trastorno por estrés postraumático complejo fue el diagnóstico que se sugirió incluir con mayor frecuencia, sobre todo por psicólogos, para dar cuenta de los procesos y consecuencias distintos del trauma complejo. La esquizofrenia fue el diagnóstico que se consideró más frecuentemente como estigmatizante, principalmente por psiquiatras, debido a la falta de conocimiento público. Del 14,4% que percibieron la necesidad de una clasificación nacional, dos tercios fueron de África o Latinoamérica. Las razones fueron que se debe considerar la diversidad socio-histórica en la expresión de psicopatología, las diferencias en la percepción de lo que es o no patológico, y la existencia de síndromes culturales. Se discuten las implicaciones para el desarrollo y difusión de la CIE-11.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Among 3,222 psychiatrists and psychologists from 35 countries who participated in either WHO survey in English or Spanish, complex PTSD was the most frequent diagnosis suggested for inclusion in the ICD-11.
“Among 3,222 psychiatrists and psychologists from 35 countries who participated in either survey in English or Spanish, complex PTSD was the most frequent diagnosis suggested for inclusion in the ICD-11 22 .”
From Emerging experience with selected new categories in the <scp>ICD</scp>‐11: complex <scp>PTSD</scp>, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder (2022) · cites this paper as [22]
The Participants section reports that 3,222 psychiatrists and psychologists from 35 countries were included in the analysis of English- or Spanish-language survey responses. The discussion says complex PTSD was the most frequent diagnosis suggested for inclusion in mental-disorder classifications and links that finding to ICD-11 proposals. It does not say respondents specifically suggested it for ICD-11. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSurvey participants indicated that the complex PTSD diagnosis was needed to better account for the distinct characteristics and consequences of complex trauma.
“Participants indicated that the diagnosis was needed to better account for the distinct characteristics and consequences of complex trauma.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Diagnostic and Statistical Manual of Mental Disorders, 5th Edition
(2013) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9780890425596.893619 · Cited by 4,390 · see citing works
Stigma: ignorance, prejudice or discrimination?
Thornicroft, G., Rose, D., Kassam, A., & Sartorius, N. (2007) · British Journal of Psychiatry · doi:10.1192/bjp.bp.106.025791 · Cited by 826 · see citing works
Diagnosis and classification of disorders specifically associated with stress: proposals for ICD-11
Maercker, A., Brewin, C. R., Bryant, R. A., Cloitre, M., van Ommeren, M., Jones, L. M., Humayan, A., Kagee, A., Llosa, A. E., Rousseau, C., et al. (2013) · World Psychiatry · doi:10.1002/wps.20057 · Cited by 762 · see citing works
Self-citationPescosolido, B. A., Monahan, J., Link, B. G., Stueve, A., & Kikuzawa, S. (1999) · American Journal of Public Health · doi:10.2105/ajph.89.9.1339 · Cited by 607 · see citing works
The WPA‐WHO Global Survey of Psychiatrists’ Attitudes Towards Mental Disorders Classification
Reed, G. M., Correia, J., Esparza, P., Saxena, S., & Maj, M. (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00034.x · Cited by 354 · see citing works
Self-citationMinding the body: Situating gender identity diagnoses in the ICD-11
Drescher, J., Cohen‐Kettenis, P. T., & Winter, S. (2012) · International Review of Psychiatry · doi:10.3109/09540261.2012.741575 · Cited by 339 · see citing works
International Advisory Group for the Revision of ICD‐10 Mental and Behavioural Disorders (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00022.x · Cited by 300 · see citing works
Reed, G. M. (2010) · Professional Psychology Research and Practice · doi:10.1037/a0021701 · Cited by 252 · see citing works
Self-citationChen, Y. (2002) · Psychopathology · doi:10.1159/000065140 · Cited by 232 · see citing works
Renaming schizophrenia: a Japanese perspective.
Sato, M. (2006) · PubMed · Cited by 189 · see citing works
Popular conceptions of mental health : their development and change
Nunnally, J. C. (1961) · Medical Entomology and Zoology · Cited by 176 · see citing works
Evans, S. C., Reed, G. M., Roberts, M. C., Esparza, P., Watts, A., Correia, J., Ritchie, P. L. ‐., Maj, M., & Saxena, S. (2013) · International Journal of Psychology · doi:10.1080/00207594.2013.804189 · Cited by 175 · see citing works
Self-citationReclassifying personality disorders
Tyrer, P. J., Crawford, M., & Mulder, R. (2011) · The Lancet · doi:10.1016/s0140-6736(10)61926-5 · Cited by 131 · see citing works
Revision of ICD – status update on feeding and eating disorders
Al‐Adawi, S., Bax, B., Bryant‐Waugh, R., Claudino, A. M., Hay, P., Monteleone, P., Norring, C. E. A., Pike, K. M., Pilon, D., Herscovici, C. R., et al. (2013) · Advances in Eating Disorders · doi:10.1080/21662630.2013.742971 · Cited by 65 · see citing works
Self-citationMellsop, G. W., Banzato, C. E. M., Shinfuku, N., Nagamine, M., Pereira, M. E. C., & Dutu, G. (2007) · International Journal of Mental Health · doi:10.2753/imh0020-7411360402 · Cited by 25 · see citing works
New Zealand Psychiatrists Views on Global Features of ICD-10 and DSM-IV
Mellsop, G. W., Dutu, G., & Robinson, G. A. (2007) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670601109931 · Cited by 23 · see citing works
Zielasek, J., Freyberger, H. J., Jänner, M., Kapfhammer, H., Sartorius, N., Stieglitz, R. D., & Gäebel, W. (2010) · European Psychiatry · doi:10.1016/j.eurpsy.2009.12.023 · Cited by 12 · see citing works
Qué es la CIE y por qué es importante en la psicología
Reed, G. M., Anaya, C. R., & Evans, S. C. (2012) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 10 · see citing works
Self-citationSuzuki, Y., Takahashi, T., Nagamine, M., Zou, Y., Cui, J.-F., Han, B., Park, J., Hwu, H., Chen, C.-C., Lin, C.-C., et al. (2010) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2009.12.004 · Cited by 10 · see citing works
Guía Latinoamericana de Diagnóstico Psiquiátrico
Jilek, W. G. (2005) · Investigación en Salud · Cited by 9 · see citing works
Udomratn, P. (2012) · World Psychiatry · doi:10.1016/j.wpsyc.2012.01.027 · Cited by 7 · see citing works
American Association of Community Psychiatrists' Views on General Features of DSM-IV
Bell, C. C., Sowers, W. E., & Thompson, K. S. (2008) · Psychiatric Services · doi:10.1176/ps.2008.59.6.687 · Cited by 6 · see citing works
[Contributions from two Latin American psychiatric classifications to the development of ICD-11].
Rodríguez, M. R., Reed, G. M., First, M. B., et al. (2011) · PubMed · Cited by 3 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Prolonged grief disorder for ICD-11: the primacy of clinical utility and international applicability
Killikelly, C., & Maercker, A. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2018.1476441 · Cited by 187 · see citing works
Reed, G. M., First, M. B., Billieux, J., Cloitre, M., Briken, P., Achab, S., Brewin, C. R., King, D. L., Kraus, S. W., & Bryant, R. A. (2022) · World Psychiatry · doi:10.1002/wps.20960 · Cited by 182 · see citing works
Self-citationKeeley, J. W., Reed, G. M., Roberts, M. C., Evans, S. C., Medina-Mora, M. E., Robles, R., Rebello, T., Sharan, P., Gureje, O., First, M. B., et al. (2016) · American Psychologist · doi:10.1037/a0039972 · Cited by 173 · see citing works
Self-citationKeeley, J. W., Reed, G. M., Roberts, M. C., Evans, S. C., Robles, R., Matsumoto, C., Brewin, C. R., Cloitre, M., Perkonigg, A., Rousseau, C., et al. (2016) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2015.09.002 · Cited by 134 · see citing works
Self-citationRomero, M., Aguilar, J. M., Del-Rey-Mejías, Á., Mayoral, F., Rapado, M., Peciña, M., Barbancho, M. Á., Ruiz-Veguilla, M., & Lara, J. P. (2016) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2016.03.001 · Cited by 115 · see citing works
- Authors
- Robles, R., Fresán, A., Evans, S. C., Lovell, A. M., Medina-Mora, M. E., Maj, M., & Reed, G. M.
- Affiliations
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (MX)
- University of Kansas (US)
- Inserm (FR)
- World Health Organization (CH)
- Corresponding author
- Reed, Geoffrey M.
- Venue
- International Journal of Clinical and Health Psychology
- Publisher
- Elsevier BV
- Published
- 2014-09
- Volume
- 14
- Issue
- 3
- Pages
- 165-177
- ISSN
- 1697-2600 (ISSN-L)
- OpenAlex
- W2171132685
- Cited by
- 30
- References
- 25
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 6 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 2 · 2016: 3 · 2015: 2 · 2014: 3
- FWCI
- 20.38
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Clinical and Health Psychology (publishedVersion, cc-by-nc-nd)
- HAL (submittedVersion, other-oa)
- Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
- Funders
- World Health Organization
- National Institute of Mental Health
- Topics
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- mental disorders classification, ICD-10, DSM-IV, personality disorders, complex PTSD, schizophrenia, stigma, diagnostic validity, culture-bound syndromes, ICD-11, cross-cultural psychiatry, complex trauma, public understanding of mental illness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
