The contribution of the WPA to the production of the ICD‐11 chapter on mental, behavioural or neurodevelopmental disorders
Authors: Mario Luciano
Journal: World Psychiatry (2018)

The WPA has been actively supporting the World Health Organization (WHO) in the production of the chapter on mental, behavioural or neurodevelopmental disorders of the 11th edition of the International Classification of Diseases and Related Health Problems (ICD-11). WPA Member Societies have participated in the WPA/WHO Global Survey of Psychiatrists' Attitudes Towards Mental Disorders Classification, whose results have significantly influenced the process of development of the chapter. The survey involved 4,887 psychiatrists in 44 countries, being the largest and most broadly international survey ever conducted of psychiatrists' attitudes towards the classification of mental disorders. Through the survey, psychiatrists provided strong endorsement of a focus on clinical utility, which was indeed the main objective of the development of the new diagnostic system. Over two thirds of the participants also indicated that they would prefer a system of flexible guidance allowing for cultural variation and clinical judgment, as opposed to a system based on strict operational criteria, a preference which has been actually reflected in the structure of the ICD-11. Several WPA Member Societies and experts have been involved in ICD-11 field trials. These included the so-called formative field studies (aimed to guide decisions about the basic structure and content of the classification by exploring clinicians' conceptualization of the interrelationships among categories of mental disorders); the Internet-based field studies, implemented through the Global Clinical Practice Network (which used vignette methodologies to examine clinical decision-making in relationship to the proposed ICD-11 diagnostic categories and guidelines); and the clinic-based (or ecological implementation) field studies (conducted to assess the reliability and clinical utility of the diagnostic guidelines with real patients). Several WPA officers and experts have served as chairpersons or members of ICD-11 Working Groups. The chairpersons have included W. Gaebel (Working Group on Psychotic Disorders), M. Maj (Working Group on Mood and Anxiety Disorders), P. Tyrer (Working Group on Personality Disorders), L. Salvador-Carulla (Working Group on Intellectual Disabilities), O. Gureje (Working Group on Somatic Distress and Dissociative Disorders) and D. Stein (Working Group on Obsessive-Compulsive and Related Disorders). Prof. M. Maj has represented the WPA in the ICD-11 International Advisory Board. A number of lectures, symposia and workshops on various issues related to the ICD-11 development have been held at the 16th and 17th World Congresses of Psychiatry, taking place respectively in Madrid and Berlin. The workshops, in particular, represented a unique opportunity for psychiatrists from many countries to directly familiarize with the various sections of the diagnostic system and exercise in the application of the ICD-11 clinical descriptions and diagnostic guidelines. World Psychiatry has been one of the main channels through which the international psychiatric community has been informed about the ICD-11 development. In particular, the journal has hosted some of the main papers summarizing the philosophy of the entire process and the structure of the diagnostic system, as well as many articles dealing with specific sections of the classification, as well as individual papers or forums on general topics of classification in psychiatry. Several examples can be found in recent issues of the journal1-15. All these contributions are freely downloadable from the WPA website (www.wpanet.org). Mario Luciano WHO Collaborating Center for Research and Training in Mental Health, University of Campania “L. Vanvitelli”, Naples, Italy