A critique of International Classification of Diseases 11th Revision criteria for the mood disorders

对国际疾病分类第11版中关于情绪障碍标准的批判

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Abstract

In 2024, WHO published the Clinical Descriptions and Diagnostic Requirements for International Classification of Diseases 11th Revision Mental, Behavioural and Neurodevelopmental Disorders manual. Stated objectives were to determine valid and reliable diagnoses and defined so as to differentiate conditions both from other conditions and from normative states. This paper provides a critique of the criteria sets derived for both the depressive and the bipolar disorders. It is argued that failure to specify a minimum number of criteria for certain conditions compromises valid intrinsic and differential definitions, while additional reasons leading to the quantified low reliability of dysthymia are noted. Several idiosyncratic definitions and rulings are noted, while numerous boundary issues (differentiating disorder categories and clinical depression from normative depression) are noted. The use and application of 'postcoordination' codes (in addition to 'specifiers') appears enigmatic and potentially unserviceable.

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