There is a very brief article by Dr Ahmad Aboraya titled ‘Recommendation for DSM-V: A Proposal for Adding Causal Specifiers to Axis I Diagnoses’ which is freely available here. Aboraya’s proposal is vey simple. In addition to providing a diagnosis, clinicians should be able to describe likely causative factors. Already there is a fairly similar idea in ICD-10 – the WHO classification scheme. Thus Chapter XXI is titled ‘Factors influencing health status and contact with health services’ and includes various factors that may influence illness. For example Z60 ‘Problems related to social environment’. Aboraya’s cited case studies are described with his qualifiers presented in the article for illustrative purposes and from a clinical perspective they provide a certain elegance both in terms of efficiency as well as addressing aspects of the individual’s journey towards depression. There has been some discussion of a synergistic approach between ICD-11 and DSM-V and preparatory work for the final versions is underway. Aboray’s suggestion would lead to clinical benefits and he predicts it would also improve communication and research. There is certainly something appealing about a system which facilitates an efficient description of an individual’s illness.
World Health Organisation. Pocket Guide to the ICD-10 Classification of Mental and Behavioural Disorders. Churchill Livingstone. 1999.
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