Diagnostic classification of irritability and oppositionality in youth: a global field study comparing ICD‐11 with ICD‐10 and DSM‐5

Background Severe irritability has become an important topic in child and adolescent mental health. Based on the available evidence and on public health considerations, WHO classified chronic irritability within oppositional defiant disorder (ODD) in ICD‐11, a solution markedly different from DSM‐5’...

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Veröffentlicht in:	Journal of child psychology and psychiatry Jg. 62; H. 3; S. 303 - 312
Hauptverfasser:	Evans, Spencer C., Roberts, Michael C., Keeley, Jared W., Rebello, Tahilia J., Peña, Francisco, Lochman, John E., Burke, Jeffrey D., Fite, Paula J., Ezpeleta, Lourdes, Matthys, Walter, Youngstrom, Eric A., Matsumoto, Chihiro, Andrews, Howard F., Elena Medina‐Mora, María, Ayuso‐Mateos, José L., Khoury, Brigitte, Kulygina, Mayya, Robles, Rebeca, Sharan, Pratap, Zhao, Min, Reed, Geoffrey M.
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	England Blackwell Publishing Ltd 01.03.2021
Schlagworte:	Adolescent Attention Deficit and Disruptive Behavior Disorders Bipolar disorder Child Child & adolescent mental health Child & adolescent psychiatry child and adolescent mental health Childhood Classification Conduct disorder Diagnostic and Statistical Manual of Mental Disorders Diagnostic systems Differentiation Disorders Emotions Field study Fieldwork Humans Individualized Instruction International Classification of Diseases International Classification of Diseases (ICD‐11) Internet Irritability Irritable Mood Japanese language Manipulation Medical diagnosis Medical personnel Mental health Mental health professionals Mental health services Mood Disorders mood dysregulation Multilingualism Oppositional defiant disorder Psychopathology Public health Spanish language Vignettes child and adolescent mental health oppositional defiant disorder irritability International Classification of Diseases (ICD-11) mood dysregulation
ISSN:	0021-9630, 1469-7610, 1469-7610
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Zusammenfassung:	Background Severe irritability has become an important topic in child and adolescent mental health. Based on the available evidence and on public health considerations, WHO classified chronic irritability within oppositional defiant disorder (ODD) in ICD‐11, a solution markedly different from DSM‐5’s (i.e. the new childhood mood diagnosis, disruptive mood dysregulation disorder [DMDD]) and from ICD‐10’s (i.e. ODD as one of several conduct disorders without attention to irritability). In this study, we tested the accuracy with which a global, multilingual, multidisciplinary sample of clinicians were able to use the ICD‐11 classification of chronic irritability and oppositionality as compared to the ICD‐10 and DSM‐5 approaches. Methods Clinicians (N = 196) from 48 countries participated in an Internet‐based field study in English, Spanish, or Japanese and were randomized to review and use one of the three diagnostic systems. Through experimental manipulation of validated clinical vignettes, we evaluated how well clinicians in each condition could identify chronic irritability versus nonirritable oppositionality, episodic bipolar disorder, dysthymic depression, and normative irritability. Results Compared to ICD‐10 and DSM‐5, ICD‐11 led to more accurate identification of severe irritability and better differentiation from boundary presentations. Participants using DSM‐5 largely failed to apply the DMDD diagnosis when it was appropriate, and they more often applied psychopathological diagnoses to developmentally normative irritability. Conclusions The formulation of irritability and oppositionality put forth in ICD‐11 shows evidence of clinical utility, supporting accurate diagnosis. Global mental health clinicians can readily identify ODD both with and without chronic irritability.
Bibliographie:	Read the Commentary on this article at doi https://doi.org/10.1111/jcpp.13354 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Spencer Evans is now affiliated with the Department of Psychology at the University of Miami, FL, USA
ISSN:	0021-9630 1469-7610 1469-7610
DOI:	10.1111/jcpp.13244