Psychiatric DiagnosisChallenges and Prospects

Editors

Ihsan M. SalloumProfessor of Psychiatry and Director, Division of Alcohol and Substance Abuse:

Treatment and Research, University of Miami Miller School of Medicine, FL, USA

Section on Classification, Diagnostic Assessment and Nomenclature,

World Psychiatric Association

Juan E. MezzichProfessor of Psychiatry and Director, International Center for Mental Health and

Division of Psychiatric Epidemiology, Mount Sinai School of Medicine,

New York University, NY, USA

Past President, World Psychiatric Association

AJohn Wiley & Sons, Ltd., Publication

Psychiatric Diagnosis:Challenges and Prospects

Psychiatric DiagnosisChallenges and Prospects

Editors

Ihsan M. SalloumProfessor of Psychiatry and Director, Division of Alcohol and Substance Abuse:

Treatment and Research, University of Miami Miller School of Medicine, FL, USA

Section on Classification, Diagnostic Assessment and Nomenclature,

World Psychiatric Association

Juan E. MezzichProfessor of Psychiatry and Director, International Center for Mental Health and

Division of Psychiatric Epidemiology, Mount Sinai School of Medicine,

New York University, NY, USA

Past President, World Psychiatric Association

AJohn Wiley & Sons, Ltd., Publication

This edition first published 2009� 2009 John Wiley & Sons Ltd.

Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s global Scientific, Technicaland Medical business with Blackwell Publishing.

Registered officeJohn Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Other Editorial Offices9600 Garsington Road, Oxford, OX4 2DQ, UK111 River Street, Hoboken, NJ 07030-5774, USA

For details of our global editorial offices, for customer services and for information about how to apply forpermission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell

The right of the author to be identified as the author of this work has been asserted in accordance with theCopyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, inany form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted bythe UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not beavailable in electronic books.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand namesand product names used in this book are trade names, service marks, trademarks or registered trademarks of theirrespective owners. The publisher is not associated with any product or vendor mentioned in this book. Thispublication is designed to provide accurate and authoritative information in regard to the subject matter covered. Itis sold on the understanding that the publisher is not engaged in rendering professional services. If professionaladvice or other expert assistance is required, the services of a competent professional should be sought.

The contents of this work are intended to further general scientific research, understanding, and discussion onlyand are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, ortreatment by physicians for any particular patient. The publisher and the author make no representations orwarranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim allwarranties, including without limitation any implied warranties of fitness for a particular purpose. In view ofongoing research, equipment modifications, changes in governmental regulations, and the constant flow ofinformation relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate theinformation provided in the package insert or instructions for each medicine, equipment, or device for, amongother things, any changes in the instructions or indication of usage and for added warnings and precautions.Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred toin this work as a citation and/or a potential source of further information does not mean that the author or thepublisher endorses the information the organization or Website may provide or recommendations it may make.Further, readers should be aware that Internet Websites listed in this work may have changed or disappearedbetween when this work was written and when it is read. No warranty may be created or extended by anypromotional statements for this work. Neither the publisher nor the author shall be liable for any damages arisingherefrom.

Library of Congress Cataloguing-in-Publication Data

Psychiatric diagnosis : challenges and prospects / editors, Ihsan M. Salloum, Juan E. Mezzich.p. ; cm.

Includes bibliographical references and index.ISBN 978-0-470-72569-61. Mental illness—Classification. 2. Psychodiagnostics.I. Salloum, Ihsan M. II. Mezzich, Juan E.[DNLM: 1. Mental Disorders—classification. 2. Mental Disorders—diagnosis.3. Comorbidity. 4. Models, Psychological. WM 141 P97357 2009]RC455.2.C4.P78 2009616.890075—dc22

2008051201

ISBN: 978-0-470-72569-6

A catalogue record for this book is available from the British Library.

Set in 10/12pt Times by Integra Software Services Pvt. Ltd, Pondicherry, India.Printed in Great Britain by Antony Rowe Ltd, Chippenham, Wiltshire.

First Impression 2009

Contents

List of contributors ix

Preface xv

SECTION I CONCEPTS OF MENTAL ILLNESS AND HEALTHACROSS THE WORLD 1

1 Historical Roots of the Concept of Mental Illness 3Paul Hoff

2 Philosophical Perspectives on Health, Illness and ClinicalJudgement in Psychiatry and Medicine 15Tim Thornton, KWM (Bill) Fulford and George Christodoulou

3 Culture and Mental Illness: Social Context andExplanatory Models 29Laurence J. Kirmayer and Dinesh Bhugra

4 Quality of Life in Illness and Health 41Heinz Katschnig, Raluca Sfetcu and Norman Sartorius

5 Recovery and Resilience 49Michaela Amering and Margit Schmolke

6 Positive Health and Health Promotion: The WPA InstitutionalProgramme of Psychiatry for the Person in a European PublicHealth Perspective 61Wolfgang Rutz

SECTION II PSYCHOPATHOLOGY 69

7 Dementia 71Olusegun Baiyewu

8 Schizophrenia and Related Disorders 85Wolfgang Gaebel and Jurgen Zielasek

9 Mood Disorders 95Marna S. Barrett and Michael E. Thase

10 Anxiety and Obsessive-Compulsive Disorders 103Juan J. Lopez-Ibor, Jr and Marıa Ines Lopez-Ibor

11 Substance-Use Disorders 119Christian Haasen, Nady el-Guebaly and Ihsan M. Salloum

12 Advances in Diagnosis and Classification of Sexual Disorders 129Ruben Hernandez Serrano, Antonio Pacheco Palha,Said Abdel Azim, Chiara Simonelli, Felipe Navarro Cremadesand Aminta Parra

13 Personality Disorders 135Giles Newton-Howes and Peter Tyrer

14 Intellectual Disabilities 141Sally-Ann Cooper and Luis Salvador-Carulla

15 Specificities of Diagnosis and Classification in Childand Adolescent Psychiatry 147Michel Botbol and Carlos E. Berganza

16 Classification in Infant and Child Psychiatry 155Sam Tyano and Lior Schapir

17 Peri-Natal Mental Disorders 171Ian Brockington, John Cox, Nicole Garret-Gloanec and Gisele Apter Denon

18 Suicide 179Zoltan Rihmer

SECTION III COMORBIDITY IN MENTAL ANDGENERAL HEALTH 187

19 Conceptual and Methodological Considerations inComorbidity 189Ihsan M. Salloum, Juan E. Mezzich and Sandra E. Cordoba

20 Mental and General Health Comorbidities in PersonsPresenting in Primary Care 197Michael S. Klinkman and Linda Gask

21 Comorbidity, Positive Health, and Integration of Services 213Juan E. Mezzich and Ihsan M. Salloum

SECTION IV DIAGNOSTIC MODELS 219

22 The Validity of Psychiatric Diagnosis: Etiopathogenicand Clinical Approaches 221Kenneth F. Schaffner

23 The Overall Development of ICD-11 233T. Bedirhan Ustun and Robert Jakob

vi CONTENTS

24 The Revision of ICD Classification of Mental and BehaviouralDisorders 247Shekhar Saxena and Benedetto Saraceno

25 Experience with the Diagnostic and Statistical Manual of MentalDisorders and Preparations for the Future 255Michael B. First

26 Experience and Implications of the Latin AmericanGuide for Psychiatric Diagnosis 263Angel Otero-Ojeda and Carlos E. Berganza

27 Chinese Classification and its Future Perspectives 273Yanfang Chen and Zhong Chen

28 Multiaxial Schemas for Psychiatric Diagnosis 279Claudio E. M. Banzato, Miguel Roberto Jorge and Marianne Kastrup

29 The Science of Well-Being and Comprehensive Diagnosis 289C. Robert Cloninger

30 Towards a Person-centred Integrative Diagnosis 297Juan E. Mezzich and Ihsan M. Salloum

Index 303

CONTENTS vii

List of contributors

Michaela AmeringProfessor, Department of Psychiatry and Psychotherapy, Division of Social Psychiatry,

Medical University of Vienna, Vienna, Austria

Gisele Apter-Denon

Responsible Unite Ppumma (Unite de Psychiatric Perinatale d’ Urgence Mobile en

Maternite), Universite Denis Diderot, Paris 7, France

Said Abdel Azim

Emeritus Professor of Psychiatry, Cairo University, Egypt

Olusegun Baiyewu

Professor of Psychiatry, College of Medicine, University of Ibadan, Nigeria

Claudio E. M. Banzato

Associate Professor of Psychiatry, University of Campinas – UNICAMP, Brazil

Marna S. Barrett

Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia,

PA, USA

Carlos E. Berganza

Professor of Child Psychiatry, San Carlos University School of Medicine, Guatemala; Past

President, Executive Committee on the Latin American Guide for Psychiatric Diagnosis

Dinesh Bhugra

Professor of Social & Cultural Psychiatry, Institute of Psychiatry, London, UK; President,

Royal College of Psychiatrists, UK

Michel Botbol

World Psychiatric Association Zonal Representative for Western Europe; Member of the

steering committee of the Institutional Program on Psychiatry for the Person; Section on

Psychoanalysis in Psychiatry, World Psychiatric Association

Ian Brockington

Professor Emeritus, University of Birmingham, Birmingham, UK

Yanfang Chen

Professor, Beijing Huilongguang Hospital, Teaching Hospital of Peking University, Beijing,

China

Zhong Chen

Professor, Shandong Mental Health Center, Teaching Hospital of Shandong University,

Jinan, China

George Christodoulou

Professor of Psychiatry, Athens University, Greece; Standing Committee on Ethics, World

Psychiatric Association; European Division, Royal College of Psychiatry; Honorary

President, Hellenic Psychiatric Association; President, Hellenic Center for Mental

Health & Research, Athens, Greece

C. Robert CloningerWallace Renard Professor of Psychiatry, Genetics & Psychology, Washington University

School of Medicine, Department of Psychiatry, St Louis, MO, USA

Sally-Ann Cooper

Professor of Learning Disabilities, Section of Psychological Medicine, Division of

Community Based Sciences, Faculty of Medicine, University of Glasgow, Gartnavel

Royal Hospital, Glasgow, UK

Sandra E. Cordoba

International Center for Mental Health, Mount Sinai School of Medicine, New York

University, NY, USA

John Cox

Professor Emeritus, Keele University, Staffordshire, UK

Felipe Navarro Cremades

Universidad Miguel Hernandez, Alicante, Spain

Michael B. First

Professor of Clinical Psychiatry, Columbia University, NY, USA; Research Psychiatrist,

New York State Psychiatric Institute, New York, NY, USA

KWM (Bill) FulfordProfessor of Philosophy and Mental Health, University of Warwick, UK; Fellow of

St Cross College and Member of the Philosophy Faculty, University of Oxford;

Honorary Consultant Psychiatrist, University of Oxford, UK; Co-Director, Institute for

Philosophy, Diversity and Mental Health, University of Central Lancashire, UK; National

Fellow for Values-Based Practice, Department of Health, London, UK

Wolfgang Gaebel

Professor & Chair, Department of Psychiatry and Psychotherapy, Heinrich-Heine-

University, Rhineland State Clinics, Dusseldorf, Germany; Chair, Section on

Schizophrenia, World Psychiatric Association

Nicole Garret-GloanecChef de Service de Psychiatric Infanto-Juvenile, Nantes, France

x LIST OF CONTRIBUTORS

Linda Gask

Divisions of Psychiatry and Primary Care, University of Manchester, UK

Nady el-Guebaly

Addiction Division, University of Calgary, Canada; Chair, Section on Addiction Psychiatry,

World Psychiatric Association

Christian Haasen

Professor, Zentrum fur interdisziplinare Suchtforschung, Hamburg, Germany

Paul HoffProfessor, Department of General and Social Psychiatry, University of Zurich, Zurich,

Switzerland

Robert Jakob

Office of Classifications, Terminologies, and Standards, World Health Organization,

Geneva, Switzerland

Miguel Roberto Jorge

Professor, Department of Psychiatry, Federal University of Sao Paulo, Brazil; Secretary for

Sections, World Psychiatric Association

Marianne KastrupHead, Centre Transcultural Psychiatry Psychiatric Clinic, Rigshospitalet, Copenhagen,

Denmark

Heinz Katschnig

Professor, Ludwig Boltzmann Institute for Social Psychiatry, Vienna, Austria

Laurence J. KirmayerProfessor & Director, Division of Social & Transcultural Psychiatry, McGill University,

Culture & Mental Health Research Unit, Sir Mortimer B Davis–Jewish General Hospital,

Montreal, Quebec, Canada

Michael S. Klinkman

Professor, Departments of Family Medicine and Psychiatry, University of Michigan, MI,

USA

Juan J. Lopez-Ibor, JrChairman, Institute of Psychiatry and Mental Health, San Carlos Hospital, Complutense

University, Madrid, Spain

Marıa Ines Lopez-Ibor

Professor of Psychiatry, Department of Psychiatry and Medical Psychology, Complutense

University, Madrid, Spain

Juan E. Mezzich

Professor of Psychiatry and Director, International Center for Mental Health and Division

of Psychiatric Epidemiology, Mount Sinai School of Medicine, New York University, NY,

USA; Past President of the World Psychiatric Association

Giles Newton-HowesDivision of Neurosciences and Mental Health, Imperial College London, London, UK

LIST OF CONTRIBUTORS xi

Angel Otero-Ojeda

Professor, Havana University School of Medicine, Cuba; Section on Diagnosis and

Classification, Latin American Psychiatric Association; Executive Committee on the

Latin America Guide for Psychiatric Diagnosis; Cuban Glossary of Psychiatry

Antonio Pacheco Palha

Hospital San Joao, University of Porto, Portugal

Aminta Parra

Universidad Central de Venezuela, Caracas, Venezuela

Zoltan RihmerProfessor, Department of Clinical and Theoretical Mental Health, and Department of

Psychiatry and Psychotherapy, Semmelweis Medical University, Budapest, Hungary

Wolfgang Rutz

Professor, University Hospital, Uppsala, Sweden; University for Applied Sciences,

Coburg, Germany

Ihsan M. Salloum

Professor of Psychiatry and Director, Division of Alcohol and Substance Abuse: Treatment

and Research, University of Miami Miller School of Medicine, FL, USA; Section on

Classification, Diagnostic Assessment and Nomenclature, World Psychiatric Association

Luis Salvador-Carulla

Professor of Psychiatry, University of Cadiz (Spain); Section on Psychiatry of Intellectual

Disability, World Psychiatric Association

Benedetto Saraceno

Director, Department of Mental Health and Substance Abuse, World Health Organization,

Geneva, Switzerland

Norman Sartorius

Professor, University of Geneva, Switzerland

Shekhar Saxena

Programme Manager, Department of Mental Health and Substance Abuse, World Health

Organization, Geneva, Switzerland

Kenneth F. Schaffner

University Professor of History and Philosophy of Science, Professor of Psychiatry,

University of Pittsburgh, PA, USA

Lior Schapir

GEHA Mental Health Center, Tel Aviv University School of Medicine, Israel

Margit Schmolke

German Academy for Psychoanalysis, Munich, Germany; Co-Chair, World Psychiatric

Association Section on Preventive Psychiatry

Ruben Hernandez Serrano

Universidad Central de Venezuela, Caracas, Venezuela

xii LIST OF CONTRIBUTORS

Raluca Sfetcu

Professor, Babes-Bolyai University, Cluj-Napoca, Romania

Chiara Simonelli

Professor, Institute of Sessuologia Clinica, University of La Sapienza, Rome, Italy

Michael E. Thase

Professor of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia,

PA, USA

Tim Thornton

Professor of Philosophy and Mental Health and Director of Philosophy, University of

Central Lancashire, UK

Sam Tyano

Professor Emeritus in Psychiatry, Tel Aviv University School of Medicine, Israel

Peter Tyrer

Division of Neurosciences and Mental Health, Imperial College London, London, UK

T. Bedirhan Ustun

Head, Office of Classifications, Terminologies, and Standards, World Health Organization,

Geneva, Switzerland

Jurgen Zielasek

Department of Psychiatry and Psychotherapy, Heinrich-Heine-University, Rhineland State

Clinics, Dusseldorf, Germany

LIST OF CONTRIBUTORS xiii