The Latin American guide for psychiatric diagnosis. A cultural overview

Abstract

The ICD-10 Classification of Mental and Behavioral Disorders is being accepted by most countries and by the World Psychiatric Association as the international standard in the field for statistical reporting and for clinical care and research. Emerging now, however, is the need to harmonize international communication with recognition of cultural diversity and specific local requirements. Latin American psychiatrists hold a long-standing commitment to the formulation of a reliable and valid diagnostic system in international psychiatry. Examples of important Latin American contributions include the pioneering use of explicit operational criteria in diagnostic methodology by Horwitz and Marconi in Chile, and the proposal of a multiaxial diagnostic formulation by Leme-Lopes in Brazil. In recent times, two main Latin American efforts at developing diagnostic adaptations to the international classification in psychiatry have emerged. One is the Cuban Glossary of Psychiatry, already in its third edition, and the second is a more ambitious project to develop the Latin American Guide for Psychiatric Diagnosis (GLADP). Departing from the experience gained by the Cuban psychiatry and keeping ICD-10 as the basis for nosological organization of mental disorders, the GLADP is being developed with the contributions of psychiatrists and other mental health professionals from most countries in Latin America. The GLADP comprises 4 parts: (I) historical and cultural framework of Latin American psychiatry; (II) a comprehensive diagnostic process and formulation, (III) psychiatric nosology (including ICD-10 major classes of disorders and Latin American cultural syndromes); and (IV) appendixes (including, a lexicologic glossary, concepts and proposals for future study, and bibliography). This is an overview of the basic principles and dimensions for psychiatric diagnosis in Latin America, with an emphasis on its cultural framework.