[10th revision of the International Classification of Diseases (ICD-10)--possibilities and limits for psychodynamically orientated diagnosis]

Abstract

The present paper will discuss some selected results of the ICD-10 Research Criteria Study, section psychotherapy/psychosomatics, which was done between 1990 and 1993 involving 11 centers with 125 diagnosticians. During case conference 610 diagnostical assessments for 16 video-documentated cases were evaluated including an independent polydiagnostic rating (ICD-9, ICD-10, DSM-III-R) and subjective assessments of the diagnostic process. The results of the study could demonstrate sufficient chance-corrected interrater-reliability coefficients (Kappa values 0.69-0.99) for the majority of the disorders. Even on the level of the subjective ratings of the diagnostic process system-related problems of the classificatory approach could be identified concerning depressive and psychosomatic disorders. The results were discussed following some problematical aspects of the concept of comorbidity and multiaxial approaches. Special reference was given to the working group "Operational Psychodynamic Diagnosis (OPD)", which was founded in the Federal Republic of Germany.