To the Editor.—
We note with interest the recent discussion on the development of DSM-IV and the emphasis placed on correspondence with the terminology of the International Classification of Diseases, Tenth Revision (ICD-10).1 While it is clearly highly desirable to avoid incongruities in terminology between these two systems, it is likely that a much more important cause of the inexact communication about patients' disorders is the tendency of most clinicians to continue to use the classification system they learned during their initial specialty training.The extent of this problem was first highlighted by the findings of Kendell,2 who noted, in relation to ICD-9, that the introduction of a new nomenclature and a companion glossary had no appreciable influence on the diagnoses made by English psychiatrists. Similar results were later reported by Lipkowitz and Idupugnanti3 in relation to DSM-III. They reviewed the criteria used by a random sample
Ellis P, Mellsop G. The Development of DSM-IV. Arch Gen Psychiatry. 1990;47(1):92. doi:10.1001/archpsyc.1990.01810130094018
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