Search

Background: Family (whanau) and other carers can play a central part in the natural history of psychiatric service users. Diagnoses or the classification of mental disorders play a significant role in communications between clinicians, psychiatric service users, and family. Despite that centrality, the views and experiences of family on the utility of the present classification systems have been little studied. Aims: This study aimed to document the understanding and opinions of families/ whanau on the utility of diagnostic labels as they observed them being applied to their family members. Method: This is a qualitative study. The families of two cultural groups (New Zealand Maori and non-Maori) of psychiatric service users were interviewed using a structured approach. Results: A number of themes on the utility of the diagnostic systems emerged. The single most powerful message being that how the diagnostic labels were communicated, and how they were utilized in the patient management planning, were of paramount importance. There were some cross-cultural differences. From Maori, there was a particular plea for a greater incorporation of culturally syntonic concepts. Conclusion: Family/whanau had positive views of the contributions current diagnostic practices make to patient care. The study elicited the view that more contextual issues, and not just phenomenology, should be taken into account in the development of diagnostic systems. [ABSTRACT FROM AUTHOR]

Background: Previous surveys have addressed the use and perceived utility of diagnostic systems but not psychiatrists' preferences and expectations about them. This paper attempts to close that gap with data from surveys of psychiatrists in three culturally, socio-economically, and geographically diverse countries. The views of psychiatrists from Brazil, Japan, and New Zealand were sought on global aspects of diagnostic systems and their preferred classificatory systems. Methods: Although the same questionnaire was used in all three countries, the sampling techniques and procedures varied across them. In Brazil and New Zealand, a postal survey was carried out, whereas in Japan a Web-based approach was adopted. The total number of responses obtained was 529 (New Zealand, n = 245; Brazil, n = 160, and Japan, n = 124). Results: Different views on the use of International Classification of Diseases (10th edition) and Diagnostic and Statistical Manual of Mental Disorders (4th edition, revised text) axes were found across the countries. Reliable inter-clinician communication is considered the main purpose of a classificatory system. The lack of axes to help treatment planning is pointed out. Perceived cross-cultural utility of current classifications varies across the countries. Psychiatrists seem to prefer classifications with less than 100 diagnostic options. Conclusions: We note two caveats about the study's limitations: No claim of representativeness of the samples is made here; this is a survey based on the opinion of psychiatrists, and, thus, it may not reflect actual use of diagnostic systems. Although psychiatrists are split with respect to taxonomic expectations, in general, they appear to be seeking, for the future, a somewhat simpler classificatory system, with comparable reliability and perhaps increased clinical usefulness. [ABSTRACT FROM AUTHOR]

Objective: The present accepted classificatory systems (ICD-10 and DSM-IV) represent the culmination of 100 years of post-Kraepelinian evolution. The present paper reports on a study to ascertain the views of New Zealand psychiatrists on their requirements of a classificatory system, and their opinions on those currently in use. Method: An anonymous postal survey of 542 psychiatrists and trainees was undertaken in New Zealand. Results: A total of 235 questionnaires were returned, completed. New Zealand psychiatrists primarily use DSM-IV and do so because that is what they were taught on. They make relatively limited use of the multiaxiality. The purposes of classificatory systems that they value most highly are reliable interclinician communication, and to inform patient management planning. The two purposes they valued least were usefulness for a national statistical base, or to indicate prognosis. Conclusions: New Zealand psychiatrists' views are consistent with some of the stated objectives of ICD-10 and DSM-IV, but there is significant diversity in the former and over-ambition in the latter, with much to be resolved. [ABSTRACT FROM AUTHOR]