Editorial Commentary: Challenges and potential of DSM-5 and ICD-11 revisions

Frances (2009) concluded that: ‘it would be wisefor us all to accept that descriptive psychiatry is‘a tired old creature’ and that a paradigm shift isessential. Neither ICD-10 nor DSM-IV is fit forpurpose. Accordingly, the criterion that anyproposed changes must include justifications ismisleadingly one-sided. It is equally necessary tojustify why an outmoded system should beretained. … More well-thought-through work isgoing into revisions necessary for DSM-5 andICD-11 than was the case with any of the previ-ous changes. In particular, there has been muchmore effort to sort out where neuroscience standsin relation to classification and, in the case ofICD-11, also what are the public health impera-tives. It would be nai¨ve to suppose that neithereconomic issues nor bureaucratic rigidities andsilliness will affect distortion on sensible decisionmaking. Rutter (2011a)