Increasing Clinical Utility by Aligning the DSM and ICD With Clinicians' Conceptualizations

Clinicians are trained to conceptualize and diagnose mental disorders according to their depiction in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) But to what extent do the DSM and ICD truly represent the way that clinicians think about mental disorders'? We outline the history of studies examining how clinicians think about mental disorders and discuss our current research on clinicians natural taxonomies of mental disorders which compares clinicians conceptualization of mental disorders with their depiction in the DSM and the ICD We make practical suggestions for how to make the DSM and ICD more like the way clinicians think about mental disorders to improve its clinical utility We argue that the DSM and ICD would be more useful to clinicians if It had fewer categories fewer diagnostic levels removed the Axis I-II distinction used in the DSM and included practical considerations such as treatment access (and the role of insurance companies in the United States or the local economy in developing countries) stigma and clinicians emotional reactions Another way the DSM and ICD could be more useful to clinicians is if they more accurately represented the way that mental illness is experienced by the person who has the mental Illness Continued research of clinicians conceptualization of mental disorders is necessary to make the DSM and ICD as useful to clinicians as possible