An International Study of the Views of Psychiatrists on Present and Preferred Characteristics of Classifications of Psychiatric Disorders

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.