DSM and ICD-10 discrepancies

[braveheart]

Maybe I'm being dense, but there is a difference, and I am definitely within the DSM criteria without much doubt. But as to the ICD-10....

See --

DSM -

~ Frantic efforts to avoid real or imagined abandonment. [Not including suicidal or self-mutilating behavior covered in Criterion 5]

~A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

~Identity disturbance: markedly and persistently unstable self-image or sense of self.

~Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, promiscuous sex, eating disorders, substance abuse, reckless driving, binge eating). [Again, not including suicidal or self-mutilating behavior covered in Criterion 5]

~Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.

~Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

~Chronic feelings of emptiness.

~Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

~Transient, stress-related paranoid ideation or severe dissociative symptoms

ICD-10

F60.3 Emotionally unstable personality disorder

F60.31 Borderline type
The general criteria for personality disorder (F60) must be met. [see below]
At least three of the symptoms mentioned in criterion 2 for F60.30 must be present* [see below], with at least two of the following in addition:

~disturbances in and uncertainty about self-image, aims, and internal preferences (including sexual);

~liability to become involved in intense and unstable relationships, often leading to emotional crisis;

~excessive efforts to avoid abandonment;

~recurrent threats or acts of self-harm;

~chronic feelings of emptiness.

F60.30 Impulsive type *
The general criteria for personality disorder (F60) must be met. [see below]
At least three of the following must be present, one of which must be (2):

~marked tendency to act unexpectedly and without consideration of the consequences;

~marked tendency to quarrelsome behaviour and to conflicts with others, especially when impulsive acts are thwarted or criticized;

~liability to outbursts of anger or violence, with inability to control the resulting behavioural explosions;

~difficulty in maintaining any course of action that offers no immediate reward;

~unstable and capricious mood.

I fit the Borderline type, but don't really fit any of the Impulsive type needed to fulfill the full criteria.
[I am not self-diagnosing, my therapist confirmed for me today that I have borderline tendencies. Its been a while since we've discussed this, and I am a lot better, much more able to contain and regulate difficult feelings.]

It just disturbs/confuses me, that I fit one version and not the other.
Is this ... usual?

 

[Retired]

I know what DSM-IV is but I am not familiar with ICD-10. Our definitions tool does not recognize either

 

[David Baxter PhD]

I wouldn't worry about it, braveheart.

DSM and ICD are two systems for categorizing mental disorders. They are developed and maintained by two different groups. Even within those groups, there are debates about the necessary and sufficient criteria and about differential diagnosis and even about whether certain syndrome clusters qualify as separate diagnoses. The best way to think about the different systems is that they are both works in progress, evolving over time, and that they tend to reflect the theoretical biases peculiar to the specific group(s) developing the systems. This is a common theme in the world of science.

DSM is the authority in North America. ICD is used more in Europe.

 

[Retired]

DSM is the authority in North America. ICD is used more in Europe

Thanks for the explanation

 

[braveheart]

Thanks David. I hadn't thought that they would have different theoretical backgrounds underpinning them. That makes sense.

It can be confusing. For example, the DSM includes dissociation and paranoia, but the ICD-10 doesn't even mention them. Both dissociation and paranoia/hyper-vigilance are a significant part of my symptoms.

My Life NOS, me.

 

[David Baxter PhD]

My Life NOS, me.

Ultimately, that's probably true for most people. Diagnoses are basically shorthand descriptions of a set of symptoms and traits. Very few people meet all the listed criteria for a diagnosis and many will meet some of the criteria for more than one diagnosis.

You will usually find yourself somewhere between your diagnosis/diagnoses and "no diagnosis".

 

[braveheart]

Or, as my ex-psychiatrist put it - 'depression and anxiety and panic attacks and other problems due to things that happened to me in the past'. Heck, even saying like that it makes me hyperventilate. lol.

But, seriously...

Thanks for the reminder, David.

I am starting to conceptualise/encapsulate my own perception of my symptoms together, in a non-standard diagnosis format. [longhand for My Life, NOS!] Which I am finding liberating, compassionate and reassuring, rather than alienating and stigmatising. I have suffered enough alienation and stigma in my life. ...