ICD VS DSM - KEY DIFFERENCES AND SIMILARITIES

International Classification of Diseases (ICD) and Diagnostic and Statistical Manu al of

Mental Disorders DSM are systems that identify and classify diseases once the diagnosis
is established. ICD and DSM are identical in some ways and differ in others. However,
both systems represent codes and manual for diseases which provide medical informatics
such as automated decision support, claims process in medical billing, statistics on
morbidity & mortality, surveying epidemic outbreak, etc. as well as for clinical purposes
such as treatment, and welfare of public health.

This write-up will focus on the differences and similarities between ICD and DSM
systems. The classifications of illness under ICD includes the ones under. However, the
inverse cannot hold true because DSM classification is exclusively limited to
psychological disorders. Neither of the two is considered biologically plausible and
final. But it is just a matter of preference for classifying health condition. Read ahead to
know in detail, the specifics of ICD vs DSM. But before that, here is an introduction and
comparison of ICD and DSM systems -

Understanding ICD and DSM

 ICD
International Classification of Diseases (ICD) is a globally accepted convention for
classifying the illnesses. It is a complete system that covers all illness documented in the
world. ICD is used for health management, epidemiology, and for various other clinical
purposes. This system is maintained by World Health Organization by accounting all
conditions, disorders, and diseases in the WHO member nations.

Whether it is signs, diseases, social circumstances, abnormal finding, or more ICD

represents a comprehensive code list that provides decision support to healthcare
providers, health insurance companies, and other healthcare agencies across the world.
ICD system is a benchmarking tool for international comparability which is used by
healthcare professionals to easily map medical conditions with a generic category.

Revision of ICD system is a periodical process. Initially, the system was designated to
be revised once in every decade. However, it became clear that the time bet ween two
successive revisions was rather short. ICD-10, updated in 1994, is the current version
which provides classifications for more than 155,000 codes. It was swiftly adopted
across the world with resources readily accessible in the form of manual and browser
from the WHO. A customized version of ICD-10 was adopted by Australia, New
Zealand, and Canada.

Currently, WHO is amidst revising ICD. The new version called ICD-11 is being
authored using iCAT (Collaborative authoring tool), an online workspace. A fter
completing the review in 2015, a final draft was planned for endorsement in 2017.
However, it was deferred for approval from the WHA (World Health Assembly) until
2018.

ICD-11 contains codes and definitions in a language that is simple enough for huma ns
to understand. The new revisions permit computerization of content which enhances its
pliability and applicability.

 DSM
Diagnostic & Statistical Manual of Mental Disorder (DSM) is a handbook that provides
criteria for classifying clinical diagnosis, particularly ones associated with mental
disorder. This system offers a common language that helps medical professionals to
make better healthcare decisions. DSM is also useful in documenting and sharing patient
diagnosis after successful evaluation.

American Psychiatric Association (APA) is the organization behind the publication of

DSM manual. DSM has a lesser recognition globally because this manual is only popular
in the United States and partially accepted across the world. The criteria included in the
DSM manual are not all-inclusive and therefore, its validity and reliability were’t
bulletproof. However recently, the system is somewhat believed to be accurate due to
its practicality in general belief and research.

Revision of the DSM is also a periodical process, and currently, the system is in the 5th
edition (DSM-5). It contains latest codes for all recognized mental disorders. The DSM
publication helps bring over $ 5 million annually to APA. The widespread use of DSM
is still yet to become a reality because the system is mostly considered bigoted and
unscientific.

"In a survey across 66 countries, psychiatrists agree that ICD is considered best for
diagnosis, while DSM benefitted research."

ICD vs DSM
In the world of medical coding, diagnosis classification, and areas where better
healthcare decision is critical, it is important to have a generally accepted codebook that
can make the process easier and more usable on a global scale. The answer to that is ICD
and DSM classifications.
They are manuals used by healthcare and insurance professionals for treatment and
reimbursement process. But, why do we need two sets of classification systems? Ahead
lies the answer to similarities and differences between ICD and DSM.

Similarities between ICD and DSM

A few similarities between ICD and DSM Systems are as follows -

Shared Definitions - ICD and DSM share several similar codes for diagnosis. However,
the specificity of defining each condition is where they differ. For example codes for social
pragmatic communication disorder, and alcohol use disorder (AUD), etc. are similar in both
the classification system

Classification - DSM and ICD are code sets which are nearly identical in many ways and
permits classifying the diagnosis for healthcare and insurance processing processes

Code Crosswalking - Both DSM and ICD allow crosswalking from old to new versions.
This allows the new version to have some definitions from the former versions

Formulation - The criteria for DSM and ICD are not decided based on factual evidence, but
they are approved by medical experts for research after reaching a consensus

Differences between ICD and DSM

Although the coding system looks identical, it does have areas where the system differs.
Here are the main differences between ICD and DSM systems -

ICD DSM
ACCURACY Although it promptly assists With clinical significance
in data collection, It is criteria and specificity in the
considered to be less accurate description, it is considered to
be far more accurate
RELIABILITY ICD systems are considered to As operational criteria were
be less reliable because they introduced, the system is
reject diagnostic criteria considered more reliable in a
without independent validation. statistical context
This leads to disagreements in
diagnosis
CREDENCE It is an official classification It is an official classification in
adopted by many nations the United States. But is
around the world adopted by many countries as
well
PURPOSE ICD is used for classifying all DSM is used particularly by
illness and is used by many psychiatrists as it represents
health practitioners code set for all mental disorders

APPLICABILITY ICD is popular in WHO DSM is the first choice for

member nations which include psychiatric health in high-
low and middle-income nations income nations

COVERAGE ICD provides guidance and DSM provides operational

diagnostic criteria without criteria which distinct
including operational criteria definitions for each condition