Ontology highlight
ABSTRACT: Background
Severe irritability has become an important topic in child and adolescent mental health. Based on the available evidence and on public health considerations, WHO classified chronic irritability within oppositional defiant disorder (ODD) in ICD-11, a solution markedly different from DSM-5's (i.e. the new childhood mood diagnosis, disruptive mood dysregulation disorder [DMDD]) and from ICD-10's (i.e. ODD as one of several conduct disorders without attention to irritability). In this study, we tested the accuracy with which a global, multilingual, multidisciplinary sample of clinicians were able to use the ICD-11 classification of chronic irritability and oppositionality as compared to the ICD-10 and DSM-5 approaches.Methods
Clinicians (N = 196) from 48 countries participated in an Internet-based field study in English, Spanish, or Japanese and were randomized to review and use one of the three diagnostic systems. Through experimental manipulation of validated clinical vignettes, we evaluated how well clinicians in each condition could identify chronic irritability versus nonirritable oppositionality, episodic bipolar disorder, dysthymic depression, and normative irritability.Results
Compared to ICD-10 and DSM-5, ICD-11 led to more accurate identification of severe irritability and better differentiation from boundary presentations. Participants using DSM-5 largely failed to apply the DMDD diagnosis when it was appropriate, and they more often applied psychopathological diagnoses to developmentally normative irritability.Conclusions
The formulation of irritability and oppositionality put forth in ICD-11 shows evidence of clinical utility, supporting accurate diagnosis. Global mental health clinicians can readily identify ODD both with and without chronic irritability.
SUBMITTER: Evans SC
PROVIDER: S-EPMC7657976 | biostudies-literature | 2021 Mar
REPOSITORIES: biostudies-literature
Evans Spencer C SC Roberts Michael C MC Keeley Jared W JW Rebello Tahilia J TJ de la Peña Francisco F Lochman John E JE Burke Jeffrey D JD Fite Paula J PJ Ezpeleta Lourdes L Matthys Walter W Youngstrom Eric A EA Matsumoto Chihiro C Andrews Howard F HF Elena Medina-Mora María M Ayuso-Mateos José L JL Khoury Brigitte B Kulygina Mayya M Robles Rebeca R Sharan Pratap P Zhao Min M Reed Geoffrey M GM
Journal of child psychology and psychiatry, and allied disciplines 20200512 3
<h4>Background</h4>Severe irritability has become an important topic in child and adolescent mental health. Based on the available evidence and on public health considerations, WHO classified chronic irritability within oppositional defiant disorder (ODD) in ICD-11, a solution markedly different from DSM-5's (i.e. the new childhood mood diagnosis, disruptive mood dysregulation disorder [DMDD]) and from ICD-10's (i.e. ODD as one of several conduct disorders without attention to irritability). In ...[more]