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Classificazione, diagnosi ed ICD-10. I - Principi generali e considerazioni critiche*

Published online by Cambridge University Press:  11 October 2011

Giovanni de Girolamo
Giovanni de Girolamo*
Affiliation:
Division of Mental Health, World Health Organization, Geneva
*
Indirizzo per la corrispondenza: Dr. G. de Girolamo, Division of Mental Health, WHO, 1211 Geneva 27, Switzerland. Fax. (+41)22-791.0746
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Summary

Objective - To discuss some theoretical and practical problems related to classification in the medical and psychiatric fields, and to present the general structure of the Tenth Revision of the International Classification of Diseases (ICD-10), officially adopted as from January 1993. Results - This paper discusses the epistemological basis of classification, the various classification strategies adopted in the medical and psychiatric fields and the main theoretical models employed in this area. The problems related to the reliability and validity of psychiatric diagnoses are then reviewed, and the different strategies to be used in order to improve them are presented. Finally the principles which have led the development of the ICD-10, and the field trials carried out in order to test the appropriatness of this system are discussed. Conclusions - In the psychiatric field classification is essential in order to make possible an ordered systematization of new knowledge and to facilitate the communication between health workers and users of services. The ICD-10 represents the biggest effort ever carried out at an international level to build a reliable classification incorporating different psychiatric traditions.

Riassunto

Scopo - Discutere i principali problemi teorico-pratici connessi alia classificazione in campo medico e psichiatrico, e presentare la struttura generale della decima revisione della Classificazione Internazionale delle Malattie (ICD-10), entrata ufficialmente in vigore dal gennaio del 1993. Risultati - Sono dapprima discussi i fondamenti epistemologici della classificazione, le varie strategic classificatorie adottate in campo medico e psichiatrico ed i principali modelli classificatori esistenti. Sono quindi analizzati i problemi relativi alia attendibilità ed alia validità delle diagnosi psichiatriche, e vengono descritte le strategic che possono essere impiegate per migliorarle. Infine sono discussi i principi che hanno informato ia stesura dell' ICD-10 ed i field trials effettuati al fine di preparare il testo finale delle direttive diagnostiche. Conclusioni - La classificazione in psichiatria rappresenta un passaggio obbligato e necessario per rendere possibile la sistematizzazione delle nuove conoscenze e la comunicazione tra operatori, ricercatori ed utenti. La decima revisione dell' ICD rappresenta lo sforzo più ampio sinora compiuto in campo psichiatrico al fine di predisporre un sistema classificatorio rigoroso che, nel contempo, sintetizzi approcci e culture psichiatriche differenziate.

Keywords

diagnosiclassificazioneICD-10diagnosisclassificationICD-10
Type
Articoli
Information
Epidemiology and Psychiatric Sciences , Volume 2 , Issue 2 , August 1993 , pp. 83 - 103
Copyright
Copyright © Cambridge University Press 1993

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Footnotes

*

Le opinioni espresse in questo articolo sono sola responasbilità dell'autore.

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