Until recently, I had never heard of the ICD (International Classification of Diseases). It was my assumption that the DSM was the international standard reference book for diagnosticians. Then I started reading about the World Health Organization’s ICD and learned that this is not the case. The DSM is the primary diagnostic system in the United States and just a few other countries. In most other countries around the world (particularly European countries), the DSM is used merely as an adjunct to the ICD diagnostic system, and sometimes the DSM is not employed at all. The two references have many and significant differences, such as their respective coding systems and disagreement in terms of which certain disorders belong on what axes. For instance: in ICD, "personality disorders" are placed on Axis 1; in DSM, they are Axis 2 diagnoses. However, there has been a lot of work done cooperatively by the American Psychological Association (APA) and the WHO to bring these two texts into concordance, and my questions are these: the ICD was first published before the DSM was. So, why did the American Psychological Association the create DSM in the first place? Why not, instead of trying to bring the DSM into concordance with the ICD and vice-versa, produce just one reference book that would set the international standard for diagnosis, epidemiology, and classification? It seems like in the longer run, such a move would end much confusion, and would be a generally simpler, yet more elegant and “streamlined” system for everyone concerned.
