A crosswalk from DSM-III-R to ICD-9-CM

Article Abstract:

The two basic texts which currently serve as guides for categorizing psychiatric evaluation and diagnosis are the DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders, third edition, revised) and the ICD-9-CM (International Classification of Diseases). The latter was developed by the American Psychiatric Association in conjunction with the Armed Forces and the Veterans Administration. The former is a product of the World Health Organization (WHO) and is the statistical classification scheme used internationally. In an attempt to reconcile any discrepancies which may exist between these two publications, a crosswalk, or translation, has been developed jointly by several federal agencies in this country. This has been found to be a useful tool in rectifying any differences by providing a link between the terminology used in the two texts. It was found that the discrepancies that do exist are primarily of a semantic nature. The DSM-III usually uses more current terminology but, in substance, the two texts are in agreement for approximately 97 percent of the coded material. Most insurance suppliers, including Medicare and Medicaid, require the use of ICD terminology, while for clinical purposes, the use of the DSM is more common. The crosswalk has been useful in the general reconciliation of the two texts. It was found that the overall compatibility of these two texts is good and that most problems that do exist are minor. The authors recommend that, in the upcoming revisions of the texts, issues of translation between them be highlighted to improve the accuracy and consistency for medical records, research, and methods of clinical analysis and treatment.

Evaluation, Identification and classification, Psychology, Pathological, Psychopathology, Categorization (Psychology), Nosology

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DSM-III-R personality disorders in patients with eating disorders

Article Abstract:

Anorexia nervosa is an eating disorder manifested as controlled starvation by the patient. Bulimia nervosa is an eating disorder characterized by repeating binge and purge cycles. A group of 35 female hospital inpatients with diagnoses of anorexia or bulimia were tested for the presence of diagnosable personality disorders. One earlier study found a higher rate of eating disorders in patients who were previously diagnosed with borderline personality disorders than those diagnosed with anxiety disorders. Other studies rating personality disorders in those already diagnosed with eating disorders have usually found strong correlations. In an attempt to overcome deficiencies in methodology in earlier research and to systematically establish reliability in data, the Personality Disorder Examination was used to estimate 12 personality disorders. Over 57 percent (20) of the women met the criteria for at least one personality disorder, the most common diagnoses being borderline, self-defeating and avoidant personality disorders. The remaining 15 patients all had personality disorder traits. They found no significant differences between the anorexic and bulimic patients, though there was a disproportionate number of self-defeating personality disorder diagnoses among the bulimics. The eating disorders are more than likely related to an underlying emotional disorder rather than just being separate disordered patterns of eating, and further study is needed to correlate personalities and eating pathologies.

Diagnosis, Eating disorders, Bulimia, Anorexia nervosa, Personality disorders

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