A Qualitative Analysis On What Brazilian Psychiatrists Expect From Current Diagnostic Classifications [avaliação Qualitativa Sobre O Que Os Psiquiatras Brasileiros Esperam Das Classificações Diagnósticas]

Introduction: The objective of the present study was to analyze the qualitative answers of an anonymous standardized survey including qualitative and quantitative questions about the Brazilian psychiatrists' perceptions on their use of the multiaxial diagnostic systems ICD-10 and DSM-IV and about their expectations regarding future revisions of these classifications (ICD-11 and DSM-V). Method: The questionnaire, elaborated by Graham Mellsop (New Zealand), was translated into Portuguese and sent through mail to 1,050 psychiatrists affiliated to the Brazilian Psychiatry Association. The quantitative analysis is presented elsewhere. Results: One hundred and sixty questionnaires returned (15.2%). From these, 71.1% of the open questions where answered. The most needed and/or desirable qualities in a psychiatric classification were found to be: simplicity, clarity of criteria, objectivity, comprehensibility, reliability, and ease to use. Axis I of the ICD-10 was reported to be the most used due to its instrumental character in addition to being the official classification also for legal and bureaucratic purposes. The DSM-IV was also used in the everyday practice, mostly for education and research purposes, by psychiatrists with academic affiliations. The less frequent use of the multiaxial systems was explained by the lack of training and familiarity, the overload of information and by the fact they are not mandatory. Based on the respondents' answers, we concluded that some diagnostic categories must be revised, such as: mental retardation, eating disorders, personality disorders, sleeping disorders, child and adolescent disorders, affective, and schizoaffective disorders. Conclusion: This material offers a systematic overview of the psychiatrists' opinions and expectations concerning the diagnostic instruments used in their daily practice. Copyright © Revista de Psiquiatria do Rio Grande do Sul - APRS.312112115Banzato, C.E.M., Pereira, M.E., Santos Jr, A., Silva, L.F., Loureiro Jr, J.C., Barros, B.R., O que os psiquiatras brasileiros esperam das classificações diagnósticas? (2007) J Bras Psiquiatr, 56 (2), pp. 88-93Kendell, R., Jablensky, A., Distinguishing between the validity and utility of psychiatric diagnoses (2003) Am J Psychiatry, 160, pp. 4-12First, M.B., Pincus, I.S., Levine, J.B., Williams, J.B., Ustun, D.S., Peele, R., Clinical utility as a criterion for revising psychiatric diagnoses (2004) Am J Psychiatry, 161 (6), pp. 946-954Jampala, V.C., Sierles, F.S., Taylor, M.A., Costumers views of DSM-III: Attitudes and practices of U.S. psychiatrists and psychiatric 1984 graduating residents (1986) Am J Psychiatry, 143 (2), pp. 148-153Maser, J.D., Kaelber, C., Weize, D.R., International use and attitudes toward DSM-III and DSM-III-R: Growing consensus in psychiatric classification (1991) J Abnorm Psychol, 100 (3), pp. 271-279Bassett, A.S., Beiser, M., DSM-III: Use of the multiaxial diagnostic system in clinical practice (1991) Can J Psychiatry, 36 (4), pp. 270-274Mezzich, J.E., International survey on the use of ICD-10 diagnostic and related systems (2002) Psychopathology, 35 (2-3), pp. 72-75Banzato, C.E., Multiaxial diagnosis in psychiatry: Review of the literature on DSM and ICD multiaxial schemas (2004) J Bras Psiquiatr, 53 (1), pp. 27-37Williams, J.B., Spitzer, R.L., Skodol, A.E., DSM-III in residency training: Results of the National Survey (1985) Am J Psychiatry, 142 (6), pp. 755-758Velamoor, V.R., Waring, E.M., Fisman, S., Cernovsky, Z., Brownstone, D., DSM-III in residency training: Results of a Canadian survey (1989) Can J Psychiatry, 34 (2), pp. 103-106Mellsop, G., Banzato, C.E., Shinfuku, N., Nagamine, M., Pereira, M.E., Dutu, G., An international study of the views of psychiatrists on present and preferred characteristics of classifications of psychiatric disorders (2008) Int J Ment Health, 36 (4), pp. 17-2