RESUMEN
In 2013, the American Psychiatric Association (APA) published the 5th edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In 2019, the World Health Assembly approved the 11th revision of the International Classification of Diseases (ICD-11). It has often been suggested that the field would benefit from a single, unified classification of mental disorders, although the priorities and constituencies of the two sponsoring organizations are quite different. During the development of the ICD-11 and DSM-5, the World Health Organization (WHO) and the APA made efforts toward harmonizing the two systems, including the appointment of an ICD-DSM Harmonization Group. This paper evaluates the success of these harmonization efforts and provides a guide for practitioners, researchers and policy makers describing the differences between the two systems at both the organizational and the disorder level. The organization of the two classifications of mental disorders is substantially similar. There are nineteen ICD-11 disorder categories that do not appear in DSM-5, and seven DSM-5 disorder categories that do not appear in the ICD-11. We compared the Essential Features section of the ICD-11 Clinical Descriptions and Diagnostic Guidelines (CDDG) with the DSM-5 criteria sets for 103 diagnostic entities that appear in both systems. We rated 20 disorders (19.4%) as having major differences, 42 disorders (40.8%) as having minor definitional differences, 10 disorders (9.7%) as having minor differences due to greater degree of specification in DSM-5, and 31 disorders (30.1%) as essentially identical. Detailed descriptions of the major differences and some of the most important minor differences, with their rationale and related evidence, are provided. The ICD and DSM are now closer than at any time since the ICD-8 and DSM-II. Differences are largely based on the differing priorities and uses of the two diagnostic systems and on differing interpretations of the evidence. Substantively divergent approaches allow for empirical comparisons of validity and utility and can contribute to advances in the field.
RESUMEN
Introducción: El consumo de drogas es considerado un elemento favorecedor de las conductas suicidas. En la medida que aumenta la frecuencia, intensidad, tiempo de consumo y la coexistencia con otros trastornos mentales también se incrementa la probabilidad de un comportamiento violento hacia sí mismo. Objetivo: Caracterizar pacientes adictos ecuatorianos con conductas suicidas y determinar posibles interacciones entre las variables sociodemográficas y de consumo consideradas. Método: Estudio transversal con pacientes drogodependientes que han sido ingresados en la Unidad de Conductas Adictivas (UCA) del Instituto de Neurociencias de Guayaquil (INC) en el periodo 2010-2016. Se seleccionó una población de 922 pacientes que refirieron algún tipo de conducta suicida luego de haber comenzado el consumo de drogas, incluyendo la ideación y el intento suicidas en cualquiera de sus variantes. Resultados: En este análisis se observó que la población masculina predominó en este grupo de estudio, de los cuales aproximadamente 4 de cada 10 intentaron suicidarse (36,3 por ciento), mientras que las mujeres fueron aproximadamente 5 de cada 10 (46,3 por ciento). Conclusiones: Entre los pacientes con conductas suicidas que ingresaron en Unidad de Conductas Adictivas del Instituto de Neurociencias de Guayaquil, Ecuador, entre el 2014 y 2017, predominaron mujeres que sufrieron de depresión o tenían comorbilidad con la esquizofrenia. Se trata de mujeres jóvenes de entre 15 a 25 años, que se iniciaron en el consumo de drogas entre los 15 y 20 años de edad, con intentos suicidas previos y depresión(AU)
Introduction: Illicit drug use is considered a favorable element highly associated to suicidal behavior. As the frequency, intensity, time of consumption and coexistence with other mental disorders, the probability of violent behavior towards oneself also increases. Objective: To characterize drug addict patients with suicidal behavior and determine possible links between sociodemographic and consumption variables. Method: A cross-sectional study in drug addict patients admitted in the Unidad de Conductas Adictivas (UCA) setted at the Instituto de Neurociencias (INC) in Guayaquil, Ecuador, was carried out, in the period 2010 throughout 2016. A total of 922 patients who referred any kind of suicidal behavior (including any kind of suicidal ideation or suicidal intent) were selected. Results: This research revealed that male population was predominant, in which 4 of 10 attempted suicide (36.3 percent), meanwhile in females was 5 in 10 approximately (46.3 percent). Conclusions: Among patients with suicidal behavior admitted in the Unidad de Conductas Adictivas (UCA) setted at the Instituto de Neurociencias (INC) in Guayaquil, Ecuador, between 2014 and 2017, women who suffered depressive symptoms or had schizophrenia as comorbidity were predominant. Women 15 to 20 years of age and with previous suicidal intent and depressive symptoms(AU)
Introdução: O uso de drogas é considerado um elemento que favorece o comportamento suicida. À medida que aumenta a frequência, intensidade, tempo de consumo e convivência com outros transtornos mentais, aumenta também a probabilidade de comportamento violento contra si mesmo. Objetivo: Caracterizar os dependentes químicos equatorianos com comportamento suicida e determinar as possíveis interações entre as variáveis sociodemográficas e de consumo consideradas. Método: Estudo transversal com pacientes dependentes químicos internados na Unidad de Conductas Adictivas (UCA) del Instituto de Neurociencias de Guayaquil (INC), Equador, no período de 2010-2016. Foi selecionada uma população de 922 pacientes que relataram algum tipo de comportamento suicida após o início do uso da droga, incluindo ideação suicida e tentativa de suicídio em qualquer uma de suas variantes Resultados: Nesta análise observou-se que a população masculina predominou neste grupo de estudo, da qual aproximadamente 4 em 10 tentativas de suicídio (36,3 porcento), enquanto as mulheres foram aproximadamente 5 em 10 (46,3porcento). Conclusões: Entre os pacientes com comportamento suicida internados na Unidade de Comportamento Aditivo do Instituto de Neurociências de Guayaquil, Equador, entre 2014 e 2017, predominaram mulheres que sofriam de depressão ou apresentavam comorbidade com esquizofrenia. São mulheres jovens entre 15 e 25 anos, que começaram a usar drogas entre 15 e 20 anos, com tentativas anteriores de suicídio e depressão(AU)