ICD 10 for Depression compared to DSM 5 for Depression
What are the diagnostic criteria for depression? In other words, what are the “official” depression symptoms? There are two main diagnostic tools for depression: the ICD 10 for depression and the DSM-5 definition of depression. In North America the DSM-5 is more widely used whereas internationally, the ICD 10 for depression is more common. (More on those below.) Although the ICD-10 depression symptoms are similar to the DSM-5 depression symptoms, there are important differences, which are discussed below.
ICD-10, ICD-11, and the ICD-10-CM and the ICD-10-PCS
The International Classification of Diseases, tenth edition – the ICD 10 – was developed and is copyrighted by the World Health Organization (WHO). ICD 11 is slated to come out in 2018. The WHO has authorized the National Center for Health Statistics (NCHS) in the US to develop a version of the ICD-10 called the ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification). This version is a clinical modification mainly for tracking mortality. There is also an ICD-10-PCS (Procedure Coding System) which is used for billing purposes.
Sometimes people might say that they feel depressed when what they mean is that they feel sad or down in the dumps. In my article “Is depression an emotion?” I discuss the difference between the emotion of sadness and the illness of depression in more detail. However, here, we will look at the official DSM-5 and ICD-10 depression symptoms.
What are the DSM-5 and what is the ICD-10?
What is the DSM-5?
The DSM-5 is the “Diagnositic and Statistical Manual” version 5. It is often loosely referred to as the “psychiatrist’s bible” for psychiatrists in North America. It has detailed diagnostic criteria for all psychiatric illnesses. Some people love it and some people hate it, but it is an industry standard either way.
What is the ICD-10?
ICD-10 stands for International Classification of Disease, Tenth Edition. The ICD-10 is sort of the international version of the DSM-5 except it applies to all diseases, not just those of the mind. From what I understand, it is not as detailed as the DSM-5. The World Health Organization regulates the ICD-10.
Many people agree that having two different manuals to diagnose psychiatric illnesses is not a very good idea. However, it is very challenging to try to merge them, so we continue to have two manuals. Another issue is that the ICD applies to all illnesses whereas the DSM only applies to psychiatric illnesses.
ICD-10 Depression symptoms:
First, there are three key symptoms for depression according to the ICD-10:
- persistent sadness or low mood
- loss of interests or pleasure
- fatigue or low energy
The main ICD-10 criterion for depression: you experience at least one of these symptoms most days, most of the time, for at least two weeks. Then the psychiatrist would ask about the following associated ICD-10 depression symptoms:
- disturbed sleep
- poor concentration or indecisiveness
- low self-confidence
- poor or increased appetite
- suicidal thoughts or acts (If you are suicidal or in crisis, please get help immediately.)
- agitation or slowing of movements
- guilt or self-blame
Those are ten symptoms in total for depression according to the ICD-10. If a person has fewer than four symptoms, they are not considered to be depressed. Four symptoms means a person has mild depression. Moderate depression is five or six symptoms. And severe depression is seven or more symptoms. (Having reviewed the text of the ICD-10 while revising this, I find that the diagnosis is somewhat more complex than I have suggested here, and so I am linking to the WHO’s ICD-10 Classification of Mental and Behavioural Disorders for those who would like details. The ICD-10 criteria for depressive disorders can be found on pages 99-106.)
Depression Symptoms according to the DSM-5
In many respects depression symptoms according to the DSM-5 are similar to the ICD-10 depression symptoms. Here are the symptoms of major depressive disorder in the DSM-5:
- Depressed mood or a loss of interest or pleasure in daily activities for more than two weeks.
- This mood represents a change from the person’s baseline.
- Impaired function: social, occupational, educational.
- Specific symptoms, at least 5 of these 9, present nearly every day:
- Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
- Decreased interest or pleasure in most activities, most of each day
- Significant weight change (5%) or change in appetite
- Change in sleep: Insomnia or hypersomnia
- Change in activity: Psychomotor agitation or retardation
- Fatigue or loss of energy
- Guilt/worthlessness: Feelings of worthlessness or excessive or inappropriate guilt
- Concentration: diminished ability to think or concentrate, or more indecisiveness
- Suicidality: Thoughts of death or suicide, or has suicide plan (Get help immediately!)
If you want to see the actual DSM-5, you need to purchase a copy (affiliate link). Unlike the ICD-10, it is not available for free (not legally, anyhow).
Both the DSM-5 and ICD-10 have fairly similar criteria for diagnosing depression. However, those of the DSM-5 are a little more complex. However, the DSM-5 and ICD-10 are tools meant to be used mainly by professional psychiatrists. As you probably know, psychiatrists are medical doctors who have taken further specialized training in mental health.
These might also be of interest:
- Books about depression
- Mental Health Resources
- Depression Treatment Plan
- Cognitive Behavioral Therapy Techniques