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The road to 11th edition of the International Classification of Diseases: trajectories of scientific consensus and contested science in the classification of intellectual disability/intellectual developmental disorders

Salvador-Carulla, Luisa; Bertelli, Marcob; Martinez-Leal, Rafaelc,d

Current Opinion in Psychiatry: March 2018 - Volume 31 - Issue 2 - p 79–87
doi: 10.1097/YCO.0000000000000396
NEURODEVELOPMENTAL DISORDERS: Edited by James C. Harris

Purpose of review To increase the expert knowledge-base on intellectual developmental disorders (IDDs) by investigating the typology trajectories of consensus formation in the classification systems up to the 11th edition of the International Classification of Diseases (ICD-11). This expert review combines an analysis of key recent literature and the revision of the consensus formation and contestation in the expert committees contributing to the classification systems since the 1950s.

Recent findings Historically two main approaches have contributed to the development of this knowledge-base: a neurodevelopmental–clinical approach and a psychoeducational–social approach. These approaches show a complex interaction throughout the history of IDD and have had a diverse influence on its classification. Although in theory Diagnostic and Statistical Manual (DSM)-5 and ICD adhere to the neurodevelopmental–clinical model, the new definition in the ICD-11 follows a restrictive normality approach to intellectual quotient and to the measurement of adaptive behaviour. On the contrary DSM-5 is closer to the recommendations made by the WHO ‘Working Group on Mental Retardation’ for ICD-11 for an integrative approach.

Summary A cyclical pattern of consensus formation has been identified in IDD. The revision of the three major classification systems in the last decade has increased the terminological and conceptual variability and the overall scientific contestation on IDD.

aCentre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia

bCREA, Research and Clinical Centre, San Sebastiano Foundation, Florence, Italy

cIntellectual Disability and Developmental Disorders Research Unit (UNIVIDD) – Fundació Villablanca, IISPV, Universitat Rovira i Virgili, Reus, Catalonia

dCIBERSAM, Centro de Investigación Biomédica en Red, Madrid, Spain

Correspondence to Prof. Luis Salvador-Carulla, MD, PhD, Head, Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, 63 Eggleston Rd, Acton, Canberra 2601, ACT, Australia. Tel: +61 2 6125 9723/+61 4 6844 0028; e-mail: luis.salvador-carulla@anu.edu.au

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