Neurological, Psychiatric, and Developmental Disorders: Meeting the Challenge in the Developing World

International Classification of Diseases (ICD-10) [4] and the APA Diagnostic and Statistical Manual, fourth edition, DSM-IV, [5] now serve as a common language for psychiatry and mental health care worldwide. The two systems identify schizophrenia in a broadly similar manner (see Table 7-1).

Notwithstanding international agreement on diagnosis, it is important to bear in mind that schizophrenia remains a clinical syndrome and that the neuro-biology underlying its manifestations is not yet fully understood. There is at present no biological test or marker that can identify the disease (or a predisposition to it) independently of clinical assessment. Furthermore, the clinical

TABLE 7-1 Overview of the ICD-10 and DSM-IV Criteria for Diagnosis of Schizophrenia

ICD-10 Schizophrenia (F20)	DSM-IV Schizophrenia (295)
One month or more of at least one of the following symptoms: thought echo, withdrawal, insertion, broadcasting delusions of control and passivity voices; 3^rd person, commentary, coming from part of body persistent delusions or at least two of the following: persistent hallucinations accompanied by delusions incoherence, irrelevant speech, neologisms catatonic signs negative symptoms significant consistent change in personal behavior	One month or more of at least two of the following symptoms: delusions hallucinations disorganized speech grossly disorganized or catatonic behavior negative symptoms Social and occupational dysfunction One or more areas affected (work, relationships, self-care) Duration Continuous symptoms and signs for ≥ 6 months These 6 months must include: At least 1 month of symptoms meeting criterion A Various combinations of prodromal and residual symptoms
Exclude:	Exclude:
Full manic or depressive episode preceding the onset of schizophrenic symptoms Organic brain disease Alcohol or drug intoxication or withdrawal	Schizoaffective and mood disorder Substance use or a medical condition Autism or pervasive developmental disorder
Source: [4,5]

Table of Contents

Front Matter R1-R24

Executive Summary 1-12

1 Introduction 13-20

2 The Magnitude of the Problem 21-56

3 Integrating Care of Brain Disorders into Health Care Systems 57-96

4 Findings and Future Strategies 97-108

5 Developmental Disabilities 109-178

6 Epilepsy 179-216

7 Schizophrenia 217-256

8 Bipolar Disorder 257-282

9 Depression 283-338

10 Stroke 339-376

Epilogue 377-382

Appendix A The Study Approach 383-390

Appendix B Measurement Issues in Calculating the Global Burden of Disease 391-392

Appendix C Workshop Agenda 393-396

Appendix D Economic Analysis 397-418

Appendix E Committee and Staff Biographies 419-424

Glossary 425-430

Acronyms 431-434