Bipolar disorder in the International Classification of Diseases-Eleventh version: A review of the changes, their basis, and usefulness

Table 1 Benchmarks for the revisions of the new classifications[9-13]

Principles and priorities	ICD-11-CDDR	DSM-51
Guiding principles
Public health imperative	The guidelines should be useful in alleviating the global mental health burden, especially the burden in the low-and middle-income countries	The manual is meant to be used as a tool for collecting and communicating accurate public health statistics on mental disorders
Clinical imperative	Clinical and public health utility were accorded the greatest priority followed by scientific validity	Clinical utility was accorded the highest priority followed by the scientific evidence
Stakeholders	The guidelines are meant for use in all countries, for all professionals, and for all service users	The manual is meant for all professionals and service users
Multiple uses	The guidelines are meant for clinical, research, teaching, and training purposes, and for collecting data	The manual is meant for clinical, research, teaching, and training purposes, and for collecting data
Settings	The guidelines are meant for all settings including specialist and primary-care settings, with special emphasis on primary-care settings in low-and middle-income countries	The manual should be applicable to all settings including specialist, primary-care, community, and forensic settings
Cross-cultural applicability	The revision should be relevant and acceptable to clinicians from all cultures	Cultural aspects relevant to the diagnosis was a key consideration
Priorities
Global applicability	Global and universal applicability: The guidelines should be relevant for all countries, all stakeholders, and in all settings	Professionals from 39 countries were involved in developing the scientific basis of the diagnostic criteria
Clinical utility	Clinical and public-health utility was accorded the highest priority during the process of revision	The manual is primarily intended for clinical use and should be feasible for clinical practice
Scientific validity	The scientific basis should be based on best available evidence. Compromises for the sake of utility should be avoided	The revision was guided by a thorough review of the best scientific evidence
Harmonization	Efforts to harmonize the ICD-11 revision with the DSM-5 involved enhancing similarities and minimizing arbitrary differences between the two systems	The APA collaborated with the WHO to develop a common and globally applicable research base for the DSM-5 and the ICD-11 disorders

¹The priorities of the DSM-5 classification were quite similar to those of the ICD-11.

APA: American Psychiatric Association; DSM-5: Diagnostic and Statistical Manual of Mental Disorders, 5^th edition[6]; ICD-11-CDDR: International Classification of Diseases, 11^th version, Clinical Descriptions and Diagnostic Requirements[8]; WHO: World Health Organization.