Introduction.

The ICD is a classification manual of diseases, which emerged as a tool

complementary and diagnostic for professionals in physical and mental health.
This manual, like the rest of the existing manuals, has gone through
different revisions and in each of them, the changes were made with intention
to facilitate diagnosis, however, on some occasions these changes have
had the opposite effect on the diagnostic work.
It is important to emphasize that no manual should be used in isolation. Each
Diagnosis must be accompanied by a series of clinical processes. The manuals
they are only a complementary tool that allows for understanding of
the signs and symptoms necessary to have a certain clinical condition.

Next, a summary with the most relevant information will be presented.

these manuals, the diagnostic criteria, the most important changes, the logic
qualifying, etc. This, with the intention of providing the reader with a document in which
can deeply understand the logic of the manuals you use to
diagnose.
 Objectives.
General.

To deeply understand the details and elements that allow knowing the manual.
ICD 11 diagnosis.
Specific.

Understand the logic of the diagnostic criteria of the ICD 11.

Facilitate the complete understanding of the manual and its use in diagnoses.
psychological.
Know the significant changes that have occurred in the different editions and
manual revisions.
 ICD 11.
Changes in the different editions of the ICD.

Sir George H. Knibbs, the eminent Australian statistician, gives credit to the
first essay of systematic classification of diseases by François Bossier de
Lacroix (1706–1777), better known by the name Sauvages (10). The extensive
Sauvages' work was published under the title of Nosología Methodica.
Contemporary to Sauvages was the great methodologist Linnaeus (1707–1778), one of
whose works were titled Genera Morborum. At the beginning of the 19th century the
the most common classification of diseases was that of William Cullen (1710–1790),
from Edinburgh, published in 1785 under the title Synopsis Nosologiae Methodicae.

But the statistical study of diseases had begun a century earlier,

with John Graunt's treatise on the mortality tables of London. In a
attempt to calculate the proportion of live-born children who died before
to reach the age of six. Although his classification was elementary and
imperfect, their calculation that 36% of mortality occurred before the age of six
it seems to have been correct in light of subsequent knowledge. Although three centuries
they have contributed something to the scientific accuracy of disease classification,
many still doubt the usefulness of the attempts and trials made to
collect statistics on diseases or even causes of death, due to
inherent difficulties in classification.

Fortunately for the progress of preventive medicine, the Registry Office

General of England and Wales, since its founding in 1837, found in the person
by William Farr (1807–1883), his first medical statistician, a man who not only
made the most of the imperfect disease classifications available
at that time, but focused on improving them and achieving their use and application.
they were uniforms from an international perspective.
Adoption of the international list of causes of death.

At a meeting held in Vienna in 1891, the International Statistical Institute,

successor of the International Statistical Congress, tasked a committee led by
Jacques Bertillon (1851–1922), head of the Statistical Services of the City of
Paris, the preparation of a classification of causes of death. The report of
this committee was presented by Bertillon at the meeting of the International Institute of
Statistical event held in Chicago in 1893, where it was decided to adopt it.

The Bertillon Classification of Causes of Death, as it was called to

initially, it received general approval and was embraced by several countries and by
numerous cities. It found its first application in North America by the
Dr. Jesús E. Monjarás in the statistics of San Luis Potosí, Mexico (13).
In 1898, at a meeting held in Ottawa, Canada, the Association
American Public Health Association (APHA)
recommended that the civil registries of Canada, Mexico, and the United States
They will adopt the Bertillon classification and also suggested that it be reviewed every 10.
years.

Consequently, the Government of France convened in Paris, in August 1900,

First International Conference for the Revision of the Bertillon List or List
International Causes of Death. Delegates from 26 attended the Conference.
countries, and on August 21, 1900, a detailed classification of the
causes of death, which included 179 groups, and an abbreviated classification of
35 groups. The advantage of ten-year reviews was recognized, and it was assigned to the
Government of France that will convene the following meeting in 1910. In reality, the
The planned meeting took place in 1909. The French government also convened the
conferences of 1920, 1929, and 1938.
The fifth decadal review conference.

The Fifth International Conference for the Review of the International List of
Causes of Death, like the previous conferences, was Conference
approved three lists: a detailed list of 200 rubrics, an intermediate list of 87
rubrics and a summarized list of 44 rubrics. He also updated the lists with the
scientific progress, particularly in the field of diseases
infectious and parasitic diseases, and made changes to the chapters related to the
puerperal ailments and accidents. The conference had a minimum of
changes in content, quantity, and even in the numbering of the items. It was designed
also a list of causes of stillbirths, which was approved by the
conference.

In relation to the classification of diseases for morbidity statistics, the

The conference recognized the growing need for a list of diseases for
satisfy the statistical requirements of very different organizations, such
such as health insurance, hospitals, military medical services, administrations
sanitary and similar entities.
Sixth review of the international lists.

The International Health Conference gathered in New York City in

June and July of 1946 (19), commissioned an Interim Commission of the Organization
World Health responsibility of:

Review the existing resources and take responsibility for the preparatory work.
what was necessary to carry out in relation to:
 The following decennial review of the 'International Classification of Diseases'
Death" (including the lists adopted through the Agreement
International of 1934, in relation to the Statistics of Causes of
Death;
The establishment of the International Lists of Causes of Morbidity.

The seventh and eighth review.

The International Conference for the Seventh Review of the Classification

International Diseases met in Paris in February 1955 under the
sponsored by the WHO. According to a recommendation from the Expert Committee
In WHO Health Statistics, this review was limited to making changes
essential and to correct the errors and inconsistencies.

The Conference for the Eighth Review, convened by the WHO, met in
Geneva from July 6 to 12, 1965. This review was more radical than the Seventh.
but left the basic structure of the Classification and the general philosophy unchanged
to classify diseases, whenever possible, according to their etiology and not
a specific demonstration.
The ninth revision.

International Disease Conference, convened by the WHO, met in Geneva on

September 30 to October 6, 1975. Several associations of specialists
They had expressed interest in the use of the ICD for their own statistics.
To that end, they requested the introduction of modifications that would allow for a
the most complete classification for each specialty, as it was considered that
Several parts of the classification were not properly organized.
The final proposals presented and accepted by the Conference maintained

the basic structure of the ICD, although with much additional detail in the
four-character subcategories and some cases with optional subcategories
of the fifth character. For the benefit of users who did not require so much detail
special care was taken to ensure that the three-character categories were
appropriate.

To assist users who wished to produce statistics and indices

oriented towards healthcare, the Ninth Revision included an optional method
for the classification of diagnostic information, which allowed to establish when a
a specific term could be used as a general underlying condition and when
to identify the affected organ or site. This method was named
cross and asterisk or dagger and asterisk system, which was maintained in the Tenth
Review. The Ninth Review included other technical innovations with the
purpose of increasing its flexibility and applicability in various situations.

The 29th World Health Assembly, based on the recommendations of the

Conference for the Ninth Revision of the International Classification of
Diseases, approved the publication, as a trial, of two classifications
supplementary: that of Deficiencies, Disabilities and Handicaps and that of
Procedures in Medicine, both as supplements, but not integral parts
from the CIE. The Conference also made recommendations on various aspects
classification technicians, as some changes were made to the rules of
selection of mortality and selection rules were introduced for the first time
from a single cause for morbidity tabulation; they were amended and expanded
the definitions and recommendations for perinatal mortality statistics and
a perinatal mortality certificate was recommended; countries were encouraged to
deepen the work and analysis of coding by multiple causes, although not
no particular formal method was recommended. A new one also emerged.
basic tabulation list.
Tenth review.

There is an increase in codes, chapters, definitions. For example, the ICD-10.

It consists of three volumes instead of the two that the ninth revision had.
Structurally, the ICD-10 had significant growth in the number of categories (from
909 to 2,036) and subcategories (from 5,161 to 12,159), which means more than double of
diagnostic terms compared to the previous review. In the ICD-10 the
codes have a letter followed by two to three numbers depending on the category
or subcategories (subdivisions).

26 letters are used, which mostly correspond to chapters, leaving free the
letter U for future additions or amendments. The number of chapters in which
the categories in the tabular list were organized, growing from 19 to 21 and the order was
modified. Some chapters changed their name and several diseases
they were assigned to different chapters affecting their comparison with the ICD-9. For
Example: Chapter I. The disease of HIV/AIDS, obstetric tetanus and tetanus
neonates are now in chapter I and in the ninth revision they were in the
chapters III, XI and XV.

Chapters III and IV present changes in nomenclature and content, for example, the
Chapter III now covers blood diseases, hematopoietic organs
and disorders that affect the immune mechanism are grouped in IV.
nutritional and metabolic endocrine diseases. In the ICD-9 the
endocrine, nutritional, metabolic, and immune diseases constituted
Chapter III and diseases of the blood and hematopoietic organs
they were found in IV. Chapters VI, VII, and VIII. Previously, they constituted a single
chapter, but with the ICD-10 the eye diseases and the
ear diseases and mastoid process, in two new chapters.

How does ICD-10 work?

The ICD-10 consists of 21 chapters, 2,036 categories, and 12,154 subcategories in its
original version presented internationally in October 1989. The ICD-10 was
approved at the World Health Assembly held in May 1990, adopted
by the majority of the member countries of the WHO since 1994, translated into more
of 40 languages in the world and will be in effect until the year 2018, at which point
The ICD-11 is expected to come into effect.

The possible codes range from A00.0 to Z99.9 except for the letter U which is not used, because
has been set aside for the provisional assignment of new diseases of etiology
uncertain, or for research. The ICD-10 allows for the addition and disaggregation of the
diseases because it uses the concept of "families" of diseases. The ICD-10
it is a basic list of 3-character categories, each of which can be
divided into 10 categories, of 4 characters.

ICD-10 is used to code morbidity (diseases, injuries and

trauma and other reasons for consultation) and mortality (death from all types of
causes). The international classification of diseases and related problems
with the health tenth revision (ICD-10), comprises 3 volumes:

Volume 1 contains the main classifications (diagnoses, symptoms,

abnormal laboratory findings, trauma and poisoning, causes
external morbidity and mortality, and factors that influence health status.

Volume 2 is a manual that provides guidance to users. And volume 3

it is the alphabetical index that helps identify the correct code when one is
coding. Correctly coding using the ICD-10 is easier if you have
with the 3 volumes.
First, the term that contains the most information related to the diagnosis is sought.
to be coded in volume 3, which is organized alphabetically and then
confirm the preselected code in the list of 4 characters from volume 1; and
Any questions can be resolved by reviewing volume 2.
ICD-10 coding.

Codes

I A00-B99 Certain infectious and parasitic diseases

II C00-D48 Neoplasms

III Blood diseases and organ diseases

D50-D89 hematopoietic and other disorders that affect the
mechanism of immunity

IV E00-E90 Endocrine, nutritional, and metabolic diseases

V F00-F99 Mental and behavioral disorders

VI G00-G99 Diseases of the nervous system

VII H00-H59 Eye diseases and their annexes

VIII H60-H95 Ear diseases and mastoid process diseases

IX I00-I99 Diseases of the circulatory system

X J00-J99 Respiratory system diseases

XI K00-K93 Diseases of the digestive system

XII L00-L99 Diseases of the skin and subcutaneous tissue

XIII Diseases of the osteomuscular system and tissue

M00-M99
connector

XIV N00-N99 Diseases of the genitourinary system

XV O00-O99 Pregnancy, childbirth, and postpartum

XVI P00-P96 Certain conditions arising in the perinatal period

 seventeen Congenital malformations, deformities, and anomalies
Q00-Q99
chromosomal

Eighteen Symptoms, signs, and abnormal clinical findings and

R00-R99
laboratory, not classified elsewhere

XIX Traumas, poisoning, and some others

S00-T98
consequences of external cause

XX V01-Y98 External causes of morbidity and mortality

XXI Factors that influence health status and contact with

Z00-Z99
health services

XXII U00-U99 Codes for special situations

Description of Chapter V.
Mental and Behavioral Disorders
In the 10th revision of the ICD, substantial changes were made to the
Chapter V regarding the previous classification:

The number of available categories for classification has increased.

of an alphanumeric classification system of codes consisting of a letter followed by
of two numbers, which complete the level of three characters.

From 30 categories of 3 numbers, chapter V moved on to 100 categories that do not

they are all used to allow for the introduction of changes without the need to
redesign the entire system.

The main categories range from F00 to F99 and describe the
different mental disorders grouped based on very practical criteria.
The main categories are grouped as follows:
F00 -F09. Organic mental disorders, including symptomatic ones.

F10 - F19. Mental and behavioral disorders due to the use of

psychotropic substances.
F20 - F29. Schizophrenia, schizotypal disorder, and other thought disorders
delirious.
 F30 - F39. Mood disorders (affective).

F40-F49. Neurotic disorders, secondary to stressful situations and

somatomorphs.
F50-F59. Disorders of behavior associated with dysfunctions
physiological.
F60-F69. Personality and behavior disorders of adulthood.
F70 -F79. Mental Retardation.

F80 - F89. Psychological development disorders.

F90-F98. Disorders of behavior and emotions starting

habitual in childhood and adolescence.
F99. Mental disorders without specification.
ICD 11.

The World Health Organization has revised the International Classification of

Diseases (ICD) towards ICD-11. Its development has taken place in a space
internet-based work that is still used as a platform for
maintenance for debates and proposals for updating the ICD. Anyone
you can present a proposal based on evidence. Proposals are processed from
in an open and transparent manner with reviews of scientific evidence, as well as
usability and utility in the various uses of the CIE. It is anticipated that there will be no
need for national modifications of the ICD-11, due to its richness and
flexibility in the details that must be notified.

The final version of the ICD-11 system is to be presented to the World Assembly
the Health of the WHO. (WHA) for its official approval in 2019.4 The version for the
implementation (preparation of the approval at the WHA) is published on June 18
from 2018.4

The ICD-11 comes with an implementation package that includes transition tables.
from and to the ICD-10, a translation tool, a tool for
coding, web services, a manual, training material and more [2]. It can be
access all tools after self-registering from the platform
for maintenance.

The official version can be consulted at icd.who.int. A translation into Spanish is

almost finished (June 2018). Around 300 specialists from 55 countries,
organized into 30 main working groups, have contributed their input to
scientifically update the ICD-11, and the structural problems have been resolved
that were revealed by the use of the ICD-10.
ICD-11 is much easier to use than ICD-10. Its ontological infrastructure
it allows for better user orientation compared to the ICD-10.

The systematic dependence on the use of combinations of codes and codes of

extension makes the ICD finally clinically relevant. With the
combinations can encode any condition down to the level of detail
desired. Now primary care, cancer coding,
traditional medicine (currently module 1: ancient Chinese medicine - China, Korea
and Japan) and a section for the evaluation of the operation. The versions
specialized in mental health, primary care, or dermatology
They are produced from the common nucleus, the foundation.

ICD-11 is truly multilingual. ICD-10 exists in 43 languages in

Electronic versions and the ICD-11 already have 15 translations in progress. The tools
produce all files and formats from the main translation tool
on the maintenance platform. For the authorization of the translations, the
Requests should be addressed to the WHO.

The ICD-11 is ready for digital health (formerly cyber health) due to the use of
Uniform resource identifiers and their ontological base. The system allows for the
connection of any software through a standard API. The same package
It is also ready for offline use.

The ICD-11 is based on the electronic base component that contains everything
content, structural information, references, and descriptors in a readable format
by machine. Next, the content is rendered for mechanical use or
human, in electronic or printed form.

In the ICD-11, each disease entity has a description that provides

key descriptions and guidance on what the meaning of the entity/category is
in human-readable terms, to guide users. It is about a
advance with respect to the ICD-10, which only had titles of property. The
Definitions have a standard structure according to a template with
standard definition templates and other features exemplified in a 'Model'
of Content
The main innovations proposed by the WHO for the ICD-11 are:
1. Use standardized content for each disease that includes: Name,
concise and understandable definition, bodily location, temporality, severity
etiology, disability, diagnostic criteria, and treatment.
2. Coding software for electronic health records.
3. Internet-based platform continuously updated and supervised by
experts.
4. The ICD-11 will not be translated from English but constructed simultaneously in the
six official languages of the United Nations (English, French,
Spanish, Russian, Chinese, and Arabic) with expert verification of equivalence
linguistics.
5. Align the ICD with the ICF while maintaining the structure of the ICD, but giving
priority to the terms of the CIF in case of duplication.

6. Give the extension codes their own chapter by incorporating and optimizing
the dagger and asterisk codes.
Clinical case.
The patient is a thirty-year-old married truck driver.
Reason for consultation: The patient was admitted to a psychiatric clinic because they felt
that a mafia group was pursuing him and wanted to kill him. He couldn't explain why.
They would have to kill, but he had been hearing voices of people he suspected.
they were drug traffickers and they discussed how to catch him and kill him.
I had previously had encounters with traffickers because for years I had
consumed methamphetamine. At 25, one of his peers convinced him that
try this drug. After an intravenous injection of 20 mg, it began to
feeling good, had the sensation of feeling all-powerful and his dream and fatigue
they disappeared. After using methamphetamine a few times, he realized
I couldn't stop consuming it. I constantly thought about how
to obtain it and began to increase the doses. When I couldn't obtain
Methamphetamine made him feel lethargic and sleepy, and he became irritable and dysphoric. His
his wife realized that he was using drugs and tried to persuade him to stop them.
he would leave because cohabitation was becoming difficult and he was becoming a hindrance to her
and his children. Two months before the admission, he had lost his job for having
behaved aggressively towards his classmates, claiming that they had
interfered with his work and tried to harm him. Lacking the means, he had to
reduce the daily injectable consumption of methamphetamine to only some occasions and
he finally left her completely after his wife threatened to leave with her.
children and divorce. After quitting drugs, he began to feel very tired,
gloomy, and often sat in a chair doing nothing. A few weeks later
Later, he told his wife that he didn't dare to leave the house because he had heard
Traffickers talk about him on the street, I heard them say how they would get rid of a person
useless. At the same time, he appeared tense and apprehensive.
I wanted them to close all the doors and windows, and I refused to eat because
He was afraid that his food was poisoned. His wife took him to a
clinical doctor who referred him to a psychiatric hospital.

Background: The patient is the younger of two male siblings. His father was
storekeeper. In school he was a good student, and upon finishing secondary school he had several
jobs as unskilled laborers. At 21, he married a woman of his age.
she worked as a waitress in a restaurant. They moved to another city where
he got a job as a truck driver. They had three children and lived in an apartment.
small. His standard of living was quite poor. The patient's somatic health had
she had been good in the past, but in recent years she had complained of weakness
muscle and difficulty walking. These problems started after
start consuming injectable methamphetamine, but did not want to consult a doctor.
Current data: Upon examination, the patient appeared reluctant and withdrawn and only
he gave short answers to the questions. He seemed to have a neutral mood.
but he admitted that he felt hunted by a gang of drug traffickers and that
sometimes I heard them talk about him, whom they referred to in the third person. He was lucid,
globally oriented and showed no impairment in his cognitive functions. The
physical examination, including neurological assessment, revealed no abnormalities beyond the
needle marks on his left arm as a result of the injections of
methamphetamine. The EEG was normal. He was treated with 6 mg of haloperidol per day.
After two weeks the symptoms disappeared and he was discharged. No
returned for his control treatment.

Discussion: This patient presents symptoms of a schizophrenic type, which are

they developed a few weeks after interrupting a long and constant consumption
methamphetamine abuse. The onset of psychotic disturbances seems to
related to substance abuse and does not appear to be caused by anything else
mental disorder. Therefore, it meets the criteria for a psychotic disorder of
late onset due to methamphetamine use (F15.75). The patient also
seems to respond to the criteria for methamphetamine dependence syndrome with
lack of ability to control oneself, and withdrawal symptoms for a period
more than a month.
F15.75 Late-onset psychotic disorder, due to substance use
methamphetamine.
with subsidiary diagnosis of
F15.2 Methamphetamine use dependence syndrome.
 Conclusions.

The CIE has undergone various modification processes to facilitate the

diagnostic work of health professionals.
The ICD is a manual created to classify and determine the causes
of morbidity in children.
The ICD uses codes to identify each of the conditions.
registered in it.
ICD 10 uses chapter five to describe and classify all the
mental disorders.
The CIE did not have significant changes until review 9, in which it was agreed
use the manual for all health-related specialties.
The ICD-10 used codes F00-F99 to classify mental disorders.
The WHO agreed that revisions and changes to the manual would be made every
10 years to keep the manual updated.
Currently, the ICD 11 is in the process of publication and brings with it changes.
important for the use of diagnostic manuals.
Diagnostic manuals like the ICD are an important tool for
the performance of clinical diagnoses, however, should not be considered
as absolute truths.
 Bibliographic references.
International Statistical Classification of Diseases and Related Health Problems
with health. Tenth revision (ICD-10), volumes 1, 2, and 3. (2003). Journal
Spanish Journal of Public Health, 77(5), 661-661. doi: 10.1590/s1135-
57272003000500015
Pan American Health Organization. (1995). Statistical Classification
International Journal of Diseases and Health-Related Problems Vol.
2(pp. 144-165). United States.