ICD-10-Diagnosen in der psychotherapeutischen Praxis

An evaluation of the ICD-10 manual (Chapter V) reveals severe shortcomings of this diagnostic instrument concerning outdoor psychotherapy. It is well known that ICD diagnoses are restricted to symptoms and deficits of psychic functions; this restriction contradicts the definitions of psychic diseases as stated by the German “Psychotherapie – Richtlinien”. In Germany, third-party-payment is bound to therapies taking etological aspects into account. It doesn't make sense that the diagnostic system abandons any etiological foundation, making no difference between neurobiological, psychological and psycho-reactive factors fostering psychic diseases. The diagnostic principle of the co-morbidity impairs the therapist's diagnostic and therapeutic capacity to synthetize different phenomena to a common gestalt. Moreover, the new diagnostic category “personality disorder” is ill-defined and doesn't allow any conclusion of therapeutic relevance. The ICD-10 manual is maybe a suitable instrument in a research context, but its usefulness to promote quality assurance in outdoor psychotherapy is considerably restricted.