THE MULTIAXIAL SYSTEM OF ICD-10 - EVALUATION OF A PRELIMINARY DRAFT IN A MULTICENTRIC FIELD TRIAL

The multiaxial system (MAS) of ICD-10, chapter V (F) consists of three axes: axis I, clinical syndromes (psychiatric disorders including per sonality disorders and somatic diseases); axis II, disabilities; axis III, environmental/circumstantial and personal life-style/life managem ent factors. Results of a multicentric field trial evaluating a prelim inary draft of the MAS are presented. 45 raters in seven German center s made 488 ratings on 12 written case histories. With a mean kappa of 0.50 for 3-character diagnoses interrater reliability for axis I was m oderate although lower than expected from previous field trials. On ax is II the WHO Disability Diagnostic Scale (WHO-DDS) was compared to th e Global Assessment of Functioning (GAF) used in DSM-III-R and DSM-IV. For both scales the intraclass correlation coefficient showed a moder ate inter rater reliability (WHO-DDS = 0.62; GAF = 0.65). On axis III the number of relevant psychosocial circumstances coded by the differe nt raters varied greatly. Interrater reliability was very poor with ka ppa values ranging from 0.03 to 0.55 for the different categories and an overall kappa of 0.16.