The GLADP-VR Person-centered Diagnostic Formulation: Back-ground, Concepts, and Structure

Main Article Content

Juan E Mezzich
Angel A. Otero
Javier E. Saavedra
Ihsan M. Salloum

Abstract

A Revised Version of the Latin American Guide of Psychiatric Diagnosis (GLADP-VR) has been recently published by the Latin American Psychiatric Association (APAL) through its Diagnostic and Classification Section, in collaboration with the World Psychiatric Association (WPA) Section on Classification and Diagnostic Assessment, the International College of Person-centered Medicine (ICPCM), and the Institute of Spanish Speaking Psychiatrists (IPLE). This development has been grounded progressively on pioneering Latin American contributions to the systematization of psychiatric diagnosis, the series of Cuban Glossaries as adaptations of the International Classification of Diseases to local realities and needs, the WPA International Guidelines for Diagnostic Assessment, the original version of the GLADP, the ICPCM Person-centered Diagnostic (PID) Model, and the support and participation of the national psychiatric societies of Latin America.The GLADP-VR person-centered diagnostic formulation uses ICD-10 categories and codes for illness description in a culturally-informed manner and is aimed at implementing a diagnosis of whole health and not only of diseases. Its informational domains involve the following levels: Health Status (from disorders and disability to well-being, all assessed with standard categories and dimensions), Health Contributing Factors (risk factors and protective factors formulated with categories and narratives), and Health Experience and Expectations  (formulated in a semi-structured and narrative manner). Completion of this diagnostic formulation is based on interactive engagement among clinicians, patients, and families. Formats for the GLADP-VR diagnostic formulation and accompanying clinical care plan are presented and illustrated with a clinical case.The GLADP-VR represents the first practical application of Person-centered Integrative Diagnosis (PID), employing culturally-annotated ICD-10 categories for use in a major region of the world. While the development of the GLADP-VR appears to have been well grounded conceptually and built on the experience of the regions' professional community, the task remains for the now published GLADP-VR to be empirically evaluated on its applicability and usefulness across Latin America and beyond.

Article Details

Section
Regular Articles
Author Biography

Juan E Mezzich, Mount Sinai School of Medicine, New York University

Born in Lima, Peru, of Yugoslavian and Peruvian ancestries. Medical graduate of Cayetano Heredia Peruvian University and president of the University Student Association.Psychiatric residency training, M.Sc. in Academic Psychiatry, and M.A. and Ph.D. in Mathematical and Statistical Psychology, all at Ohio State University, and diplomate of the American Board of Psychiatry and Neurology.Professorial positions in psychiatry, sequentially at Stanford University, California, the University of Pittsburgh, Pennsylvania, and the Mount Sinai School of Medicine, New York University.Doctor Honoris Causa at Athens University (Greece), Cordoba University (Argentina), Cayetano Heredia Peruvian University (Peru), and Cluj-Napoca University, Timisoara University and Oradea University (Romania). Honorary Professorships at Cayetano Heredia Peruvian University and University of Belgrade (Serbia), World Psychiatric Association Honorary Fellow, Simon Bolivar Award of the American Psychiatric Association, Past-President of the American Society of Hispanic Psychiatry, honorary member/fellow of several national psychiatric associations, and visiting professor and lecturer at academic institutions over 80 countries across all continents.Earlier academic and international work: Secretary & Chair (1983-1996) and Honorary Chair (2008-) of the WPA Section on Classification and Diagnostic Assessment; member of the ICD-10 Work Group and the DSM-IV Task Force; chair of the US National Institute of Mental Health Group on Culture, Diagnosis and Care; consultant on the development of the Chinese Classification of Mental Disorders (3rd Ed.), the Japanese Modification of ICD-10, the Third Cuban Glossary of Psychiatry, and the Latin American Guide for Psychiatric Diagnosis (GLADP); and director of the 1993-2003 WPA International Guidelines for Diagnostic Assessment (IGDA).Author/coauthor of over 280 scientific journal articles and book chapters (including sections on diagnosis,   epidemiology, and culture in Kaplan & Sadock's and Tasman et al’s Textbooks of Psychiatry), and of 26 books and monographs, including Images of Latin American Psychiatry (2013), Coercive Treatment in Psychiatry (2011), Conceptual Bases of Psychiatry for the Person (2011), Conceptual Explorations on Person-centered Medicine (2010), Psychiatric Diagnosis: Challenges and Prospects (2009), Cultural Formulation: A Reader for Psychiatric Diagnosis (2008), Psychiatry and Sexual Health: An Integrative Approach (2006), Philosophical & Methodological Bases of Psychiatric Diagnosis (2005), Guía Latinoamericana de Diagnóstico Psiquiátrico (GLADP) (APAL, 2004), WPA International Guidelines for Diagnostic Assessment (IGDA) (2003), Cultural Psychiatry: International Perspectives (2001), Culture and Psychiatric Diagnosis: A DSM-IV Perspective (1996), Psychiatric Epidemiology (1994). Editor, Psychopathology, (2002-2010), Deputy Editor-in-Chief (2010-2011) and Editor in Chief (2013-  ), Int’l J Person Centered Medicine,  and editorial board member of 15 other medical journals in the Americas, Europe, Asia, and Africa.WPA Secretary General (1996-2002), Vice-President and President-Elect (2002-2005), President (2005-2008), and Council Member (2008- ). President (2009-2013) and then Secetary General (2013- ) of the International Network , now International College, of Person-centered Medicine.Current Work: 1) Person-centered Psychiatry and Medicine: Organization of the 2008, 2009, 2010 and 2011 Geneva Conferences on Person-centered Medicine, and Conferences in London (2007), Paris (2008), and Uppsala (2008) on Psychiatry for the Person; thematic publication of several monographs and journal editorials & papers, and initiating the International Network for Person-centered Medicine in collaboration with the World Medical Association, the World Health Organization and 25 other international medical and health bodies, 2) International diagnostic systems, particularly ICD-11, Person-centered Integrative Diagnosis, and Latin American Guide for Psychiatric Diagnosis, through monographs, journal papers, and conferences, 3) Culture-informed clinical concepts and procedures, including the Cultural Formulation, the Personal Health Scale, the Multi-ethnic Bicultural Scale, and the Multicultural Quality of Life Index through publications, conferences and research projects.

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