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


  • Juan E Mezzich Mount Sinai School of Medicine, New York University
  • Angel A. Otero Chair, Section on Classification and Diagnostic Assessment, World Psychiatric Association; Professor of Psychiatry, Universidad de la Habana, La Habana, Cuba.
  • Javier E. Saavedra Chair, Section of Diagnosis and Classification, Latin American Psychiatric Association; Professor of Psychiatry, Universidad Peruana Cayetano Heredia; Director, Research and Education Office, “Instituto Nacional de Salud Mental Honorio Delgado – Hideyo Noguchi, Lima, Peru.
  • Ihsan M. Salloum Research Advisor, Section of Diagnosis and Classification, Latin American Psychiatric Association; Professor of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Flor-ida, USA.



Latin American Guide for Psychiatric Diagnosis, Latin American Psychiatric Association, Person-centered Integrative Diagnosis, Health Status, Health Contributing Factors, Health Experience and Expectations, Cuban Glossaries of Psychiatry,


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.

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.


Laín Entralgo, P. (1982). El Diagnóstico Médico. Barcelona: Salvat.

World Health Organization (1946) Constitution of the World Health Organization. Geneva: Author.

Miranda Sá, L. S. (1984). Psicopatologia e Propedêutica (pp.274-275). Rio de Janeiro: Livraria Atheneu.

Kendell R, Jablensky A (2003): Distinguishing between the validity and the utility of psychiatric diagnoses. American J Psychiatry 160: 4-12.

Schaffner KF. (2009) The validity of psychiatric diagnosis: Etiopathogenic and clinical approaches. In: Salloum IM, Mezzich JE (eds): Psychiatric Diagnosis: Challenges and Prospects. Wiley-Blackwell, Chichester, UK.

World Health Organization. (1992). International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10). Geneva: Author.

World Health Organization. (1992). The ICD-10 Classification of Mental and Behavioral Disorders: Clinical descriptions and diagnostic guidelines. Geneva: Author.

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th ed., (DSM-IV). Washington, D. C.: Author.

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5). Arlington, Virginia: Author.

Chinese Medical Association and Nanjin Medical University (1995). Chinese Classification of Mental Dis-orders, 2nd ed. revised. Nanjing, China: Dong Nan University Press.

Mezzich, J. E., Berganza, C. E., von Cranach, M., Jorge, M. R., Kastrup, M. C., Murthy, R. C., Okasha, A., Pull C., Sartorius, N., Skodol, A. E., & Zaudig, M. (2003). Essentials of the WPA International Guidelines for Diagnostic Assessment (IGDA). British Journal of Psychiatry, 182, Suppl. 45.

Salloum, I. M., & Mezzich, J. E. (2009). Psychiatric Diagnosis: Challenges and Prospects. Chichester, UK: Wiley-Blackwell.

Leme Lopes, J. (1954). As dimensôes do diagnóstico psiquiátrico. Rio de Janeiro: Agir.

Ramírez, E. (1989). Sistema Octogonal de Evaluación Psiquiátrica Technical Report. San Juan, Puerto Rico: Secretaría de Salud Mental.

Otero, A. A. (Ed.) (2000). Tercer Glosario Cubano de Psiquiatría (GC-3). La Habana: Hospital Psiquiátrico de La Habana.

Asociación Psiquiátrica de América Latina, Sección de Diagnóstico y Clasificación. (2004). Guía Latinoa-mericana de Diagnóstico Psiquiátrico. Guadalajara: Asociación Psiquiátrica de América Latina.

Adams N, Grieder DM (2005): Treatment Planning for Person-Centered Care. Amsterdam: Elsevier.

Mezzich, J. E., & Salloum, I. M. (2007). Towards innovative international classification and diagnostic sys-tems: ICD-11 and person-centered integrative diagnosis. Acta Psychiatrica Scandinavica, 116, 1–5.

Essen-Möller, E., & Wohlfahrt, S. (1947). Suggestions for the amendment of the official Swedish classification of mental disorders. Acta Psychiatrica Scandinavica, 47, 551.

Lecomte M., Damey A., Delage E., & Marty, P. (1947). Essai d´une statistique synoptique de médicine psychiatrique. Techniques Hospitalieres, 18, 5-8.

Bilikiewicz, T. (1951). Proba ukladu nozograficznegoetioepigenetycznego w psychiatrii. Neurologia i Neu-rochirurgia Polska 1, 68-78.

Mezzich, J. E. (1979). Patterns and issues in multiaxial psychiatric diagnosis. Psychological Medicine, 9, 125-137.

World Health Organization. (1997). Multiaxial Presentation of ICD-10 for Adults. Cambridge, U.K.: Cam-bridge University Press.

Chinese Society of Psychiatry (2001): Chinese Classification of Mental Disorders, Version 3 (CCMD-3). Jinan : Author.

Mezzich, J. E., Kleinman, A., Fabrega, H., & Parron, D. (1996). Culture and Psychiatric Diagnosis. A DSM-IV perspective. Washington D. C.: American Psychiatric Press.

Mezzich, J. E., & Good, B. J. (1997). On culturally enhancing the DSM-IV multiaxial formulation. In: T. A. Widiger, A. J. Frances, H. A. Pincus, R. Ross, M. B. First, W. Davis (eds.): DSM-IV Source Book (Volume 3). Washington, D.C.: American Psychiatric Press.

Orley, J., & Kuyken, W. (1994). The WHO Quality of Life Instrument. Geneva: World Health Organization.

Mezzich, J. E., Cohen, N. L., Ruipérez, M. A., Pérez, C., Yoon, G., Liu, J., & Mahmud, S. (2000). The Spanish version of the Quality of Life Index: Presentation and Validation. Journal of Nervous and Mental Disease, 138, 301-305.

Mezzich, J. E., Snaedal, J., van Weel, C., Heath, I. (2009). The International Network for Person-centered Medicine: Background and First Steps. World Medical Journal, 55, 104-107.

Mezzich, J. E., Salloum, I. M., Cloninger, C. R., Salvador-Carulla, L., Kirmayer, L., Banzato, C. E., Wall-craft, J., & Botbol, M. (2010). Person-centered Integrative Diagnosis: Conceptual Bases and Structural Model. Canadian Journal of Psychiatry, 55, 701-708.

Salloum IM, Mezzich JE (2011): Conceptual appraisal of the Person-centered Integrative Diagnosis Model. International Journal of Person Centered Medicine, 1: 39-42.

Asociación Psiquiátrica de América Latina, Sección de Diagnóstico y Clasificación. (2012). Guía Latinoa-mericana de Diagnóstico Psiquiátrico, Version revisada (GLADP-VR). Lima: Asociación Psiquiátrica de América Latina.

Seyer J (2012). Development of the Health Improvement Card developed by the World Health Professions Alliance. Paper presented at the 5th Geneva Conference on Person-centered Medicine. International College of Person Centered Medicine, May 2012.

Mezzich, J.E., Caracci, G., Fabrega, H. & Kirmayer, L.J. (2009). Cultural Formulation Guidelines. Transcul-tural Psychiatry 46, 383-405.

Kirmayer, L.J., Thombs, B.D., Jurcik, T., Jarvis, G.E. & Guzder, J. (2008). Use of an expanded version of the DSM-IV outline for cultural formulation on a cultural consultation service. Psychiatric Services, 59, 683-686.

Fulford, K.W.M. (1999). Moral Theory and Medical Practice. Cambridge: Cambridge University Press.

Fulford, K.W.M., Christodoulou, G.N. & Stein, D.J. (2011). Values and ethics: Perspectives on psychiatry for the person. International Journal of Person Centered Medicine 1, 131-133.

Mezzich, J. E. (2012b). Towards a Health Experience Formulation for Person-centered Integrative Diagno-sis. International Journal of Person Centered Medicine, 2, 188-192.





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