The Revision of the Latin American Guide for Psychiatric Diagnosis (GLADP): a person centered approach to international classification

Abstract

The Latin American Guide for Psychiatric Diagnosis (GLADP) is a manual developed by the Section of Diagnosis and Classification of the Latin American Psychiatric Association (APAL) in 2004. The principles for the development of GLADP included the integration of cultural elements as well as particular aspect of each patient to the current nosological advances, by virtue of the uniqueness of the patients’ contexts and experience. This perspective requires assuming a person centered approach which is sustained by the following: the highly dependency of symptoms and the experience of illness on the social context; the prevention of forced categorizing patients into entities of the international classification; the restoration of the clinician-patient relationship that could have been lost by the mechanistic and atheorical approach of the diagnostic criteria; the opinion of professional user; the possibility to integrate more easily new nosological tendencies like person centeredness; the complexities of the psychopathological phenomena; and also the possibility to deal more effectively with derogatory connotations of stigmatizing terms. The GLADP integrates in its Integrative Diagnostic Formulation, the International Guidelines for Diagnostic Assessment (IGDA) of the World Psychiatric Association. The IGDA diagnostic model consists of two sections: a Standardized Diagnostic Formulation which contains 4 axes regarding clinical disorders, disabilities or functioning, contextual factors and quality of life; and an Idiographic Formulation which is a narrative approach that considers three sections jointly formulated by clinicians, patient and family. Having in mind the timetables of the international classifications, the work group of the GLADP has planned to publish a reviewed version of GLADP (GLADP-VR) by 2012, using the codes of the CIE-10, and including proposals in relation to the clinical syndromes and a new integrative model of person-centered diagnosis (PID). It is hoped that these inputs will serve as Latin American contributions to the new classifications and to the intension to publish the second edition of the GLADP in the 2014 in conjunction with ICD-11.