The classification of mental disorders in French speaking countries: the long and winding road to the rest of the world.

Background.- Up to a recent past, psychiatrists and other mental health professionals in French speaking countries have relied on concepts that had their origin in traditional French nosology. Aims.- To review the current status of traditional French nosology and the position of psychiatrists and other mental health professionals in French speaking countries on the Tenth Revision of the International Classification of Diseases (ICD-10) and the Text Revision of the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Method.- Literature review available up to August 2011. Results.- There has been a dramatic change in diagnostic practices among psychiatrists and other mental health professionals in French speaking countries during the past two decades. Up to the nineties, most French speaking psychiatrists relied on the French Classification of Mental Disorders, i.e. a classification that departed to a large extent from the International Classification of Diseases as well as from other national classifications. In 1994, the traditional French Classification was officially abandoned in favour of the ICD-10. At the same time, there has been an increasing reliance on the Diagnostic and Statistical Manual (from DSM-III to DSM-IV-TR), especially in research settings. Conclusions.- After having relied for more than a century on specific French concepts as well as on a national French classification of mental disorders, psychiatrists and other mental health professionals in French speaking countries have progressively but totally adopted international ways of classifying mental disorders as currently represented in ICD-10 and DSM-IV-TR.