Rationale and Evidence

Terminology changes are informed by peer-reviewed psychiatric literature and expert clinical consensus within the project group, including consultation with relevant subject matter experts. Major international classification systems may be used for contextual alignment but are not treated as authoritative sources for content development. Sufficient evidence is defined as documented clinical expert consensus, supported where appropriate by peer-reviewed literature, established clinical usage, or alignment with recognised clinical guidance. The level of evidence required is applied proportionally to the scope and impact of the terminology change.

Rationale for change

• Clear explanation of why the change is needed

• Change type identified:

  • Editorial clarification

  • Clinical refinement

  • New concept or gap fill

  • Structural or modelling change

Clinical validation (required)

• Reviewed and agreed by at least one psychiatrist or designated clinical expert

• Confirmed as reflecting recognised clinical practice

• Clinical intent and expected use are clear

 Evidence recorded as: meeting notes, written comments, or review sign-off

Supporting evidence (one or more, as appropriate)

• Peer-reviewed literature, standard psychiatric text or clinical guidelines supports the concept

• Established clinical usage confirmed by expert experience or usage data

• Alignment checked against the major classifications (for context only)

 Note: Explicit citation of DSM or ICD is not required.

Proportionality check

Level of evidence is appropriate to the impact of the change:

• Level 1 Minor wording change → expert agreement sufficient

• Level 2 Clarification of meaning → expert agreement + light literature support

• Level 3 New or contentious concept → expert agreement + literature support

• Level 4 Structural change (hierarchy/model) → expert agreement + documented rationale

IP and governance considerations

• No external classification is presented as a source of truth

• Documentation language is neutral and classification-agnostic

Documentation completeness

• Descriptions are clear, concise, and clinically meaningful

• Synonyms reflect real-world usage

• Any assumptions, exclusions, or boundaries are stated where relevant