A LOT of countries don't have an own manual. Many go by ICD. Also many countries also take the DSM in count when they diagnose, even if they formally diagnose from ICD. That means, they will informally diagnose (outside USA) by DSM-IV, because it is a much easier tool to use, then formally use the ICD codes to put on your chart. How much influence DSM has in a certain country varies, but a lot of doctors world wide have a copy of the DSM in their office (Have a look).