Comparison of ICD 11 vs ICD 10 from Psychiatric Disorders Perspective

This video provides a brief overview of the changes from ICD-10 to ICD-11 regarding the classification of mental, behavioral, or neurodevelopmental disorders. These changes include a new chapter structure, new diagnostic categories, changes in diagnostic criteria, and steps towards dimensionality.

The ICD-11 Mental, Behavioral or Neurodevelopmental Disorders (MBND) chapter contains 21 disorder groupings compared with 11 disorder groupings in ICD-10

The introduction of new diagnostic categories, there were also changes in the diagnostic criteria for previously existing diagnoses. For example, the diagnostic threshold for Post-Traumatic Stress Disorder (PTSD) was raised in ICD-11 by defining three core symptoms that should be present in all cases: re-experiencing the traumatic event as vivid intrusive memories, flashbacks, or nightmares; avoidance of thoughts and memories of the event, situations or people reminiscent of the event; persistent perceptions of heightened current threat. There is some evidence indicating that the prevalence of ICD-11 PTSD is lower than the prevalence of ICD-10 PTSD

For ICD-11 , the categorical approach of ICD-10 was largely maintained. Yet, dimensional expansions regarding severity, course, and specific symptoms were added for some diagnoses. These dimensional expansions of categorical diagnoses mirror clinical practice, in which dimensional information (eg, severity of illness) is regularly taken into consideration for selecting treatments. 19 A large shift towards dimensionality concerned personality disorders. The different personality disorders in ICD-10 were replaced with a single personality disorder diagnosis in ICD-11 which is characterized by problems in functioning of aspects of the self (eg, identity) and/or interpersonal dysfunction (eg, managing conflict in relationships). The ICD-11 personality disorder diagnosis is further differentiated according to severity into mild, moderate, and severe. The diagnosis may optionally be specified by the presence of one or multiple maladaptive personality traits: Negative affectivity, detachment, dissociality, disinhibition, anankastia and Borderline pattern. Whereas a different, more complex, dimensional approach to personality disorders was deemed as not feasible in the development of DSM-5 there was a strong focus on clinical utility and simplicity in the revision of the personality disorders grouping in ICD-11

Another shift towards dimensionality concerned depressive episodes. In ICD-11 , depressive episodes in depressive or bipolar disorders may be described in detail by using qualifiers indicating the presence of specific symptoms: the melancholic features qualifier, the anxiety symptoms qualifier; the panic attacks qualifiers, and the seasonal pattern qualifier. Additionally, depressive episodes can be described according to severity (mild, moderate, or severe) and remission status (in partial or in full remission). For moderate and severe depressive episodes, the presence of psychotic symptoms may also be indicated

The development of the ICD-11 Mental, Behavioral or Neurodevelopmental Disorders (MBND) chapter was characterized by a focus on clinical utility, global applicability, and scientific validity. Thus far, mental health professionals’ evaluations of the ICD-11 are relatively positive. Changes from ICD-10 to ICD-11 include the introduction of new diagnoses, the refinement of diagnostic criteria of existing diagnoses, and notable steps in the direction of dimensionality for some diagnoses. However, there was no paradigm shift from ICD-10 to ICD-11 .

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