Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders

doi:10.1002/wps.20611

. 2019 Feb;18(1):3-19.

doi: 10.1002/wps.20611.

Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders

Geoffrey M Reed^{1

2}, Michael B First^{2

3}, Cary S Kogan⁴, Steven E Hyman⁵, Oye Gureje⁶, Wolfgang Gaebel⁷, Mario Maj⁸, Dan J Stein⁹, Andreas Maercker¹⁰, Peter Tyrer¹¹, Angelica Claudino¹², Elena Garralda¹¹, Luis Salvador-Carulla¹³, Rajat Ray¹⁴, John B Saunders¹⁵, Tarun Dua¹, Vladimir Poznyak¹, María Elena Medina-Mora¹⁶, Kathleen M Pike², José L Ayuso-Mateos¹⁷, Shigenobu Kanba¹⁸, Jared W Keeley¹⁹, Brigitte Khoury²⁰, Valery N Krasnov²¹, Maya Kulygina²¹, Anne M Lovell²², Jair de Jesus Mari¹², Toshimasa Maruta²³, Chihiro Matsumoto²⁴, Tahilia J Rebello^{2

3}, Michael C Roberts²⁵, Rebeca Robles¹⁶, Pratap Sharan²⁶, Min Zhao²⁷, Assen Jablensky²⁸, Pichet Udomratn²⁹, Afarin Rahimi-Movaghar³⁰, Per-Anders Rydelius³¹, Sabine Bährer-Kohler³², Ann D Watts³³, Shekhar Saxena³⁴

Affiliations

¹ Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.
² Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.
³ New York State Psychiatric Institute, New York, NY, USA.
⁴ School of Psychology, University of Ottawa, Ottawa, ON, Canada.
⁵ Stanley Center for Psychiatric Research, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, MA, USA.
⁶ Department of Psychiatry, University of Ibadan, Ibadan, Nigeria.
⁷ Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
⁸ Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy.
⁹ Department of Psychiatry, University of Cape Town, and South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa.
¹⁰ Department of Psychology, University of Zurich, Zurich, Switzerland.
¹¹ Centre for Mental Health, Imperial College, London, UK.
¹² Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil.
¹³ Research School of Population Health, Australian National University, Canberra, ACT, Australia.
¹⁴ National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India.
¹⁵ Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, QLD, Australia.
¹⁶ National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
¹⁷ Department of Psychiatry, Universidad Autonoma de Madrid; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.
¹⁸ Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan.
¹⁹ Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
²⁰ Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon.
²¹ Moscow Research Institute of Psychiatry, National Medical Research Centre for Psychiatry and Narcology, Moscow, Russian Federation.
²² Institut National de la Santé et de la Recherche Médicale U988, Paris, France.
²³ Health Management Center, Seitoku University, Matsudo, Japan.
²⁴ Japanese Society of Psychiatry and Neurology, Tokyo, Japan.
²⁵ Office of Graduate Studies and Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA.
²⁶ Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
²⁷ Shanghai Mental Health Center and Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
²⁸ Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, WA, Australia.
²⁹ Department of Psychiatry, Prince of Songkla University, Hat Yai, Thailand.
³⁰ Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.
³¹ Department of Child and Adolescent Psychiatry, Karolinska Institute, Stockholm, Sweden.
³² International Federation of Social Workers, Basel, Switzerland.
³³ Entabeni Hospital, Durban, South Africa.
³⁴ Harvard T.H. Chan School of Public Health, Boston, MA, USA.

PMID: 30600616
PMCID: PMC6313247
DOI: 10.1002/wps.20611

Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders

Geoffrey M Reed et al. World Psychiatry. 2019 Feb.

. 2019 Feb;18(1):3-19.

doi: 10.1002/wps.20611.

Authors

Affiliations

¹ Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.
² Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.
³ New York State Psychiatric Institute, New York, NY, USA.
⁴ School of Psychology, University of Ottawa, Ottawa, ON, Canada.
⁵ Stanley Center for Psychiatric Research, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, MA, USA.
⁶ Department of Psychiatry, University of Ibadan, Ibadan, Nigeria.
⁷ Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
⁸ Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy.
⁹ Department of Psychiatry, University of Cape Town, and South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa.
¹⁰ Department of Psychology, University of Zurich, Zurich, Switzerland.
¹¹ Centre for Mental Health, Imperial College, London, UK.
¹² Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil.
¹³ Research School of Population Health, Australian National University, Canberra, ACT, Australia.
¹⁴ National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India.
¹⁵ Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, QLD, Australia.
¹⁶ National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
¹⁷ Department of Psychiatry, Universidad Autonoma de Madrid; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Instituto de Investigación Sanitaria La Princesa, Madrid, Spain.
¹⁸ Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan.
¹⁹ Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
²⁰ Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon.
²¹ Moscow Research Institute of Psychiatry, National Medical Research Centre for Psychiatry and Narcology, Moscow, Russian Federation.
²² Institut National de la Santé et de la Recherche Médicale U988, Paris, France.
²³ Health Management Center, Seitoku University, Matsudo, Japan.
²⁴ Japanese Society of Psychiatry and Neurology, Tokyo, Japan.
²⁵ Office of Graduate Studies and Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA.
²⁶ Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
²⁷ Shanghai Mental Health Center and Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
²⁸ Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, WA, Australia.
²⁹ Department of Psychiatry, Prince of Songkla University, Hat Yai, Thailand.
³⁰ Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.
³¹ Department of Child and Adolescent Psychiatry, Karolinska Institute, Stockholm, Sweden.
³² International Federation of Social Workers, Basel, Switzerland.
³³ Entabeni Hospital, Durban, South Africa.
³⁴ Harvard T.H. Chan School of Public Health, Boston, MA, USA.

PMID: 30600616
PMCID: PMC6313247
DOI: 10.1002/wps.20611

Abstract

Following approval of the ICD-11 by the World Health Assembly in May 2019, World Health Organization (WHO) member states will transition from the ICD-10 to the ICD-11, with reporting of health statistics based on the new system to begin on January 1, 2022. The WHO Department of Mental Health and Substance Abuse will publish Clinical Descriptions and Diagnostic Guidelines (CDDG) for ICD-11 Mental, Behavioural and Neurodevelopmental Disorders following ICD-11's approval. The development of the ICD-11 CDDG over the past decade, based on the principles of clinical utility and global applicability, has been the most broadly international, multilingual, multidisciplinary and participative revision process ever implemented for a classification of mental disorders. Innovations in the ICD-11 include the provision of consistent and systematically characterized information, the adoption of a lifespan approach, and culture-related guidance for each disorder. Dimensional approaches have been incorporated into the classification, particularly for personality disorders and primary psychotic disorders, in ways that are consistent with current evidence, are more compatible with recovery-based approaches, eliminate artificial comorbidity, and more effectively capture changes over time. Here we describe major changes to the structure of the ICD-11 classification of mental disorders as compared to the ICD-10, and the development of two new ICD-11 chapters relevant to mental health practice. We illustrate a set of new categories that have been added to the ICD-11 and present the rationale for their inclusion. Finally, we provide a description of the important changes that have been made in each ICD-11 disorder grouping. This information is intended to be useful for both clinicians and researchers in orienting themselves to the ICD-11 and in preparing for implementation in their own professional contexts.

Keywords: ICD-11; International Classification of Diseases; clinical utility; culture-related guidance; diagnosis; dimensional approaches; mental disorders.

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References

1. World Health Organization . ICD‐11 for mortality and morbidity statistics (ICD‐11 MMS) 2018 version. https://icd.who.int/browse11/l‐m/en.
1. World Health Organization . Classification of diseases (ICD). http://www.who.int/classifications/icd/en/.
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[1] World Health Organization . ICD‐11 for mortality and morbidity statistics (ICD‐11 MMS) 2018 version. https://icd.who.int/browse11/l‐m/en.

[2] World Health Organization . ICD‐11 for mortality and morbidity statistics (ICD‐11 MMS) 2018 version. https://icd.who.int/browse11/l‐m/en.

[3] World Health Organization . Classification of diseases (ICD). http://www.who.int/classifications/icd/en/.

[4] World Health Organization . Classification of diseases (ICD). http://www.who.int/classifications/icd/en/.

[5] Reed GM, Correia JM, Esparza P et al. The WPA‐WHO global survey of psychiatrists’ attitudes towards mental disorders classification. World Psychiatry 2011;10:118‐31. - PMC - PubMed

[6] Reed GM, Correia JM, Esparza P et al. The WPA‐WHO global survey of psychiatrists’ attitudes towards mental disorders classification. World Psychiatry 2011;10:118‐31. - PMC - PubMed

[7] World Health Organization . The ICD‐10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization, 1992.

[8] World Health Organization . The ICD‐10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization, 1992.

[9] First MB, Rebello TJ, Keeley JW et al. Do mental health professionals use diagnostic classifications the way we think they do? A global survey. World Psychiatry 2018;17:187‐95. - PMC - PubMed

[10] First MB, Rebello TJ, Keeley JW et al. Do mental health professionals use diagnostic classifications the way we think they do? A global survey. World Psychiatry 2018;17:187‐95. - PMC - PubMed

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Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders

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Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders

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