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Diagnosis and classification of disorders specifically associated with stress: proposals for ICD‐11 |
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| Authors: | Andreas Maercker Chris R Brewin Richard A Bryant Marylene Cloitre Mark van Ommeren Lynne M Jones Asma Humayan Ashraf Kagee Augusto E Llosa Cécile Rousseau Daya J Somasundaram Renato Souza Yuriko Suzuki Inka Weissbecker Simon C Wessely Michael B First Geoffrey M Reed |
| Institution: | 1. Department of Psychology, Division of Psychopathology, University of Zurich, , Switzerland;2. Department of Clinical, Educational and Health Psychology, University College London, , London, UK;3. School of Psychology, University of New South Wales, , Sydney, Australia;4. Division of Dissemination and Training, National Center for PTSD, , CA, USA;5. Department of Mental Health and Substance Abuse, World Health Organization, , Geneva, Switzerland;6. FXB Center for Health and Human Rights, Harvard School of Public Health, Harvard University, , Cambridge, MA, USA;7. Institute of Psychiatry, , Rawalpindi, Pakistan;8. Department of Psychology, Stellenbosch University, , Stellenbosch, South Africa;9. Epicentre, , Paris, France;10. Department of Psychiatry, McGill University Health Center, , Montréal, Canada;11. University of Jaffna, , Sri Lanka;12. Glenside Mental Health Services, , Glenside, South Australia, Australia;13. International Committee of the Red Cross, , Geneva, Switzerland;14. National Center of Neurology and Psychiatry, National Institute of Mental Health, , Tokyo, Japan;15. International Medical Corps, , Washington, DC, USA;16. Institute of Psychiatry, , London, UK;17. Department of Psychiatry, Columbia University Medical Center, , New York, NY, USA |
| Abstract: | The diagnostic concepts of post‐traumatic stress disorder (PTSD) and other disorders specifically associated with stress have been intensively discussed among neuro‐ and social scientists, clinicians, epidemiologists, public health planners and humanitarian aid workers around the world. PTSD and adjustment disorder are among the most widely used diagnoses in mental health care worldwide. This paper describes proposals that aim to maximize clinical utility for the classification and grouping of disorders specifically associated with stress in the forthcoming 11th revision of the International Classification of Diseases (ICD‐11). Proposals include a narrower concept for PTSD that does not allow the diagnosis to be made based entirely on non‐specific symptoms; a new complex PTSD category that comprises three clusters of intra‐ and interpersonal symptoms in addition to core PTSD symptoms; a new diagnosis of prolonged grief disorder, used to describe patients that undergo an intensely painful, disabling, and abnormally persistent response to bereavement; a major revision of “adjustment disorder” involving increased specification of symptoms; and a conceptualization of “acute stress reaction” as a normal phenomenon that still may require clinical intervention. These proposals were developed with specific considerations given to clinical utility and global applicability in both low‐ and high‐income countries. |
| Keywords: | Classification mental disorders ICD nosology PTSD complex PTSD prolonged grief disorder cultural appropriateness DSM |