In most cases, such intrusive re-experiencing manifests as flashbacks or nightmares. A core symptom of PTSD is the re-experiencing of the aversive life event in vivid memories. Posttraumatic stress disorder (PTSD) may develop after experiencing an extremely distressing or life-threatening event or series of events, such as sexual abuse or a serious accident ( WHO, 2022). Furthermore, the diagnosis of an acute stress reaction was moved to the ICD-11 section ‘Factors influencing health status’, as such reactions are considered to be normal and are expected to be resolved within a short period after experiencing an aversive life event.įor this category, there was essentially a revision and tightening up of the previous definition. However, these proposals were not realized in the ICD-11. Regarding DSAS, the expert group also discussed the inclusion of diagnoses such as embitterment disorder, burnout, continuous trauma disorder, and a more pronounced relation to – or even inclusion of – dissociative disorders. As a consequence, the clinical utility and applicability of ICD-11 diagnoses was significantly improved. Furthermore, only symptoms with a particular sensitivity and specificity were implemented as diagnostic features. For this purpose, previous disorder subtypes were erased or limited (see Reed, 2010). Complementary to the frozen release of diagnostic features, the WHO published open access descriptions to implement future diagnostic changes 2.Īs a major aspect of all revisions, the complexity of mental disorder’s characteristics was reduced. For the CDDR, the WHO pursued an open access approach. More detailed clinical descriptions and diagnostic recommendations (CDDR) for individual disorders were developed. Between the start of the working group and the final implementation of the ICD-11, several evaluation steps were implemented: This composition of experts was chosen to ensure a global applicability of the diagnostic criteria for the new disorders in consideration.įor the proposed mental disorders of the ICD-11 and specifically for DSAS, a comprehensive clinical evaluation was conducted. First, Mark van Ommeren, Geoffrey Reed) and the International Committee of the Red Cross (Renato Souza). Jones, Ashraf Kagee), America (Marylene Cloitre, Cecile Rousseau), Asia and Australia (Asma Humayan, Daya Somasundaram, Yuriko Suzuki, Richard Bryant), and Europe (Chris Brewin, Andreas Maercker, Simon Wessely), as well as members from global organizations such as the WHO (Michael B. Researchers and clinicians with a broad global distribution took part in the working group for DSAS, from Africa (Lynne M. The advisory board of the WHO therefore expected the international working group on DSAS to further evaluate these stress-related phenomena. These preliminary mental health surveys concluded that there is a considerable need among health care professionals to create scientifically based diagnoses for stress-related phenomena like complex trauma and pathological grief reactions ( Robles et al., 2014). For instance, several global mental health surveys were conducted to assess the needs of psychologists and psychiatrists regarding mental health diagnoses ( Evans et al., 2013 Reed et al., 2011, 2013). For the development of the 11th revision of the ICD, the ICD-11, the WHO placed particular emphasis on improving the clinical utility and applicability of the diagnoses.įor DSAS, several methodological preparations for the general revision of the ICD-11 were particularly important. One of these working groups was commissioned to create the grouping of diagnoses specifically associated with stress (DSAS). Back in 2011, the WHO had appointed several international working groups for revising the section on mental disorders in the ICD-10. On 1 January 2022, the World Health Organization (WHO) introduced the 11th revision of this diagnostic system and set a new milestone in the classification of mental disorders. For almost 30 years, the 10th version of the International Classification of Diseases (ICD-10) was the standard in diagnosing physical diseases as well as mental disorders around the globe.
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