Mental and behavioural disorders: what changed

Mental, behavioural and neurodevelopmental: what changed

The chapter on mental, behavioural and neurodevelopmental disorders changed in several ways. Here are the main differences from ICD-10, as set out in a WHO-authored review.

PTSD and complex PTSD

Post-traumatic stress disorder now requires three core features: re-experiencing in the present, avoidance of reminders, and a persistent sense of current threat. Complex PTSD is new. It follows prolonged or repeated severe stressors, and adds lasting problems with affect regulation, self-concept and relationships.

A severity rating, not ten types

Personality disorders changed from ten specific types to a dimensional rating of severity: mild, moderate or severe, based on difficulties in self and interpersonal functioning.

Gaming disorder is new

Gaming disorder is new, in a new grouping of disorders due to addictive behaviours that also includes gambling disorder. It is defined by impaired control over gaming, increasing priority given to it, and continuing despite negative consequences, normally evident for at least twelve months.

• Grouping · Addictive behaviours · A new grouping of disorders due to addictive behaviours, which also includes gambling disorder.
• Gaming disorder · New · Impaired control over gaming, increasing priority given to it, and continuing despite negative consequences. Normally evident for at least 12 months.

Gender incongruence moved

Gender incongruence moved. ICD-10 listed transsexualism and gender identity disorder of children among the mental and behavioural disorders. ICD-11 calls it gender incongruence and places it in the chapter on conditions related to sexual health. WHO's reason: these identities are not conditions of mental ill-health.

Names and groups changed too

Names and groups changed too. Intellectual developmental disorders replaces mental retardation. Autism spectrum disorder merges childhood autism and Asperger's syndrome. There is no separate childhood-onset grouping, and sleep-wake disorders and sexual health conditions have their own chapters.

• Names · Replaced · “Intellectual developmental disorders” replaces “mental retardation”. Autism spectrum disorder merges childhood autism and Asperger's syndrome.
• Groups · Rearranged · No separate childhood-onset grouping. Sleep-wake disorders and sexual health conditions have their own chapters.

Check yourself

Pause and think. Where is gender incongruence classified in ICD-11? The answer: Conditions related to sexual health. ICD-11 moved gender incongruence out of the mental disorders chapter into 'Conditions related to sexual health'.

• Mental, behavioural or neurodevelopmental disorders
• Conditions related to sexual health
• Endocrine disorders
• It is not classified

Keep these in mind

PTSD and complex PTSD are separate. Personality disorder is a severity rating, not ten types. Gaming disorder is new, and gender incongruence moved. And use WHO's clinical descriptions when diagnosing.

• PTSD and complex PTSD are separate
• Personality disorder: severity, not ten types
• Gaming disorder is new; gender incongruence moved
• Use WHO's clinical descriptions to diagnose