![]() ![]() ![]() For that reason, we have omitted any reference to the ICD-11 PD model that predates 2018. Given this dramatic shift in practice and research, we take the opportunity in this article to inform and describe the nature of this profound and paradigmatic change to a diagnostic system of personality disorder marked by the concepts of severity and trait domains, and highlight challenges and opportunities that arise in the discussion and implementation of these changes.īefore moving on, we would like to make two essential clarifications: First, the present paper exclusively relies on the now official ICD-11 PD model, which eventually was modified per 2018 in response to WHO’s dialogues with the European Society for the Study of Personality Disorders (ESSPD), the North American Society for the Study of Personality Disorders (NASSPD), and the International Society for the Study of Personality Disroders (ISSPD). Finally, with the purpose of facilitating the identification of individuals who may respond to evidence-based treatments according to international and national guidelines, a Borderline Pattern specifier has been included, which is based on the DSM-5 Borderline PD diagnostic criteria. These trait domains are: Negative Affectivity, Detachment, Dissociality, Disinhibition, Anankastia. In order to further characterize individual features, the practitioner also has the option to specify one or more trait domain specifier that contribute to the individual expression of personality dysfunction. ![]() Alternatively, the user can assign a sub-threshold Personality Difficulty code (comparable to ICD-10 Z73.1 accentuated personality traits). Instead of diagnosing PDs according to familiar categorical types, the practitioner must now focus on general impairments of self- and interpersonal functioning, which can be classified according to their overall severity (i.e., Mild Personality Disorder, Moderate Personality Disorder, Severe Personality Disorder). While many diagnoses remain largely unchanged, a fundamentally different approach to classification of personality disorders (PD) is introduced in ICD-11. This migration is particularly pertinent for European countries, which have been designated to be the first in this enterprise, starting from January 2022. It is our hope that these questions will stimulate further research and discussion among researchers and clinicians in the coming years.Īll WHO member countries are expected to migrate from the ICD-10 to the ICD-11 Classification of Mental Disorders, which will be used for coding purposes, national statistics, and billing for health insurance companies. ![]() The anticipated challenges and opportunities are put forward in terms of specific unanswered questions. The advent of the ICD-11 PD classification involves major changes for health care workers, researchers, administrators, and service providers as well as patients and families involved. We discuss the perceived challenges and opportunities of using the ICD-11 approach with particular focus on its continuity and discontinuity with familiar PD categories such as avoidant PD and narcissistic PD. The present paper provides an overview of this new ICD-11 model including PD severity classification, trait domain specifiers, and the additional borderline pattern specifier. ICD-11 is expected to be implemented first in European countries before other WHO member states. The 11th revision of the World Health Organization (WHO) International Classification of Diseases (ICD-11) includes a fundamentally new approach to Personality Disorders (PD). ![]()
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