Marras Anna, Fineberg Naomi, Pallanti Stefano
1Department of Neuroscience,Psychology, Drug Research and Child Health,University of Florence,Florence,Italy.
2Highly Specialized Obsessive Compulsive and Related Disorders Service, Hertfordshire Partnership University NHS Foundation Trust,Welwyn Garden City,Hertfordshire,UK.
CNS Spectr. 2016 Aug;21(4):324-33. doi: 10.1017/S1092852916000110. Epub 2016 Jul 12.
Obsessive-compulsive disorder (OCD) has been recognized as mainly characterized by compulsivity rather than anxiety and, therefore, was removed from the anxiety disorders chapter and given its own in both the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Beta Draft Version of the 11th revision of the World Health Organization (WHO) International Classification of Diseases (ICD-11). This revised clustering is based on increasing evidence of common affected neurocircuits between disorders, differently from previous classification systems based on interrater agreement. In this article, we focus on the classification of obsessive-compulsive and related disorders (OCRDs), examining the differences in approach adopted by these 2 nosological systems, with particular attention to the proposed changes in the forthcoming ICD-11. At this stage, notable differences in the ICD classification are emerging from the previous revision, apparently converging toward a reformulation of OCRDs that is closer to the DSM-5.
强迫症（OCD）已被公认为主要以强迫行为而非焦虑为特征，因此，在美国精神病学协会（APA）的《精神疾病诊断与统计手册》（DSM-5）以及世界卫生组织（WHO）《国际疾病分类》第11版修订本的β草案版本中，它被从焦虑症章节中移除，并单独成章。这种修订后的分类基于越来越多的证据表明不同疾病之间存在共同受影响的神经回路，这与以往基于评定者间一致性的分类系统不同。在本文中，我们聚焦于强迫及相关障碍（OCRDs）的分类，审视这两种疾病分类系统所采用方法的差异，尤其关注即将发布的ICD-11中提出的变化。在现阶段，ICD分类与上一版相比出现了显著差异，显然正朝着更接近DSM-5的OCRDs重新表述方向发展。
