Reed Geoffrey M, First Michael B, Billieux Joël, Cloitre Marylene, Briken Peer, Achab Sophia, Brewin Chris R, King Daniel L, Kraus Shane W, Bryant Richard A
Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
New York State Psychiatric Institute, New York, NY, USA.
World Psychiatry. 2022 Jun;21(2):189-213. doi: 10.1002/wps.20960.
Among the important changes in the ICD-11 is the addition of 21 new mental disorders. New categories are typically proposed to: a) improve the usefulness of morbidity statistics; b) facilitate recognition of a clinically important but poorly classified mental disorder in order to provide appropriate management; and c) stimulate research into more effective treatments. Given the major implications for the field and for World Health Organization (WHO) member states, it is important to examine the impact of these new categories during the early phase of the ICD-11 implementation. This paper focuses on four disorders: complex post-traumatic stress disorder, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. These categories were selected because they have been the focus of considerable activity and/or controversy and because their inclusion in the ICD-11 represents a different decision than was made for the DSM-5. The lead authors invited experts on each of these disorders to provide insight into why it was considered important to add it to the ICD-11, implications for care of not having that diagnostic category, important controversies about adding the disorder, and a review of the evidence generated and other developments related to the category since the WHO signaled its intention to include it in the ICD-11. Each of the four diagnostic categories appears to describe a population with clinically important and distinctive features that had previously gone unrecognized as well as specific treatment needs that would otherwise likely go unmet. The introduction of these categories in the ICD-11 has been followed by a substantial expansion of research in each area, which has generally supported their validity and utility, and by a significant increase in the availability of appropriate services.
《国际疾病分类第 11 版》(ICD - 11)的重要变化之一是新增了 21 种精神障碍。通常提出新类别的目的在于:a)提高发病率统计的实用性;b)便于识别临床上重要但分类不佳的精神障碍,以便提供适当的管理;c)激发对更有效治疗方法的研究。鉴于这些新类别对该领域以及世界卫生组织(WHO)成员国具有重大影响,在 ICD - 11 实施的早期阶段审视其影响非常重要。本文重点关注四种障碍:复杂性创伤后应激障碍、持续性悲伤障碍、游戏障碍和强迫性行为障碍。选择这些类别是因为它们一直是大量活动和/或争议的焦点,并且它们被纳入 ICD - 11 代表了与《精神疾病诊断与统计手册第 5 版》(DSM - 5)不同的决定。主要作者邀请了每种障碍的专家,以深入了解为何将其添加到 ICD - 11 中被认为很重要、缺少该诊断类别对护理的影响、关于添加该障碍的重要争议,以及自 WHO 表示有意将其纳入 ICD - 11 以来与该类别相关的已产生证据和其他进展的综述。这四个诊断类别中的每一个似乎都描述了一群具有临床上重要且独特特征但此前未被认识到的人群,以及一些否则可能无法满足的特定治疗需求。在 ICD - 11 中引入这些类别之后,每个领域的研究都有了大幅扩展,这总体上支持了它们的有效性和实用性,同时适当服务的可及性也显著增加。