Domschke Katharina, Zwanzger Peter
Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstraße 5, 79104, Freiburg, Deutschland.
Fachbereich Psychosomatische Medizin, Kompetenzschwerpunkt Angst, kbo-Inn-Salzach-Klinikum, Wasserburg am Inn, Deutschland.
Nervenarzt. 2025 Jun 26. doi: 10.1007/s00115-025-01841-7.
With the introduction of the 11th revision of the World Health Organization International Statistical Classification of Diseases and Related Health Problems (ICD-11), structural and content-related adjustments to the diagnostic guidelines for anxiety disorders were made, which are presented in this review article. Previously classified as "phobic disorders" and "other anxiety disorders" within the group "neurotic, stress-related, and somatoform disorders", in ICD-11 "anxiety- or fear-related disorders" now constitute a separate group. The core diagnoses of agoraphobia, social anxiety disorder, specific phobia, panic disorder and generalized anxiety disorder are retained, with the modification that agoraphobia and panic disorder can now be diagnosed separately and comorbidly. Within the framework of the lifespan perspective, separation anxiety disorder and selective mutism have been moved to the group "anxiety- or fear-related disorders". The diagnosis "mixed anxiety and depressive disorder" is now classified as "mixed depressive and anxiety disorder" in the group "affective disorders". In accordance with the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM‑5), it is possible to code isolated panic attacks in addition to other mental or somatic disorders. Overall, ICD-11 follows the DSM‑5 classification of anxiety- and fear-related disorders in many respects. Furthermore, the omission of subcategorizations and a precise minimum number of required symptoms simplify the diagnostic criteria. Future studies will need to address questions regarding the diagnostic accuracy, clinical practicability and further operationalization of the ICD-11 diagnostic criteria for anxiety- or fear-related disorders.
随着世界卫生组织《国际疾病分类及相关健康问题统计分类》（ICD - 11）第11次修订版的推出，焦虑症诊断指南在结构和内容方面进行了调整，本文将对此进行阐述。在ICD - 11中，焦虑或恐惧相关障碍现在构成一个单独的类别，而此前在“神经症、应激相关及躯体形式障碍”组中被归类为“恐惧症”和“其他焦虑症”。广场恐惧症、社交焦虑症、特定恐惧症、惊恐障碍和广泛性焦虑症的核心诊断得以保留，但有所修改的是，广场恐惧症和惊恐障碍现在可以单独诊断，也可以合并诊断。从生命周期的角度来看，分离焦虑症和选择性缄默症已被归入“焦虑或恐惧相关障碍”组。“混合性焦虑和抑郁障碍”这一诊断现在在“情感障碍”组中被归类为“混合性抑郁和焦虑障碍”。根据《精神障碍诊断与统计手册》（DSM - 5）第5版，除了其他精神或躯体障碍外，孤立性惊恐发作也可以进行编码。总体而言，ICD - 11在许多方面遵循了DSM - 5对焦虑和恐惧相关障碍的分类。此外，子分类的省略以及所需症状的精确最小数量简化了诊断标准。未来的研究需要解决有关ICD - 11焦虑或恐惧相关障碍诊断标准的诊断准确性、临床实用性以及进一步可操作性的问题。
