The impact of proposed changes to ICD-11 on estimates of PTSD prevalence and comorbidity

PSYCHIATRY RESEARCH

卷:240

Article

Wisco, Blair E.¹  Miller, Mark W.²  Wolf, Erika J.²  Kilpatrick, Dean³  Resnick, Heidi S.³  Badour, Christal L.^3,7  Marx, Brian P.²  Keane, Terence M.²  Rosen, Raymond C.⁴  Friedman, Matthew J.^5,6 

[1] Univ N Carolina, UNCG Psychol, Dept Psychol, POB 26170, Greensboro, NC 27402 USA

[2] Boston Univ, Sch Med, Dept Psychiat, Natl Ctr PTSD,VA Boston Healthcare Syst, 150 South Huntington Ave, Boston, MA 02130 USA

[3] Med Univ S Carolina, Dept Psychiat & Behav Sci, 67 President Stress,MSC 861, Charleston, SC 29425 USA

[4] New England Res Inst, 480 Pleasant St, Watertown, MA 02472 USA

[5] VA Natl Ctr PTSD, Geisel Sch Med Dartmouth, Natl Ctr PTSD, VA Med Ctr 116D,Dept Psychiat, 215 North Main St, White River Jct, VT 05009 USA

[6] VA Natl Ctr PTSD, Geisel Sch Med Dartmouth, Natl Ctr PTSD, VA Med Ctr 116D,Dept Pharmacol & Toxicol, 215 North Main St, White River Jct, VT 05009 USA

[7] Univ Kentucky, Dept Psychol, 106-B Kastle Hall, Lexington, KY 40506 USA

关键词: PTSD;    Trauma;    DSM-5;    ICD-11;    Diagnosis;    Diagnostic criteria;   

DOI  :  10.1016/j.psychres.2016.04.043

来源: Elsevier

【 摘 要 】

The World Health Organization's posttraumatic stress disorder (PTSD) work group has published a proposal for the forthcoming edition of the International Classification of Diseases (ICD-11) that would yield a very different diagnosis relative to DSM-5. This study examined the impact of the proposed ICD-11 changes on PTSD prevalence relative to the ICD-10 and DSM-5 definitions and also evaluated the extent to which these changes would accomplish the stated aim of reducing the comorbidity associated with PTSD. Diagnostic prevalence estimates were compared using a U.S. national community sample and two U.S. Department of Veterans Affairs clinical samples. The ICD-11 definition yielded prevalence estimates 10-30% lower than DSM-5 and 25% and 50% lower than ICD-10 with no reduction in the prevalence of common comorbidities. Findings suggest that by constraining the diagnosis to a narrower set of symptoms, the proposed ICD-11 criteria set would substantially reduce the number of individuals with the disorder. These findings raise doubt about the extent to which the ICD-11 proposal would achieve the aim of reducing comorbidity associated with PTSD and highlight the public health and policy implications of such a redefinition. Published by Elsevier Ireland Ltd.

【 授权许可】

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