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

Blair E. Wisco, Mark W. Miller, Erika J. Wolf, Dean Kilpatrick, Heidi S. Resnick, Christal L. Badour, Brian P. Marx, Terence M. Keane, Raymond C. Rosen, Matthew J. Friedman

Research output: Contribution to journalArticlepeer-review

60 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)226-233
Number of pages8
JournalPsychiatry Research
Volume240
DOIs
StatePublished - Jun 30 2016

Bibliographical note

Publisher Copyright:
© 2016.

Keywords

  • DSM-5
  • Diagnosis
  • Diagnostic criteria
  • ICD-11
  • PTSD
  • Trauma

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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