If you're not already aware, as of January 2022 the ICD-11 will start coming into practice. In this manual, individual diagnoses of personality disorders have been removed entirely, and replaced with a singular "Personality Disorder" specified by mild, moderate or severe. It then gives the option to specify trait domains of Anankastia, Dissociality, Detachment, Disinhibition and Negative Affectivity, as well as the option to specify a Borderline pattern.
Read more in-depth about how the model can be applied in a clinical setting. BMC Psychiatry.
Research article discussing the DSM-5 and the ICD-11. Research Gate.
An article discussing critiques of the new framework. Recovery in the Bin.
A comparison of the ICD-11 against the DSM-5. Comparison chart.
A further article for more information. Frontiers in Psychiatry.
What are your thoughts on this?
Do you prefer the new model and think it has potential or do you prefer the current system?
Do you think DSM-6 will adopt a similar framework?
Do you have any concerns about the ICD-11?
And if so, why? How can someone be trans without at least a significant enough discomfort/incongruence with one’s birth sex?
>Gender incongruence is characterised by a marked and persistent incongruence between an individual’s experienced gender and the assigned sex. Gender variant behaviour and preferences alone are not a basis for assigning the diagnoses in this group.
Here's the description. Honestly, I don't think it seems different, like at all, from the DSM gender dysphoria description:
>The DSM-5 defines gender dysphoria in adolescents and adults as a marked incongruence between one’s experienced/expressed gender and their assigned gender, lasting at least 6 months, as manifested by at least two of the following:
I'm not copying the full criteria, both because it's long and because there's nothing to compare it to, I couldn't find any actual criteria for gender incongruence, and I'm not familiar with the ICD, so it got confusing haha. If anyone knows anything about that, do share :)
It's also in "conditions of sexual health" rather than mental health, which I appreciate.
So, what do we think? Personally, I'm not mad. I don't think the actual condition is any different from the DSM gender dysphoria one that most people in this sub already go off.
The only thing that annoys me is how similar it actually is to gender dysphoria, because I support it and I don't want to make it even harder to explain what being truscum is (following gender dysphoria in one book and gender incongruence in the other, yknow).
Hello Everyone,
While I'm excited to see 6C21 included in the ICD-11 and go into effect January of next year - I can't help but to think...
What does this mean for those who suffer BID?
Being in the US, can I walk into the doctors and be officially diagnosed next year? I'm currently reading about the ICD10-PCS (Procedure Classification System) and wondering if enough are diagnosed under 6C21(ICD-11), could a treatment be developed (we all know what the treatment is... :P ) and included in the next iteration of the PCS? Wishful thinking I know, but we need to start somewhere and if there's enough data to suggest there are a ton of us out here - we could truly see progress towards treatment.
I found this from the ICD-11 which is preliminary. The site says it is a work in progress. https://biid.hw.ac.uk/resources/resources-for-professionals.html
I think this is a good summery about what BIID is all about. They left out the envy part that many of us feel. I have added the bolding within the sentences.
ICD-11 Definition
https://icd.who.int/dev11/l-m/en#/http://id.who.int/icd/entity/256572629
Characteristics of BIID
DISCLAIMER: THIS IS NOT A SET OF APPROVED DIAGNOSTIC CRITERIA
- Early-age Onset: BIID typically emerges at a very young age and is often repressed until adulthood at which point it can consume someone’s thoughts
- Overwhelming Desire: BIID typically presents itself as an intense feeling that can take over a person’s life causing difficulties in socializing and functioning in everyday life
- Dissociation of Limb or Sense: Rather than believing their extremity is ugly or deformed, people with BIID have reported that they instead believe it does not belong to their body (this also applies to senses) and can be described as feeling like ‘growing an extra limb’.
- Non-delusional: There are no associations between delusions and BIID. Typically, a person with BIID has no false beliefs regarding their desire to be disabled coming from an external force. It is an internal belief that they would be complete after achieving their desired body.
- Location of Desired Amputation Remains Consistent: In a case of BIID, a person can usually draw a line at the exact location of where their limb ends in their personal body map and this does not change. If this is not the case and the location changes, or a person doesn’t always want their extremity removed, there is a possibility for an alternative diagnosis such as schizophrenia.
- Self-amputation Behaviors: Often, people with BIID will have thought about or attempted a self-amputation/mutilation of the unwanted limb/sense. It is not uncommon for a person with BIID to purposefully damage their limb beyond repair in hopes of receiving a surgical removal.
- No Family History: There are no definite hereditary factors or increased likelihood if there is a family history of psychiatric disorders.
Right now Sweden uses ICD-10 to assign diagnoses to trans people. You need the "transsexualism" diagnosis to get a legal gender change/bottom surgery, but this diagnosis is for binary trans people. Nonbinary people generally get one of the other two diagnoses. Obviously this incredibly frustrating for nonbinary people who often need access to legal gender change/bottom surgery as well.
ICD-11 is coming by 1 Jan 2022 and brings a lot of promising changes. Among other things, the "transsexualism" diagnosis is gone and replaced by a "gender incongruence" diagnosis with more general language that does not exclude nonbinary people.
So it seems to me that, come next year, nonbinary people will no longer have to lie about their gender identity to access legal gender change and bottom surgery.
My question: Will this actually be true in practice? What changes are being planned to the process?
The ICD-11 is scrapping the current PD diagnoses in favour of a severity based classification with more of a focus on the non-pathological "personality difficulty" which apparently around 48% of the population have (i.e. some aspects of your life are negatively affected by personality traits but the dysfunction is not pervasive or severe). Heterogeneity is accounted for by specifying prominent trait qualifiers based on the Big Five personality traits- in the ICD these will be detachment, negative affect (i.e. neuroticism), anankastia, disinhibition and dissociality. However there is only one diagnosis - personality disorder.
The idea was to move away from the labels currently used which are pretty much solely based on clinical experience rather than psychological data, which is a fairly remarkable shift away from diagnostic reliability as has been the tradition of recent editions of the ICD and DSM to diagnostic validity.
Other reasons for this were because EUPD, PD NOS and dissocial PD account for the vast majority of diagnosed PDs, and because the current labels create the impression of discrete boundaries between the various PDs where none exists. Another change is that PDs can be diagnosed in adults, as the idea is that while underlying personality is fairly stable, personality disorder is not and can develop later in life due to adverse circumstances.
What are your thoughts on this?
We did it, we pathologized gaming AND managed to have our weird fetish reclassified as a "sexual health issue." The dawn of communism is upon us.
I don't know if anyone knew this already but I thought I'd share, just in case :)
It's interesting to note, for the upcoming ICD-11, they're putting less emphasis on first rank symptoms (like audiotry voices and thought broadcasting) due to "the lack of evidence for the specificity of these symptoms for schizophrenia and their debatable prognostic significance."
ICD-11 definition (proposed): "Schizophrenia is characterized by disturbances in multiple mental modalities, including thinking, perception, self-experience, cognition, volition, and affect."
———
Positive – includes delusions, hallucinations, experiences of passivity and control, disorganized behavior, and thinking.
Negative – covers a reduction or restriction in affect, speech, motivation, and social interactions.
Depressive/Manic – covers mood symptoms which do not meet the full requirement for a diagnosis of schizoaffective disorder. These dimensions reflect mood symptoms rather than mood syndromes (e.g., symptoms related to disruption of appetite and sleep).
Psychomotor symptoms – encompass a wide range of motor disturbances including increased activity in the form of purposeless behaviors such as fidgeting, stereotypy, wringing of hands and inability to sit; generalized slowing of speech and/or movements; and catatonia symptoms.
Cognitive impairment – includes deficits in processing speed, attention/concentration, orientation, judgment, and working memory. This would be best assessed through locally validated neuropsychological testing.
The diagnosis of schizophrenia will require the presence of at least two out of seven symptoms including at least one core symptom. Core symptoms include persistent delusion of any kind; distortion of self-experience (a.k.a. ipseity disturbance), for example, thought interference/thought withdrawal, passivity phenomena; persistent hallucination in any modality; and thought disorder.
———
So why's this so significant? By this guidelines you're not required to have an overt episode of psychosis to get diagnosed with schizophrenia anymore..! Understandings are developing.
This'll help to include more murky undifferentiated and hebephrenic (disorganized) types, and simple schizophrenics who mightn't had any lengthy episodes of positive symptoms yet exhibit many of the other declines and disturbances associated with schizophrenia (negative, cogntive, self-disorder, etc).
This might also further help treatment services to be aware of and focus on setting support for the more hidden or less "dramatic" aspect of th
... keep reading on reddit ➡Hey all, I got a Desk Reference copy of the DSM 5 last year and am kinda miffed that it has ICD 9 codes in bold (really) and ICD 10 codes in grey and parenthesis next to the 9. According to this: https://www.who.int/news-room/detail/18-06-2018-who-releases-new-international-classification-of-diseases-(icd-11) ICD 11 is coming into effect January 2022. So, as we approach that date, make sure the DSM you are buying has ICD 11 codes in it. That’s all, enjoy your day.
My mind is kind of blown after having gone down some rabbit holes.
There is a new revision of the icd (the international classification of diseases) coming out January 2022. The icd is like an international DSM. They put out a preview ahead of it's release in order to allow for preparation.
In this new revision personality disorders have been completed revamped. There are no longer separate categories. No NPD, no aspd. Just one diagnostic category called Personality Disorder.
Severity will be rated from from mild to severe and assigned what they call trait domains. There are five trait domains and one basically describes NPD without labeling it as such.
This resource has tables that list the domain traits and methods used to determine severity.
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-018-1908-3
I read the reasoning for this change was partially due to the co-morbidity issues in diagnosis.
General diagnostic requirements
● An enduring disturbance characterized by problems in functioning of aspects of the self (e.g., identity, self-worth, accuracy of self-view, self-direction), and/or interpersonal dysfunction (e.g., ability to develop and maintain close and mutually satisfying relationships, ability to understand others’ perspectives and to manage conflict in relationships). ● The disturbance is manifest in patterns of cognition, emotional experience, emotional expression, and behaviour that are maladaptive (e.g., inflexible or poorly regulated). ● The disturbance is manifest across a range of personal and social situations (i.e., is not limited to specific relationships or social roles), though it may be consistently evoked by particular types of circumstances but not others. ● The disturbance is associated with substantial distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning
https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-018-1908-3
.. essentially they’ve removed all the seperate categories, and have one overarching “PD” diagnosis, that then is further defined with reference to severity and the main symptoms.
I think it’s great. I think it’s less about labelling a person as “being” something, and more about describing what’s going on.
I think it recognises the complexity and individuality of humans, and I hope that it will help with stigma.
ICD-11 Beta Draft is the beta of the new International (US is included) Classification of Diseases that World Health Organization wants to publish in 2018. In other words from this slightly old article:
> The WHO believes you suffer from “Gaming Disorder” and wants to include that condition in the latest edition of its International Classification of Diseases, which is used along with the Diagnostic and Statistical Manual of Mental Disorder to treat mental illness. Both classifications are used in the United States.
It has a rather nasty thing for gamers and the industry alike in store - "Gaming disorder", that was put under "Disorders due to addictive behaviours". It has practically the same text as "Gambling disorder" with a few edits and the language of the proposal for it (see below) asks for several sorts of industry-restricting things. "Hazardous gaming" is also present - here. The last time you might have saw it is here.
Professor of psychology Chris Ferguson in two articles, linked below, states:
> For instance, in conversations with one administrator at the World Health Organization, who is considering including potential video game addiction diagnoses in their International Compendium of Diseases, he acknowledged that political pressure, from Asian countries in particular, was one factor.
> Ferguson says he has heard indirectly that some of the WHO's interest in gaming disorder stems from leaders in countries that want to see the behaviors pathologized so that people can be coerced into treatment.
Note, that ICD is international. The proposed gaming disorder has both offline and online types of gaming and refers to any variety of it (within the definition), no matter the country of origin or type. As you can understand, making gaming into an
... keep reading on reddit ➡> Dear Editor, > > The diagnostic criteria for posttraumatic stress disorder (PTSD) have been reformulated and narrowed for ICD-11 [1] to six core symptoms across the clusters re-experiencing, avoidance, and hyperarousal. In comparison, PTSD criteria in DSM-IV consist of sixteen symptoms across three clusters, in DSM-5 of twenty symptoms across four clusters, and in ICD-10 of thirteen symptoms across three clusters. > > The new ICD-11 diagnosis Complex PTSD (CPTSD) requires symptoms of PTSD and in addition disturbances of self-organization: affect dysregulation, negative self-concept, and interpersonal problems. Impairment represented in the disturbances of self-organization domains is not necessarily associated with trauma-related stimuli. CPTSD typically follows prolonged or multiple events, but diagnosis does not require a certain type and frequency of a traumatic event...
>. >. >In conclusion, the current findings indicate that the ICD-11 PTSD criteria are less sensitive than other diagnostic manuals and may not, therefore, identify all traumatized and impaired young people with high psychological distress. This might lead to restricted access to eligible treatment for some young people since ICD is mainly used in clinical practice. ICD-11 does not as yet provide developmentally sensitive adaptations or wording of PTSD and CPTSD criteria, and this topic needs to be discussed critically. Furthermore, differences between diagnostic manuals might lead to limited comparability of treatment studies and to reduced relevance of research for practitioners.
Eilers, R., Rimane, E., Vogel, A., Renneberg, B., Steil, R., & Rosner, R. (2019). The Impact of the New ICD-11 Criteria on Abused Young People: 30% Less PTSD and CPTSD Diagnoses Compared to DSM-IV. Psychotherapy and Psychosomatics, 1–3. doi:10.1159/000503794
Full text at https://sci-hub.tw/https://doi.org/10.1159/000503794
> “Gender incongruence… has also been moved out of mental disorders in the ICD, into sexual health conditions,” reads the WHO’s release on ICD-11, available on their website.
> The release continued, “The rationale being that while evidence is now clear that it is not a mental disorder, and indeed classifying it in this can cause enormous stigma for people who are transgender, there remain significant health care needs that can best be met if the condition is coded under the ICD.”
> The shift in listings from mental to sexual health — an entirely new category for the ICD — signals a change in how transgender people are treated: as a physical issue, not a mental one.
https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f585833559
It also requires fullfilling the diagnostic criteria for "standard" PTSD.
Now the issue is that many psych professionals already have a rather stereotypical view of flashbacks, but the description of "vivid intrusive memories, flashbacks, or nightmares" does not exactly help it, or may even officially disqualify emotional flashbacks.
I really don't know what to say about this
Do you think that this change undermines years of research to find out different forms of disorders?
There's an article about that: "Battle Breaks Out Over Effort to Classify Video Game Addiction as Mental Illness".
Basically, ICD-11 Beta Draft (see wiki; it's not final (well, beta), but continue reading (and before you ask - it's also used in USA with DSM (see the previous wiki link, end of the article))) has included "Gaming disorder" under "Disorders due to addictive behaviours" (also there's a "Hazardous gaming"). And there's an open letter against such a move: this. Full article is available, here are some quotes:
> The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents...
> Moral panics around the harm of video gaming might result in premature application of a clinical diagnosis and the treatment of abundant false-positive cases, especially among children and adolescents....
> The healthy majority of gamers will be affected by stigma and perhaps even changes in policy. We expect that inclusion of gaming disorder in ICD-11 will cause significant stigma to the millions of children and adolescents who play video games as part of a normal, healthy life. Raising concerns around the dangers of video gaming is known to add tension to the parent–child relationship, which exacerbates conflict in the family and can perpet
... keep reading on reddit ➡
