Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies

Abstract

An update of the chapter on Mental, Behavioral and Neurodevelopmental Disorders in the International Classification of Diseases and Related Health Problems (ICD) is of great interest around the world. The recent approval of the 11th Revision of the ICD (ICD-11) by the World Health Organization (WHO) raises broad questions about the status of nosology of mental disorders as a whole as well as more focused questions regarding changes to the diagnostic guidelines for specific conditions and the implications of these changes for practice and research. This Forum brings together a broad range of experts to reflect on key changes and controversies in the ICD-11 classification of mental disorders. Taken together, there is consensus that the WHO's focus on global applicability and clinical utility in developing the diagnostic guidelines for this chapter will maximize the likelihood that it will be adopted by mental health professionals and administrators. This focus is also expected to enhance the application of the guidelines in non-specialist settings and their usefulness for scaling up evidence-based interventions. The new mental disorders classification in ICD-11 and its accompanying diagnostic guidelines therefore represent an important, albeit iterative, advance for the field.

Keywords: Classification; Diagnosis; ICD-11; Mental disorder.

Fig. 1

Dan Stein. Dr. Dan J. Stein is Professor and Chair of the Dept of Psychiatry at the University of Cape Town, Director of the South African Medical Research Council’s Unit on Risk & Resilience in Mental Disorders, and Scientific Director of UCT’s Neuroscience Institute. His training includes doctoral degrees in both clinical neuroscience and philosophy, and a post-doctoral fellowship in psychopharmacology. He is a clinician-scientist-advocate whose work has long focused on anxiety and related disorders, including obsessive–compulsive spectrum conditions and post-traumatic stress disorder, as well as other issues relevant to the African context

Fig. 2

Geoffrey Reed. Dr. Geoffrey M. Reed has coordinated the development of ICD-11 classification of Mental, Behavioral or Neurodevelopmental Disorders in the Department of Mental Health and Substance Abuse, World Health Organization since 2008. He is Professor of Medical Psychology, Global Mental Health Programs, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons. He founded the WHO Global Clinical Practice Network (http://gcp.network), comprising more than 15,000 mental health and primary care professionals from 158 countries contributing directly to ICD-11 through participation in field studies

Fig. 3

Peter Szatmari. Dr. Szatmari is the Chief of the Child and Youth Mental Health Collaborative at the Hospital for Sick Children, the Centre for Addiction and Mental Health, and the University of Toronto in Toronto, Canada. He has worked in the area of autism spectrum disorders for many years focusing on diagnosis and classification, genetics, and follow-up studies

Fig. 4

Wolfgang Gaebel. Dr. med. Wolfgang Gaebel is Professor of Psychiatry and Psychotherapy at the Heinrich-Heine University Düsseldorf, Germany. He was Director of the Department of Psychiatry and Psychotherapy and Head of the LVR-Klinikum Düsseldorf (LVR-KD) from 1992 until 2016. From 2014 to 2016, he was also Founding Director of the LVR-Institute for Mental Healthcare Research (LVR-IVF). Since 2014, he is also Head of the WHO Collaborating Centre on Quality Management and Empowerment in Mental Health at the LVR-KD

Fig. 5

Michael Berk. Professor Michael Berk is currently a NHMRC Senior Principal research Fellow and is Alfred Deakin Chair of Psychiatry at Deakin University and Barwon Health, where he heads IMPACT, the Institute for Mental and Physical Health and Clinical Translation. He also is an Honorary Professorial Research fellow in the Department of Psychiatry, the Florey Institute for Neuroscience and Mental Health and Orygen Youth Health at Melbourne University, as well as in the School of Public Health and Preventive Medicine at Monash University. His major interests are in the discovery and implementation of novel therapies as well as risk factors and prevention of psychiatric disorders

Fig. 6

Eduard Vieta. Dr. Eduard Vieta is Professor of Psychiatry at the University of Barcelona, Chair of the Department of Psychiatry and Psychology at the Hospital Clinic, and Scientific Director of the Spanish Biomedical Research Network on Mental Health (CIBERSAM)

Fig. 7

Mario Maj. Dr. Mario Maj is Professor of Psychiatry and Chairman at the Department of Psychiatry of the University of Campania L. Vanvitelli in Naples, Italy. He has been President of the European Psychiatric Association (2003–2004) and of the World Psychiatric Association (2008–2011). He is the Editor of World Psychiatry, the psychiatric journal with the highest impact factor (34.024). He has been a member of the International Advisory Group and Chairman of the Working Group on Mood and Anxiety Disorders for the ICD-11. He has been a member of the Working Group on Mood Disorders for the DSM-5

Fig. 8

Ymkje Anna de Vries. Dr. Ymkje Anna de Vries is a postdoctoral researcher in the Developmental Psychology research group at the University of Groningen, the Netherlands. Her research is focused on the development and treatment of depressive and anxiety disorders

Fig. 9

Annelieke Roest. Dr. Annelieke Roest works as an Assistant Professor at the University of Groningen, the Netherlands. Her research focuses on anxiety, including the epidemiology and treatment of anxiety disorders, as well as the association between anxiety and depression and somatic diseases

Fig. 10

Peter de Jonge. Dr. Peter de Jonge is Professor and Head of Department of Developmental Psychology at the University of Groningen, the Netherlands. He is programme leader of the Interdisciplinary Center Psychopathology and Emotion Regulation (www.icpe.nl)

Fig. 11

Andreas Maercker. Dr. Andreas Maercker is Professor and Chair of the Division Psychopathology and Clinical Intervention at the University of Zurich, Switzerland. His research interests include PTSD and its sibling disorders as well as cultural clinical psychology. He chaired the ICD-11 Working Group on Stress-related Disorders

Fig. 12

Chris Brewin. Dr. Chris Brewin, FAcSS, FMedSci, FBA, is Emeritus Professor of Clinical Psychology at University College London and a former consultant clinical psychologist at the Traumatic Stress Clinic, part of Camden & Islington NHS Foundation Trust

Fig. 13

Kathleen M. Pike. Dr. Kathleen M. Pike is a clinical psychologist and Professor of Psychology in Psychiatry and Epidemiology at Columbia University Irving Medical Center. She serves as Director of the Global Mental Health WHO Collaborating Centre and Chair of the Faculty Steering Committee for the Global Mental Health Programs at Columbia. She was a member of the WHO ICD-11 Feeding and Eating Disorders Group, ICD-11 Field Studies Coordination Group, and the DSM-5 Cultural Consultation Group

Fig. 14

Carlos M. Grilo. Dr. Carlos M. Grilo, a clinical psychologist, is Professor of Psychiatry at the Yale University School of Medicine and Professor of Psychology at Yale University. He is the Founding Director of the Yale Program for Obesity, Weight, and Eating Research (POWER) and has, as Principal Investigator, been fully and continuously funded by the National Institutes of Health for 25 years. He previously served as Director of Psychology at the Yale Psychiatric Institute and as Director of Training in Clinical and Community Psychology at the Yale School of Medicine

Fig. 15

Naomi A Fineberg. Dr. Naomi A Fineberg is a consultant psychiatrist and Professor of Psychiatry at the University of Hertfordshire, and Hertfordshire Partnership University NHS Foundation Trust, UK. She specializes in the research and treatment of obsessive–compulsive and related disorders. She chairs the World Psychiatric Association Scientific Section for Anxiety and Obsessive–Compulsive Disorders and an EU COST Action for the Study of Problematic Internet Usage

Fig. 16

Peer Briken. Dr. Peer Briken, is Professor for Sex Research, Sexual Medicine, and Forensic Psychiatry and Director of the Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Germany, since 2010. He was President of the German Society for Sex Research from 2010 to 2016. Since 2016, he is a member of the Independent Commission for the Inquiry of Sexual Abuse of Children in Germany. He is a consultant to the World Health Organization regarding the development of the ICD-11 classification of sexual disorders and sexual health

Fig. 17

Peggy Cohen-Kettenis. Professor Peggy Cohen-Kettenis is Professor Emeritus of Medical Psychology at the Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands, and was Director of the hospital’s Center of Expertise on Gender Dysphoria. She was a member of the World Professional Association for Transgender Health’s Standards of Care Committee and of the Task Force of the Endocrine Society Clinical Practice Guideline on the endocrine treatment of gender-dysphoric/gender-incongruent persons. She was Chair of APA’s DSM-5 GID subcommittee and member of the WHO ICD-11 Working Group on Sexual Disorders and Sexual Health