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Review
. 2022 Apr 1;9(1):12.
doi: 10.1186/s40479-022-00182-0.

The ICD-11 classification of personality disorders: a European perspective on challenges and opportunities

Bo Bach #  1 , Ueli Kramer #  2 , Stephan Doering  3 , Ester di Giacomo  4 , Joost Hutsebaut  5 , Andres Kaera  6 , Chiara De Panfilis  7 , Christian Schmahl  8 , Michaela Swales  9 , Svenja Taubner  10 , Babette Renneberg  11
Affiliations
Review

The ICD-11 classification of personality disorders: a European perspective on challenges and opportunities

Bo Bach et al. Borderline Personal Disord Emot Dysregul. .

Abstract

The 11th revision of the World Health Organization (WHO) International Classification of Diseases (ICD-11) includes a fundamentally new approach to Personality Disorders (PD). ICD-11 is expected to be implemented first in European countries before other WHO member states. The present paper provides an overview of this new ICD-11 model including PD severity classification, trait domain specifiers, and the additional borderline pattern specifier. We discuss the perceived challenges and opportunities of using the ICD-11 approach with particular focus on its continuity and discontinuity with familiar PD categories such as avoidant PD and narcissistic PD. The advent of the ICD-11 PD classification involves major changes for health care workers, researchers, administrators, and service providers as well as patients and families involved. The anticipated challenges and opportunities are put forward in terms of specific unanswered questions. It is our hope that these questions will stimulate further research and discussion among researchers and clinicians in the coming years.

Keywords: Avoidant personality disorder; Borderline personality disorder; Classification; Diagnosis; ICD-11; Narcissistic personality disorder; Personality trait; Severity.

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Conflict of interest statement

BB is involved in work related to ICD-11 field trials and clinical guidelines for personality disorders.

MS was a member of the Working Group on Classification of Personality Disorders, reporting to the World Health Organization (WHO) International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders and received payment for training materials and training sessions on the guidelines. All other authors declare no competing interests.

References

    1. Reed GM, First MB, Kogan CS, Hyman SE, Gureje O, Gaebel W, et al. Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders. World Psychiatry. 2019;18(1):3–19. - PMC - PubMed
    1. WHO . ICD-11 Clinical Descriptions and Diagnostic Guidelines for Mental and Behavioural Disorders. Geneva: World Health Organisation; 2022. - PMC - PubMed
    1. Reed GM. Progress in developing a classification of personality disorders for ICD-11. World Psychiatry. 2018;17:227–228. - PMC - PubMed
    1. Simonsen S, Bateman A, Bohus M, Dalewijk HJ, Doering S, Kaera A, et al. European guidelines for personality disorders: past, present and future. Borderline Personal Disord Emot Dysregul. 2019;6:9. - PMC - PubMed
    1. Huprich SK, Herpertz SC, Bohus M, Chanen A, Goodman M, Mehlum L, et al. Comment on Hopwood et al., the time has come for dimensional personality disorder diagnosis. Personal Ment Health. 2018;12:87–88. - PubMed