AS13-03 - Trauma- and stress-related disorders: developments for ICD 11

Abstract

As a part of the development of ICD-11, a globally representative and multidisciplinary group has been appointed by WHO to consider critical questions regarding mental and behavioural disorders categories related to trauma and severe stress or adversity. The ICD-11 Working Group on the Classification of Stress-Related Disorders seeks to improve the clinical utility of the current classification of mental and behavioural disorders. To develop a clinically useful globally applicable and classification system, with particular consideration to implementation in low-and middle-income countries and in primary care settings. Recommendations are based on literature reviews, group discussions and consultations with leading professionals. Key questions include: (1) How should the stressor or trauma criterion for Post-Traumatic Stress Disorder and Acute Stress Reaction be revised? (2) Should other proposed syndromes (Complex PTSD and Prolonged Grief) be included? (3) Can Adjustment Disorder be conceptualized as a stress-response syndrome based on positive symptoms? (4) Should the diagnosis‚ “Enduring Personality Changes after Catastrophic Experience” (EPCACE) be preserved? Proposals for the candidate disorder entities related to trauma and severe stress or adversity have been developed, including Post-Traumatic Stress Disorders, Prolonged Grief Disorder, Adjustment Disorders, and Complex PTSD/EPCACE. The main features of these proposals will be presented. The current discussion on these drafts would allow us to view these diagnoses as expressions of a stress- and trauma-reaction continuum. Future timelines and prospects of the working group will be discussed. Proposals are subject to further consultation and field testing.