Body dysmorphic disorder and olfactory reference disorder: proposals for ICD-11

Area of Science:

• Psychiatry
• Mental Health Classification
• Diagnostic Systems

Background:

• Body dysmorphic disorder (BDD) and olfactory reference disorder (ORD) have complex and often confusing classifications in ICD-10.
• ICD-10 allows multiple, ambiguous diagnoses for BDD and lacks a category for non-delusional ORD.
• Cultural variations of BDD and ORD, such as Taijin Kyofusho, add further diagnostic challenges.

Purpose of the Study:

• To review the historical classification of BDD and ORD.
• To examine the proposals by the WHO ICD-11 Working Group for these disorders.
• To provide improved diagnostic guidelines and facilitate better clinical utility.

Main Methods:

• Review of historical diagnostic systems (ICD-10, DSM-5).
• Analysis of proposals from the WHO ICD-11 Working Group on Obsessive-Compulsive and Related Disorders.
• Consideration of cultural variations in BDD and ORD presentation.

Main Results:

• ICD-10 classification of BDD and ORD leads to significant diagnostic confusion and lack of clarity.
• The ICD-11 Working Group proposes the inclusion of BDD and ORD with clear diagnostic guidelines.
• Proposed ICD-11 criteria align with global evidence and address cultural factors.

Conclusions:

• The proposed ICD-11 classification for BDD and ORD offers substantial improvements over ICD-10.
• These proposals aim to enhance accurate identification, treatment, and resource allocation for these disorders.
• The updated classification recognizes cultural nuances and promotes better clinical utility worldwide.