[Psychotic disorders in ICD-11: the revisions]

Area of Science:

• Psychiatry
• Mental Health Classification
• Diagnostic Systems

Background:

• The International Classification of Diseases (ICD) is a global standard for health statistics and epidemiology.
• Previous versions, like ICD-10, have guided the diagnosis and classification of mental health disorders.
• The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) also underwent revisions, influencing diagnostic approaches.

Purpose of the Study:

• To provide a comprehensive overview of the revisions in the ICD-11 chapter on psychotic disorders.
• To compare these changes with the psychosis chapter of the DSM-5.
• To highlight key shifts in diagnostic criteria and categorization.

Main Methods:

• Comparative analysis of ICD-10 and ICD-11 classifications for psychotic disorders.
• Examination of the ICD-11 chapter "Schizophrenia or Other Primary Psychotic Disorders" (6A2).
• Cross-referencing with DSM-5 criteria for psychosis.

Main Results:

• Abandonment of classical subtypes of Schizophrenia and the special significance of Schneider's first-rank symptoms.
• Revised definition of "Schizophrenia" (6A20) requiring two key features, including one positive symptom.
• Inclusion of "Induced Delusional Disorder" (F24) within "Delusional Disorder" (6A24) and a focus on the current episode.
• Restriction of "Acute and Transient Psychotic Disorder" (6A23) and distinct categorization of "Catatonia" (6A4).
• Introduction of an optional dimensional quantification of symptoms (6A25), similar to DSM-5.

Conclusions:

• ICD-11 represents a significant revision in the classification of psychotic disorders, moving towards a more symptom-focused and dimensional approach.
• The revisions aim to refine diagnostic accuracy and clinical utility, though developmental aspects remain unaddressed.
• These changes align ICD-11 more closely with contemporary diagnostic trends seen in DSM-5.