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[The reclassification of neurodevelopmental disorders in ICD-11. German Version]
Ludger Tebartz van Elst1, Andreas Riedel2,3, Monica Biscaldi-Schäfer4
1Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hauptstraße 5, 79104, Freiburg, Deutschland. tebartzvanelst@uniklinik-freiburg.de.
Insights
The ICD-11 reclassifies neurodevelopmental disorders, focusing on genetically-linked atypical functioning. This shift impacts understanding intellectual disability, autism, ADHD, and tic disorders.
Area of Science:
- Neurodevelopmental Disorders
- Psychiatric Classification Systems
- Genetics and Mental Functioning
Context:
- Previous classification (ICD-10) categorized developmental disorders across multiple chapters (F7, F8, F9).
- ICD-11 introduces neurodevelopmental disorders as a distinct, primary classification group.
- These disorders are characterized by genetically influenced atypical patterns in perception, cognition, language, and motor skills.
Purpose:
- To summarize the conceptual evolution of neurodevelopmental disorder classification from ICD-10 to ICD-11.
- To highlight the key changes in the categorization of intellectual disability, autism spectrum disorders, ADHD, and tic disorders.
- To underscore the understanding of these disorders as persisting characteristics and potential variants of norm.
Summary:
- ICD-11 establishes neurodevelopmental disorders as a new main classification, emphasizing genetically-related atypical functioning patterns.
- Manifesting early in development, these conditions represent persistent characteristics, not always pathological, but can influence identity and relationships.
- The article details ICD-11's revised approach to intellectual disability, autism spectrum disorders, ADHD, and tic disorders, noting high comorbidity.
Impact:
- Facilitates a more cohesive understanding and diagnosis of neurodevelopmental conditions.
- Provides a framework for recognizing subsyndromic expressions and their impact on interpersonal dynamics and identity formation.
- Supports research into the genetic underpinnings and comorbidity patterns of these disorders.
Abstract:
In the ICD-10 the developmental disorders are categorized under three different chapters: F7 for mental retardation, F8 for developmental disorders and F9 for disorders with onset in childhood and adolescence. In ICD-11 neurodevelopmental disorders represent the first new main classification group. The disorders grouped in these categories are all characterized by essentially genetically related atypical patterns of perception, emotional processing, cognition (general and social), language and motor skills. These patterns of mental functioning usually manifest in the first decade of development. They represent persisting characteristics of mental functioning, which can be understood as structural diagnoses. As such, they do not always have pathological significance but must be understood as variants of the norm, at least in less severe cases. In such constellations, they often form the psychodynamic basis for characteristic patterns of interpersonal relationship and communication problems in a subsyndromic expression and hinder the development of valid and constructive identities. These psychodynamics are often associated with interpersonal problems and conflicts as well as classical psychiatric comorbidities, such as stress reactions, adjustment disorders, anxiety disorders, obsessive-compulsive disorders, depression, personality disorders or impulsive and psychotic states. Developmental disorders have a high degree of overlap and comorbidity. This article summarizes the conceptual changes in ICD-11 compared to ICD-10, particularly with respect to the four main subgroups: intellectual disability, autism spectrum disorders, ADHD and tic disorders.
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