The reclassification of neurodevelopmental disorders in ICD-11

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.