Is ICD-11 Personality Disorder Dimensional Enough? A Necessary Positive Expansion for Improving Clinical Utility

Area of Science:

• Psychiatry
• Psychology
• Mental Health

Background:

• The International Classification of Diseases 11th Revision (ICD-11) personality disorder (PD) section is favored for its dimensional approach to personality functioning.
• This contrasts with previous categorical systems that had limited clinical validity and utility.

Purpose of the Study:

• To propose a positive framework to complement the ICD-11 PD model.
• To enhance the overall utility and comprehensiveness of the ICD-11 PD diagnostic system.

Main Methods:

• A narrative review of primary literature was conducted.
• Searches were performed in PubMed and Web of Science using keywords related to personality disorders and the ICD-11.
• Studies with diverse diagnostic criteria for PD, including the new ICD-11 definition, were included.

Main Results:

• The ICD-11 PD model shows promise but has limitations, including low discriminant validity and unclear distinctions from normal personality.
• A complementary positive framework is proposed, incorporating happiness and social well-being.
• These factors are suggested as determinants of clinical significance within the ICD-11 PD model.

Conclusions:

• An integrative model addressing the identified deficiencies is presented.
• This approach aims to provide personalized, empowering assessment and intervention strategies.
• The proposed model is expected to yield cost-effective results in both primary and specialized care settings.