Consequences of the Diagnostic Criteria Proposed for the ICD 11 on the Prevalence of PTSD in Children and Adolescents.
In 2013, a working group of the World Health Organization (WHO) proposed a reformulation of the posttraumatic stress disorder (PTSD) diagnostic criteria for the upcoming 11(th) edition of the International Classification of Diseases (ICD 11; Maercker, Brewin, Bryant, Cloitre, van Ommeren, et al. 2013) This study investigated the consequences of the proposed ICD 11 PTSD symptom reduction on the prevalence of PTSD in children and adolescents. Prevalence rates of PTSD in a clinical sample of 159 traumatized children and adolescents were compared applying criteria according to the 4(th) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV; American Psychiatric Association, 1994) the ICD 10 (WHO, 1992) and the ICD 11. The prevalence rate was 76.1% using DSM IV, 88.1% using ICD 10, and 61.0% using ICD 11. The use of the criteria proposed for ICD 11 resulted in 27.1% less positive cases compared with ICD 10 and 15.1% less positive cases compared with DSM IV. Our results showed that in a clinical sample of children and adolescents the prevalence of PTSD was significantly affected by the use of different diagnostic systems. This will constitute a major challenge for research and practice because, depending on the algorithm used, different groups of patients will be included in studies and different groups of individuals will be able to access medical care and therapy.
Journal of traumatic stress