DSM-5 AND ICD-11 DEFINITIONS OF POSTTRAUMATIC STRESS DISORDER: INVESTIGATING “NARROW” AND “BROAD” APPROACHES: Research Article: DSM-5 and ICD-11 Definitions of PTSD
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BACKGROUND: The development of the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) and ICD-11 has led to reconsideration of diagnostic criteria for posttraumatic stress disorder (PTSD). The World Mental Health (WMH) Surveys allow investigation of the implications of the changing criteria compared to DSM-IV and ICD-10. METHODS: WMH Surveys in 13 countries asked respondents to enumerate all their lifetime traumatic events (TEs) and randomly selected one TE per respondent for PTSD assessment. DSM-IV and ICD-10 PTSD were assessed for the 23,936 respondents who reported lifetime TEs in these surveys with the fully structured Composite International Diagnostic Interview (CIDI). DSM-5 and proposed ICD-11 criteria were approximated. Associations of the different criteria sets with indicators of clinical severity (distress-impairment, suicidality, comorbid fear-distress disorders, PTSD symptom duration) were examined to investigate the implications of using the different systems. RESULTS: A total of 5.6% of respondents met criteria for "broadly defined" PTSD (i.e., full criteria in at least one diagnostic system), with prevalence ranging from 3.0% with DSM-5 to 4.4% with ICD-10. Only one-third of broadly defined cases met criteria in all four systems and another one third in only one system (narrowly defined cases). Between-system differences in indicators of clinical severity suggest that ICD-10 criteria are least strict and DSM-IV criteria most strict. The more striking result, though, is that significantly elevated indicators of clinical significance were found even for narrowly defined cases for each of the four diagnostic systems. CONCLUSIONS: These results argue for a broad definition of PTSD defined by any one of the different systems to capture all clinically significant cases of PTSD in future studies.
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The ratings were not based on empirical evidence, as there has been only a small number of studies comparing ICD-11 CDDG and DSM-5 criteria for a particular disorder in terms of whether they identify the same people or yield similar prevalence estimates.
“These ratings were not based on empirical evidence, as there has been only a small number of studies comparing the ICD-11 CDDG and DSM-5 criteria for a particular disorder in terms of whether they are identifying the same people or yield similar prevalence estimates 25,26 .”
From An organization‐ and category‐level comparison of diagnostic requirements for mental disorders in <scp>ICD</scp> ‐11 and <scp>DSM</scp> ‐5 (2021) · cites this paper as [25]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredStudies comparing ICD-11 and DSM-5 diagnostic requirements have found somewhat lower PTSD prevalence rates using ICD-11, and that the two diagnostic systems do not identify exactly the same groups.
“Studies comparing the ICD-11 and DSM-5 diagnostic requirements have found somewhat lower PTSD prevalence rates using the ICD-11 60,61 , and that the two diagnostic systems do not identify exactly the same groups 25 .”
From An organization‐ and category‐level comparison of diagnostic requirements for mental disorders in <scp>ICD</scp> ‐11 and <scp>DSM</scp> ‐5 (2021) · cites this paper as [25]
Some studies suggest that the ICD-11 definition of PTSD is associated with less psychiatric comorbidity, while others indicate no marked difference between DSM-5 and ICD-11 definitions.
“Actually, some studies suggest that the ICD-11 definition of PTSD is associated with less psychiatric comorbidity 166,168 , while others indicate that there is not a marked difference in this respect between the DSM-5 and ICD-11 definitions 163,164 .”
From Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges (2019) · cites this paper as [166]
Multiple studies indicate that PTSD is diagnosed at higher rates using DSM-5 criteria compared to ICD-11 guidelines, although some reports indicate comparable rates.
“multiple studies indicate that PTSD is diagnosed at higher rates using the DSM5 criteria compared to the ICD-11 guidelines 163-165 , although there are also some reports that rates are comparable 166 .”
From Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges (2019) · cites this paper as [166]
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References 47 · Cited by 221
- Authors
- Stein, D. J., McLaughlin, K. A., Koenen, K. C., Atwoli, L., Friedman, M. J., Hill, E. D., Maercker, A., Petukhova, M., Shahly, V., van Ommeren, M., Alonso, J., Borges, G., de Girolamo, G., de Jonge, P., Demyttenaere, K., Florescu, S., Karam, E. G., Kawakami, N., Matschinger, H., Okoliyski, M., Posada-Villa, J., Scott, K. M., Viana, M. C., & Kessler, R. C.
- Affiliations
- University of Cape Town (ZA)
- University of Washington (US)
- Columbia University (US)
- Moi University (KE)
- United States Department of Veterans Affairs (US)
- Harvard University (US)
- Division of Psychopathology; Department of Psychology; University of Zurich; Switzerland
- University of Zurich (CH)
- Department of Mental Health and Substance Abuse; World Health Organization; Geneva Switzerland
- Municipal Institute for Medical Research (ES)
- Universidad Autónoma Metropolitana (MX)
- IRCCS Centro S. Giovanni di Dio Fatebenefratelli; Brescia Italy
- Department of Psychiatry (PdJ); University Medical Center Groningen; Groningen The Netherlands
- Universitair Ziekenhuis Leuven (BE)
- National School of Public Health, Management and Professional Development (RO)
- University of Balamand (LB)
- The University of Tokyo (JP)
- Leipzig University (DE)
- National Center of Public Health and Analyses (BG)
- Instituto Colombiano del Sistema Nervioso; Pontificia Universidad Javeriana; Bogota D.C. Colombia
- University of Otago (NZ)
- Department of Social Medicine; Federal University of Espírito Santo; Vitória Brazil
- Corresponding author
- Stein, Dan J.
- ORCID
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2014-06
- Volume
- 31
- Issue
- 6
- Pages
- 494-505
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC4211431
- OpenAlex
- W1961696017
- Cited by
- 221
- References
- 47
- Citations by year
- 2026: 9 · 2025: 17 · 2024: 18 · 2023: 14 · 2022: 37 · 2021: 21 · 2020: 20 · 2019: 24 · 2018: 10 · 2017: 17 · 2016: 15 · 2015: 18
- FWCI
- 19.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Repositori digital de la UPF (Universitat Pompeu Fabra) (acceptedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- eCommons - AKU (Aga Khan University) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Funders
- John D. and Catherine T. MacArthur Foundation (R13-MH066849)
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- GlaxoSmithKline
- Sanofi
- World Health Organization
- European Commission (1999-01042, QLG5–1999-01042, SANCO2004123, 2004123)
- Fundação de Amparo à Pesquisa do Estado de São Paulo (03/00204-3, 03/00204?)
- Generalitat de Catalunya (01042, RETICS RD06/0011 REM-TAP, CB06/02/0046)
- Ministry of Health, Labour and Welfare (H16-KOKORO-013, H14-TOKUBETSU-026, H13-SHOGAI-023)
- Shire
- Ministerio de Ciencia y Tecnología (SAF 2000 158-CE)
- Regione Piemonte (00/0028)
- Servier
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
- Pfizer Foundation (R01‐MH069864, R01-DA016558, R13-MH066849, R03-TW006481)
- Pan American Health Organization (FIRCA R03-TW006481)
- Instituto de Salud Carlos III (CB06/02/0046, RETICS RD06/0011 REM-TAP, RETICS RD06/0011, RD06/0011, FIS 00/0028, CIBER CB06/02/0046)
- Departament de Salut, Generalitat de Catalunya (CB06/02/0046, RETICS RD06/0011 REM-TAP)
- National Institute of Mental Health (R13-MH-066849, R01‐MH070884, MH-092526, R01-MH092526, MH069864, MH066849, K01MH092526, U01MH060220, R01‐MH069864)
- National Institute on Drug Abuse (R01DA016558)
- Fogarty International Center (FIRCA R03TW006481, R03TW006481)
- Cilag
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- post-traumatic stress disorder, DSM-5, ICD-11, diagnostic criteria, PTSD prevalence, clinical severity, suicidality, DSM-IV, ICD-10, World Mental Health Surveys, Composite International Diagnostic Interview
- MeSH terms
- Americas, Europe, Humans, Japan, Life Change Events, New Zealand, Stress Disorders, Post-Traumatic, Global Health, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders
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