Classification of Psychiatric Disorders

1. CLASSIFICATIONS OF
PSYCHIATRIC
DISORDERS
DR.SU. POORNIMA

2. INTRODUCTION
NOSOLOGY
the branch of medical
science dealing with the
classification of diseases.
Classification is the process by which the complexity of
phenomena is reduced by arranging them into categories
according to some established criteria for one or more purposes.

3. Syndrome is a condition characterized by a particular
symptom profile whose etiology, clinical significance or
severity is variable
DISEASE is a condition with specific aetiopathogenesis. It
has biomedical connotations
The term DISORDER, first introduced as a generic name
for the unit of classification in DSM-I in 1952, is a term
midway between a disease or illness and a syndrome, in
terms of consistency, correlates and significance.
The typical progression of knowledge begins with the
identification of clinical manifestations, i.e. syndrome, and
the deviance from the “norm”; then understanding of the
pathology and etiology.

4. PURPOSE OF PSYCHIATRIC CLASSIFICATION
1.Communication: A classification enables users to communicate with each
other about the disorders with which they deal. This involves using names of
categories as standard shorthand ways of summarizing a great deal of
information.
2.Control: Control of psychiatric disorders primarily refers to their treatment
and prevention. This is the ultimate purpose of any classification.
3.Comprehension: Classification should provide comprehension or
understanding of the causes of psychiatric disorders and the processes
involved in their development and maintenance.

5. WHAT CONSTITUTES A GOOD CLASSIFICATION OF PSYCHIATRIC
DISORDERS?
Reliability: It shows as to how far errors of measurement have been
excluded from assessment. Diagnostic reliability can be improved by
operational diagnostic criteria and by using structured interviews.
Validity: How far a test actually measures what it is supposed to
measure, meaning “the nature of reality”. It is an “all or none” concept.
Utility: It is a graded concept and partially context dependent. The
clinical utility of a classificatory system can be assessed empirically by
taking into account its impact on three domains: Use, decision making
process and clinical outcome.
Ease of use.
Applicability across settings and cultures.
Meet needs of various users: Clinicians, researchers and users of mental
health services.

6. PROBLEMS UNIQUE TO CLASSIFYING PSYCHIATRIC
DISORDERS
Psychiatry, in contrast to other branches of medicine, relies on the
patient's own subjective report of symptoms and the doctor's observation
of patient behavior to arrive at a diagnosis.
Psychiatry lacks objective and independent criteria for sorting out
psychiatric disorders.
Psychiatric disorders are manifested by a quantitative deviation in
behavior, ideation and emotion from a normative concept and it is difficult
to define normal human behavior.
Psychiatric symptoms are highly nonspecific and quite unstable over time.

7. IMPORTANCE OF CLEARLY DEFINING
A PSYCHIATRIC DISORDER
It influences estimates of psychiatric disorders in the community and
allocation of tax-payer's money to manage them.
It has potential legal implications in criminal cases and in awarding
disability benefits.
Lack of a clear conceptual definition can contribute to abuses of
psychiatric diagnoses as a means of controlling or stigmatizing socially
undesirable behavior (e.g., misuse of psychiatric diagnosis in former
USSR and China to jail dissidents of the system).
Lack of a proper definition of psychiatric disorder reduces confidence in
our discipline among our colleagues and the general public.

8. CATEGORICAL VS DIMENSIONAL MODELS
A fundamental choice in descriptive psychopathology classification is
between a categorical and a dimensional structure.
Although most sciences start with a categorical classification of their
subject matter, they often replace this with dimensions as accurate
measurement becomes possible.
psychiatric disorders have traditionally been classified by dividing them
into categories to represent discrete clinical entities. All our knowledge
about these disorders and clinical decision making to treat are based in
this system.
Patients do not fit neatly into the available categories. Besides, there is
the problem of comorbidities and doubts have been raised regarding the
validity of these entities.

9. CATEGORICAL VS DIMENSIONAL MODELS
• Aberrant, maladaptive
behaviours or
symptoms are counted
• Thinking about cases
leads to categorical,
yes/no answers
• One either have a case
of TB or not. These
conventions are useful
in epidemiology
• alternative and not
necessarily
contradictory approach,
is to think of behaviour
or traits as varying
along a continuum or a
dimension.
• Traits such as
aggression,
hyperactivity,
extraversion, shyness
and intelligence all vary
along a dimension.

10. Disorders In Which Evidence Favours A Dimensional
Approach
Major depression
Obsessive-compulsive disorder
Autism
Attention deficit hyperactivity disorder
Personality disorders
For all these diagnoses, symptoms listed in their criterion sets are also
normally distributed in the general population.
Catagorical and dimentional approach integration is of relevance to
the complete understanding of psychotic disorders
DIMENSION IN A CATEGORICAL MODEL

11. Every categorical diagnosis can be made dimensional by using
symptom counts, symptom duration, symptom severity, degree of
impairment, certainty of diagnosis, consensus of multiple
diagnoses, and many more such strategies even without deviating
from the contents of current DSM or ICD categorical diagnoses
categorical cut points are then used to decide about treatment

12. EARLY DISTINCTIONS
Organic
Functional – Neurosis and Psychosis
For research purposes:
Rdoc Research domain criteria
• HiTOP- The Hierarchical Taxonomy Of Psychopathology (HiTOP)
• SyNopSis-Systems Neuroscience of Psychosis (SyNoPsis) project

13. A Brief History Of Classification
1682:
Thomas
Sydenham
: Mania,
Hysteria,
Malanchol
ia
1735:
Carolus
Linnaeus:
Impaired
Judgemen
t,
Imaginati
on,
Irregular
Desires
1769:
William
Cullen:
Neuroses
1801:
Phillipe
Pinel:
Mental
Alienation
1860:
Morel:
Varying
manifestat
ions of
degenerac
y
1856-
1926:
Kraepelin
20th
Century
Adolph
Meyer

14. Currently, the two major classification systems in
psychiatry are the DSM-5 and the ICD-11.
ICD-11 DSM-V
Origin International WORLD HEALTH ORGANISATION American Psychiatric Association
Comprehensiv
eness
Comprehensive classification of all “diseases and
related health problems”
Stand-alone classification of
mental disorders
Presentation
Different versions for clinical work research and use
in primary care along with clinical version ;
ONLINE VERSION
A single document-
OPERATIONAL criteria
Languages Available in all widely spoken languages English version
Structure Part of overall ICD framework
Single axis in chapter VI; separate multiaxial
systems available
Multiaxial
Used in
Most frequently used across the world for clinical
work and training purposes
Designed, at least in the first
instance, for use by American
health professionals
Worldwide
usage
Every country is obliged to report basic morbidity
data to WHO using its categories
Most frequently used in research
work and drug trials
Content
Guidelines and criteria do not include social
consequences of disorders
Diagnostic criteria usually include
significant impairment in social
functions

15. DSM – A LONG ROAD
DSM I – 1952- 130 pages long
DSM II- 1968 . In 1974
homosexuality was removed
as a disorder by voting
DSM III – 1980 – MULTIAXIAL
DSM IV – 1994
DSM IV-TR – 2000
DSM 5- 2013

16. DSM 5
The latest DSM classification has removed the 5 AXES OF
CLASSIFICATION- THE BIGGEST CHANGE!!!
AXIS I- Clinical disorders ( OTHER CONDITIONS)
AXIS II- Personality disorders and mental retardation
AXIS III- General medical conditions
AXIS IV- Psychosocial and environmental problems
AXIS V- Global assessment of functioning

17. DSM 5
3 SECTIONS
SECTION 1- Basics of DSM-5
SECTION 2- Diagnostic criteria and codes
• 1.2.1 Neurodevelopmental disorders
• 1.2.2 Schizophrenia spectrum and other psychotic disorders
• 1.2.3 Bipolar and related disorders
• 1.2.4 Depressive disorders
• 1.2.5 Anxiety disorders
• 1.2.6 Obsessive-compulsive and related disorders
• 1.2.7 Trauma- and stressor-related disorders
• 1.2.8 Dissociative disorders
• 1.2.9 Somatic symptom and related disorders
• 1.2.10 Feeding and eating disorders
• 1.2.11 Sleep–wake disorders
• 1.2.12 Sexual dysfunctions
• 1.2.13 Gender dysphoria
• 1.2.14 Disruptive, impulse-control, and conduct disorders
• 1.2.15 Substance-related and addictive disorders
• 1.2.16 Neurocognitive disorders
• 1.2.17 Paraphilic disorders
• 1.2.18 Personality disorders
SECTION 3- Emerging measures and models

18. ADVANTAGE OF DSM
The hybrid mechanism adopted by APA -(scientific/
collegiate/ consensus) was based on focused discussion by
a group of experts
Clearly and succinctly defining key syndromes- backed by
solid historical descriptions in scientific literature
Observations on heritability

19. SHORTCOMINGS OF
DSM
Proliferation of new disorders in each new version with only limited
support in scientific evidence
Arbitrary thresholds
Frequent use of NOS
Problem of comorbidity- patients qualify for many diagnoses
simultaneously

20. ICD

21. ICD-11, Implemented By The WHO
Member States From
JANUARY 1, 2022.
ICD 10
Chapter v (F) of ICD 10
includes Mental and
behavioural disorders.
100 such categories.
alphanumeric coding
system –single letter
followed by two
numbers (A00- Z99).
11 disorder groupings
in ICD-10.
ICD 11
-Chapter 06 of ICD 11
includes
Mental,behavioural and
neuro developmental
disorders.
-Has 161 four character
categories.
-Code ranges starts with
6A00
-21 disorder groupings

22. STRUCTURE OF ICD 11
• LIFE SPAN APPROACH
• Principles for ordering disorder groupings in ICD-11 were
• shared etiology, pathophysiology, and phenomenology.
• Additionally, the aim of the WHO and American Psychiatric
Association to harmonize the structure of ICD-11 and
DSM-5 influenced the chapter structure of ICD-11.

23. Term Definition Example Notes
Stem
code
Basic code for the
given
disease
6A70.0 Single episode
depressive disorder, mild
-
Extensio
n code
A code describing the
additional information
7A00&XS5W Chronic
insomnia & mild, XS5W is
an extension code
Can never be used
alone
– always with the stem
code
Precoord
ination
Assigning a disease,
a code containing all
the
necessary information
at
once
6C43.70 Opioid-induced
mood disorder and
not 6A8Z/6C43 Mood
disorders, unspecified/
Disorders due to use of
opioids, unspecified
Such codes exist only
for
certain diseases

25. Comparison Of The ICD-11 Vs. The DSM-5
Metastructure
ICD-11
Neurodevelopmental Disorders
Schizophrenia and Other
Primary Psychotic Disorders
Catatonia
Mood Disorders
Anxiety and Fear-Related
Disorders
Obsessive-Compulsive and
Related Disorders
Disorders Specifically
Associated with Stress
DSM-5
Neurodevelopmental Disorders
Schizophrenia Spectrum and
Other Psychotic Disorders
Bipolar and Related Disorders
Depressive Disorders
Anxiety Disorders
Obsessive-Compulsive and
Related Disorders
Trauma- and Stressor-Related
Disorders

26. Dissociative Disorders
Feeding and Eating Disorders
Elimination Disorders
Disorders of Bodily Distress
and Bodily Experience
Disorders Due to Substance
Use and Addictive Behaviours
Impulse Control Disorders
Disruptive Behaviour and
Dissocial Disorders
Personality Disorders and
Related Traits
Dissociative Disorders
Feeding and Eating Disorders
EliminationDisorders
Somatic Symptom and Related
Disorders (not in the same
order as ICD-11; placed before
Feeding and Eating Disorders)
Substance-Related and
Addictive Disorders
Disruptive, Impulse-Control,
and Conduct Disorders
Personality Disorders (not in
the same order as ICD-11;
placed after Neurocognitive
Disorders)

27. Paraphilic Disorders
Factitious Disorders
Neurocognitive Disorders
Mental or Behavioural Disorders
Associated with Pregnancy,
Childbirth and the Puerperium
Secondary Mental or Behavioural
Syndromes Associated with
Disorders or Diseases Classified
Elsewhere
Paraphilic Disorders (not in the
same order as ICD-11; placed after
Personality Disorders)
Not a separate grouping but
included in Somatic Symptom and
Related Disorders
Neurocognitive Disorders
Not a separate grouping; perinatal
specifiers available for specific
disorders
Not a separate grouping but
included within the disorder
groupings with which they share
phenomenology

28. ICD-11
Psychological and Behavioural
Factors Affecting Disorders or
Diseases Classified Elsewhere
Sleep-Wake Disorders (Chapter 7)
Sexual Dysfunctions (placed in
Chapter 17, Conditions Related to
Sexual Health
Gender Incongruence (placed in
Chapter 17, Conditions related to
Sexual Health)
DSM-5
Not a separate grouping but
included in Somatic Symptom and
Related Disorders
Sleep-Wake Disorders (within
mental disorders; placed after
Elimination Disorders)
Sexual Dysfunctions (within
mental disorders; placed after
Sleep-Wake Disorders)
Gender Dysphoria (within mental
disorders; placed after Sexual
Dysfunctions)

29. Mental Disorders Included In One System But Not
The Other
 ICD-11 Developmental Language Disorder with impairment of
mainly pragmatic language
 Schizophrenia or Other Specified Primary Psychotic Disorder
 Acute and Transient Psychotic Disorder
 Catatonia Induced by Substances or Medications*
 Mixed Depressive and Anxiety Disorder
 Olfactory Reference Syndrome*
 Other specified Obsessive-Compulsive and Related Disorder
 Complex Post-Traumatic Stress Disorder*
 Post-Traumatic Stress Disorder or Adjustment Disorder (if
stressor does not qualify for Post-Traumatic Stress Disorder) or
Prolonged Grief Disorder

30.  Other Specified Trauma and Stressor-Related Disorder; included
among Conditions for Further Study as Persistent Complex
Bereavement Disorder°
 Trance Disorder
 Dissociative Identity Disorder or Other Specified Dissociative
Disorder
 Partial Dissociative Identity Disorder
 Body Integrity Dysphoria*
 Other Specified Mental Disorder Episode of Harmful Substance
Use
 Other Specified Disorders Due to Use of Hallucinogens
 Gaming Disorder

31.  Compulsive Sexual Behaviour Disorder
 Oppositional Defiant Disorder, with chronic irritability-anger
Disruptive Mood Dysregulation Disorder

 Paraphilic Disorder Involving Solitary Behaviour or Consenting
Individuals Fetishistic Disorder
 Amnestic Disorder
 Secondary Neurodevelopmental Syndrome
 Secondary Dissociative Syndrome
 Secondary Impulse Control Syndrome*

32. DSM-5
 Social (Pragmatic) Communication Disorder*
 Schizophreniform Disorder
 Brief Psychotic Disorder
 Other Substance-Induced Disorder
 Other Specified Depressive Disorder or Other Specified
Anxiety Disorder
 Other Specified Trauma and Stressor-Related Disorder
 Other Specified Dissociative Disorder Possession Trance
Disorder
 Dissociative Identity Disorder (for cases with dissociative
amnesia), or Other Specified Dissociative Disorder (for cases
without dissociative amnesia)

33.  Unspecified Substance-Related Disorder
 Hallucinogen Persisting Perception Disorder Nicotine Intoxication
Other Tobacco-Induced Disorder Volatile Inhalant Withdrawal Other
Inhalant-Induced Disorder
 Other Specified Mental Disorder; included among Conditions for
Further Study as Internet Gaming Disorder
 Other Specified Disruptive, Impulse-Control, and Conduct Disorder
 Transvestic Fetishistic Disorder
 Sexual Masochistic Disorder
 Major Neurocognitive Disorder
 Other Specified Neurodevelopmental Disorder
 Other Specified Dissociative Disorder
 Other Specified Disruptive, Impulse Control, and Conduct Disorder,
or Personality Change Due to Another Medical Condition

34. Disorders Or Diagnostic Entities With Major Differences
Between The Two Diagnostic Systems
Developmental Language Disorder in ICD-11 / Language Disorder plus Social
(Pragmatic) Communication Disorder in DSM-5
Schizophrenia in ICD-11 / Schizophrenia plus Schizophreniform Disorder in
DSM-5
Schizoaffective Disorder Acute and Transient Psychotic Disorder in ICD-11 /
Brief Psychotic Disorder in DSM-5
Mixed Episode in ICD-11 / Mood Episode with Mixed Features in DSM-5
Dysthymic Disorder in ICD-11 / Persistent Depressive Disorder in DSM-5
Hypochondriasis (in Obsessive-Compulsive and Related Disorders) in ICD-11
/ Somatic Symptom Disorder or Illness Anxiety Disorder in DSM-5
Post-Traumatic Stress Disorder plus Complex Post-Traumatic Stress Disorder
in ICD-11 / Post-Traumatic Stress Disorder in DSM-5

35. Adjustment Disorder Acute Stress Reaction (in Factors Influencing Health Status or Contact with Health
Services) in ICD-11 / Acute Stress Disorder (in Trauma- and Stressor-Related Disorders) in DSM-5
Dissociative Identity Disorder plus Partial Dissociative Identity Disorder in ICD-11 / Dissociative Identity Disorder
in DSM-5
Bulimia Nervosa Binge Eating Disorder Substance Dependence plus Harmful Pattern of Use of Substances in
ICD-11 / Substance Use Disorder in DSM-5
Oppositional Defiant Disorder with chronic irritability-anger in ICD-11 / Disruptive Mood Dysregulation Disorder
in DSM-5
Personality Disorders Coercive Sexual Sadism Disorder in ICD-11 / Sexual Sadism Disorder (coercive) in DSM-5
Paraphilic Disorder Involving Solitary Behaviour or Consenting Individuals in ICD-11 / Fetishistic Disorder,
Transvestic Disorder, Sexual Masochism Disorder, Sexual Sadism Disorder (noncoercive) in DSM-5
Dementia plus Amnestic Disorder in ICD-11 / Major Neurocognitive Disorder in DSM-5
Mental or Behavioural Disorders Associated with Pregnancy, Childbirth and the Puerperium, without and with
psychotic symptoms in ICD-11 / “with peripartum onset” specifier in DSM-5

36. Disorders With Minor Definitional Differences
Between The Two Diagnostic Systems
o Disorders of Intellectual Development in ICD-11 / Intellectual
Disability (Intellectual Developmental Disorder) in DSM-5
o Developmental Speech Sound Disorder in ICD-11 / Speech Sound
Disorder in DSM-5
o Developmental Learning Disorder in ICD-11 / Specific Learning
Disorder in DSM-5
o Tourette Syndrome in ICD-11 / Tourette’s Disorder in DSM-5
o Chronic Motor Tic Disorder plus Chronic Phonic Tic Disorder in
ICD-11 / Persistent Motor or Vocal Tic Disorder in DSM-5
o Transient Motor Tics in ICD-11 / Provisional Tic Disorder in DSM-
5
o Recurrent Depressive Disorder in ICD-11 / Major Depressive
Disorder, Recurrent, in DSM-5

37. Disorders With Essentially Identical
Definitions In The Two Diagnostic Systems
Schizotypal Disorder in ICD-11 / Schizotypal Personality Disorder
in DSM-5
Single Episode Depressive Disorder in ICD-11 / Major Depressive
Disorder, Single Episode in DSM-5

38. Icd 10
Disorders of psychological
development
Icd 11
Neurodevelopmental
disorders
Dsm V
Neurodevelopment
al disorders
F70-F79 Mental retardation
F70 Mild
F71 Moderate
F72 Severe
F73 Profound
F78 Other
F79 Unspecified
F80 Specific developmental disorders
speech and language
F84 Pervasive developmental
disorders
Childhood autism
Atypical autism
Asperger’s syndrome
F81Specific developmental disorders of
scholastic skills
F82 specific developmental disorder of
motor function
F90 hyperkinetic disorders
stereotyped movement disorder
6A00 Disorders of intellectual
development
mild, moderate,
severe,profound, provisional,
unspecified
6A01 Developmental speech
or language disorders
6A02 Autism spectrum
disorder
6A03 Developmental learning
disorder
6A04 Developmental motor
coordination disorder
6A05 Attention deficit
hyperactivity disorder
6A06 Stereotyped movement
disorder
6A0Y Other specified
neurodevelopmental
disorders
6A0Z Neurodevelopmental
disorders, unspecified
• Intellectual
disabilities
mild, moderate,
severe
• Communication
disorders
• Autism
spectrum
disorder
• Specific learninhg
disorders
• Attention deficit
hyperactivity
disorder
• Stereotyped
movement
disorder

39. Icd 10 Icd 11 Dsm V
Schizophrenia, schizotypal
and delusional disorders
F20 Schizophrenia
F21 Schizotypal disorder
F22 Persistent delusional
disorders
F23 Acute and
transient
psychotic
disorders
F24 Induced delusional
disorder
F25 Schizoaffective
disorders
F28 Other nonorganic
psychotic disorders
F29 Unspecified
nonorganic psychosis
Schizophrenia or other
primary psychotic
disorders (BlockL1-6A2)
6A20 Schizophrenia
6A21 Schizoaffective
disorder
6A22 Schizotypal
disorder
6A23 Acute and transient
psychotic disorder
6A24 Delusional disorder
6A25 Symptomatic
manifestations of
primary psychotic
disorders
6A2Z Schizophrenia or
other primary psychotic
disorders, unspecified
elimination of all subtypes
• Schizophrenia Spectrum
and Other Psychotic
Disorders
• Schizophrenia
• Schizophreniform
disorder
• Schizotypal(personality)
disorder
• Schizoaffective disorder
• Substance/Medication-
Induced Psychotic
Disorder
• Psychotic Disorder Due
to Another Medical
Condition
• Brief Psychotic Disorder
• delusional disorder
• Other Specified
Schizophrenia Spectrum
and Other
• Psychotic Disorder

41. Icd 10 Icd 11 Dsm V
Catatonia
(BlockL1-6A4)
6A40 Catatonia
associated with
another mental
disorder
6A41 Catatonia
induced by
psychoactive
substances,
including
medications
6A4Z Catatonia,
unspecified
Catatonia Associated
With Another Mental
Disorder
(Catatonia Specifier)
Catatonic Disorder
Due to Another
Medical Condition
Unspecified
Catatonia

42. Icd10 Icd 11 Dsm V
F30-F39
Mood [affective]
disorders
F30 Manic episode
F31 Bipolar affective
disorder
F32 Depressive
episode
F33 Recurrent
depressive disorder
F34 Persistent mood
[affective] disorders
F38 Other mood
[affective] disorders
F39 Unspecified
mood [affective]
disorder
Mood disorders (BlockL1-6A6)
Bipolar or related disorders
(BlockL2-6A6)
6A60 Bipolar type I disorder
6A61 Bipolar type II
disorder
6A62 Cyclothymic disorder
6A6Y Other specified bipolar or
related disorders
6A6Z Bipolar or related
disorders, unspecified
6A80 Symptomatic and course
presentations for mood
episodes in mood
Disorders
6A8Y Other specified mood
disorders
6A8Z Mood disorders,
unspecified
• Bipolar I Disorder
• Bipolar II Disorder
• Cyclothymic Disorder
• Substance/Medication-
Induced Bipolar and Related
• Disorder
• Bipolar and Related Disorder
Due to Another Medical
• Condition
• Diagnostic Criteria
• Other Specified Bipolar and
Related Disorder
• Unspecified Bipolar and
Related Disorder
• Unspecified Mood Disorder
• Specifiers for Bipolar and
Related Disorders

43. Icd 10 Icd 11 Dsm V
Depressive disorders
(BlockL2-6A7)
6A70 Single episode
depressive disorder
6A71 Recurrent depressive
disorder
6A72 Dysthymic disorder
6A73 Mixed depressive
and anxiety disorder
6A7Y Other specified
depressive disorders
6A7Z Depressive disorders,
unspecified
Qualifiers in mood disorders
prominent anxiety symptoms
presence of panic attacks
seasonal pattern.
rapid cycling
five of ten symptoms is required
• Depressive Disorders
• Disruptive Mood
Dysregulation Disorder
• Major Depressive Disorder
• Persistent Depressive
Disorder
• Premenstrual
Dysphoric Disorder
• Substance/Medication-
Induced Depressive Disorder
• Depressive Disorder Due to
Another Medical Condition
• Other Specified Depressive
Disorder
• Unspecified Depressive
Disorder
• Specifiers for Depressive
Disorders

44. Icd10 Icd 11 Dsm V
Neurotic, stress-related and
somatoform disorders
F40 Phobic anxiety disorders
F40.0 Agoraphobia
.00 Without panic disorder
.01 With panic disorder
F40.1 Social phobias
F40.2 Specific (isolated) phobias
F40.8 Other phobic anxiety
disorders
F40.9 Phobic anxiety disorder,
unspecified
F41 Other anxiety disorders
F41.0 Panic disorder [episodic
paroxysmal anxiety]
F41.1 Generalized anxiety disorder
F41.2 Mixed anxiety and
depressive disorder
F41.3 Other mixed anxiety
disorders
F41.8 Other specified anxiety
disorders
F41.9 Anxiety disorder, unspecified
Anxiety or fear-related
disorders
(BlockL1-6B0)
6B00 Generalised
anxiety disorder
6B01Panic disorder
6B02
Agarophobia(reconcep
tualised.)
6B03 Specific phobia
6B04 Social anxiety
disorder
6B05 seperation
anxiety disorder
6B06 selective
mutism
6B0Y Other specified
anxiety or fear-
related disorders
6B0Z Anxiety or fear-
related disorders,
unspecified
Hypochondriasis
• Anxiety disorder
• Generalised anxiety
disorder
• Panic disorder
• Agarophobia
• Specific phobia
• Social anxiety
disorder
• seperation anxiety
disorder
• selective mutism
• Substance/Medicati
on-Induced Anxiety
Disorder
• Anxiety Disorder
Due to Another
Medical Condition
• OTHER SPECIFIED
• Unspecified

45. Icd10 Icd 11 Dsm V
Obsessive compulsive
disorder
Hypochondriacal
disorder
Trichotilomania
Obsessive-compulsive or
related disorders
(BlockL1-6B2)
Obsessive compulsive
disorder
Body dysmorphic
disorder
6B22 Olfactory
reference disorder
6B23 Hypochondriasis
6B24 Hoarding
disorder
6B25 Body-focused
repetitive behaviour
disorders
6B2Y Other specified
obsessive-compulsive
or related disorders
6B2Z Obsessive-
compulsive or related
disorders, unspecified
Tourette syndrome
• Obsessive-
Compulsive and
Related Disorders
• Obsessive
compulsive disorder
• Body dysmorphic
disorder
• illness anxiety
disorder
• hoarding disorder
• Trichotilomania
• Excoriation disorder

46. Icd10 Icd 11 Dsm V
F43 Reaction to severe
stress, and adjustment
disorders
F43.0 Acute stress
reaction
F43.1 Post-traumatic
stress disorder
F43.2 Adjustment
disorders
. F43.8 Other reactions to
severe stress
F43.9 Reaction to severe
stress, unspecified
Disorders specifically
associated with stress
(BlockL1-6B4)
6B40 Post traumatic
stress disorder
6B41 Complex post
traumatic stress disorder
6B42 Prolonged grief
disorder
6B43 Adjustment disorder
6B44 Reactive attachment
disorder
6B45 Disinhibited social
engagement disorder
(Acute stress reaction-
normal reaction to an
extreme stressor.) factors
influencing health status or
contact with health services
• Post traumatic
stress disorder
• Adjustment
disorder
• Reactive
attachment disorder
• Disinhibited social
engagement
disorder
• Acute stress reaction

47. Icd10 Icd 11 Dsm V
F44 Dissociative [conversion]
disorders
F44.0 Dissociative amnesia
F44.1 Dissociative fugue
F44.2 Dissociative stupor
F44.3 Trance and possession
disorders
F44.4 Dissociative motor disorders
F44.5 Dissociative convulsions
F44.6 Dissociative anaesthesia and
sensory loss
F44.7 Mixed dissociative [conversion]
disorders
F44.8 Other dissociative [conversion]
disorders
.80 Ganser's syndrome
.81 Multiple personality disorder
.82 Transient dissociative [conversion]
disorders occurring in childhood
and adolescence
.88 Other specified dissociative
[conversion] disorders
F44.9 Dissociative [conversion]
Dissociative disorders
(BlockL1-6B6)
6B60 Dissociative
neurological symptom
disorder
6B61 Dissociative
amnesia
6B62 Trance disorder
6B63 Possession
trance disorder
6B64 Dissociative
identity disorder
6B65 Partial
dissociative identity
disorder
6B66
Depersonalization-
derealization disorder
“conversion” is
eliminated
• Dissociative
disoreders
• Conversion
disorder(
functional
neurological
symptom disorder
)
• Dissociative
amnesia
• Trance disorder
• Dissociative
identity disorder
• Depersonalizatio
n-derealization
disorder
others

48. Icd10 Icd 11 Dsm V
F50-F59
Behavioural syndromes
associated with physiological
disturbances and physical
factors
F50 Eating disorders
F50.0 Anorexia nervosa
F50.1 Atypical anorexia
nervosa
F50.2 Bulimia nervosa
F5O.3 Atypical bulimia
nervosa
F50.4 Overeating associated
with other psychological
disturbances
F5O.5 Vomiting associated
with other psychological
disturbances
F50.8 Other eating disorders
F50.9 Eating disorder,
unspecified
Feeding or eating
disorders
(BlockL1-6B8)
6B80 Anorexia
Nervosa
6B81 Bulimia
Nervosa
6B82 Binge eating
disorder
6B83 Avoidant-
restrictive food
intake disorder
6B84 Pica
6B85 Rumination-
regurgitation
disorder
6B8Y Other
specified feeding
or eating disorders
6B8Z Feeding or
eating disorders,
unspecified
• Pica
• Rumination disorder
• Avoidant/Restrictive
Food Intake Disorder
• Anorexia Nervosa
• Bulimia Nervosa
• Binge-Eating Disorder
• Other Specified
Feeding or Eating
Disorder

49. Icd10 Icd 11 Dsm V
F98 Other
behavioural and
emotional disorders
with onset usually
occurring in
childhood and
adolescence
F98.0 Nonorganic
enuresis
F98.1 Nonorganic
encopresis
Elimination disorders
(BlockL1-6C0)
6C00 Enuresis
6C01 Encopresis
• Elimination
disorders
• Enuresis
• Encopresis

50. Icd10 Icd 11 Dsm V
somatoform disorders Disorders of bodily
distress or bodily
experience
(BlockL1-6C2)
6C20 Bodily distress
disorder
6C21 Body integrity
dysphoria

51. Icd10 Icd 11 Dsm V
Mental and behavioural
disorders due to
psychoactive substance
use
Flx.O Acute intoxication
Flx.l Harmful use
Flx.2 Dependence
syndrome
Fix.3 Withdrawal state
Flx.4 Withdrawal state
with delirium
Fix.5 Psychotic disorder
Fix.6 Amnesic syndrome
Fix.7 Residual and late-
onset psychotic disorder
Fix.8 Other mental and
behavioural disorders
Fix.9 Unspecified mental
and behavioural disorder
Disorders due to substance use
(BlockL2-6C4)
6C40 alcohol
cannabis
synthetic cannabinoids
Opioids
sedatives, hypnotics or anxiolytics
Cocaine
Stimulants
synthetic cathinones
Caffine
Hallucinogens
Nicotine
Volatile inhalants
MDMA or related drugs
dissociative drugs including
ketamine and
phencyclidine [PCP]
ther specified psychoactive
substances,
including medications
6C4H Disorders due to use of non-
psychoactive substances
• Substance-
Related and
Addictive
Disorders
• Substance Use
Disorders
• Substance-
Induced
Disorders

52. Icd10 Icd 11 Dsm V
Pathological gambling Disorders due to
addictive behaviours
(BlockL2-6C5)
6C50 Gambling
disorder
6C51 Gaming
disorder
Non substance related
disorders
Gambling disorder

53. Icd10 Icd 11 Dsm V
F63 Habit and
impulse disorders
F63.0 Pathological
gambling
F63.1 Pathological fire-
setting [pyromania]
F63.2 Pathological
stealing [kleptomania]
F63.3 Trichotillomania
F63.8 Other habit and
impulse disorders
F63.9 Habit and
impulse disorder,
unspecified
Impulse control
disorders
(BlockL1-6C7)
6C70 Pyromania
6C71 Kleptomania
6C72 Compulsive
sexual behaviour
disorder
6C73
Intermittent
explosive
disorder
6C7Y Other
specified
impulse control
disorders
6C7Z Impulse control
disorders,
unspecified
Disruptive, impulse
control and conduct
disorders
Pyromania
kleptomania
Intermittent explosive
disorder

54. Icd10 Icd 11 Dsm V
F91 Conduct
disorders
F91.0 Conduct
disorder confined to
the family context
F91.1 Unsocialized
conduct disorder
F91.2 Socialized
conduct disorder
F91.3 Oppositional
defiant disorder
F91.8 Other conduct
disorders
F91.9 Conduct
disorder, unspecified
F92 Mixed disorders
of conduct and
emotions
Disruptive behaviour or
dissocial disorders
(BlockL1-6C9)
6C90 Oppositional
defiant disorder
6C91 Conduct-
dissocial disorder
Disruptive, impulse
control and conduct
disorders
Oppositional defiant
disorder
Conduct disorders

55. Icd10 Icd 11 Dsm V
F60 Specific personality disorders
F60.0 Paranoid personality disorder
F60.1 Schizoid personality disorder
F60.2 Dissocial personality disorder
F60.3 Emotionally unstable
personality disorder
.30 Impulsive type
.31 Borderline type
F60.4 Histrionic personality disorder
F60.5 Anankastic personality disorder
F60.6 Anxious [avoidant] personality
disorder
F60.7 Dependent personality disorder
F60.8 Other specific personality
disorders
F60.9 Personality disorder,
unspecified
F61 Mixed and other personality
disorders
F61.0 Mixed personality disorders
F61.1 Troublesome personality
changes
Personality
disorders
and related
traits
(BlockL1-6
D1)
6D10
Personalit
y disorder
mild,
moderate,
Severe,
severity
unspecifie
d
6D11
Prominent
personalit
y traits or
patterns
general
diagnostic
requireme
• General Personality Disorder
• Cluster A Personality
Disorders *
paranoid*Schizoid*Schizotyp
al
• Cluster B Personality
Disorders*Antisocial
*Borderline Personality
*Histrionic Personality
*Narcissistic Personality
• Cluster C Personality
Disorders
• Avoidant Personality
Disorder
• Dependent Personality
Disorder
• Obsessive-Compulsive
Personality Disorder
• Other Personality Disorders
• Personality Change Due to
Another Medical Condition

56. Icd 10
F60-F69
Disorders of adult
personality and behaviour
Icd 11 Dsm V
F65 Disorders of sexual
preference
F65.0 Fetishism
F65.1 Fetishistic
transvestism
F65.2 Exhibitionism
F65.3 Voyeurism
F65.4 Paedophilia
F65.5 Sadomasochism
F65.6 Multiple disorders of
sexual preference
F65.8 Other disorders of
sexual preference
F65.9 Disorder of sexual
preference, unspecified
Paraphilic disorders
(BlockL1-6D3)
6D30 Exhibitionistic
disorder
6D31 Voyeuristic disorder
6D32 Pedophilic disorder
6D33 Coercive sexual
sadism disorder
6D34 Frotteuristic disorder
6D35 Other paraphilic
disorder involving non-
consenting individuals
6D36 Paraphilic disorder
involving solitary
behaviour or consenting
Individuals
6D3Z Paraphilic disorders,
unspecified
• Paraphilic Disorders
• Voyeuristic Disorder
• Exhibitionistic
Disorder
• Frotteuristic
Disorder
• Sexual Masochism
Disorder
• Sexual Sadism
Disorder
• Pedophilic Disorder
• Fetishistic Disorder
• Transvestic Disorder

57. Icd10 Icd 11 Dsm V
F68 Other disorders of
adult personality and
behaviour
F68.0 Elaboration of
physical symptoms for
psychological reasons
F68.1 Intentional
production or feigning of
symptoms or disabilities,
either physical or
psychological [factitious
disorder]
F68.8 Other specified
disorders of adult
personality and
behaviour
Factitious disorders
(BlockL1-6D5)
6D50 Factitious
disorder imposed on
self
6D51 Factitious
disorder imposed on
another
• Factitious Disorder
• Factitious Disorder
Imposed on Self
• Factitious Disorder
Imposed on Another
(Previously
Factitious
• Disorder by Proxy)

58. Icd10
F00-F09
Organic, including
symptomatic, mental disorders
Icd 11
Neurocognitive
disorders
(BlockL1-6D7)
Dsm V
neuro cognitive
disorders
F00 Dementia in Alzheimer's
disease
F01 Vascular dementia
F02 Dementia in other
diseases classified
elsewhere
F03 Unspecified dementia
F04 Organic amnesic
syndrome, not induced by
alcohol and other
psychoactive substances
F05 Delirium, not induced by
alcohol and other
psychoactive
Substances
F06 Other mental disorders
due to brain damage and
dysfunction and
to physical disease
F07 Personality and
6D70 Delirium
6D71 Mild
neurocognitive
disorder
6D72 Amnestic
disorder
Dementia
(BlockL2-6D8)
• Delirium
• Mild
neurocognitive
disorders
• Major cognitive
disorders

59. Icd10 Icd 11 Dsm V
F53 Mental and
behavioural disorders
associated with the
puerperium,
not elsewhere
classified
mild
Severe
Other
unspecified
Mental or behavioural
disorders associated with
pregnancy, childbirth and the
puerperium (BlockL1-6E2)
6E20 Mental or behavioural
disorders associated with
pregnancy, childbirth
and the puerperium, without
psychotic symptoms
6E21 Mental or behavioural
disorders associated with
pregnancy, childbirth
or the puerperium, with
psychotic symptoms

60. Icd10 Icd 11 Dsm V
Psychological and
behavioural factors
associated with
disorders
or diseases classified
elsewhere
6E40 Psychological
or behavioural
factors affecting
disorders or diseases
classified elsewhere
• Somatic symptom
and related
disorders
• Psychological
factors affecting
other conditions

61. Secondary Mental Or Behavioural Syndromes
Associated With Disorders Or Diseases
Classified Elsewhere (Blockl1-6e6)
6E60 Secondary neurodevelopmental syndrome
6E61 Secondary psychotic syndrome
6E62 Secondary mood syndrome
6E63 Secondary anxiety syndrome
6E64 Secondary obsessive-compulsive or related syndrome
6E65 Secondary dissociative syndrome
6E66 Secondary impulse control syndrome
6E67 Secondary neurocognitive syndrome
6E68 Secondary personality change

62. CHAPTER 7 SLEEP-WAKE DISORDERS
Insomnia
Hypersomnolance
Narcolepsy
Breathing-Related Sleep Disorders
Circadian Rhythm Sleep-Wake Disorders
Parasomnias

63. CHAPTER 17
Conditions Related To Sexual Health
1. Delayed Ejaculation
2. Erectile Disorder
3. Female Orgasmic Disorder
4. Female Sexual Interest/Arousal Disorder
5. Genito-Pelvic Pain/Penetration Disorder
6. Male Hypoactive Sexual Desire Disorder
7. Premature (Early) Ejaculation
8. Substance/Medication-Induced Sexual
Dysfunction

64. SECTION III
Emerging Measures And Models
 Cultural Concepts of Distress
 Alternative DSM-5 Model for Personality Disorders
 Conditions for Further Study
 Attenuated Psychosis Syndrome
 Depressive Episodes With Short-Duration Hypomania
 Caffeine Use Disorder
 Internet Gaming Disorder
 Neurobehavioral Disorder Associated With Prenatal
Alcohol Exposure
 Suicidal Behavior Disorder
 Nonsuicidal Self-Injury Disorder

65. LIMITATIONS OF DSM AND ICD
This creates certain risks of conceptual closure of
clinical psychiatry if Phenomenology,
Intersubjectivity and the Inherent historicism of
key concepts about mental illness are ignored in
practice, education and research
DSM classification
do not link
diagnostic
categories to any
treatment options
The focus of the ICD
is on the
classification of
disorders and not
the assessment and
treatment of people
Classificatory
systems are not
designed to function
as Textbook of
Psychiatry
Comprehensive case
formulation and
treatment planning
are beyond the
scope of DSM and
ICD
Neither the structure
of the ICD-11 MBND
chapter nor the
structure of DSM-
5 are based on
neurobiology

66. CONTROVERSIES
• Some changes will perform timely revisions like the
depathologisation of disorders of sexual orientation, other
innovations may be more controversial and will require further
evaluation in field studies .
• Decision not to introduce an attenuated psychosis syndrome in ICD-
11 .
• Objective (neurobiological) assessment tools and procedures to aid
in their diagnosis and to serve as external validation tools .
• Internet gaming disorder.
• Social media addiction, mobile phone addiction.
• Still far away from etiology-based grouping Certain grouping is due
to mechanisms – e.g., substance use disorders.Certain are due to
specified causes – e.g., anxiety due to substance use or medical
disorder

67. ADVANTAGES OF ICD 11
Stepwise approach
A stepwise approach to diagnosis that retains categorical classification
to ensure clinical utility but allows more detailed dimensional
assessments of psychopathology to inform treatment in specialized
settings and research
Internet based platform
Input from all Stakeholders
Content Model
Definitions
Field Trials for use cases
Electronic Health Records
Multi Lingual Representations
The influence of culture on the presentation of disorders

68. FUTURE DIRECTIONS
• Possible inter cultural variations to be addressed
• Need more frequent/ less frequent revisions
• Harmonization with other classificatory systems
• COVID-19 emergent Psychiatry sequelae cannot wait
for 30 years till it is recognized
• Pandemic-related bereavement and social stressors are
also unique
• Pros and cons of having 3 versions of ICD 11
• Multilingual option can be provided
• Disorder separate from Dysfunction
• Eventually neurobiology-based nomenclature is needed

69. REFERENCES
Pubmed articles
Icd 10
Icd 11
Dsm 5
CTP 10th edition

70. THANK YOU