Diagnostik der PTBS im Spannungsfeld von DSM-5 und ICD-11

TY - JOUR

T1 - Diagnostik der PTBS im Spannungsfeld von DSM-5 und ICD-11

AU - Schellong, Julia

AU - Hanschmidt, Franz

AU - Ehring, Thomas

AU - Knaevelsrud, Christine

AU - Schäfer, Ingo

AU - Rau, Heinrich

AU - Dyer, Anne

AU - Krüger-Gottschalk, Antje

PY - 2019/7

Y1 - 2019/7

N2 - BACKGROUND: The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Statistical Classification of Diseases and Related Health Problems (ICD-11, Version 2018) differ with respect to the diagnostic criteria of posttraumatic stress disorder (PTSD). The present study investigated the implications of these differences for the classification of PTSD within a sample of German survivors of various traumatic events.PATIENTS AND METHODS: A total of 341 trauma survivors who participated in a multicenter study were classified according to DSM-5 and ICD-11 and the results were compared. The PTSD checklist for DSM-5 (PCL-5) was used to diagnose PTSD. The ICD-11 PTSD cases were identified using a "restrictive" and a "wide" operationalization of re-experiencing symptoms (i. e. with and without intrusive memories). Depression and the level of trauma-related impairment were also assessed.RESULTS: The diagnosis rate using ICD-11 was significantly lower than under DSM-5 (DSM-5 64.5%, ICD-11 54.0%, p < 0.001) using a restrictive operationalization of re-experiencing symptoms but differences disappeared when using a wide operationalization. Rates of comorbidity with depression were reduced under ICD-11. Individuals with high and low levels of trauma-related impairment were equally likely to receive a PTSD diagnosis under ICD-11.DISCUSSION: Differences in the diagnosis rates between ICD-11 and DSM-5 depend on the operationalization of the specific ICD-11 re-experiencing requirements. Precise diagnostic guidelines are necessary to avoid inconsistent diagnoses.

AB - BACKGROUND: The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the International Statistical Classification of Diseases and Related Health Problems (ICD-11, Version 2018) differ with respect to the diagnostic criteria of posttraumatic stress disorder (PTSD). The present study investigated the implications of these differences for the classification of PTSD within a sample of German survivors of various traumatic events.PATIENTS AND METHODS: A total of 341 trauma survivors who participated in a multicenter study were classified according to DSM-5 and ICD-11 and the results were compared. The PTSD checklist for DSM-5 (PCL-5) was used to diagnose PTSD. The ICD-11 PTSD cases were identified using a "restrictive" and a "wide" operationalization of re-experiencing symptoms (i. e. with and without intrusive memories). Depression and the level of trauma-related impairment were also assessed.RESULTS: The diagnosis rate using ICD-11 was significantly lower than under DSM-5 (DSM-5 64.5%, ICD-11 54.0%, p < 0.001) using a restrictive operationalization of re-experiencing symptoms but differences disappeared when using a wide operationalization. Rates of comorbidity with depression were reduced under ICD-11. Individuals with high and low levels of trauma-related impairment were equally likely to receive a PTSD diagnosis under ICD-11.DISCUSSION: Differences in the diagnosis rates between ICD-11 and DSM-5 depend on the operationalization of the specific ICD-11 re-experiencing requirements. Precise diagnostic guidelines are necessary to avoid inconsistent diagnoses.

KW - Comorbidity

KW - Depression/complications

KW - Diagnostic and Statistical Manual of Mental Disorders

KW - Germany

KW - Humans

KW - International Classification of Diseases

KW - Stress Disorders, Post-Traumatic/complications

KW - Survivors/psychology

U2 - 10.1007/s00115-018-0668-0

DO - 10.1007/s00115-018-0668-0

M3 - SCORING: Zeitschriftenaufsatz

C2 - 30643956

VL - 90

SP - 733

EP - 739

JO - NERVENARZT

JF - NERVENARZT

SN - 0028-2804

IS - 7

ER -