Author:
O'Donnell Meaghan L.,Alkemade Nathan,Nickerson Angela,Creamer Mark,McFarlane Alexander C.,Silove Derrick,Bryant Richard A.,Forbes David
Abstract
BackgroundThere have been changes to the criteria for diagnosing post-traumatic
stress disorder (PTSD) in DSM-5 and changes are proposed for ICD-11.AimsTo investigate the impact of the changes to diagnostic criteria for PTSD
in DSM-5 and the proposed changes in ICD-11 using a large multisite
trauma-exposed sample and structured clinical interviews.MethodRandomly selected injury patients admitted to four hospitals were
assessed 72 months post trauma (n = 510). Structured
clinical interviews for PTSD and major depressive episode, as well as
self-report measures of disability and quality of life were
administered.ResultsCurrent prevalence of PTSD under DSM-5 scoring was not significantly
different from DSM-IV (6.7% v. 5.9%, z
= 0.53, P = 0.59). However, the ICD-11 prevalence was
significantly lower than ICD-10 (3.3% v. 9.0%,
z =–3.8, P<0.001). The PTSD
current prevalence was significantly higher for DSM-5 than ICD-11 (6.7%
v. 3.3%, z = 2.5, P
= 0.01). Using ICD-11 tended to show lower rates of comorbidity with
depression and a slightly lower association with disability.ConclusionsThe diagnostic systems performed in different ways in terms of current
prevalence rates and levels of comorbidity with depression, but on other
broad key indicators they were relatively similar. There was overlap
between those with PTSD diagnosed by ICD-11 and DSM-5 but a substantial
portion met one but not the other set of criteria. This represents a
challenge for research because the phenotype that is studied may be
markedly different according to the diagnostic system used.
Publisher
Royal College of Psychiatrists
Subject
Psychiatry and Mental health
Reference28 articles.
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2. Brewin C . World Health Organization Preparation of ICD-11: clinical utility of diagnostic criteria for trauma related disorders, Part 1. Diagnosing PTSD from three core elements. Presented at the 28th Annual Meeting of the International Society for Traumatic Stress Studies, 1–3 November 2012, Los Angeles, USA (http://www.istss.org/Expert_Training_ISTSS_Conferences/5920.htm).
3. An Epidemiology of Disability among Adults in the United States
4. Development of the World
Health Organisation WHOQOL-BREF Quality of Life
Assessment;Psychol Med,1998
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