New Zealand (Aotearoa) clinicians' perspectives on the utility of the ICD‐11 personality disorder diagnosis

Abstract

AbstractThe ICD‐11 has now taken effect and includes a new dimensional personality disorder (PD) diagnosis. The current study aimed to examine Aotearoa/New Zealand practitioners' perceptions of the clinical utility of the new PD system. A sample of 124 psychologists and psychiatrists completed a survey, applying the DSM‐5 and ICD‐11 PD diagnostic systems to a current patient, and completed clinical utility metrics on the DSM‐5 and ICD‐11 models. Additional open‐ended questions further elicited clinicians' perceptions of the strengths, weaknesses and potential application issues of the ICD‐11 PD diagnosis, and these responses were analysed through thematic analysis. Overall, the ICD‐11 system was rated higher than the DSM‐5 on all six clinical metrics, with no significant difference between psychologists' and psychiatrists' ratings. Five themes emerged: appreciation for an alternative to DSM‐5, structural barriers preventing ICD‐11 PD implementation, personal barriers to ICD‐11 implementation, diagnoses viewed as low utility, clinician preference for formulation and cultural safety considerations for implementation of ICD‐11 PD in Aotearoa/NZ. Overall, clinicians had positive opinions of the clinical utility of the ICD‐11 PD diagnosis, although expressed some concerns about its implementation. The study expands upon initial evidence that mental health practitioners have generally positive perceptions of the ICD‐11 PDs' clinical utility.