title: Preliminary studies of the ICD-11 classification of personality disorder in practice.
abstract: OBJECTIVE
  This study aims to compare ICD-10 and putative ICD-11 classifications of personality disorder in different clinical populations.
  
  
  METHODS
  Prospective recording of ICD-10 and ICD-11 personality disorder classifications was carried out in (1) an anxious medical population, (2) an acute psychiatric in-patient population and (3) a retrospective recording of a mixed anxiety depression cohort in which all baseline data were scored from baseline information using the ICD-11 classification and compared with the original ICD-10 assessments.
  
  
  METHODS
  Comparison of ICD-10 and ICD-11 prevalence of personality disorder in each population was carried out.
  
  
  RESULTS
  Data from 722 patients were recorded. Using the ICD-10 criteria, the prevalence of generic personality disorder was 33.8% compared with 40.4% using the ICD-11 ones (χ2  = 6.7; P < 0.01), with 103 (14.3%) discordant assessments. Using the severity definitions in ICD-11, 34.3% of patients had personality difficulty. Severity level varied greatly by population; severe personality disorder was five times more common in the inpatient group. The four domain traits originally denoted as qualifying severity in ICD-11, negative affective, dissocial, anankastic and detached, were linked to anxious, borderline, dissocial, anankastic and schizoid personality disorders in ICD-10. Many patients had pathology in two or more domains.
  
  
  CONCLUSIONS
  The ICD-11 classification of personality disorder yields somewhat higher levels of personality dysfunction than ICD-10, possibly because the age range for the onset of diagnosis is now flexible. The range of severity levels make the classification more useful than ICD-10 in clinical practice as it identifies the greater pathology necessary for intervention.
authors.affiliation: Centre for Mental Health, Imperial College, London, W6 8RP, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Tyrer
authors.forename: Mike
authors.initials: M
authors.lastname: Crawford
authors.forename: Rahil
authors.initials: R
authors.lastname: Sanatinia
authors.forename: Helen
authors.initials: H
authors.lastname: Tyrer
authors.forename: Sylvia
authors.initials: S
authors.lastname: Cooper
authors.forename: Chris
authors.initials: C
authors.lastname: Muller-Pollard
authors.forename: Polyxeni
authors.initials: P
authors.lastname: Christodoulou
authors.forename: Maria
authors.initials: M
authors.lastname: Zauter-Tutt
authors.forename: Katerina
authors.initials: K
authors.lastname: Miloseska-Reid
authors.forename: Gemma
authors.initials: G
authors.lastname: Loebenberg
authors.forename: Boliang
authors.initials: B
authors.lastname: Guo
authors.forename: Min
authors.initials: M
authors.lastname: Yang
authors.forename: Duolao
authors.initials: D
authors.lastname: Wang
authors.forename: Scott
authors.initials: S
authors.lastname: Weich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology*; D003866:Depressive Disorder / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D049690:History, Ancient; D006801:Humans; D038801:International Classification of Diseases / Q000592:standards*; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D055815:Young Adult