title: Applicability of the ICD-11 proposal for PTSD: a comparison of prevalence and comorbidity rates with the DSM-IV PTSD classification in two post-conflict samples.
abstract: BACKGROUND
  The World Health Organization recently proposed significant changes to the posttraumatic stress disorder (PTSD) diagnostic criteria in the 11th edition of the International Classification of Diseases (ICD-11).
  
  
  OBJECTIVE
  The present study investigated the impact of these changes in two different post-conflict samples.
  
  
  METHODS
  Prevalence and rates of concurrent depression and anxiety, socio-demographic characteristics, and indicators of clinical severity according to ICD-11 in 1,075 Cambodian and 453 Colombian civilians exposed to civil war and genocide were compared to those according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).
  
  
  RESULTS
  Results indicated significantly lower prevalence rates under the ICD-11 proposal (8.1% Cambodian sample and 44.4% Colombian sample) compared to the DSM-IV (11.2% Cambodian sample and 55.0% Colombian sample). Participants meeting a PTSD diagnosis only under the ICD-11 proposal had significantly lower rates of concurrent depression and a lower concurrent total score (depression and anxiety) compared to participants meeting only DSM-IV diagnostic criteria. There were no significant differences in socio-demographic characteristics and indicators of clinical severity between these two groups.
  
  
  CONCLUSIONS
  The lower prevalence of PTSD according to the ICD-11 proposal in our samples of persons exposed to a high number of traumatic events may counter criticism of previous PTSD classifications to overuse the PTSD diagnosis in populations exposed to extreme stressors. Also another goal, to better distinguish PTSD from comorbid disorders could be supported with our data.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany.|Center for Torture Victims, Berlin, Germany; n.stammel@bzfo.de.
authors.forename: Nadine
authors.initials: N
authors.lastname: Stammel
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Abbing
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany.|Center for Torture Victims, Berlin, Germany.
authors.forename: Carina
authors.initials: C
authors.lastname: Heeke
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany.|Center for Torture Victims, Berlin, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Knaevelsrud
keywords: DSM; ICD; PTSD; comorbidity; prevalence; psychiatric diagnosis; trauma