title: The Classification of Anxiety and Fear-Related Disorders in the ICD-11.
abstract: Anxiety disorders are highly prevalent worldwide and engender substantial economic costs and disability. The World Health Organization is currently developing the Eleventh Revision of the International Classification of Diseases and Related Health Problems (ICD-11), which represents the first opportunity to improve the validity, clinical utility, and global applicability of the classification in more than 25 years. This article describes changes in the organization and diagnostic guidelines for anxiety and fear-related disorders proposed by the ICD-11 Working Group on the Classification of Mood and Anxiety Disorders and the rationale and evidence base for the proposals. In ICD-11, anxiety and fear-related disorders that manifest across the lifespan are brought together under a new grouping, and are partly distinguished by their focus of apprehension. The focus of apprehension is the stimulus or situation that triggers the fear or anxiety and may be highly specific as in specific phobia or relate to a broader class of situations as in social anxiety disorder. The guidelines also clarify the relationship between panic disorder and agoraphobia and a qualifier is provided for panic attacks in the context of other disorders. A standardized format emphasizing essential features of anxiety disorders is intended to improve clinical utility. Guidelines will be further refined based on findings from two types of field studies: those using a case-controlled vignette methodology disseminated via the Internet to practitioners worldwide (http://gcp.network) and clinic-based field trials implemented globally at participating field study centers.
authors.affiliation: School of Psychology, University of Ottawa, Ottawa, Canada.
authors.forename: Cary S
authors.initials: CS
authors.lastname: Kogan
authors.affiliation: Department of Psychiatry, University of Cape Town Groote Schuur Hospital, Cape Town, South Africa.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Maj
authors.affiliation: Department of Psychiatry, Columbia University New York State Psychiatric Institute, New York, New York.
authors.forename: Michael B
authors.initials: MB
authors.lastname: First
authors.affiliation: Department of Clinical Psychology, University of Amsterdam and The Netherlands Institute for Advanced Study, Amsterdam, The Netherlands.
authors.forename: Paul M G
authors.initials: PM
authors.lastname: Emmelkamp
authors.affiliation: Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.|Faculty of Psychology, National Autonomous University of Mexico, Mexico City, Mexico.
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Reed
mesh_terms: D001008:Anxiety Disorders / Q000145:classification* / Q000175:diagnosis*; D005239:Fear / Q000145:classification*; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male
keywords: Diagnostic and Statistical Manual of Mental Disorders (DSM-5); International Classification of Diseases (ICD) diagnosis; World Health Organization; anxiety disorders; classification