What is the citation for a comprehensive list of psychiatric diagnoses?

Citation for Comprehensive Psychiatric Diagnosis Lists

The authoritative citation for a comprehensive list of psychiatric diagnoses is the ICD-11 Mental, Behavioral or Neurodevelopmental Disorders (MBND) chapter, adopted by the World Health Assembly in May 2019 and implemented by WHO member states from January 1,2022. 1

Primary Classification Systems

ICD-11 (International Classification of Diseases, 11th Revision)

• The ICD-11 MBND chapter contains 21 disorder groupings, expanded from 11 groupings in ICD-10, providing the most comprehensive international classification of psychiatric diagnoses. 1
• The ICD-11 underwent the largest and most participative revision process in the history of mental health disorder classification, involving experts from all continents and extensive field studies. 1
• This system is used globally for public health, clinical diagnosis, service provision, and epidemiological data collection. 2
• Field studies demonstrated that 82.5% to 83.9% of clinicians rated ICD-11 as quite or extremely easy to use, accurate, clear, and understandable. 3

DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision)

• The DSM-5-TR, published by the American Psychiatric Association, serves as the primary diagnostic classification system in the United States. 3, 2
• While the DSM-5 and ICD-11 were harmonized in structure to improve international consistency, they remain distinct systems with different organizational approaches. 1

Key Structural Features of Modern Classifications

ICD-11 Organizational Principles

• Disorder groupings are organized based on shared etiology, pathophysiology, and phenomenology. 1
• A critical structural change eliminated the separate disorder grouping for mental and behavioral disorders with onset during childhood and adolescence, highlighting developmental continuity across the lifespan. 1
• Sleep-wake disorders and conditions related to sexual health were separated from the MBND chapter and cross-listed from new dedicated chapters. 1

Examples of Disorder Groupings

• The obsessive-compulsive and related disorders chapter includes OCD, body dysmorphic disorder, trichotillomania, hoarding disorder, excoriation disorder, Tourette syndrome, hypochondriasis, and olfactory reference syndrome. 1
• Personality disorders in ICD-11 use a dimensional model with severity ratings (mild, moderate, severe) and optional specification of maladaptive personality traits including negative affectivity, detachment, dissociality, disinhibition, anankastia, and borderline pattern. 4

Clinical Usage Patterns

How Clinicians Actually Use These Classifications

• In a global survey of 1,764 mental health professionals from 92 countries, 68.1% reported using classification systems often or routinely for administrative or billing purposes. 5
• Only 57.4% of respondents reported often or routinely going through diagnostic guidelines or criteria systematically to determine whether they apply to individual patients. 5
• Both ICD-10 and DSM were rated most useful for assigning a diagnosis, communicating with other health care professionals, and teaching, but least useful for treatment selection and determining prognosis. 5
• Approximately 12% of ICD-10 users and 19% of DSM users employ "residual" categories (other/unspecified) often or routinely, most commonly when clinical presentations do not conform to specific diagnostic categories. 5

Important Caveats

Limitations of Categorical Systems

• Both ICD-11 and DSM-5-TR remain primarily categorical systems that classify mental phenomena based on self-reported or clinically observable symptoms rather than incorporating neurobiological dimensions. 6
• Neither system has biological validation, resulting in biologically heterogeneous groups within the same diagnostic category. 3
• Changes from ICD-10 to ICD-11 were relatively modest with no paradigm shift toward biologically informed classification. 6
• Arbitrary boundaries between diagnostic categories limit reliability and validity, and most mental disorders exist on a severity dimension that categorical systems struggle to capture. 3, 7

Alternative Framework

• The Hierarchical Taxonomy of Psychopathology (HiTOP), published in 2017, provides a dimensional alternative that conceptualizes psychopathology as hierarchical continua rather than discrete categories. 8
• The National Institute of Mental Health's Research Domain Criteria (RDoC) framework provides a research-oriented approach emphasizing integration of behavioral and neuroscience research, though it is too complex for routine clinical practice. 6, 2