Psychotic disorders in ICD-11: the revisions

This article provides an overview of the main changes to the chapter Schizophrenia or Other Primary Psychotic Disorders (6A2) from ICD-10 to ICD-11 and compares them with the psychosis chapter of DSM-5. These changes include abandoning the classical subtypes of Schizophrenia as well as of the special significance of Schneider's first-rank symptoms, resulting in the general requirement of two key features (one must be a positive symptom) in the definition of Schizophrenia (6A20) and the allowance for bizarre contents in Delusional Disorder (6A24), which now includes Induced Delusional Disorder (F24). Further introduced are the focus on the current episode, the restriction of Acute and Transient Psychotic Disorder (6A23) to the former Polymorphic Disorder Without Schizophrenic Symptoms (F23.0), the diagnosis of delusional Obsessive-Compulsive or Related Disorders (6B2) exclusively as Obsessive-Compulsive Disorders, the specification of Schizoaffective Disorder (6A21), and the formulation of a distinct subchapter Catatonia (6A4) for the assessment of catatonic features in the context of several disorders. In analogy to DSM-5, ICD-11 now includes the optional category Symptomatic Manifestations of Primary Psychotic Disorders (6A25) for the dimensional quantification of symptoms. Again, developmental aspects remain unattended in in the ICD-11-definitions of psychotic disorders.

Automated summary

The main changes from ICD-10 to ICD-11 in the chapter on Schizophrenia or Other Primary Psychotic Disorders include abandoning classical subtypes, specifying two key features for diagnosis, allowing bizarre contents, and focusing on current episode. Additionally, there are restrictions on Acute and Transient Psychotic Disorder and inclusion of specific disorders like Delusional Obsessive-Compulsive Disorder.