International Classification of Diseases

The World Health Organisation's International Classification of Diseases and Related Health Problems (ICD) manual, as it relates to the dissociative and trauma disorders.

International Classification of Diseases and Related Health Problems (ICD) is the standard diagnostic tool for epidemiology, health management and clinical purposes; it is used to monitor and diagnose of diseases and other health problems, including mental health problems. The ICD has been used in World Health Organization Member States from 1994 and the current version is the ICD-10. In the United States and the some of UK the DSM-5 manual is used instead.

ICD-10 updates
The ICD-10-CM is the "clinical modification" of the ICD-10, designed for the United States. ICD-10-CM will replace ICD-9-CM on October 1, 2014. This is used for clinical coding of health conditions, although the primary psychiatric manual in the US remains the Diagnostic and Statistical Manual In this the term dissociative identity disorder is used instead of multiple personality disorder.

ICD-11 Beta (currently being discussed and revised)
The ICD 11 is currently in the form of a Beta draft with descriptions of mental health and behavioral disorders not yet included; this is not a final version and is updated daily. The final version is expected to be released in 2017.

Last updated: 19 February 2014

Dissociative Disorders in the ICD-11 Beta
All the '5B2' coded dissociative disorders have symptoms which "are of sufficient severity to produce significant impairment in personal, family, social, educational, occupational or other important areas of functioning," and "are not better explained by another mental and behavioural disorder, are not due to the direct effects of a substance or medication, and are not due to a neurological condition, sleep-wake disorder, or other disorder or disease." KB76 Dissociative disorder due to disorder or disease classified elsewhere does not include these conditions, and is of organic cause.

5B20 Dissociative disorders of movement or sensation
"Dissociative disorders of movement or sensation are characterized by chronic or intermittent: 1) loss of particular sensations; 2) loss of volitional and intentional control of movements; or 3) intruding sensations or movements."

5B21 Cognitive dissociative disorders
"Cognitive dissociative disorders are characterized by marked or severe deficiency of the normal integration of thoughts, memories, emotions, identity, and behavior. The symptoms include inability or disability to access knowledge or experiences or to control mental functions (e.g., dissociative amnesia, depersonalization, [[derealization]). They can also include unbidden intrusions into consciousness and behavior with accompanying deficits in continuity of subjective experience (e.g., assumption of a new identity)."

5B22 Trance and possession disorder
"Trance and possession disorder is characterized by a temporary loss of both the sense of personal identity and full awareness of the surroundings. In some instances, the individual acts as if taken over by a spirit, deity, other person, or ‘force’. Attention and awareness may be limited to or concentrated upon only one or two aspects of the immediate environment, and there is often a limited but repeated set of movements, postures, and utterances. Only trance or possession phenomena that are involuntary or unwanted, and that intrude into ordinary activities by occurring outside (or being a prolongation of) religious or other culturally accepted situations should be included here."

Exclusions states associated with: schizophrenia, psychoactive substance intoxication, postconcussional syndrome, acute and transient psychotic disorders, organic personality disorder.

5B23 Dissociative identity disorder (formerly multiple personality disorder)
"Dissociative identity disorder is characterized by the presence of two or more insufficiently integrated conscious and self-conscious subsystems of the personality. Each of these subsystems has its own pattern of conceiving, perceiving, and relating to self, the body, and the environment. They can manifest in a sequence, or in parallel. The disorder may include cognitive, behavioral, sensory and motor dissociative symptoms. In some cases, one major dissociative identity predominantly controls the individual’s behavioral and mental actions, but is recurrently intruded and influenced by the actions of one or more other dissociative identities. In other cases, two or more dissociative identities recurrently influence each other, and at least two of these take executive control for substantial periods of time."

5B2Y Other specified dissociative disorders
Not described yet.

5B2Z Dissociative disorders, unspecified
Not described yet.

KB76 Dissociative disorder due to disorder or disease classified elsewhere
"A disorder characterized by a partial or complete loss of the normal integration between memories of the past, awareness of identity and immediate sensations, and control of bodily movements (see F44.-), but arising as a consequence of an organic disorder." Exclusions: dissociative [conversion] disorders, nonorganic or unspecified.

Disorders specifically associated with stress in the ICD-11 Beta
This category is equivalent to Trauma and Stressor-related disorders in the DSM-5.

5B10 Post-traumatic stress disorder
"PTSD is a disorder that develops following exposure to an extremely threatening or horrific event or series of events characterized by: 1. reexperiencing the traumatic event(s) in the present in the form of vivid intrusive memories, flashbacks, or nightmares, with each episode of reexperiencing accompanied by fear or horror; 2. avoidance of thoughts and memories of the event(s), or avoidance of activities or situations reminiscent of the event(s); and 3. a state of perceived current threat in the form of excessive hypervigilance or enhanced startle reactions.

The symptoms must last for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning." Also known as "traumatic neurosis".

5B11 Complex post-traumatic stress disorder
"Complex PTSD is a disorder that arises after exposure to a stressor typically of an extreme or prolonged nature and from which escape is difficult or impossible. The disorder is characterized by the core symptoms of PTSD as well as the development of persistent and pervasive impairments in affective, self and relational functioning, including difficulties in emotion regulation, beliefs about oneself as diminished, defeated or worthless, and difficulties in sustaining relationships."

Other terms for complex post-traumatic stress disorder: Personality change after: concentration camp experiences, Personality change after: disasters, Personality change after: prolonged: captivity with an imminent possibility of being killed, Personality change after: prolonged: exposure to life-threatening situations such as being a victim of terrorism, Personality change after: torture. Exclusions: post-traumatic stress disorder.

5B12 Prolonged grief disorder
"Prolonged grief disorder is a disturbance in which, following the death of a person close to the bereaved, there is persistent and pervasive yearning or longing for the deceased, or a persistent preoccupation with the deceased that has persisted for an abnormally long period of time following the loss, clearly beyond the normative response for grieving within the individuals’ religious and cultural context, and is sufficiently severe to cause significant impairment in the person’s personal, family, social, educational, occupational or other important areas of functioning. The response can also be characterized by difficulty accepting the death, feeling one has lost a part of one’s self, anger about the loss, guilt, or difficulty in engaging with social or other activities. The persistent grief response goes far beyond expected social or cultural norms, and depends on cultural and contextual factors."

5B13 Adjustment disorder
"Adjustment disorder is a maladaptive reaction to identifiable psychosocial stressor(s) or life change(s) characterized by preoccupation with the stressor and failure to adapt. The failure to adapt may be manifested by a range of symptoms that interfere with everyday functioning, such as difficulties concentrating or sleep disturbance. Symptoms of anxiety, depression, and impulse control or conduct problems are commonly present and may be the presenting feature. The symptoms emerge within a month of the onset of the stressor(s) and tend to resolve in 6 months unless the stressor persists for a longer duration. In order to be diagnosed, Adjustment disorder must be associated with significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning."

Also known as Culture shock, Grief reaction, Hospitalism in children. Excludes separation anxiety disorder of childhood.

5B14 Reactive attachment disorder
"Reactive attachment disorder is characterized by grossly abnormal attachment behaviours in early childhood, occurring in the context of a history of grossly inadequate child care (e.g., severe neglect, maltreatment, institutional deprivation). Even when an adequate primary caregiver is newly available, the child does not turn to the primary caregiver for comfort, support and nurture, rarely displays security-seeking behaviours towards any adult, and does not respond when comfort is offered. Reactive attachment disorder can only be diagnosed in children, and features of the disorder develop within the first 5 years of life. However, the disorder cannot be diagnosed before the age of 1 year (or a mental age of less than 9 months), when the capacity for selective attachments may not be fully developed, or in the context of Autism spectrum disorder."

Excluded asperger syndrome, maltreatment syndromes, disinhibited attachment disorder of childhood and normal variation in pattern of selective attachment.

5B15 Disinhibited social engagement disorder
"Disinhibited social engagement disorder is characterized by grossly abnormal social behaviour, occurring in the context of a history of grossly inadequate child care (e.g., severe neglect, institutional deprivation). The child approaches adults indiscriminately, lacks reticence to approach, will go away with unfamiliar adults, and exhibits overly familiar behaviour towards strangers. Disinhibited social engagement disorder can only be diagnosed in children, and features of the disorder develop within the first 5 years of life. However, the disorder cannot be diagnosed before the age of 1 year (or a mental age of less than 9 months), when the capacity for selective attachments may not be fully developed, or in the context of Autism spectrum disorder."

May also be known as: Institutional syndrome, Affectionless psychopathy. Excluded Asperger syndrome, hospitalism in children, hyperkinetic disorders and reactive attachment disorder of childhood.

5B1Y Other specified disorders specifically associated with stress
No description yet.

5B1Z Disorders specifically associated with stress, unspecified
No description yet. Also known as reaction to severe stress, and adjustment disorders.

ICD-10
Currently in use until the ICD-11 publication.

Trauma and Stressor-related Disorders in the ICD-10
the ICD-10 are classified within neurotic, stress-related and somatoform disorders, under the Reaction to severe stress, and adjustment disorders subcategory. They stated to have a direct cause, which must be one (or both) "an exceptionally stressful life event producing an acute stress reaction", or "a significant life change leading to continued unpleasant circumstances that result in an adjustment disorder", although the life events causing the disorder does not They are described as "maladaptive responses to severe or continued stress" which "interfere with successful coping mechanisms and therefore lead to problems of social functioning".


 * F43.0 Acute stress reaction
 * F43.1 Post-traumatic stress disorder
 * F43.2 Adjustment disorders (including culture shock, grief and hospitalisation in children)
 * F43.8 Other reactions to severe stress
 * F43.9 Reaction to severe stress, unspecified

Dissociative Disorders in the ICD-10
Dissociative disorders in the ICD-10 are classified within neurotic, stress-related and somatoform disorders, which also includes Acute stress reaction (F43.0) and Post-traumatic stress disorder (F43.1). They are under the Dissociative (conversion) disorders subcategory.

Dissociative disorders are classified under codes F44 and are also referred to as conversion disorders. The dissociative disorders are:
 * Dissociative amnesia, F44.0
 * Dissociative fugue, F44.1
 * Multiple personality disorder also known as Dissociative identity disorder, F44.81
 * Depersonalization-Derealization syndrome, F48.1 (a neurotic disorder)
 * Dissociative stupor
 * Trance and Possession Disorders
 * Dissociative motor disorders
 * Dissociative convulsions
 * Dissociative anesthesia and sensory loss
 * Mixed dissociative (conversion) disorders
 * Ganser’s syndrome
 * Other dissociative (conversion) disorders
 * Transient dissociative (conversion) Disorders in children and adolescents)
 * Dissociative [conversion] disorder, unspecified

ICD-10 Languages
The ICD-10 is available in multiple languages including the official World Health Organisation languages (Arabic, Chinese, English, French, Russian and Spanish) and has been translated into 36 others.

ICD-10 Online

 * Deutsche, 2013 German
 * Español Spanish
 * français CIM-10 French
 * Italiano CIM-10 Italian
 * русский Russian
 * português CID-10 Portuguese (Brazil)