Anxiety disorder icd 10
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Anxiety Disorder ICD-10: Diagnostic Criteria and Comparisons
Overview of Anxiety Disorders in ICD-10
The International Classification of Diseases, Tenth Revision (ICD-10), categorizes anxiety disorders into distinct groups, including phobic disorders (agoraphobia, social phobia, and specific phobia) and other anxiety disorders (panic disorder, generalized anxiety disorder (GAD), and mixed anxiety and depressive disorder)5. This classification system is widely used in clinical practice, particularly in Europe, and provides a structured approach to diagnosing anxiety disorders.
Diagnostic Concordance Between ICD-10 and DSM Systems
Generalized Anxiety Disorder (GAD)
Studies have shown that while the prevalence rates for GAD are similar between ICD-10 and DSM-IV, the two systems often diagnose different groups of individuals. ICD-10 tends to identify a milder form of GAD compared to DSM-IV, which requires symptoms of excessive worry and significant distress or impairment4. Additionally, ICD-10's criteria for GAD include symptoms of autonomic arousal and exclude cases with comorbid panic/agoraphobia, social phobia, or obsessive-compulsive disorder, leading to discrepancies in diagnoses4.
Childhood and Adolescent Anxiety Disorders
For anxiety disorders in children and adolescents, DSM-IV-TR generally classifies more individuals with an anxiety disorder compared to ICD-10. The concordance between the two systems varies depending on the specific disorder, with DSM-IV-TR showing higher agreement with the ICD-10 child section (F9) than with the adult section (F4)3. This suggests that the two systems may identify different subsets of the pediatric population with anxiety disorders.
Clinical Utility and Global Applicability of ICD-10
A global field study comparing ICD-10 and ICD-11 found that the latter's diagnostic accuracy and clinical utility were equivalent or superior to ICD-10. Clinicians reported higher accuracy in diagnosing GAD, specific phobia, and adult separation anxiety disorder using ICD-11, and found the guidelines easier to use and more applicable to their clinical practice1. However, challenges remained in distinguishing between disorder and normality in subthreshold cases and in applying guidelines for panic attacks1.
Impact on Disability and Employment
Anxiety disorders diagnosed under ICD-10 are associated with significant disability, reduced labor force participation, and impaired work performance. Individuals with these disorders often face challenges in completing education, joining the workforce, and maintaining employment, highlighting the need for effective treatments and support systems6.
Conclusion
The ICD-10 classification system for anxiety disorders provides a comprehensive framework for diagnosis, though it differs in some respects from the DSM systems. These differences can impact the identification and treatment of anxiety disorders, particularly in terms of severity and comorbidity. The transition to ICD-11 aims to address some of these discrepancies, improving diagnostic accuracy and clinical utility. Understanding these nuances is crucial for clinicians, researchers, and policymakers to ensure effective diagnosis and management of anxiety disorders.
Sources and full results
Most relevant research papers on this topic
Anxiety and Fear-Related Disorders in the ICD-11: Results from a Global Case-controlled Field Study.
The new ICD-11 diagnostic guidelines for Anxiety Disorders are equivalent or superior to ICD-10 guidelines, with global clinicians finding them easy to use and clear, but need refinement for subthreshold cases and panic attacks.
RCT
Large Human TrialThe Classification of Anxiety Disorders in ICD-10 and DSM-IV: A Concordance Analysis
Removing uncontrollability and clinical significance criteria from DSM-IV and focusing on hypervigilance and scanning symptoms in ICD-10 could improve concordance between the two anxiety disorder classifications.
Observational StudyConcordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence
The two classification systems identify different children with anxiety disorders, with low to high concordance and poor to good agreement depending on the anxiety disorder.
Observational Study
Very Rigorous JournalDSM-IV and ICD-10 generalized anxiety disorder: discrepant diagnoses and associated disability
DSM-IV and ICD-10 GAD prevalence rates are nearly identical, but these classification systems are diagnosing different groups of people, with DSM-only GAD cases having higher levels of disability.
Observational StudyThe Classification of Anxiety Disorders
The classification of anxiety disorders is controversial, with only panic disorder being controversial, and the ICD-10 system being simpler and more widely accepted.
Disability, Employment and Work Performance Among People with ICD-10 Anxiety Disorders
Anxiety disorders are associated with reduced labor force participation, degraded employment trajectories, and impaired work performance compared to people without disabilities or long-term health conditions.
Observational Study
Highly CitedDistress and fear disorders: an alternative empirically based taxonomy of the ‘mood’ and ‘anxiety’ disorders
Distress and fear disorders form a broad group of 'internalizing' mood and anxiety disorders, which should be revised in DSM-V and ICD-11.
Rigorous JournalHighly CitedThe 1-month prevalence of generalized anxiety disorder according to DSM-IV, DSM-V, and ICD-10 among nondemented 75-year-olds in Gothenburg, Sweden.
GAD is common in 75-year-olds, but DSM-IV/V and ICD-10 definitions capture different individuals, with greater congruence between GAD and depression than between the two classification systems.
Observational StudyComparison of the DSM–5 and ICD–10: panic and other anxiety disorders
The DSM-5 has made significant changes to panic and other anxiety disorders, improving classification and addressing concerns raised by the ICD-10 system.
Diagnostic consequences of a new category of anxious depression and a reduced duration requirement for anxiety symptoms in the ICD-11 PHC.
The proposed ICD-11 PHC encourages early identification and management of significant anxiety symptoms in primary care, particularly when they co-occur with depression.
Observational StudyRigorous Journal