ABSTRACT

Background: The diagnostic criteria for posttraumatic stress disorder (PTSD) differ between DSM-5 and ICD-11, which may affect the estimation of prevalence.

Objective: To investigate the concordance of ICD-11 and DSM-5, as compared to ICD-10 and DSM-IV, regarding PTSD caseness among Japanese people who had experienced different potentially traumatic events. In addition, we estimated the comorbidity with major depressive disorder and generalized anxiety disorder according to these four diagnostic manuals.

Method: A web-based survey (n = 6,180) was conducted from November 2016 to March 2017. Participants completed the PTSD Checklist for DSM-5, and other standardized measures of PTSD, depression, and anxiety.

Results: The prevalence of PTSD caseness according to ICD-11 was significantly lower as compared to DSM-IV, DSM-5, and ICD-10. Cohen’s kappa between DSM-5 and ICD-11 was 0.79, indicating substantial agreement. Comorbidity with depression was significantly higher in unique DSM-5 cases than in unique ICD-11 cases. Unique DSM-5 PTSD cases were significantly stronger functionally impaired than unique ICD-11 PTSD cases.

Conclusions: Although requiring fewer items, the ICD-11 showed substantial agreement with DSM-5 regarding PTSD caseness. The lower comorbidity rates in unique cases may support the concept of the ICD-11 which intends to reduce comorbidity by identifying the core elements of PTSD.

摘要

背景：DSM-5和ICD-11之间的创伤后应激障碍（PTSD）诊断标准不同，这可能会影响患病率的估计。

目的：研究ICD-11和DSM-5与ICD-10和DSM-IV相比，在经历了不同潜在创伤事件的日本人中PTSD病例的一致性。此外，根据这四本诊断手册，我们估计了重度抑郁症和广泛性焦虑症的合并症。

方法：2016年11月至2017年3月进行了基于网络的调查（n = 6180）。参与者完成了DSM-5的PTSD检查表，以及其他PTSD，抑郁和焦虑的标准化测量。

结果：与DSM-IV，DSM-5和ICD-10相比，根据ICD-11的PTSD病例患病率显着降低。DSM-5和ICD-11之间的科恩kappa为0.79，表明存在实质性一致性。独特的DSM-5病例与抑郁症的合并症明显高于独特的ICD-11病例。独特的DSM-5 PTSD案例比独特的ICD-11 PTSD案例在功能上明显受损。

结论：尽管需要的物品更少，但ICD-11在PTSD病例方面与DSM-5表现出了实质性的一致性。在特殊情况下较低的合并症发生率可能支持ICD-11的概念，该概念旨在通过确定PTSD的核心要素来降低合并症。