Differentiating PTSD from anxiety and depression: Lessons from the ICD‐11 PTSD diagnostic criteria

Barbano, Anna C.; Mei, Willem F. van der; deRoon‐Cassini, Terri; Grauer, Ettie; Lowe, Sarah R.; Matsuoka, Yutaka; O’Donnell, Meaghan; Olff, Miranda; Qi, Wenyuan; Ratanatharathorn, Andrew; Schnyder, Ulrich; Seedat, Soraya; Kessler, Ronald C.; Koenen, Karestan C.; Shalev, Arieh Y.

doi:10.1002/da.22881

Cited by 51 publications

(36 citation statements)

References 29 publications

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“…These results together with previous findings (e.g. Barbano et al, 2019;Elhai, Grubaugh, Kashdan, & Frueh, 2008) indicated that removing overlapping symptoms ICD-11 criteria could not effectively reduce comorbidity. Actually, comorbidity is the rule rather than the exception in mental illness and is widely assumed to reflect the interaction between a limited number of latent traits (Zisner & Beauchaine, 2016) or causal associations among symptoms (Garabiles, Lao, Xiong, & Hall, 2019).…”

Section: Discussionsupporting

confidence: 66%

A comparison of ICD-11 and DSM-5 criteria for PTSD among a representative sample of Chinese earthquake survivors

Cao

Wang

et al. 2020

European Journal of Psychotraumatology

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Background: Striking differences regarding the diagnosis of PTSD exist between the ICD-11 and DSM-5. This study compared the prevalence and comorbidity of PTSD between the ICD-11 and DSM-5. Methods: An epidemiological sample of 1160 Chinese adult earthquake survivors collected nine and a half years following the Wenchuan earthquake, in Sichuan province. The PTSD Checklist for DSM-5 (PCL-5), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were used to measure PTSD, depression, and anxiety symptoms. Results: The ICD-11 PTSD criteria yielded higher prevalence estimates than the DSM-5 criteria. There were no significant differences in PTSD's comorbidity with major depressive disorder (MDD) or generalized anxiety disorder (GAD) between the ICD-11 and DSM-5 criteria. Conclusions: Results found that the ICD-11 and DSM-5 performed differently in assessing PTSD prevalence, but showed similar co-occurrence with MDD and GAD. This study adds to knowledge about the similarities and differences of using different PTSD criteria and carries implications for clinical and research utilization of the two widely used PTSD diagnostic criteria.

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Section: Discussionsupporting

confidence: 66%

A comparison of ICD-11 and DSM-5 criteria for PTSD among a representative sample of Chinese earthquake survivors

Cao

Wang

et al. 2020

European Journal of Psychotraumatology

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“…Our sample size at Week 9 was relatively modest and thereby likely underpowered compared to evaluation of ICD criteria in adult samples (e.g. Barbano et al, 2019), as is common in PTSD research with younger samples.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictive value of ICD‐11 post‐traumatic stress disorder and Complex PTSD diagnoses in children and adolescents exposed to a single‐event trauma

Elliott

McKinnon

Dixon

et al. 2020

Child Psychology Psychiatry

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Background: The 11th edition of the International Classification of Diseases (ICD-11) made a number of significant changes to the diagnostic criteria for post-traumatic stress disorder (PTSD). We sought to determine the prevalence and 3-month predictive values of the new ICD-11 PTSD criteria relative to ICD-10 PTSD, in children and adolescents following a single traumatic event. ICD-11 also introduced a diagnosis of Complex PTSD (CPTSD), proposed to typically result from prolonged, chronic exposure to traumatic experiences, although the CPTSD diagnostic criteria do not require a repeated experience of trauma. We therefore explored whether children and adolescents demonstrate ICD-11 CPTSD features following exposure to a single-incident trauma. Method: Data were analysed from a prospective cohort study of youth aged 8-17 years who had attended an emergency department following a single trauma. Assessments of PTSD, CPTSD, depressive and anxiety symptoms were performed at two to four weeks (n = 226) and nine weeks (n = 208) post-trauma, allowing us to calculate and compare the prevalence and predictive value of ICD-10 and ICD-11 PTSD criteria, along with CPTSD. Predictive abilities of different diagnostic thresholds were undertaken using positive/negative predictive values, sensitivity/specificity statistics and logistic regressions. Results: At Week 9, 15 participants (7%) were identified as experiencing ICD-11 PTSD, compared to 23 (11%) experiencing ICD-10 PTSD. There was no significant difference in comorbidity rates between ICD-10 and ICD-11 PTSD diagnoses. Ninety per cent of participants with ICD-11 PTSD also met criteria for at least one CPTSD feature. Five participants met full CPTSD criteria. Conclusions: Reduced prevalence of PTSD associated with the use of ICD-11 criteria is likely to reduce identification of PTSD relative to using ICD-10 criteria but not relative to DSM-4 and DSM-5 criteria. Diagnosis of CPTSD is likely to be infrequent following single-incident trauma.

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“…In addition, females are more likely to develop PTSD than males ( Christiansen and Hansen, 2015 ). Further, PTSD is frequently associated with symptoms of anxiety and depression ( Barbano et al, 2019 ) and often co-occurs with metabolic syndrome (MetS) ( Rosenbaum et al, 2015 ; Penninx and Lange, 2018 ). MetS, a risk factor for cardiovascular disease, is characterized by obesity, high blood pressure, dyslipidemia and insulin resistance ( Alberti et al, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

A Genome-Wide Association Study and Polygenic Risk Score Analysis of Posttraumatic Stress Disorder and Metabolic Syndrome in a South African Population

et al. 2021

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Posttraumatic stress disorder (PTSD) is a trauma-related disorder that frequently co-occurs with metabolic syndrome (MetS). MetS is characterized by obesity, dyslipidemia, and insulin resistance. To provide insight into these co-morbidities, we performed a genome-wide association study (GWAS) meta-analysis to identify genetic variants associated with PTSD, and determined if PTSD polygenic risk scores (PRS) could predict PTSD and MetS in a South African mixed-ancestry sample. The GWAS meta-analysis of PTSD participants (n = 260) and controls (n = 343) revealed no SNPs of genome-wide significance. However, several independent loci, as well as five SNPs in the PARK2 gene, were suggestively associated with PTSD (p < 5 × 10–6). PTSD-PRS was associated with PTSD diagnosis (Nagelkerke’s pseudo R2 = 0.0131, p = 0.00786), PTSD symptom severity [as measured by CAPS-5 total score (R2 = 0.00856, p = 0.0367) and PCL-5 score (R2 = 0.00737, p = 0.0353)], and MetS (Nagelkerke’s pseudo R2 = 0.00969, p = 0.0217). These findings suggest an association between PTSD and PARK2, corresponding with results from the largest PTSD-GWAS conducted to date. PRS analysis suggests that genetic variants associated with PTSD are also involved in the development of MetS. Overall, the results contribute to a broader goal of increasing diversity in psychiatric genetics.

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Differentiating PTSD from anxiety and depression: Lessons from the ICD‐11 PTSD diagnostic criteria

Cited by 51 publications

References 29 publications

A comparison of ICD-11 and DSM-5 criteria for PTSD among a representative sample of Chinese earthquake survivors

A comparison of ICD-11 and DSM-5 criteria for PTSD among a representative sample of Chinese earthquake survivors

Prevalence and predictive value of ICD‐11 post‐traumatic stress disorder and Complex PTSD diagnoses in children and adolescents exposed to a single‐event trauma

A Genome-Wide Association Study and Polygenic Risk Score Analysis of Posttraumatic Stress Disorder and Metabolic Syndrome in a South African Population

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