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# Classifying mental disorders: DSM-5-TR and ICD-11

- Concept

The two manuals that define mental disorders, how they differ, and what is needed before a diagnosis is made.

Updated Nov 13, 2026

## Key points

- ICD is the WHO global standard for recording and reporting diseases; ICD-11 has a clinical manual for mental, behavioural and neurodevelopmental disorders, published in 2024.
- A diagnosis rests on a characteristic pattern of symptoms with clinically significant distress or impairment in functioning; DSM-5-TR criteria also set symptom thresholds and durations.
- Categorical: a disorder is present or absent. Dimensional: symptoms are rated on a continuum of severity.
- ICD-11 personality disorder is graded as mild, moderate or severe, with optional trait domain qualifiers and a borderline pattern qualifier.
- ICD-11 removed all subtypes of schizophrenia and introduced a set of dimensional symptom descriptors.
- New in ICD-11: complex post-traumatic stress disorder, prolonged grief disorder, gaming disorder, compulsive sexual behaviour disorder and bipolar type II as a separate category.

## What it is

Mental disorders are classified mainly with two systems. The DSM-5-TR is the American Psychiatric Association’s manual, published in 2022 as the first revision of the DSM-5 since its publication in 2013, with diagnostic criteria that include symptom thresholds and durations. The ICD-11 is the World Health Organization’s classification, adopted in 2019 and in effect since January 2022, a global standard for recording and reporting diseases; for mental, behavioural and neurodevelopmental disorders it generally avoids arbitrary cut-offs and symptom counts and relies on flexible clinical judgement. ICD-11 is explicitly categorical but adds dimensional approaches.

## Key facts

- ICD-11 raised the threshold for a depressive episode, which increases consistency with the DSM-5.
- ICD-11 adds dimensional qualifiers and descriptors, such as severity and trait domains for personality disorder and symptom descriptors for schizophrenia.
- Culture shapes how distress is expressed; ICD-11 gives culture-related guidance for each disorder, and the DSM-5-TR text has a section on culture-related diagnostic features.
- Prolonged grief disorder is in both ICD-11 and DSM-5-TR.

## DSM-5-TR and ICD-11 side by side

| Feature | DSM-5-TR | ICD-11 |
| --- | --- | --- |
| Who publishes it | American Psychiatric Association | World Health Organization |
| Current version | Text revision (2022) of the DSM-5 (2013) | Adopted in 2019, in effect since 2022; clinical manual for mental disorders published in 2024 |
| Scope | Mental disorders only | All diseases and health problems; one chapter for mental, behavioural and neurodevelopmental disorders |
| Style of criteria | Criteria with symptom thresholds and durations | Arbitrary cut-offs and symptom counts generally avoided; more clinical judgement |
| New in the latest edition | Prolonged grief disorder among the added diagnoses | Complex PTSD, prolonged grief disorder, gaming disorder, compulsive sexual behaviour disorder |
| Gender | Gender dysphoria, with updated terminology in the text revision | Gender incongruence moved out of the mental disorders chapter into a new sexual health chapter |

## Clinical notes

- In Colombia, the Ministry of Health has published tools to help health providers adapt WHO’s ICD-API (the programming interface of ICD-11) in their software.

## Test yourself

Think of the answer, then tap the question to see it.

## Which classification is the global standard for recording and reporting diseases?

The WHO International Classification of Diseases (ICD); ICD-11 came into effect in January 2022.

## What separates a mental disorder from a normal reaction in these classifications?

A characteristic pattern of symptoms with clinically significant distress or impairment in functioning; DSM-5-TR criteria also set symptom thresholds and durations.

## How does ICD-11 classify personality disorder?

As one diagnosis graded by severity (mild, moderate, severe), with optional trait qualifiers and a borderline pattern qualifier.

## What is the difference between a categorical and a dimensional approach?

Categorical decides whether a disorder is present or absent; dimensional rates symptoms or traits along a continuum of severity.

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## Elsewhere in DurgiPedia

- [Validity and reliability](https://durgical.com/en/epidemiology/validity-and-reliability/)
- [Agreement and the kappa statistic](https://durgical.com/en/epidemiology/agreement-and-the-kappa-statistic/)

## Connections

## Related 5

- [The psychiatric interview](https://durgical.com/en/behavioral-science/the-psychiatric-interview/)
- [Normality and mental health](https://durgical.com/en/behavioral-science/normality-and-mental-health/)
- [Culture and mental illness: cultural concepts of distress](https://durgical.com/en/behavioral-science/culture-and-mental-illness-cultural-concepts-of-distress/)
- [Psychological testing: reliability, validity and norms](https://durgical.com/en/behavioral-science/psychological-testing-reliability-validity-and-norms/)
- [Normal grief, prolonged grief and depression](https://durgical.com/en/behavioral-science/normal-grief-prolonged-grief-and-depression/)

## Related conditions 5

- [Personality disorders (clusters A, B and C)](https://durgical.com/en/conditions/personality-disorders/)
- [Schizophrenia](https://durgical.com/en/conditions/schizophrenia/)
- [Major depressive disorder](https://durgical.com/en/conditions/major-depressive-disorder/)
- [Post-traumatic stress disorder (PTSD) and acute stress disorder](https://durgical.com/en/conditions/post-traumatic-stress-disorder-and-acute-stress-disorder/)
- [Bipolar disorder](https://durgical.com/en/conditions/bipolar-disorder/)

[← All of behavioral science](https://durgical.com/en/behavioral-science/)

Educational content on behavior and the clinical relationship; not a diagnostic or treatment guide and no substitute for assessment by a health professional. If you or someone near you is at risk, seek help now from an emergency service or a mental-health helpline.

Sources: [Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders](https://pmc.ncbi.nlm.nih.gov/articles/PMC6313247/) (World Psychiatry, PubMed Central, 2019); [New manual released to support diagnosis of mental, behavioural and neurodevelopmental disorders added in ICD-11](https://www.who.int/news/item/08-03-2024-new-manual-released-to-support-diagnosis-of-mental--behavioural-and-neurodevelopmental-disorders-added-in-icd-11) (World Health Organization, 2024); [DSM-5-TR: overview of what’s new and what’s changed](https://pmc.ncbi.nlm.nih.gov/articles/PMC9077590/) (World Psychiatry, PubMed Central, 2022); [Herramientas para facilitar la adaptación de la ICD-API de la OMS en el software de las IPS de Colombia](https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/GCFI/herramientas-facilitar-adpatacion-icd-api-oms-desarrolladas.pdf) (Ministerio de Salud y Protección Social (Colombia), 2024).

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/behavioral-science/classifying-mental-disorders-dsm-5-tr-and-icd-11/