Fortschr Neurol Psychiatr 2018; 86(03): 150-155
DOI: 10.1055/a-0576-7149
Diskussion
© Georg Thieme Verlag KG Stuttgart · New York

Neue Wege der Klassifikation von Persönlichkeitsstörungen in ICD-11

A new approach to classifying Personality Disorders
Sabine C Herpertz
Universitätsklinikum Heidelberg Allgemeine Psychiatrie
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Publikationsverlauf

01/03/2018

02/06/2018

Publikationsdatum:
05. April 2018 (online)

Zusammenfassung

Ausgehend von der derzeit noch gültigen ICD-10-Klassifikation der Persönlichkeitsstörungen wird der von der WHO initiierte und geführte Entwicklungsprozess hin zu einer grundsätzlichen Neukonzeptionierung von Persönlichkeitsstörungen dargestellt. Aus einer kategorialen Klassifikation von Differentialtypen auf der Basis polythetischer Kriterienlisten wird eine weitgehend dimensionale Klassifikation werden, die im Falle der Erfüllung der Allgemeinen Kriterien einer Persönlichkeitsstörung drei Schweregrade unterscheidet und zur näheren Beschreibung fünf Persönlichkeitsdomänen heranzieht. Nach einem ersten Entwurf, der von der ICD-11 Arbeitsgruppe zu Persönlichkeitsstörungen ausgearbeitet wurde, liegt inzwischen ein zweiter Entwurf vor, der Anregungen der Internationalen Gesellschaften zur Beforschung von Persönlichkeitsstörungen aufgenommen hat. Dieser beschreibt die Schweregrade mit einem höheren Systematisierungsgrad, indem er sich an Funktionsbeeinträchtigungen des Selbst und der interpersonellen Beziehungsgestaltung orientiert, Symptome bezüglich der Emotionalität, der Kognition und des Verhaltens spezifiziert und schließlich die psychosozialen Auswirkungen, also in welchem Maße die Probleme die verschiedenen situativen Kontexte durchzieht, bewertet.

Abstract

Starting from the still valid ICD-10 classification of personality disorders, this text presents the process initiated and led by the WHO that aims at a fundamental change of conceptualizing personality disorders in ICD-11. The categorical classification of differential types based on polythetic criteria list will be replaced by a widely dimensional classification; in case the general criteria of a personality disorder are given, three severity levels and five trait domains are differentiated. In the original draft of the ICD-11 group, the trait qualifiers were meant only to be used in the expert setting and the severity levels described psychosocial impacts only. Meanwhile a revised draft has been prepared by the International societies for the study of personality disorders which operationalize the severity levels in a more systematized way by describing functional impairments of the self as well as of interpersonal relationships, presenting symptoms concerning emotions, cognitions and behaviors and evaluating the psychosocial impacts.

 
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