The rationale for the reclassification of personality disorder in the 11th revision of the International Classification of Diseases (ICD-11)

Nineteen years have elapsed since the 10th revision of the International Classification of Diseases (ICD-10), and many advances have been made in the field of personality disorders since that time. This paper reflects these advances and presents the first proposals of the ICD-11 working group for the reclassification of personality disorders. The essential changes from ICD-10 are to make the primary classification of personality disorder one of five levels of severity, including one of personality difficulty below the severity of disorder, to replace the existing categories of personality disorder with five monothetic trait domains of asocial, emotionally unstable, obsessional (anankastic), anxious/dependent and dissocial groups and to provide a simple algorithm for classification that can be used in ordinary psychiatric practice. It is argued that the proposed changes will improve the clinical utility of the diagnosis of personality disorder, reduce its stigma and help in the development and selection of appropriate treatment. © 2011 John Wiley & Sons, Ltd.