View source for ICD-11

{{Short description|Medical classification created by the World Health Organisation (WHO)}}
{{Infobox technology standard
| title           = International Classification of Diseases 11th Revision
| long_name       = International Classification of Diseases for Mortality and Morbidity Statistics Eleventh Revision
| image           = ICD-11 Front.png
| caption         =
| status          = Active
| year_started    = 2007<ref name="Agenda_item">{{Cite web | author=WHO | title=International Statistical Classification of Diseases and Related Health Problems: update on the eleventh revision | date=15 April 2016 | website=apps.who.int | url=https://apps.who.int/gb/ebwha/pdf_files/EB139/B139_7-en.pdf | archive-url=https://web.archive.org/web/20161020061506/https://apps.who.int/gb/ebwha/pdf_files/EB139/B139_7-en.pdf | archive-date=20 October 2016 | url-status=live | quote=The eleventh revision of the International Classification of Diseases (ICD-11) started in 2007.}}</ref><ref name="SNOMED_ICD_interfacing">{{Cite journal | last1=Rodrigues | first1=Jean-Marie | last2=Schulz | first2=Stefan | last3=Rector | first3=Alan | last4=Spackman | first4=Kent | last5=Üstün | first5=Bedirhan | last6=Chute | first6=Christopher G. | last7=Della Mea | first7=Vincenzo | last8=Millar | first8=Jane | last9=Brand Persson | first9=Kristina | date=2013 | title=Sharing Ontology between ICD 11 and SNOMED CT will enable Seamless Re-use and Semantic Interoperability | url=https://ebooks.iospress.nl/doi/10.3233/978-1-61499-289-9-343 | journal=Medinfo 2013 | volume=192 | issue=Medinfo 2013 | pages=343–346 | doi=10.3233/978-1-61499-289-9-343 | quote=Since 2007, the World Health Organization has been working on the next revision of the International Classification of Diseases – ICD-11}}</ref>
| first_published = {{Start date|2018|06|18|df=y}} <small>(stable version)</small><ref name="Timeline">{{Cite web | title=ICD-11 Timeline | url=https://www.who.int/classifications/icd/revision/timeline/en/ | website=who.int | archive-url=https://web.archive.org/web/20190505082818/https://www.who.int/classifications/icd/revision/timeline/en/ | archive-date=5 May 2019 | url-status=dead}}</ref>
| version         = 2024-01
| version_date    = {{Start date|2024|02|df=y}}<ref>{{cite news |title=ICD-11 2024 release |url=https://www.who.int/news/item/08-02-2024-icd-11-2024-release |access-date=21 August 2024 |work=www.who.int |publisher=WHO |date=8 February 2024 |archive-url=https://web.archive.org/web/20240413222103/https://www.who.int/news/item/08-02-2024-icd-11-2024-release |archive-date=13 April 2024 |language=en}}</ref>
| preview         =
| preview_date    = {{Start date|2011|05|df=y}} <small>(alpha version)</small><br />{{Start date|2012|05|df=y}} <small>(beta version)</small><ref name="Timeline" />
| organization    = [[World Health Organization]]
| committee       =
| series          = [[ICD]]
| editors         =
| authors         =
| base_standards  =
| related_standards =
| predecessor     = [[ICD-10]]
| abbreviation    = ICD-11, ICD-11 MMS
| domain          = {{ubl|[[Medical classification]]|[[Medical statistics]]}}
| license         = [[Creative Commons license|CC]] BY-ND 3.0 IGO<ref name="Terms_of_Use">{{Cite web | author=WHO | title=Terms of Use and License Agreement | url=https://icd.who.int/en/docs/ICD11-license.pdf | website=icd.who.int | archive-url=https://web.archive.org/web/20210910112338/https://icd.who.int/en/docs/ICD11-license.pdf | archive-date=10 September 2021 | url-status=live}}</ref>
| website         = {{URL|https://icd.who.int/browse/2024-01/mms/en}}
}}
The '''ICD-11''' is the eleventh revision of the [[International Classification of Diseases]] (ICD). It replaces the [[ICD-10]] as the global standard for recording health information and causes of death. The ICD is developed and annually updated by the [[World Health Organization]] (WHO). Development of the ICD-11 started in 2007<ref name="Agenda_item" /><ref name="SNOMED_ICD_interfacing" /> and spanned over a decade of work, involving over 300 specialists from 55 countries divided into 30 work groups,<ref>{{Cite report | first=Azza | last=Badr | name-list-style=vanc | title=Fifth regional steering group meeting Bangkok | url=http://getinthepicture.org/system/files/ICD-11%20-%20WHO.pdf | date=17–19 September 2019}} [[World Health Organization|WHO]]/[http://www.emro.who.int/ EMRO].</ref><ref>{{Cite report | first1=Donna | last1=Pickett | first2=Robert N. | last2=Anderson | name-list-style = vanc | title=Status on ICD-11: The WHO Launch | url=https://ncvhs.hhs.gov/wp-content/uploads/2018/08/ICD-11_WHO-v_7-17-2018.pdf | date=18 July 2018 | publisher=[[Centers for Disease Control and Prevention|CDC]]/[[National Center for Health Statistics|NCHS]]}}</ref> with an additional 10,000 proposals from people all over the world.<ref name="ICD-11_released">{{Cite press release | title=WHO releases new International Classification of Diseases (ICD 11) | url=https://www.who.int/news-room/detail/18-06-2018-who-releases-new-international-classification-of-diseases-(icd-11) | publisher=WHO | location=Geneva, Switzerland | date=18 June 2018 | archive-url=https://web.archive.org/web/20190531055811/https://www.who.int/news-room/detail/18-06-2018-who-releases-new-international-classification-of-diseases-(icd-11) | archive-date=31 May 2019 | url-status=live}}</ref> Following an [[alpha version]] in May 2011 and a [[Beta version|beta draft]] in May 2012, a stable version of the ICD-11 was released on 18 June 2018,<ref name="Timeline" /> and officially endorsed by all WHO members during the 72nd [[World Health Assembly]] on 25 May 2019.<ref>{{Cite press release | title=World Health Assembly Update, 25 May 2019 | url=https://www.who.int/news-room/detail/25-05-2019-world-health-assembly-update | publisher=WHO | location=Geneva, Switzerland | date=25 May 2019 | archive-url=https://web.archive.org/web/20190730052948/https://www.who.int/news-room/detail/25-05-2019-world-health-assembly-update | archive-date=30 July 2019 | url-status=live}}</ref>
The ICD-11 is a large ontology consisting of about 85,000 entities, also called classes or nodes. An entity can be anything that is relevant to health care. It usually represents a disease or a [[pathogen]], but it can also be an isolated symptom or (developmental) anomaly of the body. There are also classes for reasons for contact with health services, social circumstances of the patient, and external causes of injury or death. The ICD-11 is part of the [[WHO-FIC]], a family of [[medical classification]]s. The WHO-FIC contains the Foundation Component, which comprises all entities of all classifications endorsed by the WHO. The Foundation is the common core from which all classifications are derived. For example, the [[ICD-O]] is a derivative classification optimized for use in [[oncology]]. The primary derivative of the Foundation is called the ICD-11 MMS, and it is this system that is commonly referred to as simply "the ICD-11".<ref name="Chute_(2018)">{{cite journal | vauthors = Chute CG | title = The rendering of human phenotype and rare diseases in ICD-11 | journal = Journal of Inherited Metabolic Disease | volume = 41 | issue = 3 | pages = 563–569 | date = May 2018 | pmid = 29600497 | pmc = 5959961 | doi = 10.1007/s10545-018-0172-5 | quote = The primary linearization, and the one most users will recognize and likely believe is "the ICD-11", is the Mortality and Morbidity Statistics (MMS) linearization. | doi-access = free }}</ref> MMS stands for Mortality and Morbidity Statistics. The ICD-11 is distributed under a Creative Commons [[Creative Commons license#Six regularly used licenses|BY-ND license]].<ref name="Terms_of_Use" />
The ICD-11 officially came into effect on 1 January 2022.<ref>{{cite web | author=WHO | title=International Classification of Diseases (ICD) | url=https://www.who.int/classifications/classification-of-diseases | website=www.who.int | archive-url=https://web.archive.org/web/20220204085603/https://www.who.int/classifications/classification-of-diseases | archive-date=4 February 2022 | quote=The latest version of the ICD, ICD-11, was adopted by the 72nd World Health Assembly in 2019 and came into effect on 1 January 2022.}}</ref> In February 2022, the WHO stated that 35 countries were actively using the ICD-11.<ref>{{cite web | author=WHO | title=ICD-11 2022 release | url=https://www.who.int/news/item/11-02-2022-icd-11-2022-release | date=11 February 2022 | website=www.who.int | archive-url=https://web.archive.org/web/20220210221848/https://www.who.int/news/item/11-02-2022-icd-11-2022-release | archive-date=10 February 2022 | url-status=live}}</ref> On 14 February 2023, they reported that 64 countries were "in different stages of ICD-11 implementation".<ref>{{Cite web | author=WHO | title=ICD-11 2023 release is here | website=www.who.int | url=https://www.who.int/news/item/14-02-2023-icd-11-2023-release-is-here | archive-url=https://web.archive.org/web/20231208091346/https://www.who.int/news/item/14-02-2023-icd-11-2023-release-is-here | archive-date=8 December 2023 | url-status=live}}</ref> According to a ''[[JAMA Network Open|JAMA]]'' article from July 2023, implementation in the United States would at minimum require 4 to 5 years.<ref>{{Cite journal | first1=James A. | last1=Feinstein | first2=Peter J. | last2=Gill | first3=Brett R. | last3=Anderson | date=28 July 2023 | title=Preparing for the International Classification of Diseases, 11th Revision (ICD-11) in the US Health Care System | url=https://jamanetwork.com/journals/jama-health-forum/fullarticle/2807690 | journal=[[JAMA Health Forum]] | volume=4 | issue=7 | pages=e232253 | doi=10.1001/jamahealthforum.2023.2253| pmid=37505488 | pmc=10495107 }}</ref>
The ICD-11 MMS can be viewed online on the WHO's website. Aside from this, the site offers two maintenance platforms: the ICD-11 Maintenance Platform, and the WHO-FIC Foundation Maintenance Platform. Users can submit evidence-based suggestions for the improvement of the WHO-FIC, i.e. the ICD-11, the [[International Classification of Functioning, Disability and Health|ICF]], and the [[ICHI]].
==Structure==
===WHO-FIC===
{{See also|Medical classification#WHO Family of International Classifications}}
The WHO Family of International Classifications ([[WHO-FIC]]), also called the WHO Family,<ref>{{Cite web | author=WHO | title=World Health Organization Family of International Classifications: definition, scope and purpose | url=https://cdn.who.int/media/docs/default-source/classification/who-fic-network/familydocument2007.pdf | archive-url=https://web.archive.org/web/20211123101444/https://cdn.who.int/media/docs/default-source/classification/who-fic-network/familydocument2007.pdf | archive-date=23 November 2021 | url-status=live}}</ref> is a suite of classifications used to describe various aspects of the health care system in a consistent manner, with a standardised terminology.<ref name="Refguide_1.1.3">{{Cite web | author=WHO | title=1.1.3 ICD in the context of WHO Family of International Classifications (WHO-FIC) | url=https://icdcdn.who.int/icd11referenceguide/en/html/index.html#icd-in-the-context-of-the-who-family-of-international-classifications-whofic | website=ICD-11 Reference Guide}}</ref> The abbreviation is variously written with or without a [[hyphen]] ("WHO-FIC" or "WHOFIC"). The WHO-FIC consists of four components: the WHO-FIC Foundation, the Reference Classifications, the Derived Classifications, and the Related Classifications.<ref name="Refguide_1.1.3" /> The WHO-FIC Foundation,<ref name="Foundation_Browser">{{Cite web | author=WHO | title=WHO-FIC Foundation | website=icd.who.int | url=https://icd.who.int/dev11/f/en | archive-url=https://web.archive.org/web/20240328222617/https://icd.who.int/dev11/f/en | archive-date=Mar 28, 2024 | url-status=live}}</ref> also called the Foundation Component,<ref>{{Cite web | author=WHO | title=WHO-FIC Maintenance Platform | url=https://icd.who.int/dev11 | website=icd.who.int}}</ref> represents the entire WHO-FIC universe.<ref name="Classifications">{{Cite web | author=WHO | title=WHO Family of International Classifications (FIC) | url=https://www.who.int/standards/classifications | archive-url=https://web.archive.org/web/20211122233707/https://www.who.int/standards/classifications | archive-date=22 November 2021}}</ref> It is a collection of over hundred thousand entities, also called classes or nodes.<ref name="Classifications" /> Entities are anything relevant to health care. They are used to describe diseases, disorders, body parts, bodily functions, reasons for visit, medical procedures, microbes, causes of death, social circumstances of the patient, and much more.<ref name="Refguide_1.1.3" />
The Foundation Component is a multidimensional collection of entities.<ref name="Classifications" /> An entity can have multiple parents and child nodes. For example, [[pneumonia]] can be categorized as a [[lung infection]], but also as a [[Bacterial infection|bacterial]] or [[viral infection]] (i.e. by site or by [[etiology]]). Thus, the node Pneumonia (entity id: {{ICD11|142052508|142052508}}) has two parents: Lung infections (entity id: {{ICD11|915779102|915779102}}) and Certain infectious or parasitic diseases (entity id: {{ICD11|1435254666|1435254666}}). The Pneumonia node in turn has various children, including Bacterial pneumonia (entity id: {{ICD11|1323682030|1323682030}}) and Viral pneumonia (entity id: {{ICD11|1024154490|1024154490}}).
The Foundation Component is the common core on which all Reference and Derived Classifications are based.<ref name="Refguide_1.1.3" /> The WHO-FIC contains three Reference Classifications: the ICD-11 MMS (see below), the [[International Classification of Functioning, Disability and Health|ICF]], and the [[ICHI]]. Derived Classifications are based on the three Reference Classifications, and are usually tailored for a particular specialty.<ref>{{Cite web | author=WHO | title=1.1.4.3 WHO-FIC: Derived Classifications | url=https://icdcdn.who.int/icd11referenceguide/en/html/index.html#whofic-derived-classifications | website=ICD-11 Reference Guide}}</ref> For example, the [[ICD-O]] is a Derived Classification used in [[oncology]]. Each node of the Foundation has a unique entity id, which remains the same in all Reference and Derived Classifications, guaranteeing consistency. Related Classifications are complementary, and cover specialty areas not covered elsewhere in the WHO-FIC. For example, the International Classification of Nursing Practice (ICNP), draws on terms from the Foundation Component, but also uses terms specific for [[nursing]] not found in the Foundation.<ref name="Refguide_1.1.3" />
A classification can be represented as a tabular list, which is a "flat" hierarchical tree of categories. In this tree, all entities can only have a single parent, and therefore must be mutually exclusive of each other.<ref name="Refguide_1.2.8">{{Cite web | author=WHO | title=1.2.8 Foundation Component and Tabular Lists of ICD–11 | url=https://icdcdn.who.int/icd11referenceguide/en/html/index.html#foundation-component-and-tabular-lists-of-icd11 | website=ICD-11 Reference Guide}}</ref> Such a classification is also called a linearization.
===ICD-11 MMS===
The ICD-11 MMS is the main Reference Classification of the WHO-FIC, and the primary linearization of the Foundation Component. The ICD-11 MMS is commonly referred to as simply "the ICD-11".<ref name="Chute_(2018)" /> The "MMS" was added to differentiate the ICD-11 entities in the Foundation from those in the Classification. The ICD-11 MMS does not contain all classes from the Foundation ICD-11, and also adds some classes from the [[International Classification of Functioning, Disability and Health|ICF]]. MMS stands for Mortality and Morbidity Statistics. The abbreviation is variously written with or without a [[hyphen]] between 11 and MMS ("ICD-11 MMS" or "ICD-11-MMS").
The ICD-11 MMS consists of approximately 85,000 entities. Entities can be chapters, blocks or categories. A chapter is a top level entity of the hierarchy; the MMS contains 28 of them (see [[#Chapters|Chapters section]] below). A block is used to group related categories or blocks together. A category can be anything that is relevant to health care. Every category has a unique, alphanumeric code called an ICD-11 code, or just ICD code. Chapters and blocks never have ICD-11 codes, and therefore cannot be diagnosed. An ICD-11 code is not the same as an entity id.
The ICD-11 MMS takes the form of a "flat" hierarchical tree. As aforementioned, the entities in this linearization can only have a single parent, and therefore must be mutually exclusive of each other.<ref name="Refguide_1.2.8" /> To make up for this limitation, the hierarchy of the MMS contains gray nodes.<ref>See these screenshots: [https://archive.today/tzqXX/d6dd919a3e1700f0f7c8ef70ef899e5ee5c826c4.png 1], [https://archive.today/AzkYs/62fbae3bdd00a3fb409f6bba472d443663e01eae.png 2].</ref> These nodes appear as children in the hierarchy, but actually have a different parent node. They originally belong to a different block or chapter, but are also listed elsewhere because of overlap. For example, [[Pneumonia]] ({{ICD11|CA40}}) has two parents in the Foundation: "Lung infections" (site) and "Certain infectious or parasitic diseases" ([[etiology]]). In the MMS, Pneumonia is categorized in the "Lung infections", with a gray node in "Certain infectious or parasitic diseases". The same goes for [[injuries]], [[poisoning]]s, [[neoplasms]], and developmental anomalies, which can occur in almost any part of the body. They each have their own chapters, but their categories also have gray nodes in the chapters of the organs they affect. For instance, the [[blood cancers]], including all forms of [[leukemia]], are in the "Neoplasms" chapter, but they are also displayed as gray nodes in the chapter "Diseases of the blood or blood-forming organs".
The ICD-11 MMS also contains residual categories, or residual nodes. These are the "Other specified" and "Unspecified" categories. The former can be used to code conditions that do not fit with any of the more specific MMS entities, the latter can be used when necessary information may not be available in the source documentation. The ICD-11 Reference Guide advises that health care workers always aim to include the most specific level of detail possible, either with one code or multiple codes.<ref>{{Cite web | author=WHO | title=2.8.5 Residual categories – "Other" and "Unspecified" | url=https://icdcdn.who.int/icd11referenceguide/en/html/index.html#residual-categories-other-and-unspecified | website=ICD-11 Reference Guide}}</ref> In the ICD-11 Browser, residual nodes are displayed in a [[maroon]] color.<ref>[[Talk:ICD-11/Archive 1#Residual nodes are maroon-colored]]</ref> Residual categories are not in the Foundation, and therefore don't have an entity ID. Thus, in the MMS, they are the only categories with derivative entity IDs: their IDs are the same as their parent nodes, with "/other" or "/unspecified" tagged at the end. Their ICD codes always end with Y for "Other specified" categories, or Z for "Unspecified" categories (e.g. {{ICD11|1C4Y}} and {{ICD11|1C4Z}}).
===Health informatics===
The ICD-11, both the ICD-11 Foundation and the MMS, can be accessed using a multilingual [[Representational state transfer|REST]] [[API]]. Documentation on the ICD API and some additional tools for integration into third-party applications can be found at the ICD API home page.<ref>{{Cite web | author=WHO | title=ICD API | url=https://icd.who.int/icdapi | access-date=5 May 2022 | website=icd.who.int/icdapi}}</ref>
The WHO has released spreadsheets that can be used to link and convert [[ICD-10]] codes to those of the ICD-11. They can be downloaded from the ICD-11 MMS browser.<ref name="ICD-11_MMS_Browser">{{Cite web | author=WHO | title=ICD-11 MMS Browser | url=https://icd.who.int/browse11/l-m/en | website=icd.who.int}}</ref> In 2017, [[SNOMED International]] announced plans to release a [[SNOMED CT]] to ICD-11 MMS map.<ref>{{Cite press release | title=Position Statement: SNOMED CT to ICD-11-MMS Map | date=3 November 2017 | publisher=[[SNOMED International]] | url=https://www.snomed.org/news-and-events/articles/position-statement-snomed-ct-icd-11-mms-map | archive-url=https://archive.today/20220206203441/https://www.snomed.org/news-and-events/articles/position-statement-snomed-ct-icd-11-mms-map | archive-date=6 February 2022 | url-status=dead}}</ref>
The ICD-11 Foundation, and consequently the MMS, are updated annually, similarly to the ICD-10. Following the initial release of a stable version on 18 June 2018,<ref name="Timeline" /> the Foundation and the MMS have received six updates {{as of|February 2024|lc=y}}.<ref name="ICD-11_releases">{{Cite web | author=WHO | title=ICD-11 MMS releases | url=https://icd.who.int/browse/releases/mms | website=icd.who.int | archive-url=https://web.archive.org/web/20240225150210/https://icd.who.int/browse/releases/mms | archive-date=25 February 2024 | url-status=live}}</ref><ref name="Foundation_releases">{{Cite web | author=WHO | title=ICD-11 Foundation releases | url=https://icd.who.int/browse/releases/foundation | website=icd.who.int | archive-url=https://web.archive.org/web/20240225150515/https://icd.who.int/browse/releases/foundation | archive-date=25 February 2024 | url-status=live}}</ref>
==Chapters==
Below is a table of all chapters of the ICD-11 MMS,<ref name="ICD-11_MMS_Browser" /> the primary linearization of the Foundation Component.<ref name="Foundation_Browser" />
{| class="wikitable" style="width:100%;"
! #
! Range
! Chapter
! #
! Range
! Chapter
|-
| 1
| '''1A00–1H0Z'''
| Certain infectious or parasitic diseases
| 15
| '''FA00–FC0Z'''
| Diseases of the musculoskeletal system or connective tissue
|-
| 2
| '''2A00–2F9Z'''
| Neoplasms
| 16
| '''GA00–GC8Z'''
| Diseases of the genitourinary system
|-
| 3
| '''3A00–3C0Z'''
| Diseases of the blood or blood-forming organs
| 17
| '''HA00–HA8Z'''
| Conditions related to sexual health
|-
| 4
| '''4A00–4B4Z'''
| Diseases of the immune system
| 18
| '''JA00–JB6Z'''
| Pregnancy, childbirth or the puerperium
|-
| 5
| '''5A00–5D46'''
| Endocrine, nutritional or metabolic diseases
| 19
| '''KA00–KD5Z'''
| Certain conditions originating in the perinatal period
|-
| 6
| '''6A00–6E8Z'''
| Mental, behavioural or neurodevelopmental disorders
| 20
| '''LA00–LD9Z'''
| Developmental anomalies
|-
| 7
| '''7A00–7B2Z'''
| Sleep-wake disorders
| 21
| '''MA00–MH2Y'''
| Symptoms, signs or clinical findings, not elsewhere classified
|-
| 8
| '''8A00–8E7Z'''
| Diseases of the nervous system
| 22
| '''NA00–NF2Z'''
| Injury, poisoning or certain other consequences of external causes
|-
| 9
| '''9A00–9E1Z'''
| Diseases of the visual system
| 23
| '''PA00–PL2Z'''
| External causes of morbidity or mortality
|-
| 10
| '''AA00–AC0Z'''
| Diseases of the ear or mastoid process
| 24
| '''QA00–QF4Z'''
| Factors influencing health status or contact with health services
|-
| 11
| '''BA00–BE2Z'''
| Diseases of the circulatory system
| 25
| '''RA00–RA26'''
| Codes for special purposes
|-
| 12
| '''CA00–CB7Z'''
| Diseases of the respiratory system
| 26
| '''SA00–SJ3Z'''
| Supplementary Chapter Traditional Medicine Conditions - Module I
|-
| 13
| '''DA00–DE2Z'''
| Diseases of the digestive system
| 27
| '''VA00–VC50'''
| Supplementary section for functioning assessment
|-
| 14
| {{nowrap|'''EA00–EM0Z'''}}
| Diseases of the skin
| 28
| {{nowrap|'''XA0060–XY9U'''}}
| Extension Codes
|}
Unlike the [[ICD-10]] codes, the ICD-11 MMS codes never contain the letters I or O, to prevent confusion with the numbers 1 and 0.<ref name="Refguide_1.2.7.1">{{Cite web | author=WHO | title=1.2.7.1 Code structure | url=https://icdcdn.who.int/icd11referenceguide/en/html/index.html#code-structure | website=ICD-11 Reference Guide}}</ref>
==Changes==
Below is a summary of notable changes in the ICD-11 MMS compared to the ICD-10.
===General===
The ICD-11 MMS features a more flexible coding structure. In the ICD-10; every code starts with a letter, followed by a two digit number (e.g. {{ICD10|P35}})—creating 99 slots, excluding subcategories and blocks. This proved enough for most chapters, but four are so voluminous that their categories span multiple letters: Chapter {{rn|I}} (A00–B99), Chapter {{rn|II}} (C00.0–D48.9), Chapter {{rn|XIX}} (S00–T98), and Chapter {{rn|XX}} (V01–Y98). In the ICD-11 MMS, there is a single first character for every chapter. The codes of the first nine chapters begin with the numbers 1 to 9, while the next nineteen chapters start with the letters A to X. The letters I and O are not used, to prevent confusion with the numbers 1 and 0. The chapter character is then followed by a letter, a number, and a fourth character that starts as a number (0–9, e.g. {{ICD11|KA80}}) and may then continue as a letter (A–Z, e.g. {{ICD11|KA8A}}). The WHO opted for a forced number as the third character to prevent the spelling of "undesirable words".<ref name="Refguide_1.2.7.1" /> In the ICD-10, each entity within a chapter either has a code (e.g. {{ICD10|P35}}) or a code range (e.g. {{ICD10|P35–P39}}). The latter is a block. In the ICD-11 MMS, blocks never have codes, and not every entity necessarily has a code, although each entity does have a unique id.<ref name="Refguide_1.2.7.1" />
In the ICD-10, the next level of the hierarchy is indicated in the code by a dot and a single number (e.g. {{ICD10|P35.2}}). This is the lowest available level in the ICD-10 hierarchy, causing an artificial limitation of 10 subcategories per code (.0 to .9).<ref name="Reed_et_al._(2019)">{{cite journal | vauthors = Reed GM, First MB, Kogan CS, Hyman SE, Gureje O, Gaebel W, Maj M, Stein DJ, Maercker A, Tyrer P, Claudino A, Garralda E, Salvador-Carulla L, Ray R, Saunders JB, Dua T, Poznyak V, Medina-Mora ME, Pike KM, Ayuso-Mateos JL, Kanba S, Keeley JW, Khoury B, Krasnov VN, Kulygina M, Lovell AM, de Jesus Mari J, Maruta T, Matsumoto C, Rebello TJ, Roberts MC, Robles R, Sharan P, Zhao M, Jablensky A, Udomratn P, Rahimi-Movaghar A, Rydelius PA, Bährer-Kohler S, Watts AD, Saxena S | display-authors = 6 | title = Innovations and changes in the ICD-11 classification of mental, behavioural and neurodevelopmental disorders | journal = World Psychiatry | volume = 18 | issue = 1 | pages = 3–19 | date = February 2019 | pmid = 30600616 | pmc = 6313247 | doi = 10.1002/wps.20611 | quote = In the ICD-10, the number of groupings of disorders was artificially constrained by the decimal coding system used in the classification | doi-access = free | ref = {{harvid|Reed et al.|2019}}}}</ref> In the ICD-11 MMS, this limitation no longer exists: after 0–9, the list may continue with A–Z (e.g. {{ICD11|KA62.0}} – {{ICD11|KA62.A}}). Then, following the first character after the dot, a second character may be used in the next level of the hierarchy (e.g. {{ICD11|KA40.00}} – {{ICD11|KA40.08}}). This level is currently the lowest appearing in the MMS. The large amount of unused coding space in the MMS allows for updates to be made without having to change the other categories, ensuring that codes remain stable.<ref name="Refguide_1.2.7.1" />
The ICD-11 features five new chapters. The third chapter of the ICD-10, "Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism", has been split in two: "Diseases of the blood or blood-forming organs" (chapter 3) and "Diseases of the immune system" (chapter 4). The other new chapters are "Sleep-wake disorders" (chapter 7), "Conditions related to sexual health" (chapter 17, see [[#Sexual health|section]]), and "Supplementary Chapter Traditional Medicine Conditions - Module I" (chapter 26, see [[#Traditional medicine|section]]).
===Mental disorders===
====Overview====
The following mental disorders have been newly added to the ICD-11, but were already included in the American [[ICD-10-CM]] adaption: [[Binge eating disorder]] (ICD-11: {{ICD11|6B82}}; ICD-10-CM: {{ICD10CM|F50.81}}), [[Bipolar type II disorder]] (ICD-11: {{ICD11|6A61}}; ICD-10-CM: {{ICD10CM|F31.81}}), [[Body dysmorphic disorder]] (ICD-11: {{ICD11|6B21}}; ICD-10-CM: {{ICD10CM|F45.22}}), [[Excoriation disorder]] (ICD-11: {{ICD11|6B25.1}}; ICD-10-CM: {{ICD10CM|F42.4}}), [[Frotteuristic disorder]] (ICD-11: {{ICD11|6D34}}; ICD-10-CM: {{ICD10CM|F65.81}}), [[Hoarding disorder]] (ICD-11: {{ICD11|6B24}}; ICD-10-CM: {{ICD10CM|F42.3}}), and [[Intermittent explosive disorder]] (ICD-11: {{ICD11|6C73}}; ICD-10-CM: {{ICD10CM|F63.81}}).<ref name="Reed_et_al._(2019)" />
The following mental disorders have been newly added to the ICD-11, and are not in the ICD-10-CM: [[Avoidant/restrictive food intake disorder]] ({{ICD11|6B83}}), [[Body integrity dysphoria]] ({{ICD11|6C21}}), [[Catatonia]] ({{ICD11|486722075|486722075}}), [[Complex post-traumatic stress disorder]] ({{ICD11|6B41}}), [[Gaming disorder]] ({{ICD11|6C51}}), [[Olfactory reference disorder]] ({{ICD11|6B22}}), and [[Prolonged grief disorder]] ({{ICD11|6B42}}).<ref name="Reed_et_al._(2019)" />
Other notable changes include:<ref name="Reed_et_al._(2019)" />
* Distinct [[personality disorders]] have been collapsed into a single Personality disorder diagnosis, using a dimensional (as opposed to categorical) model; see [[#Personality disorder|Personality disorders section]].
* All subtypes of [[Schizophrenia]] (e.g. [[Paranoid schizophrenia|paranoid]], [[Disorganized schizophrenia|hebephrenic]], [[Catatonic schizophrenia|catatonic]]) have been removed. Instead, a dimensional model is used with the category Symptomatic manifestations of primary psychotic disorders ({{ICD11|6A25}}), which allows the coding for [[Positive symptoms]] ({{ICD11|6A25.0}}), [[Negative symptoms]] ({{ICD11|6A25.1}}), [[Depression (mood)|Depressive]] symptoms ({{ICD11|6A25.2}}), [[Mania|Manic]] symptoms ({{ICD11|6A25.3}}), [[:wikt:psychomotor|Psychomotor]] symptoms ({{ICD11|6A25.4}}), and [[Cognitive]] symptoms ({{ICD11|6A25.5}}).
* [[Persistent mood disorders]] ({{ICD10|F34}}), which consists of [[Cyclothymia]] ({{ICD10|F34.0}}) and [[Dysthymia]] ({{ICD10|F34.1}}), have been deleted. Cyclothymia has been categorized under [[Bipolar disorder|bipolar and related disorders]] ({{ICD11|6A62}}), while dysthymia has been categorized under [[Depression_(mood)|depressive disorders]] ({{ICD11|6A72}}).
* The ICD-10 differentiates between [[Phobic anxiety disorders]] ({{ICD10|F40}}), such as [[Agoraphobia]] ({{ICD10|F40.0}}), and Other anxiety disorders ({{ICD10|F41}}), such as [[Generalized anxiety disorder]] ({{ICD10|F41.1}}). The ICD-11 merges both groups together as [[Anxiety or fear-related disorders]] ({{ICD11|1336943699|1336943699}}).
* All [[Pervasive developmental disorders]] ({{ICD10|F84}}) are merged into one category, [[Autism spectrum disorder]] ({{ICD11|6A02}}), except for [[Rett syndrome]], which is moved to the developmental anomalies chapter ({{ICD11|LD90.4}}).
* [[Hyperkinetic disorders]] ({{ICD10|F90}}) is renamed [[Attention deficit hyperactivity disorder]] ({{ICD11|6A05}}), and a distinction in subtypes is made between [[Attention deficit hyperactivity disorder predominantly inattentive|predominantly inattentive]] ({{ICD11|6A05.0}}), predominantly hyperactive-impulsive ({{ICD11|6A05.1}}), and combined ({{ICD11|6A05.2}}). Hyperkinetic conduct disorder ({{ICD10|F90.1}}) has been removed.
* [[Acute stress reaction]] ({{ICD10|F43.0}}) has been moved out of the mental disorder chapter, and placed in the chapter "Factors influencing health status or contact with health services" ({{ICD11|QE84}}). Thus, in the ICD-11, Acute stress reaction is no longer considered a mental disorder.<ref>{{Cite web | first=Jonathan D. | last=Raskin | name-list-style = vanc | title=What's New in the International Classification of Diseases? | url=https://www.psychologytoday.com/intl/blog/making-meaning/201807/what-s-new-in-the-international-classification-diseases | website=[[Psychology Today]] | date=25 July 2018 | archive-url=https://archive.today/20200405171146/https://www.psychologytoday.com/intl/blog/making-meaning/201807/what-s-new-in-the-international-classification-diseases | archive-date=5 April 2020 | url-status=live}}</ref>
====ICD-11 CDDR====
Following an extensive, years-long revision process involving nearly 15,000 clinicians from 155 countries,<ref name="Reed_et_al._(2019)" /> the WHO developed the '''ICD-11 CDDG''' (Clinical Descriptions and Diagnostic Guidelines),<ref name="First_(2015)">{{Cite journal | first=Michael B. | last=First | display-authors=etal | date=5 February 2015 | title=The development of the ICD-11 Clinical Descriptions and Diagnostic Guidelines for Mental and Behavioural Disorders | journal=[[World Psychiatry]] | volume=14 | issue=1 | pages=82–90 | doi=10.1002/wps.20189| pmc=4329901 }}</ref><ref>{{Cite journal | first=Anirban | last=Gozi | year=2019 | title=Highlights of ICD-11 Classification of Mental, Behavioral, and Neurodevelopmental Disorders | journal=Indian Journal of Private Psychiatry | volume=13 | issue=1 | pages=11–17 | quote=Publication of the CDDG version of ICD-11 is expected following approval of the overall system by the World Health Assembly. | doi=10.5005/jp-journals-10067-0030| doi-access=free }}</ref><ref>{{Cite journal | first1=Wolfgang | last1=Gaebel | first2=Johannes | last2=Stricker | first3=Ariane | last3=Kerst | date=1 April 2022 | title=Changes from ICD-10 to ICD-11 and future directions in psychiatric classification | journal=[[Dialogues in Clinical Neuroscience]] | volume=22 | issue=1 | pages=7–15 | doi=10.31887/DCNS.2020.22.1/wgaebel | pmid=32699501 | pmc=7365296 | quote=A series of field studies evaluated how well the ICD-11 CDDG function when applied by health professionals.}}</ref> later renamed the '''ICD-11 CDDR''' (Clinical Descriptions and Diagnostic Requirements).<ref>{{Cite journal | first=Geoffrey M. | last=Reed | display-authors=etal | date=7 May 2022 | title=Emerging experience with selected new categories in the ICD-11: complex PTSD, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder | url=https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20960 | journal=[[World Psychiatry]] | volume=21 | issue=2 | pages=189–213 | doi=10.1002/wps.20960 | quote=The change in title from CDDG to CDDR relates to the development by the WHO over the past decade of a body of policies that define guidelines in a specific way that is not applicable to the CDDR.}}</ref> The CDDR is a comprehensive diagnostic manual for identifying and measuring mental illnesses with a uniform terminology, similar to the [[DSM-5]].<ref>{{Cite journal | first=Pasquale | last=Pezzella | date=7 May 2022 | title=The ICD-11 is now officially in effect | journal=[[World Psychiatry]] | volume=21 | issue=2 | pages=331–332 | doi=10.1002/wps.20982| pmid=35524598 | pmc=9077598 }}</ref><ref name="CDDR_book_released">{{Cite press release | title=New manual released to support diagnosis of mental, behavioural and neurodevelopmental disorders added in ICD-11 | url=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 | publisher=WHO | location=Geneva, Switzerland | date=8 March 2024 | archive-url=https://web.archive.org/web/20240308092719/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 | archive-date=8 March 2024 | url-status=live}}</ref> The ICD-11 CDDR was developed around the same time as the DSM-5, and the work groups of both projects regularly met to discuss their efforts. The CDDR and the DSM-5 are similar, but not identical.<ref>{{Cite book | author=WHO | date=8 March 2024 | title=Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders | url=https://iris.who.int/bitstream/handle/10665/375767/9789240077263-eng.pdf | edition=electronic | isbn=978-92-4-007726-3 | page=8 | publisher=World Health Organization | archive-url=https://web.archive.org/web/20240309090538/https://iris.who.int/bitstream/handle/10665/375767/9789240077263-eng.pdf | archive-date=9 March 2024 | url-status=live | quote=In this regard, ICD-11 and DSM-5 are quite similar to one another, though not identical, and substantially different from ICD10 and DSM-IV.}}</ref> The ICD-11 CDDR is the successor to the ICD-10 CDDG, which was first released in 1992<ref>[https://books.google.com/books?id=DFM0DgAAQBAJ Google Books entry on the ICD-10 CDDG]</ref> and was also known as the "Blue Book".<ref name="First_(2015)" /> The CDDR is integrated into the ICD-11, and can be viewed in [https://icd.who.int/browse/latest-release/mms/en the ICD-11 Browser].<ref name="ICD-11_MMS_Browser" /> On 8 March 2024,<ref name="CDDR_book_released" /> the CDDR was also released in book form. It can be downloaded for free from the WHO's website.<ref>{{Cite web | author=WHO | title=Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders (CDDR) | url=https://www.who.int/publications/i/item/9789240077263 | website=who.int | date=8 March 2024 | archive-url=https://web.archive.org/web/20240308110820/https://www.who.int/publications/i/item/9789240077263 | archive-date=8 March 2024 | url-status=live}}</ref>
====Personality disorder====
The [[personality disorder]] (PD) section has been completely revamped. All distinct PDs have been merged into one: Personality disorder ({{ICD11|6D10}}), which can be coded as mild ({{ICD11|6D10.0}}), moderate ({{ICD11|6D10.1}}), severe ({{ICD11|6D10.2}}), or severity unspecified ({{ICD11|6D10.Z}}). There is also an additional category called personality difficulty ({{ICD11|QE50.7}}), which can be used to describe personality traits that are problematic, but do not rise to the level of a PD. A personality disorder or difficulty can be specified by one or more Prominent personality traits or patterns ({{ICD11|6D11}}). The ICD-11 uses five trait domains: (1) [[negative affectivity]] ({{ICD11|6D11.0}}); (2) detachment ({{ICD11|6D11.1}}), (3) [[dissociality]] ({{ICD11|6D11.2}}), (4) [[disinhibition]] ({{ICD11|6D11.3}}), and (5) [[Obsessive–compulsive personality disorder|anankastia]] ({{ICD11|6D11.4}}). Listed directly underneath is borderline pattern ({{ICD11|6D11.5}}), a category similar to [[borderline personality disorder]]. This is not a trait in itself, but a combination of the five traits in certain severity.
Described as a clinical equivalent to the [[Big Five personality traits|Big Five model]],<ref>{{cite journal | vauthors = Irwin L, Malhi GS | title = Borderline personality disorder and ICD-11: A chance for change | url = https://journals.sagepub.com/doi/10.1177/0004867419837365 | journal = The Australian and New Zealand Journal of Psychiatry | volume = 53 | issue = 7 | pages = 698–700 | date = July 2019 | pmid = 30897927 | doi = 10.1177/0004867419837365 | s2cid = 85446539 }}</ref> the five-trait system addresses several problems of the old category-based system. Of the ten PDs in the ICD-10, two were used with a disproportionate high frequency: [[Borderline personality disorder|emotionally unstable personality disorder, borderline type]] ({{ICD10|F60.3}}) and [[Antisocial personality disorder|dissocial (antisocial) personality disorder]] ({{ICD10|F60.2}}).{{efn|It is perhaps important to note that the ICD has never featured the category [[narcissistic personality disorder]] (NPD), unlike the DSM, which has it since [[DSM-III]] and codes it under the ICD-category [[Other specific personality disorders]] (ICD-9: {{ICD9|301.8}}; ICD-10: {{ICD10|F60.8}}). Patients who might have NPD are sometimes also diagnosed with [[Antisocial personality disorder|Dissocial/Antisocial personality disorder]] (ICD-9: {{ICD9|301.7}}; ICD-10: {{ICD10|F60.2}}).}} Many categories overlapped, and individuals with severe disorders often met the requirements for multiple PDs, which Reed et al. (2019) described as "artificial [[Comorbidity#Mental health|comorbidity]]".<ref name="Reed_et_al._(2019)" /> PD was therefore reconceptualized in terms of a general dimension of severity, focusing on five negative personality traits which a person can have to various degrees.<ref name="Reed_(2018)">{{cite journal | vauthors = Reed GM | title = Progress in developing a classification of personality disorders for ICD-11 | journal = World Psychiatry | volume = 17 | issue = 2 | pages = 227–229 | date = June 2018 | pmid = 29856549 | pmc = 5980531 | doi = 10.1002/wps.20533 | quote = PD was conceptualized in terms of a general dimension of severity, continuous with normal personality variation and sub-threshold personality difficulty. | doi-access = free }}</ref>
There was considerable debate regarding this new dimensional model, with many believing that categorical diagnosing should not be abandoned. In particular, there was disagreement about the status of borderline personality disorder. Reed (2018) wrote: "Some research suggests that borderline PD is not an independently valid category, but rather a [[Homogeneity and heterogeneity#Sociology|heterogeneous]] marker for PD severity. Other researchers view borderline PD as a valid and distinct clinical entity, and claim that 50 years of research support the validity of the category. Many – though by no means all – clinicians appear to be aligned with the latter position. In the absence of more definitive data, there seemed to be little hope of accommodating these opposing views. However, the WHO took seriously the concerns being expressed that access to services for patients with borderline PD, which has increasingly been achieved in some countries based on arguments of treatment efficacy, might be seriously undermined."<ref name="Reed_(2018)" /> Thus, the WHO believed the inclusion of a borderline pattern category to be a "pragmatic compromise".<ref name="Watts_(2019)">{{cite journal | vauthors = Watts J | title = Problems with the ICD-11 classification of personality disorder | journal = The Lancet. Psychiatry | volume = 6 | issue = 6 | pages = 461–463 | date = June 2019 | pmid = 31122470 | doi = 10.1016/S2215-0366(19)30127-0 | s2cid = 163165767 | url = https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30127-0/fulltext }}</ref>
The Alternative DSM-5 Model for Personality Disorders (AMPD) included near the end of the [[DSM-5]] is similar to the PD-system of the ICD-11, although much larger and more comprehensive.<ref>[[DSM-5]], [https://books.google.com/books?id=-JivBAAAQBAJ&q=Alternative%20DSM-5%20Model%20for%20Personality%20Disorders pp. 761-781].</ref> It was considered for inclusion in the ICD-11, but the WHO decided against it because it was considered "too complicated for implementation in most clinical settings around the world",<ref name="Reed_(2018)" /> since an explicit aim of the WHO was to develop a simple and efficient method that could also be used in low-resource settings.<ref name="Watts_(2019)" />
====Gaming disorder====
[[Gaming disorder]] ({{ICD11|6C51}}) has been newly added to the ICD-11, and placed in the group "Disorders due to addictive behaviours", alongside [[Gambling disorder]] ({{ICD11|6C50}}). The latter was called Pathological gambling ({{ICD10|F63.0}}) in the ICD-10. Aside from Gaming disorder, the ICD-11 also features Hazardous gaming ({{ICD11|QE22}}), an ancillary category that can be used to identify problematic gaming which does not rise to the level of a disorder.
Although a majority<ref name="Rumpf_et_al._(2018)">{{cite journal | vauthors = Rumpf HJ, Achab S, Billieux J, Bowden-Jones H, Carragher N, Demetrovics Z, Higuchi S, King DL, Mann K, Potenza M, Saunders JB, Abbott M, Ambekar A, Aricak OT, Assanangkornchai S, Bahar N, Borges G, Brand M, Chan EM, Chung T, Derevensky J, Kashef AE, Farrell M, Fineberg NA, Gandin C, Gentile DA, Griffiths MD, Goudriaan AE, Grall-Bronnec M, Hao W, Hodgins DC, Ip P, Király O, Lee HK, Kuss D, Lemmens JS, Long J, Lopez-Fernandez O, Mihara S, Petry NM, Pontes HM, Rahimi-Movaghar A, Rehbein F, Rehm J, Scafato E, Sharma M, Spritzer D, Stein DJ, Tam P, Weinstein A, Wittchen HU, Wölfling K, Zullino D, Poznyak V | display-authors = 6 | title = Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective | journal = Journal of Behavioral Addictions | volume = 7 | issue = 3 | pages = 556–561 | date = September 2018 | pmid = 30010410 | pmc = 6426367 | doi = 10.1556/2006.7.2018.59 | url = https://www.researchgate.net/publication/326427203 | quote = Their arguments led to a series of commentaries, most of which were in favor of including the new diagnosis of GD in the ICD-11. | doi-access = free | ref = {{harvid|Rumpf et al.|2018}}}}</ref> of scholars supported the inclusion of Gaming disorder (GD), a significant number did not. Aarseth et al. (2017) stated that the evidence base which this decision relied upon is of low quality, that the diagnostic criteria of gaming disorder are rooted in substance use and gambling disorder even though they are not the same, that no consensus exist on the definition and assessment of GD, and that a pre-defined category would lock research in a confirmatory approach.<ref name="Aarseth_et_al._(2017)">{{cite journal | vauthors = Aarseth E, Bean AM, Boonen H, Colder Carras M, Coulson M, Das D, Deleuze J, Dunkels E, Edman J, Ferguson CJ, Haagsma MC, Helmersson Bergmark K, Hussain Z, Jansz J, Kardefelt-Winther D, Kutner L, Markey P, Nielsen RK, Prause N, Przybylski A, Quandt T, Schimmenti A, Starcevic V, Stutman G, Van Looy J, Van Rooij AJ | display-authors = 6 | title = Scholars' open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal | journal = Journal of Behavioral Addictions | volume = 6 | issue = 3 | pages = 267–270 | date = September 2017 | pmid = 28033714 | pmc = 5700734 | doi = 10.1556/2006.5.2016.088 | doi-access = free }}</ref> Rooij et al. (2017) questioned if what was called "gaming disorder" is in fact a coping strategy for underlying problems, such as [[Depression (mood)|depression]], [[social anxiety]], or [[ADHD]]. They also asserted [[moral panic]], fueled by sensational media stories, and stated that the category could be [[stigmatizing]] people who are simply engaging in a very immersive hobby.<ref>{{cite journal | vauthors = van Rooij AJ, Ferguson CJ, Colder Carras M, Kardefelt-Winther D, Shi J, Aarseth E, Bean AM, Bergmark KH, Brus A, Coulson M, Deleuze J, Dullur P, Dunkels E, Edman J, Elson M, Etchells PJ, Fiskaali A, Granic I, Jansz J, Karlsen F, Kaye LK, Kirsh B, Lieberoth A, Markey P, Mills KL, Nielsen RK, Orben A, Poulsen A, Prause N, Prax P, Quandt T, Schimmenti A, Starcevic V, Stutman G, Turner NE, van Looy J, Przybylski AK | display-authors = 6 | title = A weak scientific basis for gaming disorder: Let us err on the side of caution | journal = Journal of Behavioral Addictions | volume = 7 | issue = 1 | pages = 1–9 | date = March 2018 | pmid = 29529886 | pmc = 6035022 | doi = 10.1556/2006.7.2018.19 | doi-access = free }}</ref> Bean et al. (2017) wrote that the GD category caters to false stereotypes of gamers as physically unfit and socially awkward, and that most gamers have no problems balancing their expected social roles outside games with those inside.<ref>{{Cite journal | vauthors = Bean AM, Nielsen RK, Van Rooij AJ, Ferguson CJ | date=2017 | title=Video Game Addiction: The Push To Pathologize Video Games | url=https://www.researchgate.net/publication/317335670 | journal=[[Professional Psychology: Research and Practice]] | volume=48 | issue=5 | pages=378–389 | doi=10.1037/pro0000150| s2cid=148978635 }}</ref>
In support of the GD category, Lee et al. (2017) agreed that there were major limitations of the existing research, but that this actually necessitates a standardized set of criteria, which would benefit studies more than self-developed instruments for evaluating problematic gaming.<ref>{{cite journal | vauthors = Lee SY, Choo H, Lee HK | title = Balancing between prejudice and fact for Gaming Disorder: Does the existence of alcohol use disorder stigmatize healthy drinkers or impede scientific research? | journal = Journal of Behavioral Addictions | volume = 6 | issue = 3 | pages = 302–305 | date = September 2017 | pmid = 28816518 | pmc = 5700722 | doi = 10.1556/2006.6.2017.047 | quote = The use of the proposed GD criteria in ICD-11 is expected to promote a higher quality of research than the current use of unstandardized, mostly self-developed instruments for evaluating problematic gaming. | doi-access = free }}</ref> Saunders et al. (2017) argued that gaming addiction should be in the ICD-11 just as much as gambling addiction and substance addiction, citing [[functional neuroimaging]] studies which show similar brain regions being activated, and psychological studies which show similar antecedents ([[risk factor]]s).<ref>{{cite journal | vauthors = Saunders JB, Hao W, Long J, King DL, Mann K, Fauth-Bühler M, Rumpf HJ, Bowden-Jones H, Rahimi-Movaghar A, Chung T, Chan E, Bahar N, Achab S, Lee HK, Potenza M, Petry N, Spritzer D, Ambekar A, Derevensky J, Griffiths MD, Pontes HM, Kuss D, Higuchi S, Mihara S, Assangangkornchai S, Sharma M, Kashef AE, Ip P, Farrell M, Scafato E, Carragher N, Poznyak V | display-authors = 6 | title = Gaming disorder: Its delineation as an important condition for diagnosis, management, and prevention | journal = Journal of Behavioral Addictions | volume = 6 | issue = 3 | pages = 271–279 | date = September 2017 | pmid = 28816494 | pmc = 5700714 | doi = 10.1556/2006.6.2017.039 | doi-access = free }}</ref> Király and Demetrovics (2017) did not believe that a GD category would lock research into a confirmatory approach, noting that the ICD is regularly revised and characterized by permanent change. They wrote that moral panic around gamers does indeed exist, but that this is not caused by a formal diagnosis.<ref>{{cite journal | vauthors = Király O, Demetrovics Z | title = Inclusion of Gaming Disorder in ICD has more advantages than disadvantages | journal = Journal of Behavioral Addictions | volume = 6 | issue = 3 | pages = 280–284 | date = September 2017 | pmid = 28816495 | pmc = 5700721 | doi = 10.1556/2006.6.2017.046 | url = https://www.researchgate.net/publication/319166000 | quote = Both diagnostic manuals (i.e., the DSM and the ICD) are regularly revised, thus characterized by permanent change. (...) Moral panics and stigmatization related to video games are mostly induced and maintained by media scaremongering and the differences in mentality of the younger and older generations (i.e., generation gap) and not the existence of a formal diagnosis. | doi-access = free }}</ref> Rumpf et al. (2018) noted that stigmatization is a risk not specific to GD alone. They agreed that GD could be a coping strategy for an underlying disorder, but that in this debate, "[[Comorbidity#Mental health|comorbidity]] is more often the rule than the exception". For example, a person can have an [[Alcoholism|alcohol dependence]] due to [[PTSD]]. In clinical practice, ''both'' disorders need to be diagnosed and treated. Rumpf et al. also warned that the lack of a GD category might jeopardize insurance reimbursement of treatments.<ref>{{harvtxt|Rumpf et al.|2018}}: "The argument of potential stigmatization is not specific to GD but relates to many other well-established mental disorders. (...) Health insurance companies and other financers of treatment may adopt the arguments raised by non-clinical researchers (e.g., "gaming is a normal lifestyle activity"); so that, those in need of treatment and with limited funds are unable to get professional help."</ref>
The [[DSM-5]] (2013) features a similar category called Internet Gaming Disorder (IGD).<ref>DSM-5, [https://books.google.com/books?id=-JivBAAAQBAJ&q=%22internet+gaming+disorder%22 pp. 795-798].</ref> However, due to the controversy over its definition and inclusion, it is not included in its main body of mental diagnoses, but in the additional chapter "Conditions for Further Study". Disorders in this chapter are meant to encourage research and are not intended to be officially diagnosed.<ref>DSM-5: "These proposed criteria sets are not intended for clinical use; only the criteria sets and disorders in Section II of DSM-5 are officially recognized and can be used for clinical purposes." ([https://books.google.com/books?id=-JivBAAAQBAJ&q=%22not%20intended%20for%20clinical%20use%22 p. 783]).</ref>
===Burn-out===
In May 2019, a number of media incorrectly reported that [[Occupational burnout|burn-out]] was newly added to the ICD-11.<ref>{{Cite news | first=Ryan | last=Prior | name-list-style = vanc | title=Burnout is an official medical diagnosis, World Health Organization says | url=https://edition.cnn.com/2019/05/27/health/who-burnout-disease-trnd/index.html | date=28 May 2019 | work=[[CNN]] | archive-url=https://web.archive.org/web/20200329021152/https://edition.cnn.com/2019/05/27/health/who-burnout-disease-trnd/index.html | archive-date=29 March 2020 | url-status=live}}</ref><ref>{{Cite news | first=Suzanne | last=Degges-White | name-list-style = vanc | title=Burnout is Officially Classified as ICD-11 Syndrome | url=https://www.psychologytoday.com/us/blog/lifetime-connections/201905/burnout-is-officially-classified-icd-11-syndrome | date=28 May 2019 | work=Psychology Today | archive-url=https://archive.today/20200111235123/https://www.psychologytoday.com/us/blog/lifetime-connections/201905/burnout-is-officially-classified-icd-11-syndrome | archive-date=11 January 2020 | url-status=live}}</ref><ref>{{Cite news | title=WHO adds burnout to ICD-11 | url=https://www.healio.com/psychiatry/practice-management/news/online/%7B0308f73d-7977-4efe-88c9-3b9fa2243ac2%7D/who-adds-burnout-to-icd-11 | date=28 May 2019 | work=Healio | archive-url=https://web.archive.org/web/20190528175528/https://www.healio.com/psychiatry/practice-management/news/online/%7B0308f73d-7977-4efe-88c9-3b9fa2243ac2%7D/who-adds-burnout-to-icd-11 | archive-date=28 May 2019 | url-status= live}}</ref><ref>{{Cite news | first=Sara | last=Berg | name-list-style = vanc | title=WHO adds burnout to ICD-11. What it means for physicians | url=https://www.ama-assn.org/practice-management/physician-health/who-adds-burnout-icd-11-what-it-means-physicians | date=23 July 2019 | work=ama-assn.org | publisher=[[American Medical Association]] | archive-url=https://web.archive.org/web/20190728133139/https://www.ama-assn.org/practice-management/physician-health/who-adds-burnout-icd-11-what-it-means-physicians | archive-date=28 July 2019 | url-status=live}}</ref> In reality, burn-out is also in the ICD-10 ({{ICD10|Z73.0}}), albeit with a short, one-sentence definition only. The ICD-11 features a longer summary, and specifically notes that the category should only be used in an occupational context. Furthermore, it should only be applied when [[mood disorders]] ({{ICD11|6A60–6A8Z|76398729}}), Disorders specifically associated with stress ({{ICD11|6B40–6B4Z|991786158}}), and [[Anxiety or fear-related disorders]] ({{ICD11|6B00–6B0Z|1336943699}}) have been ruled out.
As with the ICD-10, burn-out is not in the mental disorders chapter, but in the chapter "Factors influencing health status or contact with health services", where it is coded {{ICD11|QD85}}. In response to media attention over its inclusion, the WHO emphasized that the ICD-11 does not define burn-out as a mental disorder or a disease, but as an occupational phenomenon that undermines a person's well-being in the workplace.<ref>{{Cite news | first=Megan | last=Brooks | name-list-style = vanc | title=Burnout Inclusion in ICD-11: Media Got It Wrong, WHO Says | url=https://www.medscape.com/viewarticle/914077 | date=7 June 2019 | work=[[Medscape]] | archive-url=https://web.archive.org/web/20190821191807/https://www.medscape.com/viewarticle/914077 | archive-date=21 August 2019 | url-status=dead}}</ref><ref>{{Cite web | author=Mental Health: Evidence and Research team | title=Burn-out an "occupational phenomenon": International Classification of Diseases | url=https://www.who.int/mental_health/evidence/burn-out/en/ | date=28 May 2019 | website=who.int | archive-url=https://web.archive.org/web/20190529191450/https://www.who.int/mental_health/evidence/burn-out/en/ | archive-date=29 May 2019 | url-status=live}}</ref>
===Sexual health===
====Sexual dysfunctions====
Regarding general sexual dysfunction, the ICD-10 has three main categories: [[Lack or loss of sexual desire]] ({{ICD10|F52.0}}), [[Sexual aversion and lack of sexual enjoyment]] ({{ICD10|F52.1}}), and [[Failure of genital response]] ({{ICD10|F52.2}}). The ICD-11 replaces these with two main categories: [[Hypoactive sexual desire dysfunction]] ({{ICD11|HA00}}) and [[Sexual arousal dysfunction]] ({{ICD11|HA01}}). The latter has two subcategories: [[Female sexual arousal dysfunction]] ({{ICD11|HA01.0}}) and [[Male erectile dysfunction]] ({{ICD11|HA01.1}}). The difference between Hypoactive sexual desire dysfunction and Sexual arousal dysfunction is that in the former, there is a reduced or absent desire for sexual activity. In the latter, there is insufficient physical and emotional response to sexual activity, even though there still is a ''desire'' to engage in satisfying sex. The WHO acknowledged that there is an overlap between desire and arousal, but they are not the same. Management should focus on their distinct features.<ref>{{harvtxt|Reed et al.|2016}}: "Although there is significant comorbidity between desire and arousal dysfunction, the overlap of these conditions does not mean that they are one and the same; research suggests that management should be targeted toward their distinct features."</ref>
The ICD-10 contains the categories [[Vaginismus]] ({{ICD10|N94.2}}), Nonorganic vaginismus ({{ICD10|F52.5}}), [[Dyspareunia]] ({{ICD10|N94.1}}), and Nonorganic dyspareunia ({{ICD10|F52.6}}). As the WHO aimed to steer away from the aforementioned "outdated mind/body split", the organic and nonorganic disorders were merged. Vaginismus has been reclassified as [[Sexual pain-penetration disorder]] ({{ICD11|HA20}}). Dyspareunia ({{ICD11|GA12}}) has been retained. A related condition is [[Vulvodynia]], which is in the ICD-9 ({{ICD9|625.7}}), but not in the ICD-10. It has been re-added to the ICD-11 ({{ICD11|GA34.02}}).<ref name="Reed_et_al._(2016)" />
Sexual dysfunctions and Sexual pain-penetration disorder can be coded alongside a temporal qualifier, "lifelong" or "acquired", and a situational qualifier, "general" or "situational". Furthermore, the ICD-11 offers five aetiological qualifiers, or "Associated with..." categories, to further specify the diagnosis.<ref name="Reed_et_al._(2016)" /> For example, a woman who experiences sexual problems [[Selective serotonin reuptake inhibitor#Sexual dysfunction|due to adverse effects of an SSRI antidepressant]] may be diagnosed with "Female sexual arousal dysfunction, acquired, generalised" ({{ICD11|HA01.02}}) combined with "Associated with use of psychoactive substance or medication" ({{ICD11|HA40.2}}).
====Compulsive sexual behaviour disorder====
[[Excessive sexual drive]] ({{ICD10|F52.7}}) from the ICD-10 has been reclassified as [[Compulsive sexual behaviour disorder]] (CSBD, {{ICD11|6C72}}) and listed under Impulse control disorders. The WHO was unwilling to overpathologize sexual behaviour, stating that having a high [[Libido|sexual drive]] is not necessarily a disorder, so long as these people do not exhibit impaired control over their behavior, significant distress, or impairment in functioning.<ref name="Kraus_et_al._(2018)">{{cite journal | vauthors = Kraus SW, Krueger RB, Briken P, First MB, Stein DJ, Kaplan MS, Voon V, Abdo CH, Grant JE, Atalla E, Reed GM | display-authors = 6 | title = Compulsive sexual behaviour disorder in the ICD-11 | journal = World Psychiatry | volume = 17 | issue = 1 | pages = 109–110 | date = February 2018 | pmid = 29352554 | pmc = 5775124 | doi = 10.1002/wps.20499 | doi-access = free }}</ref> Kraus et al. (2018) noted that several people self-identify as "sex addicts", but on closer examination do not actually exhibit the clinical characteristics of a sexual disorder, although they may have other mental health problems, such as anxiety or depression. Experiencing shame and guilt about sex is not a reliable indicator of a sex disorder, Kraus et al. stated.<ref name="Kraus_et_al._(2018)" />
There was debate on whether CSBD should be considered a (behavioral) addiction. It has been claimed that [[neuroimaging]] shows overlap between compulsive sexual behavior and substance-use disorder through common [[neurotransmitter]] systems.<ref>{{cite journal | vauthors = Kraus SW, Voon V, Potenza MN | title = Should compulsive sexual behavior be considered an addiction? | journal = Addiction | volume = 111 | issue = 12 | pages = 2097–2106 | date = December 2016 | pmid = 26893127 | pmc = 4990495 | doi = 10.1111/add.13297 }}</ref> Nonetheless, it was ultimately decided to place the disorder in the Impulse control disorders group. Kraus et al. wrote that, for the ICD-11, "a relatively conservative position has been recommended, recognizing that we do not yet have definitive information on whether the processes involved in the development and maintenance of [CSBD] are equivalent to those observed in substance use disorders, gambling and gaming".<ref name="Kraus_et_al._(2018)" />
====Paraphilic disorders====
[[Paraphilic disorders]], called Disorders of sexual preference in the ICD-10, have remained in the mental disorders chapter, although they have gray nodes in the sexual health chapter. The ICD-10 categories [[Sexual fetishism|Fetishism]] ({{ICD10|F65.0}}) and [[Fetishistic transvestism]] ({{ICD10|F65.1}}) were removed because, if they do not cause distress or harm, they are not considered mental disorders. [[Frotteuristic disorder]] ({{ICD11|6D34}}) has been newly added.<ref name="Reed_et_al._(2016)" />
===Antimicrobial resistance and GLASS===
The group related to coding [[antimicrobial resistance]] has been significantly expanded from ICD-10 to ICD-11.<ref>Compare {{ICD10|U82-U85}} in the ICD-10 to {{ICD11|1882742628|1882742628}} in the ICD-11.</ref> Also, the ICD-11 codes are more closely in line with the WHO's Global Antimicrobial Resistance Surveillance System (GLASS).<ref name="ICD-11_released" /> Launched in October 2015, this project aims to track [[Antimicrobial resistance|the growing worldwide resistance]] of malicious [[microbes]] ([[viruses]], [[bacteria]], [[fungi]], and [[protozoa]]) against medication.<ref>{{Cite web | title=Global Antimicrobial Resistance Surveillance System (GLASS) | url=https://www.who.int/glass/en/ | website=who.int | publisher=World Health Organization | archive-url=https://web.archive.org/web/20180202171413/https://www.who.int/glass/en/ | archive-date=2 February 2018 | url-status=live}}</ref>
===Traditional medicine===
"Supplementary Chapter Traditional Medicine Conditions - Module I" is an additional chapter in the ICD-11. It consists of concepts that are commonly referred to as [[traditional Chinese medicine]] (TCM), although the WHO prefers to use the more general and neutral sounding term [[traditional medicine]] (TM). Many of the traditional therapies and medicines that originally came from [[China]] also have long histories of usage and development in [[Japan]] ([[Kampo]]), [[Korea]] ([[Traditional Korean medicine|TKM]]), and [[Vietnam]] ([[Traditional Vietnamese medicine|TVM]]).<ref name="Choi_&_Chang_(2010)">{{cite journal | vauthors = Choi SH, Chang IM | title = A Milestone in Codifying the Wisdom of Traditional Oriental Medicine: TCM, Kampo, TKM, TVM-WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region | journal = Evidence-Based Complementary and Alternative Medicine | volume = 7 | issue = 3 | pages = 303–5 | date = September 2010 | pmid = 19124553 | pmc = 2887335 | doi = 10.1093/ecam/nen083 | doi-access = free }}</ref> Medical procedures that can be labeled as "traditional" continue to be used all over the world, and are an integral part of health services in some countries. A 2008 survey by the WHO found that "[i]n some Asian and African countries, 80% of the population depend on traditional medicine for primary health care". Also, "[i]n many developed countries, 70% to 80% of the population has used some form of alternative or complementary medicine (e.g. [[acupuncture]])".<ref>{{Cite web | title=Traditional medicine fact sheet | format=Revised December 2008 | url=https://www.who.int/mediacentre/factsheets/fs134/en | website=who.int | publisher=World Health Organization | archive-url=https://web.archive.org/web/20090129212351/http://www.who.int/mediacentre/factsheets/fs134/en | archive-date=29 January 2009 | url-status=dead}}</ref>
From approximately 2003 to 2007,<ref name="Morris,_Gomes,_Allen">{{cite journal | vauthors = Morris W, Gomes S, Allen M | title = International classification of traditional medicine | journal = Global Advances in Health and Medicine | volume = 1 | issue = 4 | pages = 38–41 | date = September 2012 | pmid = 24278830 | pmc = 3833512 | doi = 10.7453/gahmj.2012.1.4.005 | doi-access = free }}</ref> a group of experts from various countries developed the WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region, or simply IST.{{efn|The abbreviation "IST" is used in official WHO documentation.<ref name="IST_book" /> Other abbreviations that have been used are "WHO-IST"<ref name="Morris,_Gomes,_Allen" /> and "WHO ISTT".<ref name="Choi_&_Chang_(2010)" />}}<ref name="IST_book">{{Cite book | author=World Health Organization: Regional Office for the Western Pacific | date=2007 | title=WHO international standard terminologies on traditional medicine in the Western Pacific Region | isbn=978-9-29-061305-3 | location=Manila, Philippines | publisher=WHO Regional Office for the Western Pacific | hdl=10665/206952 | quote=Among the various standards in {{abbr|TRM|Traditional Medicine}}, such as acupuncture point locations, information and clinical practice, the development of an international standard terminology (IST) is the very first step towards overall standardization of TRM. (p1) (...) The International Standard Terminologies project has been conducted in parallel with information standardization projects like international classification for traditional medicine (ICTM), thesaurus and clinical ontology in traditional medicine. The outcome of IST is the bases for each of these information standardization projects. (p6) }}</ref> In the following years, based on this nomenclature, the group created the International Classification of Traditional Medicine, or ICTM.{{efn|text=Morris, Gomes, & Allen (2012) also used the term "International Classification of Traditional Medicine-China, Japan, Korea" (ICTM-CJK).<ref name="Morris,_Gomes,_Allen" /> This term does not appear in official WHO documentation, and has only limited use.{{Cn|date=August 2024}} Also, Choi (2020) have used the term "ICD-11-26" to refer to the TM-chapter.<ref>{{cite journal | vauthors=Choi SH | title=A Proposed Revision of the International Classification of Diseases, 11th Revision, Chapter 26 | journal=Integrative Cancer Therapies | volume=19 | date=2020 | pmid=32070150 | pmc=7031786 | doi=10.1177/1534735420908334 | doi-access=free}}</ref>}}<ref name="Morris,_Gomes,_Allen" /><ref>{{Cite report | vauthors = Choi SH, Watanabe K, Shim B, Zhu H, Roberts R | title=International Classification of Traditional Medicine: ICTM / Proposal to WHO-FIC Family Development Committee for inclusion of ICTM in the World Health Organization Family of International Classifications | url=https://apps.who.int/classifications/apps/icd/meetings/2006meeting/WHOFIC2006%20-%20C408%20-%20ICTM%20proposal.pdf | publisher=World Health Organization}}</ref> {{As of|February 2023}}, Module I, also called TM1,<ref>{{Cite web | title=26 Supplementary Chapter Traditional Medicine Conditions - Module I | url=https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f718687701 | website=ICD-11 Browser | publisher=World Health Organization}}</ref><ref name="Refguide_1.5">{{Cite web | author=WHO | title=1.5 Traditional Medicine | url=https://icdcdn.who.int/icd11referenceguide/en/html/index.html#traditional-medicine | website=ICD-11 Reference Guide}}</ref> is the only module of the ICTM to have been released. Morris, Gomes, & Allen (2012) have stated that Module II will cover [[ayurveda]], that Module III will cover [[homeopathy]], and that Module IV will cover "other TM systems with independent diagnostic conditions in a similar fashion".<ref name="Morris,_Gomes,_Allen" /> However, these modules have yet to be made public, and Singh & Rastogi (2018) noted that this "keeps the speculations open for what actually is encompassing under the current domain [of the ICTM]".<ref>{{Cite journal | first1=Ram Harsh | last1=Singh | first2=Sanjeev | last2=Rastogi | name-list-style = vanc | date=2018 | title=WHO ICD- 11 Showcasing of Traditional Medicine: Lesson from a lost opportunity | url=http://aamjournal.in/fulltext/70-1540784300.pdf | journal=Annals of Ayurvedic Medicine | volume=7 | issue=3 | pages=66–71 | archive-url=https://web.archive.org/web/20200406140129/http://aamjournal.in/fulltext/70-1540784300.pdf | archive-date=6 April 2020 | url-status=live}}</ref>
The decision to include T(C)M in the ICD-11 has been criticized, because it is often alleged to be [[pseudoscience]]. [[Editorial]]s by ''[[Nature (journal)|Nature]]'' and ''[[Scientific American]]'' admitted that some TM techniques and herbs have shown effectiveness or potential, but that others are pointless, or even outright harmful. They wrote that the inclusion of the TM-chapter is at odds with the scientific, evidence-based methods usually employed by the WHO. Both editorials accused the [[government of China]] of pushing the WHO to incorporate TCM, a global, billion-dollar market in which China plays a leading role.<ref>{{Cite journal | date=5 June 2019 | title=The World Health Organization's decision about traditional Chinese medicine could backfire | department=Editorial | journal=[[Nature (journal)|Nature]] | volume=570 | issue=5 | page=5 | doi=10.1038/d41586-019-01726-1 | pmid=31165792 | bibcode=2019Natur.570Q...5. | doi-access=free}}</ref><ref>{{Cite journal | author=((The Editors)) | date=1 April 2019 | title=The World Health Organization Gives the Nod to Traditional Chinese Medicine. Bad Idea | url=https://www.scientificamerican.com/article/the-world-health-organization-gives-the-nod-to-traditional-chinese-medicine-bad-idea/ | journal=[[Scientific American]] | volume=320 | issue=4 | page=6 | archive-url=https://archive.today/20200406145913/https://www.scientificamerican.com/article/the-world-health-organization-gives-the-nod-to-traditional-chinese-medicine-bad-idea/ | archive-date=6 April 2020 | url-status=live}}</ref> The WHO has stated that the categories of TM1 "do not refer to – or endorse – any form of treatment", and that their inclusion is primarily intended for statistical purposes.<ref>{{Cite report | author=WHO's Director-General | date=4 April 2019 | title=Eleventh revision of the International Classification of Diseases / Report by the Director-General | url=https://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_29-en.pdf | page=8 | publisher=World Health Organization | archive-url=https://web.archive.org/web/20200406142408/https://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_29-en.pdf | archive-date=6 April 2020 | url-status=live}}</ref> The TM1 codes are recommended to be used in conjunction with the [[Western medicine]] concepts of ICD-11 chapters 1-25.<ref name="Refguide_1.5" />
===Other changes===
Other notable changes in the ICD-11 include:
* [[Stroke]] is now classified as a neurological disorder instead of a disease of the [[circulatory system]].<ref name="ICD-11_Lancet">{{cite journal | title=ICD-11 | journal=The Lancet | volume=393 | issue=10188 | page=275 | department=Editorial | date=June 2019 | pmid=31180012 | doi=10.1016/S0140-6736(19)31205-X | doi-access=free | last1=The Lancet }}</ref>
* [[Allergies]] are now coded under diseases of the [[immune system]].<ref name="ICD-11_Lancet" />
* In the ICD-10, a distinction was made between Sleep disorders ({{ICD10|G47}}), included in nervous system diseases chapter, and Nonorganic sleep disorders ({{ICD10|F51}}), included in the mental disorders chapter. In the ICD-11, they are merged and placed into a new chapter called [[sleep-wake disorders]], since the separation between organic (physical) and non-organic (mental) disorders is considered obsolete.<ref name="Reed_et_al._(2019)_separate_quote" />
* "Supplementary section for functioning assessment" is an additional chapter that provides codes for use in the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0),<ref>{{cite web |title=WHO Disability Assessment Schedule (WHODAS 2.0) |url=https://www.who.int/classifications/icf/whodasii/en/ |website=www.who.int |access-date=31 August 2024 |archive-url=https://web.archive.org/web/20230510082231/https://www.who.int/classifications/international-classification-of-functioning-disability-and-health/who-disability-assessment-schedule |archive-date=10 May 2023 |language=en}}</ref> the model disability survey (MDS),<ref>{{cite web |title=Disability: Model disability survey |url=https://www.who.int/news-room/questions-and-answers/item/model-disability-survey |website=www.who.int |access-date=31 August 2024 |archive-url=https://web.archive.org/web/20240824062228/https://www.who.int/news-room/questions-and-answers/item/model-disability-survey |archive-date=24 August 2024 |language=en}}</ref> and the [[International Classification of Functioning, Disability and Health|ICF]].
==Footnotes==
{{notelist}}
==References==
{{reflist|2}}
==External links==
* [https://www.youtube.com/@WHOICD-11 Official YouTube channel]
* [https://www.who.int/standards/classifications WHO-FIC Classifications and Terminologies]
* [https://icd.who.int/dev11/ WHO-FIC Maintenance Platform]
* [https://icd.who.int/ ICD-11 Home Page]
** [https://icd.who.int/browse/latest-release/mms/en ICD-11 for Mortality and Morbidity Statistics browser (ICD-11 for MMS)]
{{Medical classification}}
[[Category:International Classification of Diseases]]
[[Category:2022 introductions]]