Exploring mood symptoms overlap in PTSD diagnosis: ICD-11 and DSM-5 criteria compared in a sample of subjects with Bipolar Disorder.


Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
01 11 2020
Historique:
received: 05 12 2019
revised: 20 05 2020
accepted: 23 06 2020
pubmed: 23 7 2020
medline: 16 2 2021
entrez: 23 7 2020
Statut: ppublish

Résumé

The latest edition of the ICD (ICD-11) introduced relevant modifications to Post-traumatic Stress Disorder (PTSD) diagnostic criteria with respect to those of the DSM-5, including the exclusion of DSM-5 symptoms that potentially overlapped with mood disorders. To date, no study has yet investigated the differences in PTSD and its related symptoms, according to the two diagnostic systems in subjects with mood disorders. The aim of the present study was to compare the DSM-5 and ICD-11 diagnostic criteria for PTSD in a sample of patients with Bipolar Disorder (BD). An overall sample of 210 in-patients with BD completed the Trauma and Loss Spectrum-Self Report, assessing post-traumatic stress symptoms, to compare symptomatological PTSD diagnosis according to either the DSM-5 or the ICD-11 criteria. DSM-5 PTSD was detected in 41% of the whole sample, whereas ICD-11 PTSD in 31.8%. The two diagnostic systems showed good concordance (Cohen's k = 0.643), whereas the concordance of re-experiencing and arousal criteria were moderate (Cohen's k = 0.578) and good (Cohen's k = 0.791), respectively. Almost all the subjects with a diagnosis of ICD-11 PTSD (92.5%) endorsed the "negative alterations in cognitions and mood" DSM-5 criterion. The small size, the use of a self-report instrument. Our findings show high rates of PTSD and post-traumatic stress symptoms among subjects with BD according to both DSM-5 and ICD-11 criteria, despite significantly lower with the latter. However, potentially DSM-5 mood overlapping symptoms appear to be significantly higher among bipolar patients with ICD-11 PTSD with respect to those without.

Sections du résumé

BACKGROUND
The latest edition of the ICD (ICD-11) introduced relevant modifications to Post-traumatic Stress Disorder (PTSD) diagnostic criteria with respect to those of the DSM-5, including the exclusion of DSM-5 symptoms that potentially overlapped with mood disorders. To date, no study has yet investigated the differences in PTSD and its related symptoms, according to the two diagnostic systems in subjects with mood disorders. The aim of the present study was to compare the DSM-5 and ICD-11 diagnostic criteria for PTSD in a sample of patients with Bipolar Disorder (BD).
METHODS
An overall sample of 210 in-patients with BD completed the Trauma and Loss Spectrum-Self Report, assessing post-traumatic stress symptoms, to compare symptomatological PTSD diagnosis according to either the DSM-5 or the ICD-11 criteria.
RESULTS
DSM-5 PTSD was detected in 41% of the whole sample, whereas ICD-11 PTSD in 31.8%. The two diagnostic systems showed good concordance (Cohen's k = 0.643), whereas the concordance of re-experiencing and arousal criteria were moderate (Cohen's k = 0.578) and good (Cohen's k = 0.791), respectively. Almost all the subjects with a diagnosis of ICD-11 PTSD (92.5%) endorsed the "negative alterations in cognitions and mood" DSM-5 criterion.
LIMITATIONS
The small size, the use of a self-report instrument.
CONCLUSION
Our findings show high rates of PTSD and post-traumatic stress symptoms among subjects with BD according to both DSM-5 and ICD-11 criteria, despite significantly lower with the latter. However, potentially DSM-5 mood overlapping symptoms appear to be significantly higher among bipolar patients with ICD-11 PTSD with respect to those without.

Identifiants

pubmed: 32697700
pii: S0165-0327(20)32453-8
doi: 10.1016/j.jad.2020.06.056
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

205-211

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Auteurs

Claudia Carmassi (C)

Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy.

Carlo Antonio Bertelloni (CA)

Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy. Electronic address: carlo.ab@hotmail.it.

Annalisa Cordone (A)

Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy.

Andrea Cappelli (A)

Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy.

Enrico Massimetti (E)

Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy.

Valerio Dell'Oste (V)

Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy.

Liliana Dell'Osso (L)

Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy.

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