The World Health Organization is expected to change the diagnostic codes of personality disorder for the first time in 29 years in May.

The WHO will hold the World Health Assembly in May to change the criteria of personality disorder diagnosis, during which it will present the new International Classification of Diseases (ICD-11), an updated version after the adoption of the ICD-10 in 1990.

Professor Kim Youl-ri of the Psychiatry Department at Inje University Seoul Paik Hospital

The 194 WHO member states are scheduled to adopt the ICD-11 at the assembly in May and the new classification will take effect as of Jan. 1, 2022.

The new ICD version shows innovative changes in the classification of personality disorder diagnosis, drawing keen attention from medical professionals around the globe.

To date, practitioners could diagnose the onset of the personality dysfunction in the age group of late teens to those in the early 20s only. The new codes will allow them to diagnose the disorder from teenagers to the elderly.

The ICD-11 classified human personality into dimensions instead of the conventional categories. It divided personality disorder types into five traits – negative affectivity, anankastic, detachment, dissociality, and disinhibition. It also specified three levels of severity in personality disorder as well.

Kim Youl-ri, a professor at the psychiatry department of Inje University Seoul Paik Hospital, contributed to the revision of the diagnostic criteria for personality disorder. She reflected the result of the local field trial on the new version.

“The revision reflects research results of personality psychology. It means that personality disorder consists of a single dimension on a continuous line of normal and abnormal, and reflects the highest degree of characteristics of all personality as the severity of the disability," Kim said.

The new criteria also included personality difficulty in the subcategory of personality disorder, for those who show mild symptoms that do not meet the requirements of the diagnosis.

Kim noted that one of the purposes of the ICD-11 is to help people who rarely have access to psychiatrists in many parts of the world to use the classification.

“We tried to make an easy-to-understand classification and to help psychiatrists in all fields readily use it,” she added.

Kim urged the local health authorities to support medical professionals to understand the changed criteria for personality disorder and to prepare related policies.

In a complex modern society characterized by close interpersonal relationships, personality disorder emerged as a mental disorder in need of particular attention. According to a survey by the WHO in 2010, the prevalence of personality disorder exceeded 7 percent worldwide.

Individuals with personality disorder are biased and inflexible. Due to their personality characteristics, they cannot adapt to society and have persistent and notable problems in interpersonal relationships.

The severity of personality disorder varies ranging from the mild one where patients show personality dysfunction under severe stress to the severe one where patients commit a cruel crime without a sense of guilt.

Personality disorder is suspected in the following cases: a person who is emotionally disturbed even under minor stress; a person who demands an excessive level of perfection from themselves and others; a lone wolf; a person who tries to manipulate and take advantage of other people; and a person who cannot control emotions and behavior.

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