Public stakeholders’ comments on ICD-11 chapters related to mental and sexual health

Abstract

A unique strength of the development of the World Health Organization (WHO)’s ICD-11 classification of mental, behavioural and neurodevelopmental disorders has been the active input from multiple global stakeholders. Draft versions of the ICD-11 for Morbidity and Mortality Statistics (MMS), including brief definitions, have been available on the ICD-11 beta platform (https://icd.who.int/dev11/l-m/en) for public review and comment for the past several years1. Submissions were reviewed by the WHO for the development of both the MMS version of the ICD-11 and the version for clinical use by mental health specialists, the Clinical Descriptions and Diagnostic Guidelines (CDDG)1. Here, we summarize common themes of the submissions for the categories that generated the greatest response. All comments and proposals were reviewed for categories currently classified in the chapter on mental and behavioural disorders in ICD-10, although some of these have been reconceptualized and moved to new ICD-11 chapters on sleep-wake disorders and conditions related to sexual health2. Between January 1, 2012 and December 31, 2017, 402 comments and 162 proposals were submitted on mental, behavioural and neurodevelopmental disorders, sleep-wake disorders, and conditions related to sexual health. The largest number of submissions related to mental, behavioural and neurodevelopmental disorders focused on compulsive sexual behaviour disorder (N=47), complex post-traumatic stress disorder (N=26), bodily distress disorder (N=23), autism spectrum disorder (N=17), and gaming disorder (N=11). Submissions on conditions related to sexual health mainly addressed gender incongruence of adolescence and adulthood (N=151) and gender incongruence of childhood (N=39). Few submissions were related to sleep-wake disorders (N=18).