th EDITION ICD11 CHANGES IN MENTAL BEHAVIOURAL AND NEURODEVELOPMENTAL DISORDERSSUBSTANCE USE DISORDER BY DR OSHIEGBU MOSES 10262022 1 OUTLINE Objectives Introduction Changes in international classification of disease 11 ID: 1043735
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1. INTERNATIONAL CLASSIFICATION OF DISEASE 11th EDITION (ICD-11) CHANGES IN MENTAL BEHAVIOURAL AND NEURODEVELOPMENTAL DISORDERS-SUBSTANCE USE DISORDER BY DR. OSHIEGBU MOSES10/26/20221
2. OUTLINEObjectivesIntroductionChanges in international classification of disease 11th edition(ICD-11) in disorders of substance use. Limitation of the presentationRecommendation Conclusion References 10/26/20222
3. OBJECTIVES The objectives of this presentation are:To discuss the changes in ICD-11 in substance use disorders.To keep up-to-date with the criteria needed in making diagnosis of substance use disorder. 10/26/20223
4. INTRODUCTION Disorders due to substance use are mental and behavioural disorders that develop as a result of the use of predominantly psychoactive substances, including medications, or specific repetitive rewarding and reinforcing behaviours.10/26/20224
5. There is a repeated drug use which leads tolong-lasting changes in the brain that undermine voluntary control.From a neurobiological perspective, substance use disorder is a disease of the brain and the associated abnormal behaviour is the result of dysfunction of the brain tissues. 10/26/20225
6. EPIDEMIOLOGY10/26/20226
7. INTERNATIONAL CLASSIFICTION OF DISEASE 11TH EDITION (ICD-11)The World Health Organization released a pre-final version of the international classification of disease and related Health problems(ICD-11) in 2018 ,to its 194 member states.The revision of the ICD-11 took about 10years to develop.10/26/20227
8. INTERNATIONAL CLASSIFICTION OF DISEASE 11TH EDITION (ICD-11)Member states began transiting from ICD-10 to ICD-11 with reporting of health statistics to the WHO using ICD-11 on 1st January, 2022 .The development of ICD-11 has been the most global, multilingual, multidisciplinary and participative revision process ever implemented for a classification of mental disorders.10/26/20228
9. CHANGES IN ICD-11 CLASSIFICATION OF DISORDERS OF SUBSTANCE USE The changes are:The coding systemWhat constitutes harmful use was broadened.Time line was specified for dependenceOther classifications as: unspecified psychoactive substance, multiple unspecified psychoactive substance, dissociative drugs, non-psychoactive substanes were added10/26/20229
10. ICD 10ICD 11OVERALL FRAMEWORKGROUPINDIVIDUALIZED10/26/202210
11. FEAUTURESICD 10ICD 11CODING SYSTEMDECIMALALPHANUMERICNUMBER OF CLASSES OF PSYCHOACTIVE SUBSTANCES LESSMORE CLASSES OF SUBSTANCES HAVE BEEN INCLUDED:SYNTHETIC CATHINONES,SYNTHETIC CANNABINOID,CAFFINE, METHYLENEDIOXYMETHAMPHETAMINE(MDMA),DISSOCIATIVE DRUGSCHANGE IN TERMS1. CANNABINOID,TOBACCO2. MENTAL AND BEHAVIOURAL DISORDERS(MBD)1. CANNABIS, NICOTINE2. DISORDERS OF SUBSTANCE USEHARMFUL USEA PATTERN OF PSYCHOACTIVE SUBSTANCE USE THAT IS CAUSING DAMAGE TO HEALTH- PHYSICAL OR MENTAL OF THE USER A PATTERN OF USE THAT HAS CAUSED DAMAGE TO A PERSON’S PHYSICAL OR MENTAL HEALTH OR HAS RESULTED IN BEHAVIOUR LEADING TO HARM TO THE HEALTH OF OTHERS10/26/202211
12. FEAUTURESICD 10ICD 11HARMFUL USEHARMFUL USESINGLE EPISODE OF HARM FUL USEHARMFUL PATTERN OF USE:EPISODICCONTINUOUSUNSPECIFIEDDEPENDENCE SYNDROMECURRENTLY ABSTINENTCURRENTLY ABSTINENT, BUT IN A PROTECTED ENVIRONMENTCURRENTLY ON A CLINICALLY SUPERVISED MAINTAINANCE OR REPLACEMENT REGIMENCURRENT USE:CONTINOUSEPISODICREMISSION:EARLY FULL REMISSIONSUSTAINED PARTIAL REMISSION10/26/202212
13. DEPENDENCE SYNDROMEICD 10ICD 11CURRENTLY ABSTINENT, BUT RECEIVING AVERSIVE OR BLOCKING DRUGSCURRENTLY USING THE SUBSTANCECONTINOUS USEEPISODIC USESUSTAINED FULL REMISSION10/26/202213
14. PSYCHOTIC DISORDERICD 10ICD 11SCHIZOPRENIA-LIKEPREDOMINANTLY DELUSIONALPREDOMINANTLY HALLUCINATORYPREDOMINANTLY POLYMORPHICPREDOMINANTLY DEPRESSIVEPREDOMINANTYL MANIC SYMPTOMSMIXEDSUBSTANCE INDUCED PSYCHOTIC DISORDERSUBSTANCE INDUCED MOOD DISORDERSUBSTANCE INDUCED ANXIETY DISORDER.SPECIFIC DISORDER THAT ARE SPECIFIC FOR A SUBSTANCE10/26/202214
15. The ICD-11 also includes category of hazardous substance use, which are not classified as mental disorders but are situated in the chapter on “factors influencing health status or contact with health services” 10/26/202215
16. This category may be used when a pattern of substance use increases the risk of harmful physical and mental consequences to the user or to others to an extent that warrant attention and advice from health professionals, but no overt harm has occurred.10/26/202216
17. They are meant to signal opportunities for early and brief interventions, particularly in primary care settings10/26/202217
18. OTHER CHANGESOther character codes in ICD 10:Flashback Personality or behavioural disorderResidual affective disorderDementia Persisting cognitive impairmentLate-onset psychotic disorder Have been expunged in ICD-1110/26/202218
19. LIMITATION OF THIS PRESENTATIONThe changes presented above are those of the international classification of diseases for mortality and morbidity statistics version of ICD, not the clinical and diagnostic guidelines versionAs the clinical and diagnostic guidelines for ICD-11 is yet to be released.10/26/202219
20. RECOMMENDATIONThe World Health Organization should release The clinical and diagnostic guidelines version of ICD-1110/26/202220
21. CONCLUSION A lot of efforts were put in place to capture the clinical presentations in ICD-11 classification of substance use disorder.It aptly describes various ways disorders of substance can present to us.Therefore, I urge everyone to as soon as possible make diagnosis with the ICD-11. 10/26/202221
22. REFERENCES World Health Organization International Classification of Disease for Mortality and Morbidity Statistics, 11th edition,2018,pages 59-152.World Health Organization ,International Statistical Classification of Diseases and Related Health Problems, 10th edition,2008 ; pages225-289.10/26/202222
23. REFERENCES CONT’DGeoffrey M. Reed et al. Innovations and Changes in the ICD-11 classification of mental ,behavioural and neurodevelopmental disorders , world psychiatry 2019;18:14-15.Harrison et al Shorter Oxford Textbook of Psychiatry 7th edition ,oxford university press, 2018;chapter 20,pages563-566.National Postgraduate Medical College update 2022:Substance Use Disorder.10/26/202223
24. THANK YOU FOR LISTENING10/26/202224