Psychiatry · Schizophrenia and Other Psychotic Disorders

According to ICD-11 (2022), which major structural change was made to the Schizophrenia spectrum classification compared to ICD-10?

  • A ICD-11 introduced a first-rank symptom requirement (Schneiderian symptoms)
  • B ICD-11 introduced a minimum 6-month duration criterion identical to DSM-5
  • C ICD-11 merged schizophrenia and schizoaffective disorder into one diagnostic category
  • D ICD-11 abolished the schizophrenia subtypes (paranoid, hebephrenic, catatonic, undifferentiated, residual) and replaced them with symptom dimensional qualifiers
Correct answer: D. ICD-11 abolished the schizophrenia subtypes (paranoid, hebephrenic, catatonic, undifferentiated, residual) and replaced them with symptom dimensional qualifiers

Explanation

A major revision in ICD-11 for schizophrenia and related disorders was the elimination of the traditional subtypes used in ICD-10 (paranoid, hebephrenic, catatonic, undifferentiated, post-schizophrenic depression, residual, simple). These were replaced by a dimensional qualifier system capturing prominent symptom domains: positive, negative, depressive, manic, psychomotor (including catatonia), and cognitive impairment. This dimensional approach was adopted because the traditional subtypes showed poor reliability, instability over time, and limited prognostic value. ICD-11 retains a shorter minimum duration (1 month for first-rank symptoms; symptoms must be present 'most of the time') compared to DSM-5's 6-month criterion.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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