Evidence map›Paper›PMID 28077178›Full record

ArticlePsychological medicine2017

PTSD or not PTSD? Comparing the proposed ICD-11 and the DSM-5 PTSD criteria among young survivors of the 2011 Norway attacks and their parents.

G S Hafstad, S Thoresen, T Wentzel-Larsen, A Maercker, G Dyb

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In one paragraph

Article in Psychological medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

5 authors.

G S HafstadNorwegian Centre for Violence and Traumatic Stress Studies,Pb. 181 Nydalen,0409 Oslo,Norway.
S ThoresenNorwegian Centre for Violence and Traumatic Stress Studies,Pb. 181 Nydalen,0409 Oslo,Norway.
T Wentzel-LarsenNorwegian Centre for Violence and Traumatic Stress Studies,Pb. 181 Nydalen,0409 Oslo,Norway.
A MaerckerDepartment of Psychology - Psychopathology and Clinical Intervention,University of Zurich,Binzmühlestrasse 14/17,8050 Zürich,Switzerland.
G DybNorwegian Centre for Violence and Traumatic Stress Studies,Pb. 181 Nydalen,0409 Oslo,Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe conceptualization of post-traumatic stress disorder (PTSD) in the upcoming International Classification of Diseases (ICD)-11 differs in many respects from the diagnostic criteria in the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5). The consequences of these differences for individuals and for estimation of prevalence rates are largely unknown. This study investigated the concordance of the two diagnostic systems in two separate samples at two separate waves.

methodYoung survivors of the 2011 Norway attacks (n = 325) and their parents (n = 451) were interviewed at 4-6 months (wave 1) and 15-18 months (wave 2) after the shooting. PTSD was assessed with the UCLA PTSD Reaction Index for DSM-IV adapted for DSM-5, and a subset was used as diagnostic criteria for ICD-11.

resultsIn survivors, PTSD prevalence did not differ significantly at any time point, but in parents, the DSM-5 algorithm produced significantly higher prevalence rates than the ICD-11 criteria. The overlap was fair for survivors, but amongst parents a large proportion of individuals met the criteria for only one of the diagnostic systems. No systematic differences were found between ICD-11 and DSM-5 in predictive validity.

conclusionsThe proposed ICD-11 criteria and the DSM-5 criteria performed equally well when identifying individuals in distress. Nevertheless, the overlap between those meeting the PTSD diagnosis for both ICD-11 and DSM-5 was disturbingly low, with the ICD-11 criteria identifying fewer people than the DSM-5. This represents a major challenge in identifying individuals suffering from PTSD worldwide, possibly resulting in overtreatment or unmet needs for trauma-specific treatment, depending on the area of the world in which patients are being diagnosed.

Indexed as

Diagnostic and Statistical Manual of Mental DisordersInternational Classification of DiseasesAdolescentAdultFemaleHumansMaleMiddle AgedNorwayParentsPrevalenceStress Disorders, Post-TraumaticSurvivorsTerrorismDSM-5ICD-11post-traumatic stress disorderprevalence

Identifiers

PMID28077178
PMCPMC5426334

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.