The WPA has been actively supporting the World Health Organization (WHO) in the development and scientific validation of the Clinical Descriptions and Diagnostic Requirements for ICD-11 Mental, Behavioural and Neurodevelopmental Disorders (CDDR).

Several WPA officers and experts served as chairpersons or members of the ICD-11 Working Groups that produced the drafts of the various sections of the CDDR. The chairpersons included W. Gaebel (Working Group on Psychotic Disorders), M. Maj (Working Group on Mood and Anxiety Disorders), P. Tyrer (Working Group on Personality Disorders), L. Salvador-Carulla (Working Group on Intellectual Disabilities), O. Gureje (Working Group on Somatic Distress and Dissociative Disorders) and D. Stein (Working Group on Obsessive-Compulsive and Related Disorders). Prof. M. Maj has represented the WPA in the ICD-11 International Advisory Board.

WPA Member Societies have participated in the WPA/WHO Global Survey of Psychiatrists’ Attitudes Towards Mental Disorders Classification, whose results have significantly informed the process of development of the ICD-11 CDDR. The survey involved 4,887 psychiatrists from 44 countries, representing the largest and most broadly international survey ever conducted of psychiatrists’ attitudes towards the classification of mental disorders. Through the survey, psychiatrists provided strong endorsement of a focus on clinical utility, which was indeed the main objective of the process of development of the CDDR. More than two thirds of the participants indicated that they would prefer a system of flexible guidance allowing for cultural variation and clinical judgement, as opposed to a system based on strict operational criteria, a preference which has been actually reflected in the structure of the CDDR.

Several WPA Member Societies and experts have been involved in the CDDR field trials, including the so-called formative field studies (aimed to guide decisions about the basic structure and content of the ICD-11 by exploring clinicians’ conceptualization of the interrelationships among categories of mental disorders); the Internet-based field studies (which used vignette methodologies to examine clinical decision-making in relationship to the proposed CDDR); and the clinic-based field studies (conducted to assess the reliability and clinical utility of the CDDR with real patients). The results of the largest clinic-based CDDR field trial – conducted among 1,806 patients in 13 countries, and focusing on schizophrenia and other primary psychotic disorders, mood disorders, anxiety and fear-related disorders, and disorders specifically associated with stress – have been published in World Psychiatry, the official WPA journal.

World Psychiatry has also been one of the main channels through which WPA Member Societies and the international psychiatric community have been informed about the development of the ICD-11 CDDR. In particular, the journal has hosted some of the main papers summarizing the philosophy of the entire process and the structure of the diagnostic system, and many articles dealing with specific sections of the classification, as well as individual papers or forums on general topics of classification in psychiatry. Several examples can be found in recent issues of the journal^1-13. All these contributions are freely downloadable from the WPA website (www.wpanet.org).

Educational courses focusing on various sections of the ICD-11 chapter on mental, behavioural and neurodevelopmental disorders have been held in connection with several WPA meetings, including the 18th, 19th and 20th World Congresses of Psychiatry (Mexico City, Mexico, September 27-30, 2018; Lisbon, Portugal, August 21-24, 2019; Bangkok, Thailand, March 10-13, 2021), and the Regional Congresses on “Interdisciplinary Understanding of Co-morbidity in Psychiatry: from Science to Integrated Care” (St. Petersburg, Russia, May 16-18, 2021) and “Psychopathology in Periods of Transition” (Kyiv, Ukraine, July 7-9, 2021). These courses have represented a unique opportunity for psychiatrists from many countries to directly familiarize with the CDDR and exercise in their application.

A comprehensive online 20-hr training course in the use of the CDDR has been organized by the Naples WHO Collaborating Centre on Research and Training in Mental Health and the European Psychiatric Association from 9 to 30 April, 2021. The course has been coordinated by G.M. Reed and M. Maj, and has covered all the main sections of the CDDR. W. Gaebel, M. Cloitre, M. Maj, C.S. Kogan, P. Monteleone, M. Swales, J.B. Saunders and N.A. Fineberg composed the Faculty. The live course has been attended by 120 psychiatrists, selected from almost 500 applicants, representing 78 different countries. A further group of 250 psychiatrists have had access to the course on demand. A training course co-organized by the WPA and the Global Mental Health Academy, with a structure similar to the course organized by the Naples WHO Collaborating Centre and the European Psychiatric Association, but with access also to psychologists and primary care practitioners, took place online from 8 to 29 November, 2021.

A number of lectures and symposia on various issues related to the ICD-11 CDDR have been held at several World Congresses of Psychiatry. In particular, at the 19th World Congress of Psychiatry, held in Lisbon in August 2019, a plenary session dealt with the implementation of the ICD-11. G. Reed and M. Maj, who chaired the session, summarized some lessons that should be learned from the implementation of previously developed classification systems.

A WHO International Advisory Group on Training and Implementation of the ICD-11 CDDR has been established to develop and evaluate educational, training and implementation processes related to the CDDR in various countries. WPA former officers who contributed to the development of the CDDR – such as M. Maj, W. Gaebel and D. Stein – are members of this Advisory Group.

The strong collaboration between the WHO and various WPA components in all the steps of the development and testing of the ICD-11 CDDR is now expected to continue in the phase of implementation of the diagnostic system at the international level.

WPA 一直积极支持世界卫生组织 (WHO) 开发和科学验证 ICD-11 精神、行为和神经发育障碍 (CDDR) 的临床描述和诊断要求。

几位 WPA 官员和专家担任 ICD-11 工作组的主席或成员，该工作组起草了 CDDR 各部分的草案。主席包括 W. Gaebel（精神障碍工作组）、M. Maj（情绪和焦虑障碍工作组）、P. Tyrer（人格障碍工作组）、L. Salvador-Carulla（智力障碍工作组） 、O. Gureje（躯体痛苦和解离障碍工作组）和 D. Stein（强迫症及相关障碍工作组）。 M. Maj 教授代表 WPA 参加 ICD-11 国际顾问委员会。

WPA 会员协会参加了 WPA/WHO 全球精神病学家对精神障碍分类态度调查，其结果为 ICD-11 CDDR 的制定进程提供了重要信息。该调查涉及来自 44 个国家的 4,887 名精神科医生，这是迄今为止针对精神科医生对精神障碍分类的态度进行的规模最大、范围最广的国际调查。通过调查，精神科医生强烈支持注重临床实用性，这确实是 CDDR 发展过程的主要目标。超过三分之二的参与者表示，他们更喜欢允许文化差异和临床判断的灵活指导体系，而不是基于严格操作标准的体系，这一偏好实际上已反映在 CDDR 的结构中。

一些 WPA 成员协会和专家参与了 CDDR 现场试验，包括所谓的形成性现场研究（旨在通过探索临床医生对各类别之间相互关系的概念化来指导有关 ICD-11 基本结构和内容的决策）。精神障碍）；基于互联网的实地研究（使用小插图方法来检查与拟议的 CDDR 相关的临床决策）；以及基于临床的实地研究（用于评估 CDDR 与真实患者的可靠性和临床实用性）。最大规模的基于临床的 CDDR 现场试验的结果已发表，该试验在 13 个国家的 1,806 名患者中进行，重点关注精神分裂症和其他原发性精神障碍、情绪障碍、焦虑和恐惧相关疾病以及与压力特别相关的疾病发表在 WPA 官方期刊《世界精神病学》上。

世界精神病学也是 WPA 会员协会和国际精神病学界了解 ICD-11 CDDR 发展情况的主要渠道之一。特别是，该杂志发表了一些总结整个过程的原理和诊断系统结构的主要论文，以及许多涉及分类特定部分的文章，以及有关分类一般主题的个人论文或论坛在精神病学中。在最近几期的期刊^1-13中可以找到几个例子。所有这些贡献都可以从 WPA 网站 (www.wpanet.org) 免费下载。

与多次 WPA 会议相关的教育课程重点关注 ICD-11 章节中有关精神、行为和神经发育障碍的各个部分，其中包括第 18 届、第 19 届和第 20 届世界精神病学大会（墨西哥墨西哥城，9 月 27 日至 30 日） ，2018 年；葡萄牙里斯本，2019 年 8 月 21 日至 24 日；泰国曼谷，2021 年 3 月 10 日至 13 日），以及“精神病学共病的跨学科理解：从科学到综合护理”区域大会（圣路易斯）俄罗斯圣彼得堡，2021 年 5 月 16-18 日）和“过渡时期的精神病理学”（乌克兰基辅，2021 年 7 月 7-9 日）。这些课程为来自许多国家的精神科医生提供了直接熟悉 CDDR 并练习其应用的独特机会。

那不勒斯世界卫生组织精神卫生研究与培训合作中心和欧洲精神病学协会于 2021 年 4 月 9 日至 30 日组织了关于使用 CDDR 的综合在线 20 小时培训课程。该课程由 GM 协调Reed 和 M. Maj，涵盖了 CDDR 的所有主要部分。 W. Gaebel、M. Cloitre、M. Maj、CS Kogan、P. Monteleone、M. Swales、JB Saunders 和 NA Fineberg 组成了该学院。参加现场课程的有 120 名精神科医生，他们是从来自 78 个不同国家的近 500 名申请者中挑选出来的。另外还有 250 名精神科医生按需参加了该课程。由 WPA 和全球心理健康学院联合举办的培训课程在网上进行，其结构与那不勒斯世卫组织合作中心和欧洲精神病学协会举办的课程类似，但也有心理学家和初级保健从业者的机会2021年11月8日至29日。

多次世界精神病学大会上已就与 ICD-11 CDDR 相关的各种问题举办了许多讲座和研讨会。特别是，2019 年 8 月在里斯本举行的第十九届世界精神病学大会上，全体会议讨论了 ICD-11 的实施问题。会议主席 G. Reed 和 M. Maj 总结了应从实施先前开发的分类系统中吸取的一些经验教训。

世卫组织成立了 ICD-11 CDDR 培训和实施国际咨询小组，以制定和评估各国与 CDDR 相关的教育、培训和实施流程。为 CDDR 的发展做出贡献的 WPA 前官员——例如 M. Maj、W. Gaebel 和 D. Stein——都是该咨询小组的成员。

世卫组织与 WPA 各组成部分在 ICD-11 CDDR 开发和测试所有步骤中的密切合作预计将在国际诊断系统实施阶段继续下去。