04 - QE51.0 Relationship distress with spouse or p

QE51.0 Relationship distress with spouse or partner

Clinical Descriptions and Diagnostic Requirements for ICD-11 Mental, Behavioural or Neurodevelopmental Disorders QE51.0 Relationship distress with spouse or partner QE51.1 History of spouse or partner violence QE51.10 History of spouse or partner violence, physical QE51.12 History of spouse or partner violence, sexual QE51.11 History of spouse or partner violence, psychological QE51.13 History of spouse or partner violence, neglect. Relationship distress with spouse or partner and different forms of intimate partner maltreatment can co-occur. As many of the categories in this section may be assigned together as necessary to describe the relevant clinical phenomena. General cultural considerations for relationship distress and maltreatment by spouse or partner • Presentations of relationship distress vary, depending on cultural constraints on their expression. In some cultures, women may be more attentive to relationship problems and therefore more likely report relationship distress. • The prevalence of the different forms of spouse or partner maltreatment (e.g. physical, sexual, psychological) vary widely by country, based on the social acceptance, detection and consequences of abusive behaviours. General sex- and/or gender-related features for relationship distress and maltreatment by spouse or partner • Although men and women are both affected by relationship distress, women’s health may be more influenced by relationship distress, whereas men’s health may be more influenced by relationship status (i.e. being in an intimate partner relationship or not). • Gender differences are country- and culture-specific. Overall, women are at much higher risk of victimization by maltreatment by their spouses or intimate partners. Relationship distress with spouse or partner Essential (required) features • Substantial and sustained dissatisfaction with the intimate relationship (e.g. pervasive unhappiness with the relationship, significant thoughts of divorce/separation) is required for diagnosis. • The dissatisfaction is associated with disturbance in at least one major area of functioning such as: • behaviour (e.g. persistent and intense conflicts, pervasive withdrawal or neglect, lack of positive behaviours); Relationship problems and maltreatment | Relationship distress and current or past maltreatment by spouse or partner QE51.0

713 Relationship problems and maltreatment • cognition (e.g. pervasive negative attributions of partner’s intent); • emotion (e.g. persistent and intense anger, sadness or apathy); • physical health (e.g. pain and other physical symptoms not fully explained by a medical condition); • interpersonal interaction (e.g. social isolation, decreased involvement in social activities); • major life role activities (e.g. work, school, caregiving). Note: this category is assigned to the individual being evaluated. In situations in which a couple is being evaluated, it may be assigned to both parties if applicable. Additional clinical features • Relationship distress with spouse or partner is associated with increased risk of various mental disorders (e.g. depressive disorders, anxiety and fear-related disorders, disorders due to substance use), and risk of exacerbation of existing medical conditions. Boundary with normality (threshold) • Occasional relationship dissatisfaction and disagreements occur in most relationships. Relationship distress with a spouse or partner should only be assigned when relationship dissatisfaction or conflict is a pervasive pattern affecting the individual’s functioning in at least one major area. Boundaries with other disorders and conditions (differential diagnosis) Boundary with spouse or partner maltreatment (physical, psychological, sexual, or neglect) Relationship distress with spouse or partner is not considered a form of maltreatment. However, if all diagnostic requirements are met for both relationship distress with spouse or partner and a maltreatment category, both may be assigned. Relationship problems and maltreatment | Relationship distress and current or past maltreatment by spouse or partner