DSM-5-TR vs ICD-11 Anxiety Disorders: Key Classification Differences
Updated: Oct 8
Author: Ukrainian Psychological Hub · Published: September 30, 2026 · Editorial Policy
DSM-5-TR and ICD-11 classify a largely overlapping core of anxiety disorders, but they are not interchangeable systems. DSM-5-TR calls the chapter “Anxiety Disorders,” while ICD-11 uses “Anxiety or Fear-Related Disorders.” Both include generalized anxiety disorder, panic disorder, agoraphobia, social anxiety disorder, specific phobia, separation anxiety disorder, and selective mutism. The most important differences concern how the systems are organized, how diagnostic requirements are written, where substance-induced and medically caused anxiety presentations are placed, how generalized anxiety disorder is defined, and how subthreshold or mixed presentations are handled. First et al., 2021.
This comparison is about classification, not self-diagnosis. A diagnostic system does more than name symptoms: it defines clinical thresholds, duration, exclusions, impairment, differential diagnosis, and relationships among disorders. Normal fear, ordinary worry, stress responses, panic attacks, avoidance, safety behaviors, screening scores, personality traits, and clinical anxiety disorders can overlap without being the same thing. The American Psychiatric Association states that DSM criteria are intended for trained professionals using clinical judgment, and the World Health Organization describes the ICD-11 Clinical Descriptions and Diagnostic Requirements as a manual for qualified health professionals. APA: About DSM-5-TR; WHO ICD-11 CDDR.
One methodological point matters before comparing the systems. Much of the peer-reviewed harmonization literature compares ICD-11 with DSM-5 rather than DSM-5-TR. That literature remains highly relevant because DSM-5-TR is a text revision of DSM-5, and APA states that the text-revision process did not set out to make conceptual changes to the criteria sets, although clarifications and subsequent approved updates can occur. For current clinical use, the operative sources are the current DSM-5-TR materials and WHO ICD-11 guidance. APA DSM history and DSM-5-TR overview; APA DSM-5-TR updates.
DSM-5-TR vs ICD-11 at a Glance
Who publishes each system?
DSM-5-TR is published by the American Psychiatric Association. It is a specialized classification and diagnostic manual for mental disorders and is especially central to U.S. psychiatric and mental-health practice. ICD-11 is published by the World Health Organization and is a global classification covering diseases and health-related conditions across medicine. WHO’s 2024 Clinical Descriptions and Diagnostic Requirements provide the clinical diagnostic guidance for mental, behavioral, and neurodevelopmental disorders. American Psychiatric Association; World Health Organization.
What is the anxiety chapter called?
DSM-5-TR uses the chapter title “Anxiety Disorders.” ICD-11 uses “Anxiety or Fear-Related Disorders.” The wording reflects ICD-11’s organizing idea that disorders in the group can be differentiated partly by the focus of apprehension: what the person fears, anticipates, or experiences as threatening. The ICD-11 working-group paper describes this as a central organizing principle, ranging from highly specific stimuli in specific phobia to broader social situations in social anxiety disorder or diffuse apprehension in generalized anxiety disorder. Kogan et al., 2016.
Do they contain the same main disorders?
At the level most readers care about, the answer is mostly yes. Both systems recognize the same central set: generalized anxiety disorder, panic disorder, agoraphobia, social anxiety disorder, specific phobia, separation anxiety disorder, and selective mutism. DSM-5’s reorganization and ICD-11’s later development were deliberately harmonized in many areas, and a major comparison concluded that the two systems are closer than earlier DSM and ICD generations. First et al., 2021.
Are the diagnostic rules written in the same style?
No. DSM tends to use more explicitly operationalized criteria sets: specified symptoms, counts, duration requirements, exclusions, and specifiers. ICD-11 CDDR emphasizes essential clinical features and generally uses less rigid symptom counting when evidence does not justify a precise numerical threshold. In a cross-system comparison, panic disorder, agoraphobia, specific phobia, social anxiety disorder, and separation anxiety disorder were judged to describe essentially the same diagnostic entities but with greater specification in DSM-5. Selective mutism was judged essentially identical. First et al., 2021; Domschke & Zwanzger, 2025.
The Shared Core of Anxiety and Fear-Related Disorders
The overlap between DSM-5-TR and ICD-11 is large enough that a reader should not imagine two rival maps of anxiety with completely different disorders. The systems share a common modern architecture, but the details of the boundaries are not always identical.
Generalized anxiety disorder
Both systems recognize generalized anxiety disorder as a persistent pattern of generalized anxiety or worry that is difficult to control and clinically significant. The major cross-system difference is not whether GAD exists, but how broadly and for how long the core anxiety state must be present.
Panic disorder
Both systems recognize panic disorder as a disorder centered on recurrent panic attacks and their consequences. Panic disorder is not equivalent to having one panic attack. A panic attack can occur in many psychiatric conditions, in medical illness, after substance use, or without establishing panic disorder.
Agoraphobia
Both systems treat agoraphobia as its own diagnosis rather than making it merely a subtype or consequence of panic disorder. A person can meet requirements for agoraphobia without panic disorder, panic disorder without agoraphobia, or both.
Social anxiety disorder
Both systems recognize clinically significant fear or anxiety related to social situations in which a person may be scrutinized, evaluated, embarrassed, rejected, or otherwise exposed to feared social consequences. The conceptual entity is highly aligned across systems even when operational detail differs.
Specific phobia
Both systems recognize specific phobia as clinically significant fear or anxiety focused on a circumscribed object or situation. Popular names for individual fears do not create separate DSM-5-TR or ICD-11 disorders; clinically, such presentations map to specific phobia when the relevant diagnostic requirements are met.
Separation anxiety disorder
Both systems recognize separation anxiety disorder across the lifespan. This is important historically because older classification traditions strongly associated separation anxiety with childhood. Modern DSM and ICD frameworks recognize clinically significant separation anxiety in adults as well.
Selective mutism
Both systems place selective mutism within the anxiety/fear-related grouping. A detailed cross-system review rated the definitions as essentially identical. Selective mutism is a clinical diagnosis involving a consistent pattern of not speaking in particular situations despite adequate speech in other settings; it is not simply shyness, unwillingness to talk, or a screening score. First et al., 2021.
Key Difference 1: DSM Says “Anxiety Disorders”; ICD-11 Says “Anxiety or Fear-Related Disorders”
The title difference is conceptually meaningful. ICD-11 explicitly retains both anxiety and fear in the grouping name and uses the focus of apprehension as a way of distinguishing disorders. A specific phobia may be organized around a narrow stimulus; social anxiety around social evaluation; agoraphobia around situations in which escape or help may be difficult; separation anxiety around separation from attachment figures; panic disorder around recurrent unexpected panic attacks and their feared consequences; and GAD around multiple life domains or generalized apprehensiveness. Kogan et al., 2016.
DSM-5-TR reaches many of the same clinical distinctions through its disorder-specific criteria rather than making “fear-related” part of the chapter title. The practical lesson is that a similar patient presentation may receive a closely corresponding diagnosis in either system even though the surrounding chapter language and diagnostic architecture are not identical.
Key Difference 2: DSM-5-TR Is More Operationalized; ICD-11 Emphasizes Essential Features
DSM criteria sets are designed to state what symptoms and conditions must be present, for how long, and what must be ruled out. APA describes the criteria as tools for improving diagnostic reliability while emphasizing that clinical judgment remains necessary. ICD-11 CDDR was designed for global clinical utility and uses a standardized format centered on essential features, boundaries with normality, differential diagnosis, developmental presentations, and culture-related features. APA: About DSM-5-TR; WHO ICD-11 CDDR.
This difference in style is visible in the anxiety group. First and colleagues classified panic disorder, agoraphobia, specific phobia, social anxiety disorder, and separation anxiety disorder as having minor differences largely because DSM specifies the requirements in greater operational detail. That does not mean ICD-11 is “vague” or DSM is automatically “more accurate.” The systems were built with partly different priorities: DSM emphasizes reproducible explicit criteria; ICD-11 places strong weight on global usability across health systems and clinical settings. First et al., 2021.
A WHO global field study involving 1,840 mental-health professionals found that ICD-11 anxiety guidelines produced diagnostic accuracy and clinical-utility ratings that were equivalent or superior to ICD-10 for the tested cases, with particularly improved accuracy for GAD, specific phobia, and adult separation anxiety. The study also found areas requiring clarification, including the boundary between disorder and normality and the application of panic-attack guidance. Rebello et al., 2019.
Key Difference 3: Generalized Anxiety Disorder Has a Real Duration and Phenomenology Difference
GAD is one of the clearest disorder-level differences. Both systems require anxiety to be present more days than not, but DSM-5 uses a minimum duration of six months, whereas ICD-11 allows a duration of “at least several months.” ICD-11 also permits a presentation of generalized apprehensiveness that is not restricted to identifiable worries about particular events or activities, often described as free-floating anxiety. First et al., 2021.
The difference matters because it can affect the threshold for classifying some presentations. A person with a clinically significant generalized anxiety pattern lasting less than six months may be handled differently under the two systems. It also matters cross-culturally because some people experience pervasive anxiety without being able to give a detailed verbal account of multiple discrete worry topics.
The associated symptom descriptions also differ somewhat. The comparative review notes that the two systems share most associated features but are not word-for-word equivalents. These distinctions are a reason to avoid treating a DSM-5-TR checklist and an ICD-11 clinical description as interchangeable copies. First et al., 2021.
Key Difference 4: Substance- or Medication-Induced Anxiety Is Organized Differently
DSM-5-TR includes Substance/Medication-Induced Anxiety Disorder within the Anxiety Disorders chapter. ICD-11 takes a more substance-specific, etiological approach: substance-induced anxiety disorders are classified within Disorders Due to Substance Use or Addictive Behaviors under the relevant substance. For example, alcohol-induced and cannabis-induced anxiety disorders belong to the substance-related part of ICD-11 rather than functioning as a single generic anxiety-disorder category in the anxiety grouping. Domschke & Zwanzger, 2025.
This is a classification difference, not evidence that anxiety caused by a substance is less clinically important in ICD-11. It reflects where the diagnostic system chooses to place causally attributed syndromes. In practice, determining whether anxiety is substance-induced requires a careful timeline, dose and withdrawal history, medication review, differential diagnosis, and clinical judgment. Temporal coincidence alone does not establish causation.
Key Difference 5: Anxiety Due to a Medical Condition Is Placed Differently
DSM-5-TR places Anxiety Disorder Due to Another Medical Condition in the Anxiety Disorders chapter. ICD-11 uses Secondary Anxiety Syndrome in the broader grouping of Secondary Mental or Behavioural Syndromes Associated with Disorders or Diseases Classified Elsewhere. ICD-11 can cross-list secondary syndromes with the relevant phenomenological grouping, but its primary organizational logic is etiological. First et al., 2021.
This difference is especially important for readers who see an anxiety-like presentation alongside thyroid disease, cardiac disease, respiratory disease, neurologic illness, endocrine disorders, medication effects, intoxication, or withdrawal. Symptoms such as palpitations, chest discomfort, dizziness, breathlessness, trembling, weakness, or faintness should not be attributed to an anxiety disorder merely because they occur during fear. Classification comes after appropriate medical assessment, not before it.
Key Difference 6: Mixed Anxiety and Depression Is Not Organized the Same Way
ICD-11 includes Mixed Depressive and Anxiety Disorder within Mood Disorders rather than within Anxiety or Fear-Related Disorders. DSM-5 does not have a directly equivalent stand-alone diagnosis; clinically similar subthreshold presentations may be captured through other specified depressive or anxiety categories depending on the pattern. The cross-system comparison therefore treats this as an example of a category present in one system without a one-to-one equivalent in the other. First et al., 2021; Domschke & Zwanzger, 2025.
This is a good example of why a diagnostic crosswalk cannot be reduced to matching labels by keyword. “Mixed anxiety and depression” is a phenomenological description; the formal diagnostic owner depends on the classification system and the complete presentation.
Panic Disorder and Agoraphobia: Separate Diagnoses in Both Modern Systems
Older diagnostic traditions often linked panic disorder and agoraphobia more tightly. DSM-5 separated them into independently diagnosable disorders. ICD-11 likewise permits panic disorder and agoraphobia to be diagnosed separately and together when both sets of requirements are met. Recent ICD-11 taxonomy reviews describe this as one of the important changes from ICD-10 and as an area of increased alignment with DSM-5. Domschke & Zwanzger, 2025.
That separation protects two different clinical patterns. A person can fear and avoid public transportation, open spaces, enclosed places, crowds, lines, or being outside home alone because escape or help feels difficult without having recurrent unexpected panic attacks. Conversely, a person can have panic disorder without the situational pattern required for agoraphobia.
A panic attack is not a diagnosis of panic disorder
Both modern systems also recognize that panic attacks can occur outside panic disorder. DSM-5 introduced a panic-attack specifier applicable across disorders, and ICD-11 provides a way to record panic attacks in the context of other mental or somatic disorders. This matters because panic attacks can occur with social anxiety disorder, specific phobia, PTSD, depressive disorders, substance effects, medical conditions, and other presentations. Kogan et al., 2016; Domschke & Zwanzger, 2025.
The everyday phrase “anxiety attack” has no single formal DSM-5-TR or ICD-11 definition. People use it to describe many experiences, from escalating worry to panic-like episodes. Clinical assessment should translate the description into observable symptoms, timing, triggers, impairment, and differential diagnosis rather than treating the phrase itself as a diagnostic category.
Disorder-by-Disorder Crosswalk
Generalized anxiety disorder: similar core, meaningful threshold differences
Both systems identify a generalized pattern rather than fear tied to one narrow stimulus. DSM-5-TR uses a six-month duration threshold and a more operationalized symptom framework. ICD-11 uses “several months,” allows generalized apprehensiveness without clearly articulated worry content, and uses a somewhat different associated-symptom formulation. This is one of the comparisons most likely to matter for borderline-duration cases.
Panic disorder: same construct, DSM more specified
The cross-system harmonization review classifies panic disorder as essentially the same diagnostic entity with greater degree of specification in DSM. Both require a clinically significant recurrent panic pattern rather than a single episode. The exact operational detail should be taken from the current manual being used, rather than mixing a DSM symptom count with an ICD diagnosis. First et al., 2021.
Agoraphobia: same construct, DSM more specified
Both systems center agoraphobia on fear or anxiety across situations where escape, leaving, or obtaining help could be difficult if anxiety or other incapacitating symptoms occur. DSM expresses the threshold through more explicit situational and duration criteria. ICD-11 uses essential clinical features with less numerical operationalization.
Social anxiety disorder: highly aligned, not identical wording
Both systems center the disorder on marked fear or anxiety in social situations involving possible scrutiny or evaluation, together with avoidance or endurance under intense distress and clinically significant impact. DSM gives more explicit operational detail. The key boundary remains the same in both: ordinary shyness, introversion, nervousness before public speaking, or culturally expected reserve is not automatically social anxiety disorder.
Specific phobia: one diagnostic family, many possible fear objects
Both systems use specific phobia for disproportionate, persistent, clinically significant fear or anxiety linked to a particular object or situation. Neither system creates a new disorder for every popular fear name found online. A named fear may be useful as an everyday label, but clinical mapping depends on the actual presentation and impairment.
Separation anxiety disorder: lifespan diagnosis in both
Modern DSM and ICD classifications both moved away from treating separation anxiety solely as a childhood condition. The harmonization literature describes separation anxiety disorder as the same conceptual entity across systems, with DSM providing greater specification. WHO field testing found improved recognition of adult separation anxiety under the ICD-11 guidelines compared with ICD-10. First et al., 2021; Rebello et al., 2019.
Selective mutism: especially close alignment
Selective mutism stands out because First and colleagues rated its definitions in ICD-11 and DSM-5 as essentially identical. Both systems treat the pattern as an anxiety/fear-related disorder rather than as a simple behavior problem. Diagnostic assessment still needs language competence, context, duration, communication history, developmental factors, and differential diagnosis. First et al., 2021.
What Is Not an Anxiety Disorder in DSM-5-TR or ICD-11?
The word anxiety appears across many diagnoses, traits, and life experiences. Classification depends on the owner category, not on whether anxiety is present.
OCD is not classified as an anxiety disorder
Obsessive-compulsive disorder can involve intense anxiety, fear, doubt, avoidance, and reassurance seeking, but both DSM-5-TR and ICD-11 place OCD in Obsessive-Compulsive and Related Disorders. Anxiety may be part of the experience without making OCD a subtype of an anxiety disorder. OCD diagnostic criteria: DSM-5-TR and ICD-11.
PTSD is not classified as an anxiety disorder
Post-traumatic stress disorder can include fear, hyperarousal, avoidance, sleep disturbance, and panic-like symptoms. DSM-5-TR places PTSD in Trauma- and Stressor-Related Disorders; ICD-11 places it in Disorders Specifically Associated with Stress. The classification boundary matters because trauma exposure and trauma-specific symptom organization are central to PTSD. First et al., 2021.
Illness anxiety is not simply another anxiety disorder
DSM-5 places Illness Anxiety Disorder in Somatic Symptom and Related Disorders. ICD-11 uses Hypochondriasis and places it in Obsessive-Compulsive and Related Disorders. This is a major reason not to classify every health-focused fear under the anxiety-disorders umbrella. First et al., 2021.
Neuroticism is a personality trait, not an anxiety diagnosis
Neuroticism describes a broad personality dimension involving proneness to negative emotionality. It can be associated with anxiety symptoms and anxiety-disorder risk, but a trait score does not establish a clinical disorder. The same principle applies to trait anxiety: measurement of a tendency is not equivalent to a formal diagnosis.
Historical “anxiety neurosis” is not a current diagnosis
Anxiety neurosis belongs to the history of psychiatric classification. Modern diagnostic systems divided much of that older territory among diagnoses such as panic disorder and generalized anxiety disorder. Reading a historical label as though it were a current DSM-5-TR or ICD-11 category creates unnecessary confusion. Anxiety Neurosis: Historical Meaning, Panic Disorder, GAD, and Modern Classification.
Why DSM and ICD Can Produce Different Diagnostic Decisions
If the systems overlap so strongly, why can a diagnosis still differ? Because small changes in duration, symptom operationalization, exclusion rules, category placement, or diagnostic thresholds can matter at the edge of a category. The systems also differ in how much judgment is left to the clinician versus specified in a criteria set.
The greatest practical divergence is often found in borderline cases rather than textbook presentations. Someone with a classic, long-standing panic disorder may fit both systems readily. Someone with generalized anxiety lasting four months, a mixed anxiety-depression presentation, anxiety attributed to a medical condition, or a substance-induced syndrome may encounter different classification pathways.
The large First et al. comparison found that the classifications are more harmonized than previous generations, but not identical. Across 103 mental disorders shared by the systems, some definitions were essentially identical, some had minor differences, and a smaller number had major differences. The anxiety group illustrates all three kinds of issue: close alignment for selective mutism, greater DSM specification for several fear disorders, and a more substantive GAD difference in duration and manifestations. First et al., 2021.
Normal Anxiety, Symptoms, Screening, and Diagnosis
Both systems are clinical classifications, not dictionaries of every anxious experience. Anxiety is a normal human response when it is proportionate to a threat, uncertainty, challenge, or transition and does not cross a clinically significant threshold. APA’s public guidance emphasizes persistence, disproportion, and interference with daily functioning when distinguishing anxiety disorders from ordinary anxiety. APA: What Are Anxiety Disorders?.
A symptom is one component of a presentation. A panic attack is an episode. Avoidance is a behavior. A safety behavior is something a person does to reduce perceived danger. Worry is a cognitive process. A questionnaire score is a screening or severity result. A risk factor changes probability. A trait describes a relatively stable tendency. None of these alone equals a diagnosis.
The boundary is clinically important because false precision can medicalize normal distress, while excessive normalization can miss a disorder that causes substantial impairment. WHO field testing of ICD-11 anxiety guidelines found that clinicians still had difficulty with subthreshold cases near the boundary between disorder and normality, which is exactly where context and professional judgment become most important. Rebello et al., 2019.
DSM-5-TR Codes Are Not the Same Thing as ICD-11 Diagnostic Rules
One source of confusion is that DSM-5-TR diagnoses display ICD-derived codes. APA explains that DSM diagnostic codes used in U.S. practice are derived from ICD-10-CM, the U.S. clinical modification of ICD-10. That coding relationship does not mean DSM-5-TR is using ICD-11 diagnostic requirements. A DSM diagnosis and an ICD code can coexist because coding systems and diagnostic manuals serve related but distinct functions. APA: About DSM-5-TR.
This distinction matters when reading a medical record. A code beginning with F does not by itself tell you whether the clinician conceptually applied DSM-5-TR criteria, ICD-10-CM conventions, an ICD-11 framework, or local coding rules. The surrounding clinical documentation and jurisdiction matter.
Which System Do Clinicians Use?
There is no single worldwide answer. WHO describes ICD-11 as the global standard for recording and reporting diseases and health-related conditions, and it is designed for use across member states and health systems. DSM-5-TR is the American Psychiatric Association’s manual and is the standard classification of mental disorders used by many U.S. mental-health professionals. Local regulation, reimbursement, health-system rules, training, research protocols, and professional practice determine which system is used for which purpose. WHO ICD-11 CDDR; APA DSM-5-TR.
ICD-11 itself is maintained over time. The WHO ICD browser lists the 2026-01 release as the latest MMS release as of September 30, 2026, while the mental-health CDDR was published in 2024 as the clinical diagnostic manual. Readers should therefore distinguish the statistical coding release from the CDDR clinical guidance rather than assuming every update is a wholesale change to psychiatric diagnostic requirements. WHO ICD-11 releases; WHO CDDR, 2024.
Does One System Have “More” Anxiety Disorders?
Counting diagnoses is less informative than understanding where each system places them. DSM-5-TR keeps substance/medication-induced anxiety disorder and anxiety disorder due to another medical condition inside its Anxiety Disorders chapter. ICD-11 handles comparable substance-induced and secondary anxiety syndromes primarily in etiological groupings outside the core Anxiety or Fear-Related Disorders group. At the same time, both systems share the seven central clinical disorders that dominate everyday anxiety-disorder assessment.
The count can also change depending on whether someone treats “other specified” and “unspecified” categories as disorders in a list, whether panic attacks are mistakenly counted as a disorder, or whether adjacent conditions such as OCD, PTSD, illness anxiety, or mixed depressive-anxiety presentations are incorrectly folded into the anxiety chapter. A good comparison therefore follows formal classification rather than internet lists.
What the Classification Difference Means for Treatment
A DSM-versus-ICD label should not be used as a shortcut for choosing treatment. Treatment evidence is disorder-specific and depends on severity, age, comorbidity, medical history, patient preference, access, previous response, and other clinical factors. A classification crosswalk tells you how a presentation is named and bounded; it does not turn one psychotherapy or medication into a universal treatment for every anxiety-related problem.
This is especially important when two systems place etiological syndromes differently. If anxiety is caused by a substance, withdrawal state, medication, or medical disease, management may require addressing that cause. If symptoms reflect OCD, PTSD, illness anxiety, depression, or another condition, treatment evidence should be drawn from that disorder’s literature rather than automatically from generalized anxiety or panic-disorder studies.
How to Compare a DSM and ICD Diagnosis Correctly
First, identify the exact diagnosis rather than comparing chapter names alone. “Anxiety” is too broad. Compare GAD with GAD, panic disorder with panic disorder, agoraphobia with agoraphobia, and so on.
Second, compare the current diagnostic requirements, not a symptom list from a search snippet. Duration, impairment, context, exclusion criteria, developmental features, and differential diagnosis can change whether a presentation qualifies.
Third, separate classification from coding. A DSM-5-TR diagnosis may carry an ICD-10-CM code in U.S. documentation. That does not make the diagnostic criteria ICD-11 criteria.
Fourth, check whether the apparent mismatch reflects category placement rather than clinical disagreement. Substance-induced anxiety and anxiety secondary to a medical condition are good examples: both systems recognize clinically important anxiety syndromes, but they organize them differently.
Fifth, do not infer a diagnosis from a comparison article. Formal diagnosis requires a clinical assessment of symptoms, time course, impairment, medical and substance factors, developmental context, and competing explanations.
Frequently Asked Questions
Is ICD-11 the same as DSM-5-TR?
No. They are separate classification systems produced by different organizations. Their anxiety classifications are strongly harmonized, but not identical in organization, diagnostic style, GAD requirements, and placement of some etiological syndromes.
Which anxiety disorders are in both DSM-5-TR and ICD-11?
The shared core includes generalized anxiety disorder, panic disorder, agoraphobia, social anxiety disorder, specific phobia, separation anxiety disorder, and selective mutism. Both systems also provide residual categories for clinically significant presentations that do not fit a named core disorder, although labels and implementation differ.
Is ICD-11 newer than DSM-5-TR?
The dates do not support a simple winner. ICD-11 came into effect for health reporting in 2022; WHO published the mental-health CDDR in 2024 and continues to maintain ICD releases. DSM-5-TR was published in 2022 and APA maintains approved updates. For clinical work, the relevant question is which current system and local rules apply.
Does DSM-5-TR include OCD as an anxiety disorder?
No. OCD is in Obsessive-Compulsive and Related Disorders. It may involve intense anxiety, but classification follows the OCD diagnostic territory rather than the anxiety-disorders chapter.
Does ICD-11 include PTSD as an anxiety disorder?
No. ICD-11 places PTSD in Disorders Specifically Associated with Stress. DSM-5-TR likewise places PTSD outside the Anxiety Disorders chapter, in Trauma- and Stressor-Related Disorders.
Is illness anxiety disorder an anxiety disorder?
Despite the word anxiety in its name, DSM-5-TR places Illness Anxiety Disorder in Somatic Symptom and Related Disorders. ICD-11 uses the related diagnosis Hypochondriasis in Obsessive-Compulsive and Related Disorders. Health-focused fear therefore should not be automatically counted as a subtype of the core anxiety-disorders group.
Are panic disorder and agoraphobia the same diagnosis?
No. They are separate diagnoses in both modern systems. They can occur independently or together.
Is a panic attack an anxiety disorder?
A panic attack is an episode or specifier/qualifier, not a stand-alone anxiety disorder. One or more panic attacks do not by themselves establish panic disorder.
Is “anxiety attack” a DSM-5-TR or ICD-11 diagnosis?
No. “Anxiety attack” is an informal expression without one standardized diagnostic definition. Clinical assessment needs to determine what actually happened: gradual anxiety, a panic attack, a medical event, substance effect, stress response, or another presentation.
Can the same person meet DSM-5-TR but not ICD-11 requirements?
Yes, particularly near diagnostic boundaries. GAD duration is a clear example because DSM uses six months while ICD-11 permits “several months.” Differences in operational detail can also matter in borderline presentations. In many clear-cut cases, however, the systems will converge.
Does a GAD-7 score tell me whether I meet DSM-5-TR or ICD-11 criteria?
No. GAD-7 is a screening and symptom-severity instrument, not a substitute for a formal diagnostic assessment. A score can support further evaluation, but diagnosis requires the full clinical picture and the requirements of the classification system being used.
Why does my DSM diagnosis have an ICD code?
In U.S. practice, DSM diagnostic codes are derived from ICD-10-CM. Coding and diagnostic criteria are related but distinct. An ICD-derived code on a DSM diagnosis does not mean the clinician used ICD-11 diagnostic requirements.
Which system is better for anxiety disorders?
The evidence supports substantial convergence with purposeful differences rather than a simple hierarchy. DSM offers more explicit operationalization in several anxiety disorders; ICD-11 prioritizes global clinical utility and flexible essential-feature guidance. The appropriate system depends on jurisdiction, health-system requirements, research design, and clinical purpose.
Bottom Line
DSM-5-TR and ICD-11 now describe a highly similar modern anxiety-disorder landscape. Their shared core is generalized anxiety disorder, panic disorder, agoraphobia, social anxiety disorder, specific phobia, separation anxiety disorder, and selective mutism. The biggest practical differences are the chapter name and organizing logic, the level of diagnostic operationalization, GAD duration and manifestations, and the placement of substance-induced, medically caused, and mixed anxiety-depression presentations. First et al., 2021; Kogan et al., 2016.
For readers, the safest interpretation is precise rather than expansive: anxiety is not one diagnosis, a panic attack is not panic disorder, an “anxiety attack” is not a formal diagnostic term, screening is not diagnosis, and neighboring conditions such as OCD, PTSD, illness anxiety, neuroticism, and historical anxiety neurosis retain their own diagnostic or conceptual territories.
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References
American Psychiatric Association. (2022). About DSM-5-TR. https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm
American Psychiatric Association. (n.d.). What are anxiety disorders? https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders
Domschke, K., & Zwanzger, P. (2025). Taxonomy of anxiety disorders—a comparison of ICD-10 and ICD-11. Der Nervenarzt, 96(Suppl 1), 1–5. https://doi.org/10.1007/s00115-025-01842-6
First, M. B., Gaebel, W., Maj, M., et al. (2021). An organization- and category-level comparison of diagnostic requirements for mental disorders in ICD-11 and DSM-5. World Psychiatry, 20(1), 34–51. https://doi.org/10.1002/wps.20825
Kogan, C. S., Stein, D. J., Maj, M., First, M. B., Emmelkamp, P. M. G., & Reed, G. M. (2016). The classification of anxiety and fear-related disorders in the ICD-11. Depression and Anxiety, 33(12), 1141–1154. https://doi.org/10.1002/da.22530
Rebello, T. J., Keeley, J. W., Kogan, C. S., et al. (2019). Anxiety and fear-related disorders in the ICD-11: Results from a global case-controlled field study. Archives of Medical Research, 50(8), 490–501. https://pubmed.ncbi.nlm.nih.gov/32018071/
World Health Organization. (2024). Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders (CDDR). https://www.who.int/publications/i/item/9789240077263
World Health Organization. (2026). ICD-11 for Mortality and Morbidity Statistics: Releases. https://icd.who.int/browse/releases/mms/en