Personality Difficulty in ICD-11: Meaning and Diagnostic Limits

Author: Ukrainian Psychological Hub · Published: October 13, 2026 · Editorial Policy

In the World Health Organization's International Classification of Diseases, Eleventh Revision (ICD-11), personality difficulty is a formal designation for persistent personality characteristics that cause some problems or influence health care but fall below the threshold for a personality disorder. Its code is QE50.7. The distinction is clinically important: someone can have enduring patterns of emotional or interpersonal difficulty without meeting the requirements for a mental disorder. The WHO's ICD-11 Clinical Descriptions and Diagnostic Requirements and official ICD-11 classification establish this distinction.

A clinician may use personality difficulty to describe a longstanding vulnerability that becomes troublesome under stress, complicates a particular relationship, or affects engagement with care, while recognizing that the person's overall functioning remains substantially preserved. The classification is intended to support proportionate description and clinical communication. It is not a diagnosis of mild personality disorder, a medical determination from a questionnaire, or a way to classify another person based on a few encounters. Bach and First's clinical cases illustrate how the ICD-11 framework locates personality difficulty on the lower side of a clinical threshold.

What Is Personality Difficulty in ICD-11?

Personality difficulty is an ICD-11 category within factors influencing health status or contact with health services, under problems associated with interpersonal interactions. WHO describes it as pronounced personality characteristics that may affect treatment or healthcare use, but lack the severity needed for a diagnosis of personality disorder. The relevant patterns are longstanding, generally considered over a period such as at least two years, and concern how a person experiences and interprets the self, other people, and the surrounding world. WHO's ICD-11 guidance is the primary diagnostic authority; Bangash's 2024 commentary explains why the designation is explicitly treated as a non-disorder category.

Three elements define the boundary. The characteristic ways of thinking, feeling, or relating are persistent enough to matter clinically; their expression may nevertheless be comparatively low in intensity or restricted to stressful times and particular situations; and associated problems do not produce the notable, pervasive disruption required for personality disorder. Occasional arguments, shyness, perfectionism, sensitivity to criticism, or a preference for solitude do not independently satisfy those elements. The assessor considers the person's circumstances and the consequences of the pattern, rather than interpreting ordinary trait language as a diagnosis. Bach and First describe this distinction using clinical formulations.

Where QE50.7 Fits in the ICD-11 Classification

ICD-11 separates personality disorder, classified under 6D10, from personality difficulty, classified under QE50.7. Personality disorder is a mental-disorder diagnosis when the general requirements and the threshold of significant dysfunction are met. Its severity may then be specified as mild (6D10.0), moderate (6D10.1), or severe (6D10.2). QE50.7 is deliberately located outside that severity sequence as a health-related designation for subthreshold difficulties. It should not be described as a fourth personality-disorder severity diagnosis. This structure is set out in the WHO clinical requirements and in Mulder's review.

Coding and clinical formulation serve related purposes. A code can record an issue relevant to care without claiming that the issue is a psychiatric disorder. A clinician using QE50.7 should be able to explain what has been observed, how long the pattern has been present, why it matters to the person's health or care, and why the disorder threshold is not met. The exact coding procedures and eligibility for reimbursement depend on the country and the clinical system in use; an ICD-11 description is not automatically an equivalent U.S. insurance-billing diagnosis. The distinction between the two classification frameworks is covered in our DSM-5-TR vs ICD-11 guide.

Personality Difficulty vs Mild Personality Disorder

The word mild creates understandable confusion. Mild personality disorder is already a personality disorder: a clinician has established the ICD-11 diagnostic requirements and judged the resulting dysfunction to be at the less severe end of the disorder range. Personality difficulty means that enduring features are relevant but the requirements for personality disorder have not been met. The difference depends on the nature, breadth, intensity, stability, and real-life consequences of personality dysfunction, not on whether a person appears generally pleasant, dramatic, withdrawn, or successful. See the ICD-11 severity levels explained and WHO requirements.

For personality difficulty, problems may appear mainly during periods of stress, occur within one relationship or situation, or have a limited effect on daily functioning. For mild personality disorder, disturbances in self and/or interpersonal functioning are sufficiently persistent and clinically significant to establish a disorder, even though the overall severity is lower than in moderate or severe cases. A person can work, maintain some relationships, and still meet personality-disorder requirements; conversely, experiencing intense distress during one difficult period does not automatically establish personality disorder. Bach and First's clinical applications emphasize assessment of the entire pattern.

A hypothetical example of the threshold

Imagine a person who has been unusually sensitive to criticism for many years. Under occupational stress, they become defensive and repeatedly misread a supervisor's feedback, but they maintain close friendships, recover after conflict, and manage their responsibilities. Those facts could prompt a clinician to investigate personality difficulty if the pattern affects care or wellbeing. Now imagine a different person whose pervasive, enduring problems with self-appraisal and interpersonal functioning substantially disrupt work, close relationships, and self-direction across contexts. That second presentation warrants an assessment of personality disorder. Neither example is a diagnosis, because developmental history, alternative explanations, context, severity, and safety still require professional evaluation.

How Personality Difficulty Differs From an Ordinary Personality Trait

A personality trait describes a relatively characteristic pattern of emotion, thought, motivation, or behavior. Traits such as conscientiousness, social reserve, emotional sensitivity, or assertiveness vary naturally among people and cultures. A maladaptive trait describes a feature that can contribute to problems under particular conditions. Personality difficulty refers to a more clinically relevant, enduring pattern below the disorder threshold, while personality disorder requires a diagnosable disturbance with sufficient impairment. These terms answer different questions, and no single trait guarantees a clinical classification. Our personality disorders versus personality traits article develops that clinical distinction; Tyrer and colleagues' classification review explains the dimensional rationale.

The location of a trait on a scale and its effects in daily life are not the same fact. Strong orderliness may support work performance, although rigidity can become costly in specific relationships. A tendency toward intense emotion may coexist with supportive relationships and effective coping. Clinicians evaluate how traits interact with flexibility, environmental demands, culture, support, distress, and impairment. Describing someone as difficult, intense, controlling, narcissistic, or avoidant in everyday speech supplies little reliable evidence about QE50.7. Such labels may also conceal situational factors and the observer's own role in a conflict.

The Role of Self and Interpersonal Functioning

ICD-11 evaluates personality dysfunction through difficulties concerning the self and interpersonal relationships. Self-functioning includes a relatively coherent experience of identity, realistic self-appraisal, self-worth, and the capacity to direct behavior toward meaningful goals. Interpersonal functioning concerns understanding other people's perspectives, developing and maintaining mutually satisfying relationships, and navigating disagreement. When reviewing subthreshold personality difficulty, a clinician considers how these abilities operate over time and whether any limitation is narrow, situational, low-intensity, or clinically pervasive. The governing source is the WHO CDDR; our personality functioning guide offers a detailed clinical explanation.

Identity, self-direction, empathy, and intimacy are particularly familiar in the DSM-5 Alternative Model for Personality Disorders, where they organize the Level of Personality Functioning assessment. ICD-11 uses closely related dimensions of self and interpersonal dysfunction but has its own diagnostic requirements and severity approach. The frameworks overlap conceptually without being identical instruments or automatic equivalents. A person may have a relatively stable identity and still struggle with conflict, or be socially capable while having unstable self-evaluation. Clinical reasoning integrates these observations and avoids reducing someone to a single deficit or score. Mulder and Bach and Mulder review the comparison.

Can Personality Difficulty Have ICD-11 Trait Qualifiers?

The ICD-11 personality framework describes five prominent trait domains: negative affectivity, detachment, dissociality, disinhibition, and anankastia. Negative affectivity concerns a tendency to intense adverse emotional responses; detachment involves interpersonal or emotional distance; dissociality concerns disregard for the rights or feelings of others; disinhibition involves impulsive or poorly regulated action; and anankastia involves rigidity, perfectionism, and control. These dimensions describe patterns; they do not by themselves establish that a disorder exists. The WHO clinical manual and Bach and First's applied examples provide the framework, while our ICD-11 trait-domain guide treats each domain in greater depth.

Clinically, a prominent trait can help explain the form a person's personality difficulty takes. Someone may tend toward negative affectivity during stressful interactions, or toward anankastic rigidity when routines change. The presence of one or several such patterns does not imply a corresponding DSM-5-TR category, nor does it convert QE50.7 into mild personality disorder. Trait descriptions are most useful when their connections to concrete situations, strengths, functioning, and care needs are made explicit. A clinician should distinguish a stable disposition from behavior caused by acute distress, substance effects, environmental threat, or another condition.

What Clinicians Assess Before Using the Term

Assessment starts by clarifying the concern and the person's goals. A clinician asks about duration, development, emotional experiences, self-image, relationships, occupational or educational functioning, flexibility, and patterns that recur across situations. They explore what happens under stress and whether problems improve when circumstances change. They also consider strengths, supportive relationships, cultural expectations, the effects of adversity, and how the person understands their experiences. A diagnosis or health-related designation should emerge from a sufficiently broad clinical formulation, not from an isolated encounter. WHO and Bach and Mulder describe why severity and context matter.

Possible sources include clinical interviews, a longitudinal history, relevant records, and collateral information when appropriate, consented to, and ethically justified. Screening questionnaires or trait inventories may organize a discussion, but their scores do not establish QE50.7 or show that personality disorder is absent. Measurement instruments vary in their validation, population norms, and relationship to functioning. The available literature supports cautious use of ICD-11-oriented measures as aids to assessment while calling for continued validation of clinical interviews and their impact on treatment decisions. See Bach and Mulder's assessment review and our clinical personality-disorder assessment guide.

Why persistence and context both matter

A recurring pattern persisting for roughly two years or longer may be relevant, but duration alone proves little. A clinician also asks whether the pattern is longstanding relative to developmental stage, whether it reflects an understandable response to prolonged stress, and whether it differs meaningfully from the person's usual functioning. Relationship conflict, employment instability, cultural displacement, sleep deprivation, or an active mental-health condition can influence both the presentation and its interpretation. ICD-11 classification requires judgment about the whole clinical situation; it does not authorize treating two years of arguments or perfectionism as an automatic personality designation.

What Personality Difficulty Does Not Mean

QE50.7 is not an official diagnosis of borderline personality disorder, narcissistic personality disorder, avoidant personality disorder, or another DSM personality disorder. It does not describe the personality as defective, place someone in the historical DSM Clusters A, B, or C, or predict dangerousness. It is also distinct from a colloquial accusation that somebody has a difficult personality. The formal reason for considering the designation is its relevance to clinically meaningful longstanding patterns and their impact on functioning or care. Bangash discusses the contested clinical utility and possible stigma implications, and WHO establishes the classification itself.

A popular personality quiz, a social-media checklist, an AI-generated interpretation of someone else's messages, or a partner's account of conflict cannot establish this designation. The same holds for descriptions such as quiet BPD, covert narcissism, favorite person, psychopath, or sociopath: none supplies a QE50.7 assessment, and internet language cannot replace clinical evaluation. A person may display harmful or inconsiderate behavior without a psychiatric disorder; the responsibility to address harm remains a separate practical issue. It is reasonable to set boundaries in a relationship without assigning a diagnosis to the other person.

Differential Diagnosis: Conditions and Contexts to Consider

Personality difficulty should be considered alongside, and sometimes distinguished from, anxiety disorders, depression, trauma-related conditions, neurodevelopmental differences, substance-related problems, medical conditions, and situational stresses. For example, withdrawal may reflect depression, trauma-associated vigilance, autistic differences, or a longstanding preference for solitude; rigidity may appear in obsessive-compulsive disorder, certain neurodevelopmental presentations, or coping with uncertainty. The relevant question is how symptoms begin, change over time, relate to developmental history and context, and impair functioning. The detailed differential belongs to the appropriate condition-specific assessments. WHO's clinical requirements emphasize adequate differential evaluation.

More than one clinical issue can be present. A person might receive treatment for major depression while a persistent interpersonal pattern also affects the therapeutic relationship. Identifying that second pattern could improve communication, goals, and follow-up, without making a personality-disorder diagnosis. Likewise, a person with marked distress may have a mental disorder that deserves treatment even when personality functioning falls below the ICD-11 personality-disorder threshold. The classification should describe relevant information, support coordinated care, and avoid turning every recurrent problem into evidence of pathology. Bach and First and Mulder explain the clinical formulation approach.

Age, Development, Culture, and Changing Circumstances

Personality patterns develop across the life course, and their expression depends on environmental opportunities and pressures. Adolescents and young adults may be developing identity, emotional regulation, autonomy, and relationship skills; an apparent pattern requires careful consideration of developmental stage and context. At later ages, changing social roles, illness, cognitive changes, caregiving pressures, and losses may alter interpersonal functioning. Clinical judgment weighs the continuity of the presentation and actual impairment instead of assuming that one period defines the whole life course. WHO's international requirements supply the overarching diagnostic standard.

Cultural values influence what counts as appropriate emotional expression, independence, closeness, deference, conflict resolution, and self-presentation. A reserved communication style or strong family obligation may be normative in one context and misunderstood in another. Marginalization, migration, disability, trauma exposure, and ongoing environmental stressors can also shape observable behavior. Clinicians should ask how the person experiences the situation and how members of the relevant cultural and social setting understand it. A label derived from an outsider's preference for a different interpersonal style risks medicalizing diversity rather than clarifying care.

Is Personality Difficulty a Mental Disorder?

No. In the ICD-11 classification, personality difficulty is a coded health-related circumstance beneath the threshold for personality disorder. The distinction is categorical in coding even though personality functioning and traits are dimensional in clinical understanding. It is possible to experience substantial distress about a limited relationship or recurring situation while the personality-disorder diagnostic requirements are not fulfilled. Whether another mental disorder is present must be assessed independently. WHO's clinical manual sets the framework; Bangash's commentary directly identifies QE50.7 as a non-disorder category.

Not calling something a disorder does not dismiss the underlying experience. It allows a clinician to acknowledge recurring difficulties accurately and determine which practical supports may be helpful. On the other hand, applying a formal code to a modest difficulty can itself have social and personal consequences. The rationale for documentation should be transparent, proportionate, and understandable to the person concerned. The usefulness and acceptance of this specific category in everyday clinical settings remain matters for further research.

Clinical Utility and the Current Scientific Evidence

The dimensional ICD-11 model was developed to address longstanding problems with numerous overlapping personality-disorder categories and to give clinical importance to severity. The inclusion of subthreshold personality difficulty reflects that wider rationale. Tyrer and colleagues trace the model's development, while Mulder reviews its clinical implications and the promising but evolving validation work. These studies support understanding why the framework was designed, not an assertion that every element has demonstrated practical benefit in every healthcare system.

A 2021 scoping review by Tracy and colleagues identified eight studies evaluating clinical utility of the ICD-11 personality-disorder classification overall. Findings were mixed: four studies offered strong support, three offered qualified support with limitations, and one was critical. The authors called for further work on communication with patients and families, feasibility, and everyday use. The review examined the wider model, not independent proof that QE50.7 improves outcomes. A favorable result for the severity framework should not automatically be interpreted as validation of personality difficulty as a specific clinical code.

Bangash's 2024 commentary argues that personality difficulty may offer a useful description for clinically relevant subthreshold patterns and may help with some stigma concerns, while noting uncertainty and debate about its use. Bach and Mulder's 2022 review finds promising measurement properties across ICD-11-oriented instruments but calls for more development of clinician assessment methods and treatment research. These are different types of evidence: classification authority establishes the category; reviews evaluate preliminary utility; an expert commentary advances an interpretation. None demonstrates that assigning QE50.7 itself causes better mental-health outcomes.

What research has yet to establish

Several questions remain open: how consistently clinicians distinguish personality difficulty from mild personality disorder; how reliably the code is used across languages, cultures, care settings, and age groups; whether patients find the term helpful; how documentation influences stigma and service access; and whether using QE50.7 improves treatment selection, engagement, functioning, or longer-term outcomes compared with a careful descriptive formulation without that code. Research focused narrowly on personality difficulty is more limited than the broader research on ICD-11 personality-disorder severity. This uncertainty is relevant to how firmly any article or clinician should describe the designation's benefits. Tracy and colleagues and Bangash provide complementary perspectives.

Treatment and Support: What Follows From the Designation?

Personality difficulty does not carry its own evidence-established, universal psychotherapy, medication regimen, or medical treatment protocol. Support is selected according to the person's actual concerns: recurring conflict, sensitivity to criticism, emotional regulation, rigidity, difficulties with trust, or problems navigating particular environments. Collaborative goal setting, reflective discussion, learning new coping strategies, communication work, and attention to stressful circumstances may be appropriate depending on the clinical formulation and patient preference. Any co-occurring mental disorder is assessed and treated on its own evidence base. Bach and Mulder review severity- and trait-informed clinical ideas while stressing the need for stronger treatment-specific research.

A therapist might help someone identify common conflict triggers, test interpretations of ambiguous social situations, practice flexible responses to disappointment, or strengthen self-directed decisions. Such methods are clinical options tailored to a person's needs, not proof that a particular therapy has been validated specifically for ICD-11 QE50.7. Similarly, a medication would be considered for a separately identified clinical indication rather than prescribed to treat personality difficulty as a standalone entity. Changes in family conditions, work demands, discrimination, and social support may be as relevant to a person's practical improvement as an individual psychological intervention.

When professional care is worth considering

Professional consultation is reasonable when recurring patterns cause meaningful distress, interfere with treatment, produce repeated relationship or workplace problems, or leave the person feeling unable to act flexibly in important situations. The goal can be to understand the pattern and address concrete difficulties regardless of whether QE50.7 is recorded. A person facing escalating self-harm risk, suicidal thoughts with intent, psychosis, severe mood symptoms, acute intoxication, or immediate danger needs assessment appropriate to that problem without waiting for a personality designation. The intensity of support follows actual symptoms and risk, not the relative mildness of a personality label.

Can Personality Difficulty Change Over Time?

Personality is relatively stable in some respects yet individual functioning changes with learning, treatment, roles, relationships, and environment. A longstanding vulnerability may become less disruptive when circumstances are more supportive or coping is stronger; difficulties can also become more evident in new stressful situations. The presence of personality difficulty at one assessment does not establish a permanent condition, inevitable progression to personality disorder, or an unfavorable prognosis. If functioning changes, clinicians should review the description and its relevance to care. The broader ICD-11 framework places strong emphasis on describing current severity and the nature of functioning, as reviewed by Mulder and Bach and First.

Long-term outcomes cannot be predicted from QE50.7 alone. The specific problems, protective factors, relationships, available care, co-occurring symptoms, and ongoing stressors all matter. Research on personality-disorder prognosis should not simply be transferred to people with personality difficulty, because the groups have different diagnostic thresholds. Describing potential for change is appropriate; promising that a code will disappear after a fixed number of sessions, or that it will inevitably become a disorder, would exceed the evidence.

How to Discuss the Term With a Clinician

If a clinician mentions personality difficulty, useful questions concern meaning and purpose: Which enduring patterns are relevant? In what situations do they occur? What evidence suggests they have persisted? How do they affect my wellbeing, relationships, or treatment? Why do they fall below the disorder threshold? Are other conditions or circumstances more explanatory? What practical goals or supports would help? Is the code needed in the medical record, and what are its local administrative implications? These questions support shared understanding without turning classification into a judgment of personal worth.

If the term appears in a medical report with little explanation, asking for the clinical rationale is appropriate. A different opinion may also be useful when the account does not match the person's history or when material differential questions remain unresolved. Neither personality difficulty nor personality disorder should be inferred from a partner's description, a short online interaction, or a general test result. Clear discussion can preserve the distinction between clinically relevant struggles, an individual's identity, and a formal mental-disorder diagnosis.

Frequently Asked Questions

What is the ICD-11 code for personality difficulty?

The ICD-11 code is QE50.7. It is a health-related category for persistent, subthreshold personality characteristics relevant to care or functioning, not code 6D10 for personality disorder. See WHO ICD-11.

Does personality difficulty mean I have mild personality disorder?

No. Mild personality disorder (6D10.0) indicates that the criteria for personality disorder are fulfilled and the disorder's severity is judged mild. Personality difficulty (QE50.7) concerns enduring traits or patterns that fall below that disorder threshold. WHO's clinical requirements explain the distinction.

Can a person have personality difficulty without feeling distressed?

Yes, the code can concern patterns that affect functioning, relationships, or healthcare even when the person's own distress is limited. But the purpose and significance of using it should still be clinically justified and discussed, with attention to the individual's perspective and setting.

How long must the patterns have existed?

ICD-11 describes longstanding difficulties, for example around two years or more. Duration supports assessment of persistence but does not determine classification by itself. The extent, context, and consequences of the pattern remain central. See Bach and First.

Is personality difficulty the same as accentuated personality traits?

The ideas overlap historically but are not interchangeable coding categories. The ICD-11 code has its own definition and location; an unusually prominent everyday trait requires no formal designation unless it has clinical relevance. Historical comparisons with ICD-10 accentuation of personality traits are discussed by Bach and First.

Is personality difficulty in DSM-5-TR?

The exact ICD-11 category QE50.7 has no direct one-to-one DSM-5-TR diagnosis with the same name and function. DSM-5-TR retains its own categorical diagnoses and alternative personality-disorder model. Coding and assessment follow the classification in use. See our DSM-5-TR versus ICD-11 comparison.

Can an online personality test identify QE50.7?

No single self-report score establishes personality difficulty or rules out personality disorder. A clinician assesses persistence, self and interpersonal functioning, relevant history, differential explanations, and clinically meaningful impact. Bach and Mulder discuss promising measurement tools and their current limits.

Do trait qualifiers turn personality difficulty into a disorder?

No. Negative affectivity, detachment, dissociality, disinhibition, and anankastia describe patterns. They do not establish the diagnostic threshold. WHO and Bach and First separate description of prominent traits from the judgment of severity and disorder status.

Does personality difficulty always require therapy?

No. The decision depends on actual distress, functioning, practical goals, other clinical problems, and personal preference. Some situations may benefit from targeted support; others may require no intervention. There is no established treatment regimen specific to QE50.7.

Can clinicians use this code for children and teenagers?

Any assessment in a young person needs especially careful developmental and cultural context. A stable-looking behavior during a developmental transition should not be automatically treated as a fixed personality pattern. Local coding guidance and age-appropriate clinical judgment govern use of the designation.

Can personality difficulty later become personality disorder?

A person's difficulties can change, and reassessment may be indicated if their persistence, breadth, or effects become more severe. QE50.7 does not mean that progression will occur. It is a description of a clinical threshold at assessment rather than a prediction of future diagnosis.

Related Articles

For the larger diagnostic architecture, read DSM-5-TR vs ICD-11 Personality Disorders: Diagnosis and Classification, the parent article of this page. ICD-11 Personality Disorder Severity: Mild, Moderate, and Severe explains the threshold above personality difficulty, and ICD-11 Personality Disorder Trait Domains Explained addresses optional descriptive qualifiers.

For the functioning and assessment concepts behind that threshold, see Personality Functioning: Identity, Self-Direction, Empathy, and Intimacy, Personality Disorders vs Personality Traits: Clinical Differences, How Are Personality Disorders Diagnosed? The Clinical Assessment Process, and the central clinical overview Personality Disorders: Types, Symptoms, Diagnosis, and Treatment.

For the historical DSM Cluster C diagnostic grouping, see Cluster C Personality Disorders: Avoidant, Dependent, and Obsessive-Compulsive. Cluster C categories are distinct from ICD-11 personality difficulty.

For the distinct DSM-5-TR residual diagnosis categories, see Other Specified and Unspecified Personality Disorder Diagnoses.

References

Bach, B., & First, M. B. (2018). Application of the ICD-11 classification of personality disorders. BMC Psychiatry, 18, 351. https://doi.org/10.1186/s12888-018-1908-3.

Bach, B., & Mulder, R. (2022). Clinical implications of ICD-11 for diagnosing and treating personality disorders. Current Psychiatry Reports, 24, 553–563. https://doi.org/10.1007/s11920-022-01364-x.

Bangash, A. (2024). Personality difficulty: A useful addition to the literature on personality disturbance. Personality and Mental Health. https://doi.org/10.1002/pmh.1638.

Mulder, R. T. (2021). ICD-11 personality disorders: Utility and implications of the new model. Frontiers in Psychiatry, 12, 655548. https://doi.org/10.3389/fpsyt.2021.655548.

Tracy, M., Tiliopoulos, N., Sharpe, L., & Bach, B. (2021). The clinical utility of the ICD-11 classification of personality disorders and related traits: A preliminary scoping review. Australian & New Zealand Journal of Psychiatry, 55(9), 849–862. https://doi.org/10.1177/00048674211025607.

Tyrer, P., Mulder, R., Kim, Y.-R., & Crawford, M. J. (2019). The development of the ICD-11 classification of personality disorders: An amalgam of science, pragmatism, and politics. Annual Review of Clinical Psychology, 15, 481–502. https://doi.org/10.1146/annurev-clinpsy-050718-095736.

World Health Organization. (2024). Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders (CDDR). WHO publication.

World Health Organization. (2026). ICD-11 for Mortality and Morbidity Statistics, 2026-01 release: QE50.7, Personality difficulty. Official ICD-11 browser.