Forwarded report re. inclusion of PA in ICD-11

ICD-11 Includes Parental Alienation

By William Bernet, M.D., President, Parental Alienation Study Group

Numerous members of PASG, Parental Alienation Study Group, helped bring about this recognition.

FOR THE FIRST TIME, the term “parental alienation” is included in the new edition of the International Classification of Diseases (ICD-11). Parental alienation is not a separate diagnosis in ICD-11, but is considered a synonym or an index term for a specific diagnosis, that is, caregiver-child relationship problem (QE52.0). The final version of ICD-11 is freely available on the Internet at Go to that link and then to “ICD Browser.” You can easily search for “parental alienation” and “parental estrangement.” Both terms are recognized because they are in the Index of the three-volume set of ICD-11.

Both terms take the reader to the diagnosis of caregiver-child relationship problem. That is what ICD personnel have been telling us for more than a year, that is, that alienation and estrangement are considered “index terms” for caregiver-child relationship problem. We knew all along that parental alienation would not be a separate diagnosis, but was considered an alternative term for caregiver-child relationship problem.

If you ask me, I think it is correct to say, “Parental alienation is in ICD-11.” Also, “PA is considered another name for caregiver-child relationship problem.” Also, “ICD-11 recognizes the reality of PA,” and so on. Numerous members of PASG helped bring about the recognition of parental alienation by ICD11 and the World Health Organization (WHO).

Starting about two years ago, PASG members logged into the website, where ICD-11 was under development. On the ICD-11 website, PASG members indicated their support for including some reference to alienation and estrangement. (We tried to go one step further, that is, for ICD-11 to include definitions for “alienation” and “estrangement,” but that initiative was not successful.)

The WHO released the final version of ICD-11 on June 18, 2018. According to a WHO press release, ICD-11 will be presented at the World Health Assembly in May 2019 for adoption by Member States, and will come into effect on January 1, 2022. Starting now, individual countries can plan how to use the new version, prepare translations, and train health professionals. ICD-11 contains around 55, 000 unique codes for injuries, diseases, and causes of death. It provides a common language that allows health professionals to share health information across the globe.


William Bernet, M.D.

Professor Emeritus

Vanderbilt University School of Medicine

1313 21st Avenue South

209 Oxford House

Nashville, TN  37232