Discussion 1: Evidence-Based Interventions Used in Trauma Individuals can experience trauma from public events at the nationa

DIAGNOSTIC AND STATISTICAL MANUAL OF

MENTAL DISORDERS F I F T H E D I T I O N

DSM-5TM

American Psychiatric Association

Officers 2012-2013 P residen t D ilip V. J este, M.D.

P resid en t-Elect J effrey A. Lieberm a n , M.D. Tr ea su rer Da v id F a ssler, M.D.

Secreta ry R cxser Peele, M.D.

Assembly Spea k er R. Sc o tt B en so n , M.D.

S peaker-Elect M elin da L. Yo u n g , M.D.

Board o f Trustees Jeffrey A ka ka, M .D.

C aro l A. B ern stein, M.D. B rL·̂ ̂C ro w ley, M.D.

An ita S. Everett, M.D. J effrey G eller, M .D., M .P.H .

M ^ c D a v id G ra ff, M.D. ' J ^ e&A. G i^ eneVM.D. Ju d ith F. Ka sh ta n , M.D. M o lly K. M c Vo y, M .D. J a m es E. N in in g er, M.D. Jo h n M. O ldh a m , M .D.

A lan F. Sc h a tzberg , M.D. A lik s . W id g e, M .D., P h .D.

E r ik R. V an d erlip, M .D ., M em ber-in-T raining Tr u stee-E lect

DIAGNOSTIC AND STATISTICAL MANUAL OF

MENTAL DISORDERS7 F I F T H E D I T I O N

DSM-5TM

New School Library

/«44

Amcriccin

O svch iatric

ADivi«ono(AmCT»MlVhijtiKAMod<tk>n

W ashin g ton , DC Lon d on , E n gland

Copyright © 2013 American Psychiatric Association

DSM and DSM-5 are trademarks of the American Psychiatric Association. Use of these terms is prohibited without permission of the American Psychiatric Association.

ALL RIGHTS RESERVED. Unless authorized in writing by the APA, no part of this book may be reproduced or used in a manner inconsistent with the APA's copyright. This prohibition apphes to unauthorized uses or reproductions in any form, including electronic applications.

Correspondence regarding copyright permissions should be directed to DSM Permissions, American Psychiatric Publishing, 1000 Wilson Boulevard, Suite 1825, Arlington, VA 22209­ 3901.

Manufactured in the United States of America on acid-free paper.

ISBN 978-0-89042-554-1 (Hardcover)

ISBN 978-0-89042-555-8 (Paperback)

American Psychiatric Association 1000 Wilson Boulevard Arlington, VA 22209-3901 www.psych.org

The correct citation for this book is American Psychiatric Association: Diagnostic and Statisti­ cal Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Associa­ tion, 2013.

Library of Congress Cataloging-in-Publication Data Diagnostic and statistical manual of mental disorders : DSM-5. — 5th ed.

p. ; cm. DSM-5 DSM-V Includes index. ISBN 978-0-89042-554-1 (hardcover : alk. paper) — ISBN 978-0-89042-555-8 (pbk. : alk. paper) I. American Psychiatric Association. II. American Psychiatric Association. DSM-5 Task Force, m. Title: DSM-5. IV. Title: DSM-V. [DNLM: 1. Diagnostic and statistical manual of mental disorders. 5th ed. 2. Mental Disorders— classification. 3. Mental Disorders—diagnosis. WM 15] RC455.2.C4 616.89Ό75—dc23

2013011061 British Library Cataloguing in Publication Data ^ n A CIP record is available from the British Library. ^

Text Design—Tammy J. Cordova

Manufacturing—Edwards Brothers Malloy ^

cH

Contents

DSM-5 Classification…………………………………………………………xiii Preface…………………………………………………………………………….. xli

Section I DSM-5 Basics

Introduction……………………………………………………………………….. 5

Use of the M anual………………………………………………………………19

Cautionary Statement for Forensic Use of DSM-5………………… 25

Section II Diagnostic Criteria and Codes

Neurodevelopmental Disorders………………………………………….. 31 Schizophrenia Spectrum and Other Psychotic Disorders……….87 Bipolar and Related Disorders………………………………………….. 123 Depressive Disorders………………………………………………………. 155 Anxiety Disorders………………………………………………………………189 Obsessive-Compulsive and Related Disorders………………….. 235 Trauma- and Stressor-Related Disorders…………………………… 265 Dissociative Disorders…………………………………………………….. 291 Somatic Symptom and Related Disorders…………………………. 309 Feeding and Eating Disorders………………………………………….. 329 Elimination Disorders………………………………………………………. 355 Sleep-Wake Disorders………………………………………………………. 361 Sexual Dysfunctions…………………………………………………………423 Gender Dysphoria…………………………………………………………….451

Disruptive, Impulse-Control, and Conduct Disorders…………..461 Substance-Related and Addictive Disorders……………………… 481 Neurocognitive Disorders…………………………………………………. 591 Personality Disorders………………………………………………………. 645 Paraphilic Disorders………………………………………………………… 685 Other Mental Disorders…………………………………………………… 707

Medication-Induced Movement Disorders and Other Adverse Effects of M edication……………………….. 709

Other Conditions That May Be a Focus of Clinical Attention .. 715

Section III Emerging Measures and Models

Assessment Measures…………………………………………………….. 733

Cultural Formulation………………………………………………………… 749

Alternative DSM-5 Model for Personality Disorders…………….761

Conditions for Further Study……………………………………………. 783

Appendix Highlights of Changes From DSM-IV to DSM -5………………….. 809 Glossary of Technical Term s……………………………………………. 817 Glossary of Cultural Concepts of Distress…………………………. 833 Alphabetical Listing of DSM-5 Diagnoses and Codes

(ICD-9-CM and ICD-10-CM)……………………………………………. 839 Numerical Listing of DSM-5 Diagnoses and Codes

(ICD-9-CM)………………………………………………………………….. 863 Numerical Listing of DSM-5 Diagnoses and Codes

(ICD-10-CM)………………………………………………………………….877 DSM-5 Advisors and Other Contributors…………………………… 897

Index………………………………………………………………………………. 917

DSM-5 Task Force D a vid J. K u pfer, M.D.

Task Force Chair D a rrel A. R egier, M .D., M .P.H .

Task Force Vice-Chair William E. Narrow, M.D.,

Research Director

Dan G. Blazer, M.D., Ph.D., M.P.H. Jack D. Burke Jr., M.D., M.P.H. William T. Carpenter Jr., M.D. F. Xavier Castellanos, M.D. Wilson M. Compton, M.D., M.P.E. Joel E. Dimsdale, M.D. Javier I. Escobar, M.D., M.Sc. Jan A. Fawcett, M.D. Bridget F. Grant, Ph.D., Ph.D. (2009-) Steven E. Hyman, M.D. (2007-2012) Dilip V. Jeste, M.D. (2007-2011) Helena C. Kraemer, Ph.D. Daniel T. Mamah, M.D., M.P.E. James P. McNulty, A.B., Sc.B. Howard B. Moss, M.D. (2007-2009)

Susan K. Schultz, M.D., Text Editor Emily A. Kuhl, Ph.D., APA Text Editor

Charles P. O'Brien, M.D., Ph.D. Roger Peele, M.D. Katharine A. Phillips, M.D. Daniel S. Pine, M.D. Charles F. Reynolds III, M.D. Maritza Rubio-Stipec, Sc.D. David Shaffer, M.D. Andrew E. Skodol II, M.D. Susan E. Swedo, M.D. B. Timothy Walsh, M.D. Philip Wang, M.D., Dr.P.H. (2007-2012) William M. Womack, M.D. Kimberly A. Yonkers, M.D. Kenneth J. Zucker, Ph.D. Norman Sartorius, M.D., Ph.D., Consultant

APA Division of Research Staff on DSIVI-5 Darrel A. Regier, M.D., M.P.H.,

Director, Division o f Research William E. Narrow, M.D., M.P.H.,

Associate Director Emily A. Kuhl, Ph.D., Senior Science

Writer; Staff Text Editor Diana E. Clarke, Ph.D., M.Sc., Research

Statistician

Lisa H. Greiner, M.S.S.A., DSM-5 Field Trials Project Manager

Eve K. Moscicki, Sc.D., M.P.H., Director, Practice Research Network

S. Janet Kuramoto, Ph.D. M.H.S., Senior Scientific Research Associate, Practice Research Network

Amy Porfiri, M.B.A. Director o f Finance and Administration

Jennifer J. Shupinka, Assistant Director, DSM Operations

Seung-Hee Hong, DSM Senior Research Associate

Anne R. Hiller, DSM Research Associate Alison S. Beale, DSM Research Associate Spencer R. Case, DSM Research Associate

Joyce C. West, Ph.D., M.P.P., Health Policy Research Director, Practice Research Network

Farifteh F. Duffy, Ph.D., Quality Care Research Director, Practice Research Network

Lisa M. Countis, Field Operations Manager, Practice Research Network

Christopher M. Reynolds, Executive Assistant

APA Office of the IVIedlcal Director Jam es H. S c u l l y Jr ., M.D.

Medical Director and CEO

Editorial and Coding Consultants Michael B. First, M.D. Maria N. Ward, M.Ed., RHIT, CCS-P

DSM-5 Work Groups ADHD and Disruptive Behavior Disorders

D a v id Sha ffer, M.D. Chair

F. Xa v ier C a stella n o s, M.D. Co-Chair

Paul J. Frick, Ph.D., Text Coordinator Luis Augusto Rohde, M.D., Sc.D. Glorisa Canino, Ph.D. Rosemary Tannock, Ph.D. Terrie E. Moffitt, Ph.D. Eric A. Taylor, M.B. Joel T. Nigg, Ph.D. Richard Todd, Ph.D., M.D. (d. 2008)

Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic, and Dissociative Disorders

K a th a rin e A. Ph illips, M.D. Chair

Michelle G. Craske, Ph.D., Text Scott L. Rauch, M.D. Coordinator H. Blair Simpson, M.D., Ph.D.

J. Gavin Andrews, M.D. David Spiegel, M.D. Susan M. Bögels, Ph.D. Dan J. Stein, M.D., Ph.D. Matthew J. Friedman, M.D., Ph.D. Murray B. Stein, M.D. Eric Hollander, M.D. (2007-2009) Robert J. Ursano, M.D. Roberto Lewis-Fernandez, M.D., M.T.S. Hans-Ulrich Wittchen, Ph.D. Robert S. Pynoos, M.D., M.P.H.

Childhood and Adolescent Disorders D an iel S. Pin e, M.D.

Chair Ronald E. Dahl, M.D. James F. Leckman, M.D. E. Jane Costello, Ph.D. (2007-2009) Ellen Leibenluft, M.D. Regina Smith James, M.D. Judith H. L. Rapoport, M.D. Rachel G. Klein, Ph.D. Charles H. Zeanah, M.D.

Eating Disorders B. T im o th y W alsh, M.D.

Chair Stephen A. Wonderlich, Ph.D., Richard E. Kreipe, M.D.

Text Coordinator Marsha D. Marcus, Ph.D. Evelyn Attia, M.D. James E. Mitchell, M.D. Anne E. Becker, M.D., Ph.D., Sc.M. Ruth H. Striegel-Moore, Ph.D. Rachel Bryant-Waugh, M.D. G. Terence Wilson, Ph.D. Hans W. Hoek, M.D., Ph.D. Barbara E. Wolfe, Ph.D. A.P.R.N.

Mood Disorders J a n a . F a w c e t t , M.D.

Chair Ellen Frank, Ph.D., Text Coordinator Jules Angst, M.D. (2007-2008) William H. Coryell, M.D. Lori L. Davis, M.D. Raymond J. DePaulo, M.D. Sir David Goldberg, M.D. James S. Jackson, Ph.D.

Kenneth S. Kendler, M.D., Ph.D. (2007-2010)

Mario Maj, M.D., Ph.D. Husseini K. Manji, M.D. (2007-2008) Michael R. Phillips, M.D. Trisha Suppes, M.D., Ph.D. Carlos A. Zarate, M.D.

Neurocognitive Disorders D ilip V. Je s te , M .D. (2007-2011)

Chair Emeritus D an G. Bla zer, M .D., P h .D., M.P.H.

Chair R o n a l d C. P e te r s e n , M .D., Ph.D.

Co-Chair Mary Ganguli, M.D., M.P.H.,

Text Coordinator Deborah Blacker, M.D., Sc.D. Warachal Faison, M.D. (2007-2008)

Igor Grant, M.D. Eric J. Lenze, M.D. Jane S. Paulsen, Ph.D. Perminder S. Sachdev, M.D., Ph.D.

Neurodevelopmental Disorders Su sa n E. Sw ed o , M.D.

Chair Gillian Baird, M.A., M.B., B.Chir.,

Text Coordinator Edwin H. Cook Jr., M.D. Francesca G. Happé, Ph.D. James C. Harris, M.D. Walter E. Kaufmann, M.D. Bryan H. King, M.D.

Catherine E. Lord, Ph.D. Joseph Piven, M.D. Sally J. Rogers, Ph.D. Sarah J. Spence, M.D., Ph.D. Fred Volkmar, M.D. (2007-2009) Amy M. Wetherby, Ph.D. Harry H. Wright, M.D.

Personality and Personality Disorders^ A n d rew E. Sk o d o l, M.D.

Chair Joh n M. O l d h a m , M.D.

Co-Chair Robert F. Krueger, Ph.D., Text

Coordinator Renato D. Alarcon, M.D., M.P.H. Carl C. Bell, M.D. Donna S. Bender, Ph.D.

Lee Anna Clark, Ph.D. W. John Livesley, M.D., Ph.D. (2007-2012) Leslie C. Morey, Ph.D. Larry J. Siever, M.D. Roel Verheul, Ph.D. (2008-2012)

̂The members of the Personality and Personality Disorders Work Group are responsible for the alternative DSM-5 model for personality disorders that is included in Section III. The Section II personality disorders criteria and text (with updating of the text) are retained from DSM-IV-TR.

Psychotic Disorders W illiam T. C arpen ter J r ., M.D.

Chair Deanna M. Barch, Ph.D., Text Dolores Malaspina, M.D., M.S.P.H.

Coordinator Michael J. Owen, M.D., Ph.D. Juan R. Bustillo, M.D. Susan K. Schultz, M.D. Wolfgang Gaebel, M.D. Rajiv Tandon, M.D. Raquel E. Gur, M.D., Ph.D. Ming T. Tsuang, M.D., Ph.D. Stephan H. Heckers, M.D. Jim van Os, M.D.

Sexual and Gender Identity Disorders K en n eth J. Zu c k er, Ph .D.

Chair Lori Brotto, Ph.D., Text Coordinator Martin P. Kafka, M.D. Irving M. Binik, Ph.D. Richard B. Krueger, M.D. Ray M. Blanchard, Ph.D. Niklas Langström, M.D., Ph.D. Peggy T. Cohen-Kettenis, Ph.D. Heino F.L. Meyer-Bahlburg, Dr. rer. nat. Jack Drescher, M.D. Friedemann Pfäfflin, M.D. Cynthia A. Graham, Ph.D. Robert Taylor Segraves, M.D., Ph.D.

Sleep-Wake Disorders C h a rles F. Reyn o ld s III, M.D.

Chair Ruth M. O'Hara, Ph.D., Text Coordinator Kathy P. Parker, Ph.D., R.N. Charles M. Morin, Ph.D. Susan Redline, M.D., M.P.H. Allan I. Pack, Ph.D. Dieter Riemann, Ph.D.

Somatic Symptom Disorders J o el E. D im sd a le, M.D.

Chair James L. Levenson, M.D., Text Michael R. Irwin, M.D.

Coordinator Francis J. Keefe, Ph.D. (2007-2011) Arthur J. Barsky III, M.D. Sing Lee, M.D. Francis Creed, M.D. Michael Sharpe, M.D. Nancy Frasure-Smith, Ph.D. (2007-2011) Lawson R. Wulsin, M.D.

Substance-Related Disorders C h a rles P. O 'B rien, M .D., Ph .D.

Chair Th o m a s J. C ro w ley, M.D.

Co-Chair Wilson M. Compton, M.D., M.P.E., Thomas R. Kosten, M.D. (2007-2008)

Text Coordinator Walter Ling, M.D. Marc Auriacombe, M.D. Spero M. Manson, Ph.D. (2007-2008) Guilherme L. G. Borges, M.D., Dr .Sc. A. Thomas McLellan, Ph.D. (2007-2008) Kathleen K. Bucholz, Ph.D. Nancy M. Petry, Ph.D. Alan J. Budney, Ph.D. Marc A. Schuckit, M.D. Bridget F. Grant, Ph.D., Ph.D. Wim van den Brink, M.D., Ph.D. Deborah S. Hasin, Ph.D. (2007-2008)

DSM-5 Study Groups Diagnostic Spectra and DSM/ICD Harmonization

Steven E. H ym a n , M.D. Chair (2007-2012)

William T. Carpenter Jr., M.D. William E. Narrow, M.D., M.P.H. Wilson M. Compton, M.D., M.P.E. Charles P. O'Brien, M.D., Ph.D. Jan A. Fawcett, M.D. John M. Oldham, M.D. Helena C. Kraemer, Ph.D. Katharine A. Phillips, M.D. David J. Kupfer, M.D. Darrel A. Regier, M.D., M.P.H.

Lifespan Developmental Approaches E ric J. L en ze, M.D.

Chair Susa n K. Sc h u ltz, M.D.

Chair Emeritus Dan iel S. P in e, M.D.

Chair Emeritus Dan G. Blazer, M.D., Ph.D., M.P.H. F. Xavier Castellanos, M.D. Wilson M. Compton, M.D., M.P.E.

Daniel T. Mamah, M.D., M.P.E. Andrew E. Skodol II, M.D. Susan E. Swedo, M.D.

Gender and Cross-Cultural Issues K im berly A. Yo n kers, M.D.

Chair R oberto L ew is-Fern â n d ez, M .D., M .T.S.

Co-Chair, Cross-Cultural Issues Renato D. Alarcon, M.D., M.P.H. Diana E. Clarke, Ph.D., M.Sc. Javier I. Escobar, M.D., M.Sc. Ellen Frank, Ph.D. James S. Jackson, Ph.D. Spiro M. Manson, Ph.D. (2007-2008) James P. McNulty, A.B., Sc.B.

Leslie C. Morey, Ph.D. William E. Narrow, M.D., M.P.H. Roger Peele, M.D. Philip Wang, M.D., Dr.P.H. (2007-2012) William M. Womack, M.D. Kermeth J. Zucker, Ph.D.

Psychiatric/General Medical Interface L a w so n R. W u lsin, M.D.

Chair Ronald E. Dahl, M.D. Joel E. Dimsdale, M.D. Javier I. Escobar, M.D., M.Sc. Dilip V. Jeste, M.D. (2007-2011) Walter E. Kaufmann, M.D.

Richard E. Kreipe, M.D. Ronald C. Petersen, Ph.D., M.D. Charles F. Reynolds III, M.D. Robert Taylor Segraves, M.D., Ph.D. B. Timothy Walsh, M.D.

Impairment and Disability J a n e S. P a u ls e n , Ph.D .

Chair J. Gavin Andrews, M.D. Glorisa Canino, Ph.D. Lee Anna Clark, Ph.D. Diana E. Clarke, Ph.D., M.Sc. Michelle G. Craske, Ph.D.

Hans W. Hoek, M.D., Ph.D. Helena C. Kraemer, Ph.D. William E. Narrow, M.D., M.P.H. David Shaffer, M.D.

Diagnostic Assessment Instruments J a ck D. Burk e Jr ., M .D., M .P.H.

Chair Lee Anna Clark, Ph.D. Diana E. Clarke, Ph.D., M.Sc. Bridget F. Grant, Ph.D., Ph.D.

Helena C. Kraemer, Ph.D. William E. Narrow, M.D., M.P.H. David Shaffer, M.D.

DSM-5 Research Group W illiam E. N a rro w , M .D., M.P.H.

Chair Jack D. Burke Jr., M.D., M.P.H. Diana E. Clarke, Ph.D., M.Sc. Helena C. Kraemer, Ph.D.

David J. Kupfer, M.D. Darrel A. Regier, M.D., M.P.H. David Shaffer, M.D.

Course Specifiers and Glossary W o lfg a n g G a ebel, M.D.

Chair Ellen Frank, Ph.D. Charles P. O'Brien, M.D., Ph.D. Norman Sartorius, M.D., Ph.D.,

Consultant Susan K. Schultz, M.D.

Dan J. Stein, M.D., Ph.D. Eric A. Taylor, M.B. David J. Kupfer, M.D. Darrel A. Regier, M.D., M.P.H.

Before each disorder name, ICD-9-CM codes are provided, followed by ICD-IO-CM codes in parentheses. Blank lines indicate that either the ICD-9-CM or the ICD-IO-CM code is not applicable. For some disorders, the code can be indicated only according to the subtype or specifier.

ICD-9-CM codes are to be used for coding purposes in the United States through Sep­ tember 30,2014. ICD-IO-CM codes are to be used starting October 1,2014.

Following chapter titles and disorder names, page numbers for the corresponding text or criteria are included in parentheses.

Note for all mental disorders due to another medical condition: Indicate the name of the other medical condition in the name of the mental disorder due to [the medical condi­ tion]. The code and name for the other medical condition should be listed first immedi­ ately before the mental disorder due to the medical condition.

Neurodevelopm ental Disorders (31)

Intellectual Disabilities (33) 319 (___.__) Intellectual Disability (Intellectual Developmental Disorder) (33)

Specify current severity; (F70) Mild (F71) Moderate (F72) Severe (F73) Profound

315.8 (F88) Global Developmental Delay (41)

319 (F79) Unspecified Intellectual Disability (Intellectual Developmental Disorder) (41)

Communication Disorders (41) 315.39 (F80.9) Language Disorder (42)

315.39 (F80.0) Speech Sound Disorder (44)

315.35 (F80.81) Childhood-Onset Fluency Disorder (Stuttering) (45) Note: Later-onset cases are diagnosed as 307.0 (F98.5) adult-onset fluency

disorder. 315.39 (F80.89) Social (Pragmatic) Communication Disorder (47)

307.9 (F80.9) Unspecified Communication Disorder (49)

Autism Spectrum Disorder (50) 299.00 (F84.0) Autism Spectrum Disorder (50)

Specify if: Associated with a known medical or genetic condition or envi­ ronmental factor; Associated with another neurodevelopmental, men­ tal, or behavioral disorder

Specify current severity for Criterion A and Criterion B: Requiring very substantial support. Requiring substantial support. Requiring support

Specify if: With or without accompanying intellectual impairment. With or without accompanying language impairment. With catatonia (use additional code 293.89 [F06.1])

Attention-Deficit/Hyperactivity Disorder (59) ___.__ (__ .__) Attention-Deficit/Hyperactivity Disorder (59)

Specify whether: 314.01 (F90.2) Combined presentation 314.00 (F90.0) Predominantly inattentive presentation 314.01 (F90.1) Predominantly hyperactive/impulsive presentation

Specify if: In partial remission Specify current severity: Mild, Moderate, Severe

314.01 (F90.8) Other Specified Attention-Deficit/Hyperactivity Disorder (65)

314.01 (F90.9) Unspecified Attention-Deficit/Hyperactivity Disorder (66)

Specific Learning Disorder (66) ___.__ (___.__) Specific Learning Disorder (66)

Specify if: 315.00 (F81.0) With impairment in reading {specify if with word reading

accuracy, reading rate or fluency, reading comprehension) 315.2 (F81.81 ) With impairment in written expression {specify if with spelling

accuracy, grammar and punctuation accuracy, clarity or organization of written expression)

315.1 (F81.2) With impairment in mathematics {specify if with number sense, memorization of arithmetic facts, accurate or fluent calculation, accurate math reasoning)

Specify current severity: Mild, Moderate, Severe

Motor Disorders (74) 315.4 (F82) Developmental Coordination Disorder (74)

307.3 (F98.4) Stereotypic Movement Disorder (77) Specify if: With self-injurious behavior. Without self-injurious behavior Specify if: Associated with a known medical or genetic condition, neuro­

developmental disorder, or environmental factor Specify current severity: Mild, Moderate, Severe

Tic Disorders 307.23 (F95.2) Tourette's Disorder (81)

307.22 (F95.1) Persistent (Chronic) Motor or Vocal Tic Disorder (81) Specify if: With motor tics only. With vocal tics only

307.21 (F95.0) Provisional Tic Disorder (81)

307.20 (F95.8), Other Specified Tic Disorder (85)

307.20 (F95.9) Urispecified Tic Disorder (85)

Other Neurodevelopmental Disorders (86) 315.8 (FSB) Other Specified Neurodevelopmental Disorder (86)

315.9 (F89) Unspecified Neurodevelopmental Disorder (86)

Schizophrenia Spectrum and Other Psychotic Disorders (87)

The following specifiers apply to Schizophrenia Spectrum and Other Psychotic Disorders where indicated: ^Specify if: The following course specifiers are only to be used after a 1-year duration of the dis­

order: First episode, currently in acute episode; First episode, currently in partial remission; First episode, currently in full remission; Multiple episodes, currently in acute episode; Mul­ tiple episodes, currently in partial remission; Multiple episodes, currently in full remission; Continuous; Unspecified

^Specify if: With catatonia (use additional code 293.89 [F06.1]) ^Specify current severity of delusions, hallucinations, disorganized speech, abnormal psycho­

motor behavior, negative symptoms, impaired cognition, depression, and mania symptoms

301.22 (F21)

297.1 (F22)

298.8 (F23)

295.40 (F20.81)

295.90 (F20.9)

295.70 (F25.0) 295.70 (F25.1)

293.81 (F06.2) 293.82 (F06.0)

Schizotypal (Personality) Disorder (90)

Delusional Disorder^' ̂ (90) Specify whether: Erotomanie type. Grandiose type. Jealous type. Persecu­

tory type. Somatic type. Mixed type. Unspecified type Specify if: With bizarre content Brief Psychotic Disorder^' ̂ (94) Specify if: With marked stressor(s). Without marked stressor(s). With

postpartum onset Schizophreniform Disorder^' ̂ (96) Specify if: With good prognostic features. Without good prognostic fea­

tures Schizophrenia^' ̂ (99)

Schizoaffective Disorder^' ̂ (105) Specify whether:

Bipolar type Depressive type

Substance/Medication-Induced Psychotic Disorder^ (110) Note: See the criteria set and corresponding recording procedures for

substance-specific codes and ICD-9-CM and ICD-IO-CM coding. Specify if: With onset during intoxication. With onset during withdrawal

Psychotic Disorder Due to Another Medical Condition^ (115) Specify whether:

With delusions With hallucinations

293.89 (F06.1) Catatonia Associated With Another Mental Disorder (Catatonia Specifier) (119)

293.89 (F06.1) Catatonic Disorder Due to Another Medical Condition (120)

293.89 (F06.1) Unspecified Catatonia (121) Note: Code first 781.99 (R29.818) other symptoms involving nervous and

musculoskeletal systems. 298.8 (F28) Other Specified Schizophrenia Spectrum and Other Psychotic

Disorder (122)

298.9 (F29) Unspecified Schizophrenia Spectrum and Other Psychotic Disorder (122)

Bipolar and Related Disorders (123) The following specifiers apply to Bipolar and Related Disorders where indicated:

Ŝpecify: With anxious distress (specify current severity: mild, moderate, moderate-severe, severe); With mixed features; With rapid cycling; With melancholic features; With atypical features; With mood-congruent psychotic features; With mood-incongruent psychotic features; With catatonia (use additional code 293.89 [F06.1]); With péripartum onset; With seasonal pattem

296.41 296.42 296.43 296.44 296.45 296.46 296.40 296.40 296.45 296.46 296.40

296.51 296.52 296.53 296.54 296.55 296.56 296.50 296.7

(F31.11) (F31.12) (F31.13) (F31.2) (F31.73) (F31.74) (F31.9) (F31.0) (F31.73) (F31.74) (F31.9)

(F31.31) (F31.32) (F31.4) (F31.5) (F31.75) (F31.76) (F31.9) (F31.9)

296.89 (F31.81)

Bipolar I Disorder® (123) Current or most recent episode manic

Mild Moderate Severe With psychotic features In partial remission In full remission Unspecified

Current or most recent episode hypomanie In partial remission In kill remission Unspecified

Current or most recent episode depressed Mild Moderate Severe With psychotic features In partial remission In full remission Unspecified

Current or most recent episode unspecified

Bipolar II Disorder® (132) Specify current or most recent episode: Hypomanie, Depressed Specify course if full criteria for a mood episode are not currently met: In

partial remission. In full remission Specify severity if full criteria for a mood episode are not currently met:

Mild, Moderate, Severe

301.13 (F34.0) y

293.83 (__ ._ )

(F06.33) (F06.33) (F06.34)

296.89 (F31.89)

296.80 (F31.9)

Cyclothymic Disorder (139) Specify if: With anxious distress

Substance/Medication-Induced Bipolar and Related Disorder (142) Note: See the criteria set and corresponding recording procedures for

substance-specific codes and ICD-9-CM and ICD-IO-CM coding. Specify if: With onset during intoxication. With onset during withdrawal

Bipolar and Related Disorder Due to Another Medical Condition (145)

Specify if: With manic features With manic- or hypomanic-like episode With mixed features

Other Specified Bipolar and Related Disorder (148)

Unspecified Bipolar and Related Disorder (149)

Depressive Disorders (155) The following specifiers apply to Depressive Disorders where indicated: ^Specify: With anxious distress (specify current severity: mild, moderate, moderate-severe,

severe); With mixed features; With melancholic features; With atypical features; With mood- congruent psychotic features; With mood-incongruent psychotic features; With catatonia (use additional code 293.89 [F06.1]); With péripartum onset; With seasonal pattern

296.99 (F34.8) Disruptive Mood Dysregulation Disorder (156)

. ( _ ■ ) Major Depressive Disorder® (160)

. ( _ . ) Single episode 296.21 (F32.0) Mild 296.22 (F32.1) Moderate 296.23 (F32.2) Severe 296.24 (F32.3) With psychotic features 296.25 (F32.4) In partial remission 296.26 (F32.5) In full remission 296.20 (F32.9) Unspecified

. ( _ · ) Recurrent episode 296.31 (F33.0) Mild 296.32 (F33.1) Moderate 296.33 (F33.2) Severe 296.34 (F33.3) With psychotic features 296.35 (F33.41) In partial remission 296.36 (F33.42) In full remission 296.30 (F33.9) Unspecified 300.4 (F34.1) Persistent Depressive Disorder (Dysthymia)® (168)

Specify if: In partial remission. In full remission Specify if: Early onset. Late onset Specify if: With pure dysthymic syndrome; With persistent major depres­

sive episode; With intermittent major depressive episodes, with current

625.4 (N94.3)

(_ _ ■ _ )

293.83 (__ ._ )

(F06.31) (F06.32) (F06.34)

311 (F32.8)

311 (F32.9)

episode; With intermittent major depressive episodes, without current episode

Specify current severity: Mild, Moderate, Severe Premenstrual Dysphoric Disorder (171)

Substance/Medication-Induced Depressive Disorder (175) Note: See the criteria set and corresponding recording procedures for

substance-specific codes and ICD-9-CM and ICD-IO-CM coding. Specify if: With onset during intoxication. With onset during withdrawal

Depressive Disorder Due to Another Medical Condition (180) Specify if:

With depressive features With major depressive-like episode With mixed features

Other Specified Depressive Disorder (183)

Unspecified Depressive Disorder (184)

Anxiety Disorders (189) 309.21 (F93.0)

312.23 (F94.0)

300.29 (__ ._ )

(F40.218) (F40.228) ( _ · _ ) (F40.230) (F40.231) (F40.232) (F40.233) (F40.248) (F40.298)

300.23 (F40.10)

300.01 (F41.0)

300.22 (F40.00)

300.02 (F41.1)

Separation Anxiety Disorder (190)

Selective Mutism (195)

Specific Phobia (197) Specify if:

Animal Natural environment Blood-injection-injury

Fear of blood Fear of injections and transfusions Fear of other medical care Fear of injury

Situational Other

Social Anxiety Disorder (Social Phobia) (202) Specify if: Performance only Panic Disorder (208)

Panic Attack Specifier (214)

Agoraphobia (217)

Generalized Anxiety Disorder (222)

Substance/Medication-Induced Anxiety Disorder (226) Note: See the criteria set and corresponding recording procedures for

substance-specific codes and ICD-9-CM and ICD-IO-CM coding. Specify if: With onset during intoxication. With onset during withdrawal.

With onset after medication use

293.84 (F06.4) Anxiety Disorder Due to Another Medical Condition (230)

300.09 (F41.8) Other Specified Anxiety Disorder (233)

300.00 (F41.9) Unspecified Anxiety Disorder (233)

Obsessive-Compulsive and Related Disorders (235) The following specifier applies to Obsessive-Compulsive and Related Disorders where indicated: ^Specify if: With good or fair insight. With poor insight. With absent insight/delusional beliefs

300.3 (F42)

300.7 (F45.22)

300.3 (F42)

312.39 (F63.2)

698.4 (L98.1)

(_._J

294.8 (F06.8)

300.3 (F42)

300.3 (F42)

Obsessive-Compulsive Disorder^ (237) Specify if: Tic-related Body Dysmorphic Disorder^ (242) Specify if: With muscle dysmorphia Hoarding Disorder^ (247) Specify if: With excessive acquisition Trichotillomania (Hair-Pulling …