Major Depressive Disorder Persistent Depressive Disorder

DIAGNOSTIC AND STATISTICAL MANUAL OF

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

DSM-5™

American Psychiatric Association

Officers 2012–2013 PRESIDENT DILIP V. JESTE, M.D.

PRESIDENT-ELECT JEFFREY A. LIEBERMAN, M.D. TREASURER DAVID FASSLER, M.D. SECRETARY ROGER PEELE, M.D.

Assembly SPEAKER R. SCOTT BENSON, M.D.

SPEAKER-ELECT MELINDA L. YOUNG, M.D.

Board of Trustees JEFFREY AKAKA, M.D.

CAROL A. BERNSTEIN, M.D. BRIAN CROWLEY, M.D.

ANITA S. EVERETT, M.D. JEFFREY GELLER, M.D., M.P.H.

MARC DAVID GRAFF, M.D. JAMES A. GREENE, M.D.

JUDITH F. KASHTAN, M.D. MOLLY K. MCVOY, M.D. JAMES E. NININGER, M.D. JOHN M. OLDHAM, M.D.

ALAN F. SCHATZBERG, M.D. ALIK S. WIDGE, M.D., PH.D.

ERIK R. VANDERLIP, M.D., MEMBER-IN-TRAINING TRUSTEE-ELECT

Washington, DC London, England

DIAGNOSTIC AND STATISTICAL MANUAL OF

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

DSM-5™

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.

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ISBN 978-0-89042-554-1 (Hardcover) 2nd printing June 2013

ISBN 978-0-89042-555-8 (Paperback) 2nd printing June 2013

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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. III. 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 616.89'075—dc23

2013011061

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

Text Design—Tammy J. Cordova

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Contents

DSM-5 Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xli

Section I DSM-5 Basics

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

Use of the Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .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 Medication . . . . . . . . . . . . . . . . 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 Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 DAVID J. KUPFER, M.D.

Task Force Chair DARREL A. REGIER, M.D., M.P.H.

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

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

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)

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 DSM-5 Darrel A. Regier, M.D., M.P.H.,

Director, Division of 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 of 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 Medical Director JAMES H. SCULLY 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 DAVID SHAFFER, M.D.

Chair

F. XAVIER CASTELLANOS, M.D. Co-Chair

Paul J. Frick, Ph.D., Text Coordinator Glorisa Canino, Ph.D. Terrie E. Moffitt, Ph.D. Joel T. Nigg, Ph.D.

Luis Augusto Rohde, M.D., Sc.D. Rosemary Tannock, Ph.D. Eric A. Taylor, M.B. Richard Todd, Ph.D., M.D. (d. 2008)

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

KATHARINE A. PHILLIPS, M.D. Chair

Michelle G. Craske, Ph.D., Text Coordinator

J. Gavin Andrews, M.D. Susan M. Bögels, Ph.D. Matthew J. Friedman, M.D., Ph.D. Eric Hollander, M.D. (2007–2009) Roberto Lewis-Fernández, M.D., M.T.S. Robert S. Pynoos, M.D., M.P.H.

Scott L. Rauch, M.D. H. Blair Simpson, M.D., Ph.D. David Spiegel, M.D. Dan J. Stein, M.D., Ph.D. Murray B. Stein, M.D. Robert J. Ursano, M.D. Hans-Ulrich Wittchen, Ph.D.

Childhood and Adolescent Disorders DANIEL S. PINE, M.D.

Chair

Ronald E. Dahl, M.D. E. Jane Costello, Ph.D. (2007–2009) Regina Smith James, M.D. Rachel G. Klein, Ph.D.

James F. Leckman, M.D. Ellen Leibenluft, M.D. Judith H. L. Rapoport, M.D. Charles H. Zeanah, M.D.

Eating Disorders B. TIMOTHY WALSH, M.D.

Chair

Stephen A. Wonderlich, Ph.D., Text Coordinator

Evelyn Attia, M.D. Anne E. Becker, M.D., Ph.D., Sc.M. Rachel Bryant-Waugh, M.D. Hans W. Hoek, M.D., Ph.D.

Richard E. Kreipe, M.D. Marsha D. Marcus, Ph.D. James E. Mitchell, M.D. Ruth H. Striegel-Moore, Ph.D. G. Terence Wilson, Ph.D. Barbara E. Wolfe, Ph.D. A.P.R.N.

Mood Disorders JAN A. FAWCETT, 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. (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 DILIP V. JESTE, M.D. (2007–2011)

Chair Emeritus

DAN G. BLAZER, M.D., PH.D., M.P.H. Chair

RONALD C. PETERSEN, 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 SUSAN E. SWEDO, 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. Rosemary Tannock, Ph.D. Fred Volkmar, M.D. (2007–2009) Amy M. Wetherby, Ph.D. Harry H. Wright, M.D.

Personality and Personality Disorders1

ANDREW E. SKODOL, M.D. Chair

JOHN M. OLDHAM, 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)

1 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 WILLIAM T. CARPENTER JR., M.D.

Chair

Deanna M. Barch, Ph.D., Text Coordinator

Juan R. Bustillo, M.D. Wolfgang Gaebel, M.D. Raquel E. Gur, M.D., Ph.D. Stephan H. Heckers, M.D.

Dolores Malaspina, M.D., M.S.P.H. Michael J. Owen, M.D., Ph.D. Susan K. Schultz, M.D. Rajiv Tandon, M.D. Ming T. Tsuang, M.D., Ph.D. Jim van Os, M.D.

Sexual and Gender Identity Disorders KENNETH J. ZUCKER, PH.D.

Chair

Lori Brotto, Ph.D., Text Coordinator Irving M. Binik, Ph.D. Ray M. Blanchard, Ph.D. Peggy T. Cohen-Kettenis, Ph.D. Jack Drescher, M.D. Cynthia A. Graham, Ph.D.

Martin P. Kafka, M.D. Richard B. Krueger, M.D. Niklas Långström, M.D., Ph.D. Heino F.L. Meyer-Bahlburg, Dr. rer. nat. Friedemann Pfäfflin, M.D. Robert Taylor Segraves, M.D., Ph.D.

Sleep-Wake Disorders CHARLES F. REYNOLDS III, M.D.

Chair

Ruth M. O’Hara, Ph.D., Text Coordinator Charles M. Morin, Ph.D. Allan I. Pack, Ph.D.

Kathy P. Parker, Ph.D., R.N. Susan Redline, M.D., M.P.H. Dieter Riemann, Ph.D.

Somatic Symptom Disorders JOEL E. DIMSDALE, M.D.

Chair

James L. Levenson, M.D., Text Coordinator

Arthur J. Barsky III, M.D. Francis Creed, M.D. Nancy Frasure-Smith, Ph.D. (2007–2011)

Michael R. Irwin, M.D. Francis J. Keefe, Ph.D. (2007–2011) Sing Lee, M.D. Michael Sharpe, M.D. Lawson R. Wulsin, M.D.

Substance-Related Disorders CHARLES P. O’BRIEN, M.D., PH.D.

Chair

THOMAS J. CROWLEY, M.D. Co-Chair

Wilson M. Compton, M.D., M.P.E., Text Coordinator

Marc Auriacombe, M.D. Guilherme L. G. Borges, M.D., Dr.Sc. Kathleen K. Bucholz, Ph.D. Alan J. Budney, Ph.D. Bridget F. Grant, Ph.D., Ph.D. Deborah S. Hasin, Ph.D.

Thomas R. Kosten, M.D. (2007–2008) Walter Ling, M.D. Spero M. Manson, Ph.D. (2007-2008) A. Thomas McLellan, Ph.D. (2007–2008) Nancy M. Petry, Ph.D. Marc A. Schuckit, M.D. Wim van den Brink, M.D., Ph.D.

(2007–2008)

DSM-5 Study Groups

Diagnostic Spectra and DSM/ICD Harmonization STEVEN E. HYMAN, M.D.

Chair (2007–2012)

William T. Carpenter Jr., M.D. Wilson M. Compton, M.D., M.P.E. Jan A. Fawcett, M.D. Helena C. Kraemer, Ph.D. David J. Kupfer, M.D.

William E. Narrow, M.D., M.P.H. Charles P. O’Brien, M.D., Ph.D. John M. Oldham, M.D. Katharine A. Phillips, M.D. Darrel A. Regier, M.D., M.P.H.

Lifespan Developmental Approaches ERIC J. LENZE, M.D.

Chair

SUSAN K. SCHULTZ, M.D. Chair Emeritus

DANIEL S. PINE, 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 KIMBERLY A. YONKERS, M.D.

Chair

ROBERTO LEWIS-FERNÁNDEZ, 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. Kenneth J. Zucker, Ph.D.

Psychiatric/General Medical Interface LAWSON R. WULSIN, 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 JANE S. PAULSEN, 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 JACK D. BURKE 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 WILLIAM E. NARROW, 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 WOLFGANG GAEBEL, 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.

xiii

DSM-5 Classification

Before each disorder name, ICD-9-CM codes are provided, followed by ICD-10-CM codes in parentheses. Blank lines indicate that either the ICD-9-CM or the ICD-10-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-10-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.

Neurodevelopmental Disorders (31)

Intellectual Disabilities (33)

___.__ (___.__) Intellectual Disability (Intellectual Developmental Disorder) (33) Specify current severity:

317 (F70) Mild 318.0 (F71) Moderate 318.1 (F72) Severe 318.2 (F73) Profound

315.8 (F88) Global Developmental Delay (41)

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

Communication Disorders (41) 315.32 (F80.2) 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)

xiv DSM-5 Classification

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

DSM-5 Classification xv

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

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

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

Other Neurodevelopmental Disorders (86) 315.8 (F88) 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: aSpecify 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

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

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

301.22 (F21) Schizotypal (Personality) Disorder (90)

297.1 (F22) Delusional Disordera, c (90) Specify whether: Erotomanic type, Grandiose type, Jealous type, Persecu-

tory type, Somatic type, Mixed type, Unspecified type Specify if: With bizarre content

298.8 (F23) Brief Psychotic Disorderb, c (94) Specify if: With marked stressor(s), Without marked stressor(s), With

postpartum onset

295.40 (F20.81) Schizophreniform Disorderb, c (96) Specify if: With good prognostic features, Without good prognostic fea-

tures

295.90 (F20.9) Schizophreniaa, b, c (99)

___.__ (___.__) Schizoaffective Disordera, b, c (105) Specify whether:

295.70 (F25.0) Bipolar type 295.70 (F25.1) Depressive type

___.__ (___.__) Substance/Medication-Induced Psychotic Disorderc (110) Note: See the criteria set and corresponding recording procedures for

substance-specific codes and ICD-9-CM and ICD-10-CM coding. Specify if: With onset during intoxication, With onset during withdrawal

___.__ (___.__) Psychotic Disorder Due to Another Medical Conditionc (115) Specify whether:

293.81 (F06.2) With delusions 293.82 (F06.0) With hallucinations

xvi DSM-5 Classification

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: aSpecify: 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 peripartum onset; With seasonal pattern

___.__ (___.__) Bipolar I Disordera (123) ___.__ (___.__) Current or most recent episode manic 296.41 (F31.11) Mild 296.42 (F31.12) Moderate 296.43 (F31.13) Severe 296.44 (F31.2) With psychotic features 296.45 (F31.73) In partial remission 296.46 (F31.74) In full remission 296.40 (F31.9) Unspecified 296.40 (F31.0) Current or most recent episode hypomanic 296.45 (F31.71) In partial remission 296.46 (F31.72) In full remission 296.40 (F31.9) Unspecified ___.__ (___.__) Current or most recent episode depressed 296.51 (F31.31) Mild 296.52 (F31.32) Moderate 296.53 (F31.4) Severe 296.54 (F31.5) With psychotic features 296.55 (F31.75) In partial remission 296.56 (F31.76) In full remission 296.50 (F31.9) Unspecified 296.7 (F31.9) Current or most recent episode unspecified

296.89 (F31.81) Bipolar II Disordera (132) Specify current or most recent episode: Hypomanic, 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 currently met:

Mild, Moderate, Severe

DSM-5 Classification xvii

301.13 (F34.0) 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-10-CM coding. Specify if: With onset during intoxicat

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