Discussion: Personality Disorders Personality disorders can arise through trauma, and they often carry added stigma. In th
Discussion: Personality Disorders
Personality disorders can arise through trauma, and they often carry added stigma. In this Discussion, you analyze a case study focused on a personality disorder while also reflecting on how power, privilege, and stigma affect such diagnoses.
To prepare: Review the case provided by your instructor for this week’s Discussion and consider your differential diagnostic process for them. Be sure to consider any past diagnoses and what influence those might have on their current diagnosis and needs. Finally, return to the Week 1 resources on stigma and reflect on stigma related to personality disorders.
By Day 4
Post a 300- to 500-word response in which you address the following:
- Provide the full DSM-5 diagnosis. Remember, a full diagnosis should include the name of the disorder, ICD-10-CM code, specifiers, severity, and the Z codes (other conditions that may need clinical attention). Keep in mind a diagnosis covers the most recent 12 months.
- Explain the diagnosis by matching the symptoms identified in the case to the specific criteria for the diagnosis.
- Support your decision by identifying the symptoms which meet specific criteria for each diagnosis.
- Identify any close differentials and why they were eliminated. Concisely support your decisions with the case materials and readings.
- Explain how diagnosing a client with a personality disorder may affect their treatment.
- Analyze how power and privilege may influence who is labeled with a personality disorder and which types of personality disorders.
- Identify how trauma affects the case, either precipitating the diagnosis and/or resulting from related symptoms or treatment of diagnosis.
Required Readings:
Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.
American Psychiatric Association. (2013). Personality Disorders. In Diagnostic and Statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm18
- Chapter 16, “Diagnosing Personality and Relationship Problems” (pp. 251–270)
1
CASE OF TIMMY
Intake Date: May 2021
DEMOGRAPHIC DATA:
Timmy is a 23-years-old Caucasian, Protestant male. This is Timmy’s first psychiatric evaluation. Timmy is single and lives at home with his parents. Timmy has had difficulty in jobs and has been taking low paying service jobs for several years.
CHIEF COMPLAINT:
“I was driving out of a strip club and the cops were watching all the customers and nailing who ever they could. I was arrested for a DUI. The cops were against me and the judge sent me here.”
HISTORY OF ILLNESS:
Timmy states he is only here since the cops were watching everyone. He denies any need of treatment but must attend outpatient treatment to satisfy the judge. He believes everyone is in cahoots with each other and this is all a money maker for everyone but him.
SUBSTANCE USE HISTORY:
At 14 Timmy began drinking. His friends would take the alcohol from their parents houses or sometimes break into apartments in his friends’ apartment building and steal alcohol. His chemical use increased when he began using cocaine and amphetamines. His cocaine use started a couple of times a year but he decided he really likes the feeling. He reports trying ecstasy several times over the years as well as marijuana, PCP, LSD, and opiates but does not have a strong liking for any of those. His use of alcohol and pills continued. Timmy reports that he drinks almost daily now but has control over the alcohol. He continues to use cocaine recreationally and amphetamines periodically.
PSYCHOSOCIAL HISTORY:
Timmy had on again/off again friends growing up. He would bully and intimidate his peers from elementary school. He always knew he was better than them anyway. Sometimes he would actually initiate physical fights with his peers.
Timmy has worked since 16 years old but has difficulty keeping jobs. He has worked in the service industry. Although the customers liked him, he was asked to leave many times because of money always missing from the register. He had several jobs for a while but would not stay long at any job. He had several meetings with his supervisors because of many indications of unethical behavior. He hated this since it reminded him of childhood when he had to do whatever he needed to obtain favors from his peers and be able to manipulate them for things they had. Timmy has few friends currently and hangs around mostly with people he uses drugs with.
Timmy denies any legal history until this current arrest. He feels vindicated that the police did not test him for cocaine, only alcohol. He wasn’t intending to use cocaine that evening but it was offered to him and he felt no reason to refuse it. It is not unusual for him to use cocaine if it was being offered for free. Timmy knows his body can handle cocaine since it does not have the same initial effect a small amount used to have.
MEDICAL HISTORY:
Timmy states he is very healthy with no medical problems.
FAMILY ISSUES AND DYNAMICS:
Timmy is the only child from his parents’ union. Timmy reports his growing up to be normal. His mother and father both worked hard, mom being a school teacher and dad being a school principal. He still lives at home but currently fights often with his parents. They want him to settle down and get a full-time job. Money has gone missing and they suspect Timmy took it but are unable to prove it. Timmy believes they work and make good money so they can give him what he needs.
MENTAL STATUS EXAM:
Timmy presents as a neatly dressed male who appears younger than his stated age. His nails are neatly groomed. Facial expressions are appropriate to thought content. Motor activity is appropriate. Thoughts are logical and organized. There is no evidence of hallucinations or delusions. Timmy is oriented to time, place, and person. His intelligence appears normal.
1
,
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
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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.
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ISBN 978-0-89042-554-1 (Hardcover)
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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, 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
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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
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