DSM-5 STUDY GUIDE ANXIETY DISORDERS Excessive fear and anxiety and related behavioral disturbances Fear – emotional response to real or perceived imminent threat (e.g. arousal for fight or flight, thoughts of immediate danger, escape behaviors) Anxiety – anticipation of future threat (e.g. muscle tension, vigilance, cautious or avoidant behaviors) Panic attack – particular type of fear response prominent within anxiety disorders Anxiety disorders are best differentiated by the types of situations feared or avoided and content of associated thoughts or beliefs Transient fear or anxiety (often stress-induced and temporary) vs. Anxiety disorder (persistent, usually 6 months or more) Fear or anxiety is excessive or out of proportion Sex Ratio: Female-Male: 2:1 Panic attacks (may be expected – response to typically feared object or situation; unexpected – occurs for no apparent reason) Generalized Anxiety Disorder – persistent and excessive anxiety and worry about various domains which are difficult to control in addition to physical symptoms such as restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension and sleep disturbance Panic Disorder – recurrent unexpected panic attacks and persistently worried of having more panic attacks which may cause maladaptive behaviors Agoraphobia – fear and anxiety of “unsafe” situations (e.g. public transportation, open spaces, enclosed places, standing in line or being in a crowd, being outside home alone) where panic-like symptoms may occur and help or escape is unlikely Specific Phobia – fear, anxiety or avoidance of circumscribed objects or situations that is out of proportion to actual risk (subtypes: animal, natural environment, blood-injection-injury, situational, other) Social Anxiety Disorder (Social Phobia) – fear, anxiety or avoidance of social interactions and situations where scrutiny is possible in addition to cognitive ideation of being negatively evaluated or offending others Separation Anxiety Disorder – fear or anxiety about developmentally inappropriate separation from attachment figures; nightmares and physical symptoms may be present Selective Mutism – consistent failure to speak in social situations even though individual speaks in other situations which leads to significant consequences on achievement or interferes social communication (usually diagnosed in addition to social anxiety disorder) Substance/Medication-Induced Anxiety Disorder – anxiety due to substance intoxication or withdrawal or exposure to a medication treatment Anxiety Disorder Due to Another Medical Condition – anxiety symptoms are direct pathophysiological consequence of another medical condition Other Specified Anxiety Disorder – anxiety-like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. limited symptom attacks, generalized anxiety not occurring more days than not)
Unspecified Anxiety Disorder - anxiety-like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician does not choose to communicate the reason and there is insufficient information to make more specific diagnosis (e.g. emergency room settings) TRAUMA- AND STRESSOR-RELATED DISORDERS Psychological distress following exposure to a traumatic or stressful event is a required criteria Most prominent characteristics are anhedonic and dysphoric symptoms, aggressive symptoms or dissociative symptoms Generally more common in females Conditions associated with social neglect (inadequate care during childhood): cognitive delays, language delays, developmental delays, stereotypies, reactive attachment, disinhibited social engagement, malnutrition or poor care Reactive Attachment Disorder – expressed with depressive symptoms and withdrawn behavior and compromised emotional regulation capacity which are caused by serious social neglect Disinhibited Social Engagement Disorder – marked by culturally inappropriate, overly familiar behavior with relative strangers which is caused by serious social neglect Posttraumatic Stress Disorder – development of varying characteristics symptoms (e.g. fear-based emotional and behavioral, anhedonic or dysphoric mood and negative cognitions, arousal and reactive-externalizing) following exposure to one or more traumatic events Acute Stress Disorder – PTSD symptoms lasting from 3 days to 1 month following exposure to the traumatic event/s Adjustment Disorders – presence of emotional or behavioral symptoms in response to an identifiable stressor; may be single/multiple, recurrent/continuous Other Specified Trauma- and Stressor Related Disorder – trauma- and stressor-like symptoms that cause clinically significant distress or impairment but do not meet full criteria and clinician specifies the reason (ex. Persistent complex bereavement disorder, adjustment-like disorders with delayed onset of symptoms that occur more than 3 months after the stressor, ataque de nervios) Unspecified Trauma- and Stressor Related Disorder – trauma- and stressor-like symptoms that cause clinically significant distress or impairment but do not meet full criteria and clinician chooses not to specify the reason and there is insufficient information to make more specific diagnosis (e.g. emergency room settings)
OBSESSIVE-COMPULSIVE AND RELATED DISORDERS Presence of obsessions (e.g. recurrent and persistent, intrusive thoughts, urges or images) and compulsions (e.g. repetitive behaviors or mental acts driven in response to obsessions) Obsessive-Compulsive Disorder – repetitive and persistent, time-consuming intrusive obsessions (which individual attempts to ignore or suppress) by means of compulsions; common dimensions: cleaning, symmetry, forbidden thoughts (sex/aggression/religion) and harm
Body Dysmorphic Disorder – cognitive symptom related to perceived defects or flaws in physical appearance and repetitive behaviors or mental acts in response to appearance concerns Hoarding Disorder – cognitive symptom related to perceived need to save possessions Trichotillomania (Hair-Pulling Disorder) – recurrent and repetitive hairpulling behaviors resulting in hair loss and repeated attempts to decrease or stop hair-pulling Excoriation (Skin-Picking Disorder) – recurrent and repetitive skin-picking behaviors resulting in skin lesions and repeated attempts to decrease or stop skin-picking Substance/Medication-Induced Obsessive-Compulsive and Related Disorder – obsessive-compulsive symptoms due to substance intoxication/withdrawal or to a medication Obsessive-Compulsive and Related Disorder Due to Another Medical Condition – obsessive-compulsive-like symptoms that are direct pathophysiological consequence of medical disorder Other Specified Obsessive-Compulsive and Related Disorder – obsessivecompulsive-like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. body-focused repetitive disorder, obsessional jealousy) Unspecified Obsessive-Compulsive and Related Disorder – obsessivecompulsive-like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician does not choose to communicate the reason and there is insufficient information to make more specific diagnosis (e.g. emergency room settings)
SOMATIC SYMPTOM AND RELATED DISORDERS Emphasis on the distressing (positive) somatic symptoms plus abnormal thoughts, feelings and behaviors in response to them Commonly encountered in primary care and other medical settings than mental health settings Highly comorbid with depression and anxiety disorders and medical disorders Somatic Symptom Disorder – multiple, current, somatic symptoms (e.g. cognitive: attention, worry and fear; behavioral: repeated check-up) that cause clinically significant distress or impairment and may or may not be medically explained Illness Anxiety Disorder (Hypochondriasis) – enduring preoccupation of having or acquiring serious illness and extensive worries about one’s health (illness becomes part of identity) but no or minimal somatic symptoms Conversion Disorder (Functional Neurological Symptom Disorder) – neurological symptoms (loss of function) are found but incompatible with neurological pathophysiology Factitious Disorder – falsification and presentation of symptoms, injury or disease to others, assuming a “sick role” and in the absence of obvious external rewards
Psychological Factors Affecting Other Medical Conditions – one or more clinically significant psychological or behavioral factors that adversely affects medical condition by increasing risk for suffering, death or disability Other Specified Somatic Symptom and Related Disorder - somatic-like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. brief somatic symptom disorder, brief illness anxiety disorder, pseudocyesis) Unspecified Somatic Symptom and Related Disorder - somatic -like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician does not choose to communicate the reason and there is insufficient information to make more specific diagnosis (e.g. emergency room settings)
DISSOCIATIVE DISORDERS Disruption and/or discontinuity in normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control and behavior Positive dissociated symptoms: fragmentation of identity, depersonalization and derealization; Negative dissociated symptoms: amnesia Depersonalization/Derealization Disorder – persistent depersonalization (unreality or detachment from oneself) and/or derealization (unreality or detachment from one’s surroundings) accompanied by intact reality testing Dissociative Amnesia – inability to recall autobiographical information which may be generalized (identity and life history), localized (event or period of time) or selective (specific aspect of event) and may or may not involve dissociative fugue (purposeful travel or wandering) Dissociative Identity Disorder – presence of two or more distinct personality states (or experience of possession) and recurrent episodes of amnesia Other Specified Dissociative Disorder - dissociative-like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. dissociative trance, acute dissociative reactions to stressful events) Unspecified Dissociative Disorder - dissociative-like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician does not choose to communicate the reason and there is insufficient information to make more specific diagnosis (e.g. emergency room settings) DEPRESSIVE DISORDERS Presence of sad, empty or irritable mood accompanied by somatic and cognitive changes significantly affecting one’s capacity to function In grief, the predominant affect is feelings of emptiness and loss, in major depressive episode it is persistent depressed mood and inability to anticipate happiness or pleasure Disruptive Mood Dysregulation Disorder – chronic, severe persistent (nonepisodic) irritability through frequent verbal and/or behavioral temper outbursts in response to frustration and persistent irritable or angry mood between the outbursts
Major Depressive Disorder – persistent depressed mood and/or loss of interest or pleasure nearly most of the day every day for at least two weeks (plus 4 more symptoms) Persistent Depressive Disorder (Dysthymia) – depressed mood most of the day, for more days than not, for at least 2 years (plus 2 more symptoms) Premenstrual Dysphoric Disorder – mood lability, irritability, dysphoria and anxiety symptoms accompanied by behavioral and physical symptoms that occur repeatedly during premenstrual phase and remit around onset of menses or shortly thereafter Substance/Medication-Induced Depressive Disorder – prominent and persistent depressed mood and/or anhedonia that developed during or soon after intoxication, withdrawal or exposure to substance/medication which is capable of producing said symptoms Depressive Disorder Due to Another Medical Condition – prominent and persistent depressed and/or anhedonia that is the direct pathophysiological consequence of another medical condition Other Specified Depressive Disorder – presentations of depressed mood with clinically significant impairment that do not meet criteria for duration or severity (e.g. recurrent brief depression, short-duration depressive episode (413 days), depressive episode with insufficient symptoms) Unspecified Depressive Disorder – presentations of depressed mood with clinically significant impairment that do not meet full criteria and clinician does not wish to specify the reason, possibly due to insufficient information Specifiers: With anxious distress, With mixed features, With melancholic features, With atypical features, With psychotic features, With catatonia, With peripartum onset, With seasonal pattern; In partial remission, In full remission; Severity: Mild, Moderate, Severe
BIPOLAR AND RELATED DISORDERS Manic episode: abnormal, persistent elevated, expansive or irritable mood and abnormal, persistent increased goal-directed activity or energy most of the day, nearly every day for at least one week (any duration if hospitalized) plus 3 additional symptoms Hypomanic episode: abnormal, persistent elevated, expansive or irritable mood and abnormal, persistent increased goal-directed activity or energy most of the day, nearly every day for at least 4 days plus 3 additional symptoms Major depressive episode: depressed mood or loss of interest or pleasure and 4 additional symptoms most of the day, nearly every day for at least 2 weeks Highly comorbid with anxiety disorders (75%) Bipolar I Disorder – at least one lifetime manic episode (hypomanic episode or major depressive episode may occur but not required) Bipolar II Disorder – at least one hypomanic episode and at least one major depressive episode, never been a manic episode Cyclothymic Disorder – numerous distinct sub-criteria periods with hypomanic symptoms and periods of depressive symptoms present at least half the time for at least 2 years (has not been without symptoms for more than 2 months at a time)
Substance/Medication-Induced Bipolar and Related Disorder – prominent and persistent elevated, expansive or irritable mood and/or depressed mood or anhedonia that developed during or soon after intoxication, withdrawal or exposure to substance/medication which is capable of producing said symptoms Known Substances/Medications: Sedative, hypnotic or anxiolytic; Amphetamine (or other stimulant); Cocaine Exceptions: Case of hypomania/mania that occurs after and persists beyond physiological effects of antidepressant medication or treatment (such as ECT) Bipolar and Related Disorder Due to Another Medical Condition – prominent and persistent elevated, expansive or irritable mood and increased activity or energy that are the direct pathophysiological consequences of another medical condition (e.g. Cushing’s disease, multiple sclerosis, stroke, traumatic brain injury) Other Specified Bipolar and Related Disorder – bipolar-like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. short-duration hypomanic episodes (2-3 days) and major depressive episodes, hypomanic episode without prior major depressive episode, short-duration cyclothymia) Unspecified Bipolar and Related Disorder – bipolar-like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician does not choose to communicate the reason, possibly due to insufficient information Specifiers – With anxious distress, With mixed features, With rapid cycling, With melancholic features, With atypical features, With psychotic features, With catatonia, With peripartum onset, With seasonal pattern; In partial remission, In full remission; Mild, Moderate, Severe
SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC DISORDERS Abnormalities in at least one of the following domains: Delusions: fixed beliefs not amenable to change in light of conflicting evidence; may be persecutory, referential, grandiose, erotomanic, nihilistic, somatic or bizarre Hallucinations: involuntary vivid and clear perception-like experiences that occur without an external stimulus and in the context of clear sensorium Disorganized thinking (formal thought disorder): inferred from one’s speech such as in derailment or loose association (switching of topics), tangentiality (unrelated answers), incoherence (word salad) Grossly disorganized or abnormal motor behavior (including catatonia): ranges from childlike silliness to unpredictable agitation; catatonia is marked decrease in reactivity to environment
Negative symptoms: diminished emotional expression, avolition (reduced drive to pursue goal-directed behavior), alogia (diminished speech output), anhedonia (decreased ability to experience pleasure), asociality (apparent lack of interest in social interactions) Highly comorbid with substance use and anxiety disorders Schizotypal (Personality) Disorder – pervasive pattern of social and interpersonal deficits, cognitive or perceptual distortions and eccentricities of behavior Delusional Disorder – at least 1 month of delusion(s) but no other prominent psychotic symptoms Brief Psychotic Disorder – at least 1 day but less than 1 month sudden onset of at least one positive psychotic symptom: delusions, hallucinations or disorganized speech; may or may not be accompanied by grossly disorganized or catatonic behavior Schizophreniform Disorder – symptomatic presentation equivalent to schizophrenia but less than 6 months duration (more than 1 month) and decline in functioning not required Schizophrenia – presence of primary psychotic symptoms for a continuous period of at least 6 months accompanied by marked decline in functioning wherein an active phase occurred for at least 1 month for a significant portion of time (2 or more symptoms) Schizoaffective Disorder – presence of both prominent mood episode (major depressive or manic) and active-phase symptoms preceded or followed by at least 2 weeks of delusions or hallucinations without prominent mood symptoms; decline in functioning not required Substance/Medication-Induced Psychotic Disorder – delusions and/or hallucinations that developed during or soon after intoxication, withdrawal or exposure to substance/medication which is capable of producing said symptoms Known Substances/Medications: Alcohol; Cannabis; Phencyclidine; Other hallucinogen; Inhalant; Sedative, hypnotic or anxiolytic; Amphetamine (or other stimulant); Cocaine Psychotic Disorder Due to Another Medical Condition – prominent delusions or hallucinations are direct physiological consequence of another medical condition Known Medical Conditions: neurological conditions (neoplasms, cerebrovascular disease, Huntington’s, multiple sclerosis, epilepsy, auditory or visual nerve injury, deafness, migraine, CNS infections); endocrine conditions (hyper-/hypothyroidism, hyper-hypoadrenocorticism); metabolic conditions (hypoxia, hypercarbia, hypoglycemia); fluid or electrolyte imbalances; hepatic or renal diseases and autoimmune disorders with CNS involvement (lupus) Catatonia: presence of 3 or more of 12 psychomotor features; essential feature is marked psychomotor disturbance that may involve decreased motor activity, decreased engagement during assessment, or excessive and peculiar motor activity Stupor: no psychomotor activity, not actively relating to environment Catalepsy: passive induction of a posture held against gravity Waxy flexibility: slight, even resistance to positioning by examiner Mutism: no, or very little, verbal response (exclude if known aphasia) Negativism: opposition or no response to instructions or external stimuli
Posturing: spontaneous and active maintenance of a posture against gravity Mannerism: odd, circumstantial caricature of normal actions Stereotypy: repetitive, abnormally frequent, non-goal-directed movements Agitation: (not influenced by external stimuli) Grimacing Echolalia: mimicking another’s speech Echopraxia: mimicking another’s movement Catatonia Associated With Another Mental Disorder (Catatonia Specifier) – presence of 3 or more catatonic psychomotor features during the course of a neurodevelopmental, psychotic, bipolar, depressive or other mental disorder Catatonic Disorder Due to Another Medical Condition – presence of 3 or more catatonic psychomotor features that are direct physiological consequence of another medical condition Known Medical Conditions: neurological conditions (neoplasms, head trauma, cerebrovascular disease, encephalitis) and metabolic conditions (hypercalcemia, hepatic encephalopathy, homocystinuria, diabetic ketoacidosis) Unspecified Catatonia – catatonia-like symptoms cause clinically significant distress or impairment but nature of underling mental disorder or other medical condition is unclear, or full criteria are not met, or insufficient information to make a more specific diagnosis Other Specified Schizophrenia Spectrum and Other Psychotic Disorder – related symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. persistent auditory hallucinations, attenuated psychosis syndrome, delusional symptoms in partner of individual with delusional disorder) Unspecified Schizophrenia Spectrum and Other Psychotic Disorder – related symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician does not choose to communicate the reason, possibly due to insufficient information
PERSONALITY DISORDERS Shared criteria: Pervasive pattern of emotions, cognitions and behaviors + begins by early adulthood (or adolescence) + present in a variety of contexts + does not occur exclusively during the course of another mental disorder + not attributable to another medical condition General Personality Disorder – enduring pattern of inner experience and behavior that deviates markedly from expectations of one’s culture in at least 2 ways (cognitive, affectivity, interpersonal functioning, impulse control) Paranoid Personality Disorder – distrust and suspiciousness of others without any justification (indicated by 4 symptoms) Schizoid Personality Disorder – detachment from social relationships and restricted range of emotional expression in interpersonal settings (indicated by 4 symptoms) Schizotypal Personality Disorder – social and interpersonal deficits and cognitive or perceptual distortions and eccentricities of behavior (indicated by 4 symptoms) Antisocial Personality Disorder – disregard for and violation of the rights of others (indicated by 3 symptoms)
Borderline Personality Disorder – instability of interpersonal relationships, self-image and affects and marked impulsivity (indicated by 5 symptoms) Histrionic Personality Disorder – excessive emotionality and attention seeking (indicated by 5 symptoms) Narcissistic Personality Disorder – grandiosity, need for admiration and lack of empathy (indicated by 5 symptoms) Avoidant Personality Disorder – social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation (indicated by 4 symptoms) Dependent Personality Disorder – excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation (indicated by 5 symptoms) Obsessive-Compulsive Personality Disorder – preoccupation with orderliness, perfectionism and mental and interpersonal control, at the expense of flexibility, openness and efficiency (indicated by 4 symptoms) Personality Change Due to Another Medical Condition – persistent personality disturbance due to the direct physiological effects of a medical condition (e.g. frontal lobe lesion) Other Specified Personality Disorder / Unspecified Personality Disorder – (1) personality pattern meets the general criteria for personality disorder, and traits of several different personality disorders are present, but criteria for any specific personality disorder are not met; or (2) personality pattern meets general criteria but considered to have a personality disorder not included in DSM-5 classification (e.g. passive-aggressive personality disorder)
Feeding and Eating Disorders Persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning Disorders differ substantially in clinical course, outcome and treatment needs Obesity is not included as mental disorder but associated with several mental disorders such as binge-eating disorder, depressive and bipolar disorder, schizophrenia Pica – persistent eating of one or more nonnutritive, nonfood substances over a period of at least 1 month Rumination Disorder – repeated regurgitation of food occurring after feeding or eating over a period of at least 1 month Avoidant/Restrictive Food Intake Disorder – avoidance or restriction of food intake with no excessive concern about body weight or shape Anorexia Nervosa – persistent energy intake restriction, intense fear of gaining weight or becoming fat / persistent behavior that interferes with weight gain and disturbance in self-perceived weight or shape (restricting type or binge-eating/purging type) Bulimia Nervosa – recurrent episodes of binge eating, recurrent inappropriate compensatory behaviors to prevent weight gain and self-evaluation unduly influenced by body shape and weight Binge-Eating Disorder – recurrent episodes of binge eating without recurrent use of inappropriate compensatory behaviors Other Specified Feeding or Eating Disorder – related symptoms that cause clinically significant distress or impairment but does not meet full criteria and
clinician specifies the reason (e.g. atypical anorexia nervosa, bulimia nervosa of low frequency and/or limited duration, purging disorder, night eating syndrome) Unspecified Feeding or Eating Disorder – related symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician does not choose to communicate the reason, possibly due to insufficient information
Elimination Disorders Nocturnal: Nighttime sleep; Diurnal: Waking hours Enuresis – repeated voiding of urine into bed or clothes, whether involuntary or intentional (2x a week for 3 months, at least 5 years of age) Encopresis – repeated passage of feces into inappropriate places, whether involuntary or intentional (once a month for 3 months, at least 4 years of age) Other Specified Elimination Disorder – related symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. low-frequency enuresis) Unspecified Elimination Disorder – related symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician does not choose to communicate the reason, possibly due to insufficient information Sleep and Wake Disorders Sleep-wake complaints of dissatisfaction regarding quality, timing and amount of sleep Parasomnias: abnormal behavior, experiential or physiological events occurring in association with sleep, specific sleep stages or sleep-wake transitions Insomnia Disorder – difficulty initiating sleep (sleep-onset/initial insomnia), difficulty maintaining sleep (sleep maintenance/middle insomnia) and/or earlymorning awakening with inability to return to sleep (late insomnia) (3x a week for 3 months) Hypersomnolence Disorder – self-reported excessive sleepiness despite main sleep period of at least 7 hours (3x a week for 3 months) Narcolepsy – recurrent daytime naps or lapses into sleep, may be accompanied by cataplexy, hypocretin deficiency or REM sleep latency less than or equal to 15 min (3x a week for 3 months) Obstructive Sleep Apnea Hypopnea – polysomnographic evidence of at least 5 obstructive apneas or hypopneas per hour of sleep accompanied by either nocturnal breathing disturbances or daytime sleepiness, fatigue or unrefreshing sleep Central Sleep Apnea – polysomnographic evidence of at least 5 central apneas per hour of sleep Sleep-Related Hypoventilation – polysomnographic evidence of decreased respiration associated with elevated CO2 levels Circadian Rhythm Sleep-Wake Disorders – persistent pattern of sleep disruption primarily due to alteration of the circadian system Non-Rapid Eye Movement Sleep Arousal Disorders – recurrent episodes of incomplete awakening from sleep (sleepwalking or sleep terrors)
Nightmare Disorder – extended, extremely dysphoric and well-remembered dreams involving efforts to avoid threats to survival, security or physical integrity Rapid Eye Movement Sleep Behavior Disorder – repeated episodes of arousal during sleep associated with vocalization and/or complex motor behaviors Restless Legs Syndrome – urge to move the legs (or arms) begins or worsens during periods of rest or inactivity, is partially or totally relieved by movement and is worse in the evening than during the day or occurs only in the evening Substance/Medication-Induced Sleep Disorder – prominent and severe sleep disturbance during or soon after substance intoxication/withdrawal or exposure to medication capable of producing said symptoms Other Specified Insomnia Disorder – insomnia-like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. brief insomnia disorder, restricted to nonrestorative sleep) Unspecified Insomnia Disorder Other Specified Hypersomnolence Disorder – hypersomnolence-like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. brief-duration hypersomnolence) Unspecified Hypersomnolence Disorder Other Specified Sleep-Wake Disorder – related sleep-wale symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. repeated arousals during REM sleep without polysomnography) Unspecified Sleep-Wake Disorder
Sexual Dysfunctions Clinically significant disturbance in a person’s ability to respond sexually or to experience sexual pleasure for a duration of at least 6 months Lifelong: sexual problem that has been present from first sexual experiences / Acquired: sexual disorders that develop after a period of relatively normal sexual function Generalized: sexual difficulties that are not limited to certain types of stimulation, situations or partners / Situational: sexual difficulties that only occur with certain types of stimulation, situations or partners Delayed Ejaculation – marked delay in or inability to achieve ejaculation despite adequate sexual stimulation and desire to ejaculate during partnered sexual activities Erectile Disorder – repeated failure to obtain or maintain erections during partnered sexual activities Female Orgasmic Disorder – difficulty experiencing orgasm and/or markedly reduced intensity of orgasmic sensations Female Sexual Interest/Arousal Disorder – lack of or significantly reduced sexual interest/arousal Genito-Pelvic Pain/Penetration Disorder – difficulty having intercourse, genitor-pelvic pain, fear of pain or vaginal penetration, or tension of the pelvic floor muscles
Male Hypoactive Sexual Desire Disorder – persistent deficient or absent sexual/erotic thoughts or fantasies and desire for sexual activity Premature (Early) Ejaculation – persistent ejaculation during partnered sexual activity within approximately 1 minute following vaginal penetration and before individual wishes it Substance/Medication-Induced Sexual Dysfunction – clinically significant sexual disturbance during or soon after substance intoxication/withdrawal or exposure to medication capable of producing said symptoms Other Specified Sexual Dysfunction – related sexual disturbance that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. sexual aversion) Unspecified Sexual Dysfunction – related sexual disturbance that cause clinically significant distress or impairment but does not meet full criteria and clinician does not choose to communicate the reason, possibly due to insufficient information
Gender Dysphoria Sex: biological indicators of male and female, such as in sex chromosomes, gonads, sex hormones and nonambiguous internal and external genitalia Gender: lived role in society and/or the identification as male or female could not be uniformly associated with or predicted from the biological indicators Gender assignment: initial assignment as male or female, occurs usually at birth (natal gender) Gender-atypical / Gender-nonconforming: somatic features or behaviors that are not typical of individuals with the same assigned gender in a given society and historical era Gender reassignment: official and legal change of gender Gender identity: category of social identity and refers to an individual’s identification as male, female or some category other than male or female Gender dysphoria: general term for individual’s affective/cognitive discontent with the assigned gender Transgender: broad spectrum of individuals who transiently or persistently identify with a gender different from their natal gender Transsexual: individual who seeks, or has undergone, a social transition from male to female (or vice-versa) which usually involves cross-sex hormone treatment and genital surgery Gender Dysphoria – clinically significant distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender (at least 6 symptoms in children, 2 symptoms in adolescents and adults for at least 6 months) Other Specified Gender Dysphoria – related symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. brief gender dysphoria Unspecified Gender Dysphoria – related symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician
does not choose to communicate the reason, possibly due to insufficient information Paraphilic Disorders Selected for specific listing and assignment of diagnostic criteria because they are relatively common and some are classed as criminal offenses due to their noxiousness and potential harm to others Paraphilia: any intense and persistent sexual interest other than in genital stimulation Anomalous Activity Preferences: sexual interest in activities that equals or exceeds one’s interest in copulation or equivalent interaction with another person Courtship disorders: resemble distorted components of human courtship behavior / Algolagnic disorders: involve pain and suffering Anomalous Target Preferences: sexual interest in children, corpses or amputees or in nonhuman animals, such as horses or dogs or in inanimate objects Paraphilic disorder: paraphilia that causes distress or impairment to individual or paraphilia whose satisfaction entails personal harm, or risk of harm, to others Shared criteria: Recurrent and intense sexual arousal + as manifested by fantasies, urges or behaviors + acting on these sexual urges with a nonconsenting person or related clinically significant distress or impairment + over the period of at least 6 months Voyeuristic Disorder – recurrent and intense sexual arousal from observing an unsuspecting person who is naked, disrobing or engaging in sexual activity Exhibitionistic Disorder – recurrent and intense sexual arousal from exposure of one’s genitals to an unsuspecting person Frotteuristic Disorder – recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person Sexual Masochism Disorder – recurrent and intense sexual arousal from the act of being humiliated, beaten, bound or otherwise made to suffer (specifier: with asphyxiophilia) Sexual Sadism Disorder – recurrent and intense sexual arousal from the physical or psychological suffering of another person Pedophilic Disorder – recurrent and intense sexual arousal involving sexual activity with a prepubescent child or children (generally 13 years or younger) (must be at least age 16 years and at least 5 years older than the child) Fetishistic Disorder – recurrent and intense sexual arousal from either use of nonliving objects or highly specific focus on nongenital body part/s Tranvestic Disorder – recurrent and intense sexual arousal from crossdressing Other Specified Paraphilic Disorder – paraphilic symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. telephone scatologia, necrophilia, zoophilia, coprophilia, urophilia) Unspecified Paraphilic Disorder – paraphilic symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician does not choose to communicate the reason, possibly due to insufficient information Disruptive, Impulse-Control and Conduct Disorders
Conditions involving problems in the self-control of emotions and behaviors that violate the rights of others and/or bring into significant conflict with societal norms or authority figures Tend to have first onset in childhood or adolescence Oppositional Defiant Disorder – persistent pattern of 4 symptoms of angry/irritable mood, argumentative/defiant behavior or vindictiveness (1x a week for 6 months) Intermittent Explosive Disorder – recurrent impulsive or anger-based behavioral outbursts representing failure to control aggressive impulses (either verbal/physical aggression occurring 2x a week for 3 months; or 3 damage of property or physical assault within 12 months) Conduct Disorder – persistent pattern of behavior in which basic rights of others or societal norms or rules are violated (3 symptoms of aggression to people and animals, destruction of property, deceitfulness or theft, serious violation of rules in the past 12 months) Antisocial Personality Disorder – pervasive pattern of disregard for and violation of the rights of others (indicated by 3 symptoms) Pyromania – deliberate and purposeful fire setting on more than one occasion accompanied by pleasure, gratification or relief when setting fires or when witnessing or participating in their aftermath Kleptomania – recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value accompanied by pleasure, gratification or relief at the time of committing the theft Other Specified Disruptive, Impulse-Control and Conduct Disorder – related symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. recurrent behavioral outbursts of insufficient frequency) Unspecified Disruptive, Impulse-Control and Conduct Disorder – related symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician does not choose to communicate the reason, possibly due to insufficient information
Substance-Related and Addictive Disorders Cluster of cognitive, behavioral and physiological symptoms indicating that the individual continues using the substance despite significant substance-related problems Drugs taken in excess have direct activation of the brain reward system, typically producing feelings of pleasure often referred to as “high” Also includes gambling disorder Two main groups: Substance use disorders and substance-induced disorders Craving: intense desire or urge for the drug that may occur at any time but is more likely when in an environment where the drug previously was obtained or used Tolerance: requiring a markedly increased dose of the substance to achieve the desired effect or a markedly reduced effect when usual dose is consumed Withdrawal: syndrome that occurs when blood or tissue concentrations of a substance decline in an individual who had maintained prolonged heavy use of the substance
Substance intoxication: development of a reversible substance-specific syndrome due to recent ingestion of a substance (does not apply to tobacco) Substance withdrawal: development of a substance-specific problematic behavioral change due to the cessation or reduction in heavy and prolonged substance use Shared criteria: impaired control, social impairment, risky use and pharmacological criteria Substance/Medication-Induced Mental Disorder – clinically significant mental disturbance during or soon after substance intoxication/withdrawal or exposure to medication capable of producing said symptoms as evidenced from history, physical examination or lab findings Alcohol Use Disorder – problematic pattern of alcohol use with at least 2 symptoms within 1 year of impaired control, social impairment, risky use and pharmacological criteria Alcohol Intoxication – (at least 1 during or shortly after) slurred speech, incoordination, unsteady gait, nystagmus, attention and memory impairment, stupor or coma Alcohol Withdrawal – (at least 2 within several hours to few days) autonomic hyperactivity, increased hand tremor, insomnia, nausea or vomiting, transient hallucinations or illusions, psychomotor agitation, anxiety or generalized tonicclonic seizures Other Alcohol-Induced Disorders – ex. Alcohol-induced psychotic disorder / bipolar disorder / depressive disorder / anxiety disorder / sleep disorder / sexual dysfunction / neurocognitive disorder Unspecified Alcohol-Related Disorder – Caffeine Intoxication – excess of 250mg caffeine consumption resulting in (at least 5 during or shortly after) restlessness, nervousness, excitement, insomnia, flushed face, diuresis, GIT disturbance, muscle twitching, rambling flow of thought or speech, tachycardia or cardiac arrhythmia, inexhaustibility or psychomotor agitation Caffeine Withdrawal – (at least 3 within 24 hours) headache, marked fatigue or drowsiness, dysphoric mood/ depressed mood/irritability, difficulty concentrating, flu-like symptoms (nausea, vomiting, or muscle pain/stiffness) Other Caffeine-Induced Disorders - e.g. caffeine-induced anxiety disorder / sleep disorder Unspecified Caffeine-Related Disorder – Cannabis Use Disorder – problematic pattern of cannabis use with at least 2 symptoms within 1 year of impaired control, social impairment, risky use and pharmacological criteria Cannabis Intoxication – (at least 2 within 2 hours) conjunctival injection, increased appetite, dry mouth, tachycardia Cannabis Withdrawal – (at least 3 within 1 week) irritability/anger/aggression, nervousness/anxiety, sleep difficulty, decreased appetite/weight loss, restlessness, depressed mood, physical symptoms (abdominal pain, shakiness/tremors, sweating, fever, chills, headache) Other Cannabis-Induced Disorders – e.g. cannabis-induced psychotic disorder / anxiety disorder / sleep disorder Unspecified Cannabis-Related Disorder –
Phencyclidine Use Disorder – problematic pattern of phencyclidine (PCP, angel dust) use with at least 2 symptoms within 1 year of impaired control, social impairment, risky use and pharmacological criteria Other Hallucinogen Use Disorder – problematic pattern of hallucinogen (MDMA, ecstasy, LSD, DMT) use with at least 2 symptoms within 1 year of impaired control, social impairment, risky use and pharmacological criteria Phencyclidine Intoxication – (at least 2 within 1 hour) vertical or horizontal nystagmus, hypertension or tachycardia, numbness or diminished responsiveness to pain, ataxia, dysarthria, muscle rigidity, seizures or coma, hyperacusis Other Hallucinogen Intoxication – (at least 2 during or shortly after) pupillary dilation, tachycardia, sweating, palpitations, blurring of vision, tremors, incoordination Hallucinogen Persisting Perception Disorder – reexperiencing of one or more perceptual symptoms experienced while intoxicated with hallucinogen (LSD) following cessation Other Phencyclidine-Induced Disorders – ex. Phencyclidine-induced psychotic disorder / bipolar disorder / depressive disorder / anxiety disorder Other Hallucinogen-Induced Disorders – ex. Hallucinogen-induced psychotic disorder / bipolar disorder / depressive disorder/ anxiety disorder Unspecified Phencyclidine-Related Disorder – Unspecified Hallucinogen-Related Disorder – Inhalant Use Disorder – problematic pattern of hydrocarbon-based inhalant (glues, fuels, paints) use with at least 2 symptoms within 1 year of impaired control, social impairment, risky use and pharmacological criteria Inhalant Intoxication – (at least 2 during or shortly after) dizziness, nystagmus, incoordination, slurred speech, unsteady gait, lethargy, depressed reflexes, psychomotor retardation, tremor, generalized muscle weakness, blurred vision or diplopia, stupor or coma, euphoria Other Inhalant-Induced Disorders – ex. Inhalant-induced psychotic disorder / depressive disorder / anxiety disorder / neurocognitive disorder Unspecified Inhalant-Related Disorder – Opioid Use Disorder – problematic pattern of opioid (heroin, morphine, codeine, oxycodone, propoxyphene) use with at least 2 symptoms within 1 year of impaired control, social impairment, risky use and pharmacological criteria Opioid Intoxication – papillary constriction and (at least 1 during or shortly after) drowsiness or coma, slurred speech, impairment in attention or memory Opioid Withdrawal – (at least 3 within minutes to several days) dysphoric mood, nausea or vomiting, muscle aches, lacrimation or rhinorrhea, pupillary dilation/piloerection/sweating, diarrhea, yawning, fever, insomnia Other Opioid-Induced Disorders – ex. Opioid-induced depressive disorder / anxiety disorder / sleep disorder / sexual dysfunction Unspecified Opioid-Related Disorder – Sedative, Hypnotic or Anxiolytic Use Disorder – problematic pattern of sedative, hypnotic or anxiolytic (benzodiazepine, carbamate, barbiturate) use with at least 2 symptoms within 1 year of impaired control, social impairment, risky use and pharmacological criteria
Sedative, Hypnotic or Anxiolytic Intoxication – (at least 1 during or shortly after) slurred speech, incoordination, unsteady gait, nystagmus, cognition impairment, stupor or coma Sedative, Hypnotic or Anxiolytic Withdrawal – (at least 2 within several hours to few days) autonomic hyperactivity, hand tremor, insomnia, nausea or vomiting, transient hallucinations or illusions, psychomotor agitation, anxiety, grand mal seizures Other Sedative-, Hypnotic- or Anxiolytic-Induced Disorders – ex. Sedative-, hypnotic- or anxiolytic-induced psychotic disorder / bipolar disorder / depressive disorder/ anxiety disorder / sleep disorder / sexual dysfunction / neurocognitive disorder Unspecified Sedative-, Hypnotic-, or Anxiolytic-Related Disorder – Stimulant Use Disorder – problematic pattern of stimulant (amphetamine, metamphetamine cocaine) use with at least 2 symptoms within 1 year of impaired control, social impairment, risky use and pharmacological criteria Stimulant Intoxication – (at least 2 during or shortly after) tachycardia or bradycardia, pupillary dilation, elevated or lowered blood pressure, perspiration or chills, nausea or vomiting, evidence of weight loss, psychomotor agitation or retardation, muscular weakness/respiratory depression/chest pain/cardiac arrhythmias, confusion/seizures/dyskinesias/dystonias/coma Stimulant Withdrawal – dysphoric mood and (at least 2 within few hours to several days) fatigue, vivid unpleasant dreams, insomnia or hypersomnia, increased appetite, psychomotor retardation or agitation Other Stimulant -Induced Disorders – stimulant-induced psychotic disorder / bipolar disorder / depressive disorder / anxiety disorder / obsessive-compulsive disorder / sleep disorder / sexual dysfunction Unspecified Stimulant-Related Disorder – Tobacco Use Disorder – problematic pattern of tobacco (nicotine) use with at least 2 symptoms within 1 year of impaired control, social impairment, risky use and pharmacological criteria Tobacco Withdrawal – (at least 4 within 24 hours) irritability/frustration/anger, anxiety, difficulty concentrating, increased appetite, restlessness, depressed mood, insomnia Other Tobacco-Induced Disorders – tobacco-induced sleep disorder Unspecified Tobacco Related Disorder – Other (or Unknown) Substance Use Disorder – problematic pattern of intoxicating substance (not able to be classified: anabolic steroids, nonsteroidal anti-inflammatory drugs, cortisol) use with at least 2 symptoms within 1 year of impaired control, social impairment, risky use and pharmacological criteria Other (or Unknown) Substance Intoxication – development of reversible substance-specific syndrome attributable to recent ingestion or exposure to substance not listed elsewhere or unknown Other (or Unknown) Substance Withdrawal – development of substancespecific syndrome shortly after cessation or reduction in substance use Unspecified Other (or Unknown) Substance-Related Disorder – Gambling Disorder – clinically significant persistent and recurrent problematic gambling behavior (at least 4 in 1 year)
Neurocognitive Disorders
Group of disorders in which the primary clinical deficit is in cognitive function and that are acquired rather than developmental Neurocognitive domains: Complex attention, Executive function, Learning and memory, Language, Perceptual-motor, Social cognition Sustained attention: maintenance of attention over time Selective attention: maintenance of attention despite competing stimuli and/or distracters Divided attention: attending to two tasks within the same time period Planning: ability to find the exit to a maze Decision making: performance of tasks that assess process of deciding in the face of competing alternatives Working memory: ability to hold information for a brief period and to manipulate it Feedback/error utilization: ability to benefit from feedback to infer the rules for solving a problem Overriding habits/inhibition: ability to choose a more complex and effortful solution to be correct Mental/cognitive flexibility: ability to shift between two concepts, tasks or response rules Immediate memory span: ability to repeat a list of words or digits Recent memory: assesses the process of encoding new information through free recall, cued recall and recognition memory Expressive language: confrontational naming, fluency or phonemic Grammar and syntax: omission or incorrect use of articles, prepositions, auxiliary verbs Receptive language: comprehension; performance of actions/activities according to verbal command Visual perception: line bisection tasks can be used to detect basic visual defect or attentional neglect Visuoconstructional: assembly of items required hand-eye coordination, such as drawing, copying and block assembly Perceptual-motor: integrating perception with purposeful movement Praxis: integrity of learned movements, such as ability to imitate gestures or pantomime use of objects to command Gnosis: perceptual integrity of awareness and recognition, such as recognition of faces and colors Recognition of emotions: identification of emotion in images of faces representing a variety of both positive and negative emotions Theory of mind: ability to consider another person’s mental state (thoughts, desires, intentions) or experience Delirium – disturbance of attention or awareness accompanied by a change in baseline cognition, that is a direct physiological consequence of another medical condition, substance intoxication or withdrawal, or toxin exposure, or combination of these factors Other Specified Delirium – delirium-like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician specifies the reason (e.g. attenuated delirium syndrome)
Unspecified Delirium – delirium-like symptoms that cause clinically significant distress or impairment but does not meet full criteria and clinician does not choose to communicate the reason, possibly due to insufficient information Major Neurocognitive Disorder – significant cognitive decline from a previous level of performance in at least one neurocognitive domain which interferes with independence in everyday activities Mild Neurocognitive Disorder – modest cognitive decline from a previous level of performance in at least one neurocognitive domain which does not interfere with independence in everyday activities but greater effort, compensatory strategies or accommodating may be required Specifiers – Alzheimer’s disease, frontotemporal lobar degeneration, Lewy body disease, vascular disease, traumatic brain injury, substance/medication use, HIV infection, Prion disease, Parkinson’s disease, Huntington’s disease, another medical condition, multiple etiologies, unspecified Due to Alzheimer’s Disease – insidious onset and gradual progression of cognitive and behavioral symptoms typically with impairment in memory and learning Frontotemporal (Lobar Degeneration) – progressive development of behavioral and personality change and/or language impairment (behavioral disinhibition, apathy or inertia, loss of sympathy or empathy, perseverative/stereotyped/compulsive/ritualistic behavior, hyperorality and dietary changes) With Lewy Bodies (Disease) – core features are pronounced variations in attention and alertness, recurrent detailed visual hallucinations and spontaneous features of Parkinsonism; suggestive features are REM sleep behavior disorder and severe neuroleptic sensitivity Vascular (Disease) – clinical features consistent with vascular etiology as suggested by relation of onset to at least one cerebrovascular event and prominent decline in complex attention and frontal-executive function domains Due to Traumatic Brain Injury – clinical features presented immediately after occurrence of traumatic brain injury or immediately after recovery of consciousness as evidenced by loss of consciousness, posttraumatic amnesia, disorientation and confusion, neurological symptoms Substance/Medication Induced – clinically significant neurocognitive impairment during or soon after substance intoxication/withdrawal or exposure to medication capable of producing said symptoms Due to HIV Infection – neurocognitive impairment attributable to a documented infection with human immunodeficiency virus (HIV) Due to Prion Disease – neurocognitive impairment attributable to prion disease (most common type is Creutzfeldt-Jakob disease), with insidious onset and rapid progression of motor features such as myoclonus or ataxia Due to Parkinson’s Disease – neurocognitive impairment attributable to established Parkinson’s disease Due to Huntington’s Disease – neurocognitive impairment attributable to clinically established Huntington’s disease or risk based on family history or genetic testing Due to Another Medical Condition – neurocognitive impairment that is the pathophysiological consequence of another medical condition based on history,
physical examination or laboratory findings (e.g. primary or secondary brain tumors, subdural hematoma, hypothyroidism, epilepsy, multiple sclerosis, deficiencies of thiamine or niacin) Due to Multiple Etiologies – neurocognitive impairment that is the pathophysiological consequence of more than one etiological process, excluding substances Unspecified Neurocognitive Disorder – neurocognitive impairment that does not meet the full criteria and in which the precise etiology cannot be determined with sufficient certainty
Neurodevelopmental Disorders Group of conditions with onset in the developmental period, typically manifesting before the child enters grade school, and are characterized by developmental deficits from learning or control of executive functions to global impairments of social skills or intelligence Speech: expressive production of sounds and includes articulation, fluency, voice and resonance quality Language: form, function and use of a conventional system of symbols in a rulegoverned manner for communication Communication: any verbal or nonverbal behavior (whether intentional or unintentional) that influences behavior, ideas or attitudes of another individual Expressive ability: production of vocal, gestural or verbal signals Receptive ability: process of receiving and comprehending language messages Pragmatics: social use of language and communication Intellectual Disability (Intellectual Developmental Disorder) – deficits in general mental abilities (reasoning, problem solving, planning, abstract thinking, judgment, academic learning and learning from experience) and impairment in everyday adaptive functioning in comparison to one’s age, gender and peers (Mild, Moderate, Severe, Profound) Global Developmental Delay – failure to meet expected developmental milestones in several areas of intellectual functioning and inability to undergo systematic assessment of intellectual functioning (under age of 5 years, requires reassessment after a period of time) Unspecified Intellectual Disability (Intellectual Developmental Disorder) – assessment of degree of intellectual disability is difficult or impossible because of associated sensory or physical impairments (over age of 5 years, requires reassessment) Language Disorder – persistent difficulties in acquisition and use of language across modalities due to deficits in comprehension or production of vocabulary, sentence structure and discourse Speech Sound Disorder – persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages Childhood-Onset Fluency Disorder (Stuttering) – disturbance in the normal fluency and motor production of speech (repetitive sounds or syllables, prolongation of consonants or vowel sounds, broken words, blocking or words produced with an excess of physical tension) Social (Pragmatic) Communication Disorder – persistent difficulties in the social use of verbal and nonverbal communication
Unspecified Communication Disorder – clinically significant symptoms characteristic of communication disorder but do not meet full criteria and reason not specified Autism Spectrum Disorder – persistent deficits in social communication and social interaction accompanied by excessively repetitive behaviors, restricted interests and insistence on sameness Attention-Deficit/Hyperactivity Disorder – persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development Other Specified Attention-Deficit/Hyperactivity Disorder – clinically significant symptoms characteristic of communication disorder but do not meet full criteria (e.g. with insufficient inattention symptoms) Unspecified Attention-Deficit/Hyperactivity Disorder – clinically significant symptoms characteristic of communication disorder but do not meet full criteria Specific Learning Disorder – specific deficits in ability to perceive or process information efficiently and accurately; persistent and impairing difficulties with learning foundational academic skills in reading, writing and/or math Developmental Coordination Disorder – deficits in the acquisition and execution of coordinated motor skills and manifested by clumsiness and slowness or inaccuracy of motor performance Stereotypic Movement Disorder – repetitive, seemingly driven, and apparently purposeless motor behaviors (hand flapping, body rocking, head banging, self-biting, hitting) Tic Disorders: presence of motor or vocal tics which are sudden, rapid, recurrent, nonrhythmic, stereotyped motor movements or vocalizations Tourette’s Disorder – waxing-waning multiple motor and vocal tics present for at least 1 year Persistent (Chronic) Motor or Vocal Tic Disorder – waxing-waning single or multiple motor or vocal tics (not both at the same time) present for at least 1 year Other Specified Tic Disorder – clinically significant symptoms characteristic of tic disorder but do not meet full criteria (e.g. with onset after age 18 years) Unspecified Tic Disorder – clinically significant symptoms characteristic of tic disorder but do not meet full criteria and reason not specified Other Specified Neurodevelopmental Disorder – clinically significant symptoms characteristic of neurodevelopmental disorder but do not meet full criteria (e.g. neurodevelopmental disorder associated with prenatal alcohol exposure) Unspecified Neurodevelopmental Disorder – clinically significant symptoms characteristic of neurodevelopmental disorder but do not meet full criteria and reason not specified
Residual Categories Disturbance caused by physiological effects of another medical condition Other Specified Mental Disorder Due to Another Medical Condition – e.g. Dissociative symptoms Unspecified Mental Disorder Due to Another Medical Condition Symptoms characteristic of a mental disorder that cause clinically significant distress or impairment of functioning but do not meet full criteria for any other mental disorder in DSM-5
Other Specified Mental Disorder Unspecified Mental Disorder
