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DIAGNOSTIC AND STATISTICAL MANUAL OF

MENTAL DISORDERS FIFTH E D I T I O N

AMERICAN PSYCHIATRIC ASSOCIATION

DIAGNOSTIC AND STATISTICAL MANUAL OF

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

DSM-5

A División of American PsychiatricAssodation

Washington, DC London, England

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 tised in a manner inconsistent with the APA's copyright. This prohibition applies to unauthorized uses or reproductions in any form, including electronic applications.

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

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

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

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

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

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

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

p . ; cm. DSM-5 DSM-V Includes index. ISBN 978-0-89042-554-1 (hardcover : alk. paper) — ISBN 978-0-89042-555-8 (pbk. : alk. paper) L American Psychiatric Association. II. American Psychiatric Association. DSM-5 Task Forcé. 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 616.89W5—dc23

2013011061

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

Text Design—Tammy J. Cordova

Manufacturing—Edwards Brothers Malloy

Contents

DSM-5 C lassification...................... ............................................. xiii Preface........................................................... .................................. xli

Section 9 DSM-5 Basics

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

Use of the M an ua l...........................................................................19

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

Section 11 íiiagnostic 0rft@ri3 snd (#od©s

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

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

Medication-lnduced Movement Disorders and Other Adverse Effects of M ed ica tion .............................. 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 D isorders.................761

Conditions for Further S tudy....................................................... 783

Highlights of Changes From DSM-IV to DSM-5.........................809 Glossary of Technical Term s....................................................... 817

Glossary of Cultural Concepts of D istress.............. ..................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 C ontributors...................................897

Index 917

DSM-5 Task Forcé David J. Kupfer, M.D.

Task Forcé Chair D a r r e l A» Regier, M.D., M.P.H.

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

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 División of Research Staff on DSM-5 Darrel A. Regier, M.D., M.P.H.,

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

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

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

Statistician

Lisa H. Greiner, M.S.S.A., DSM-5 Field Triáis Project M anager

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

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

Jennifer J. Shupirika, Assistant Director, DSM Operations

Seung-Hee Hong, DSM Sénior 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

Amy Porfiri, M.B.A. Christopher M. Reynolds, Director ofFinance and Administration Executive Assistant

APA Office of the Medical Director James H. S c u lly Jr., M.D.

Medical Director and CEO

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

DSM-5 Work Groups ADHD and Disruptive Behavior Disorders

David Sh a ffer , M .D. Chair

R Xavier Ca stella n o s, M.D. Co-Chair

Paul J. Frick, Ph.D., Text Coordinator Glorísa 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 DIssocíatíve Disorders

K atharine A. P h illip s , M.D. Chair

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

J. Gavin Andrews, M.D. Susan M. Bógels, 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. M urray B. Stein, M.D. Robert J. Ursano, M.D. Hans-XJlrich Wittchen, Ph.D.

Childhood and Adolescent Disorders Daniel S. F in e , 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.

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

Eatíng Disorders B. Timothy W a ls h , 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. Jam es 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 Ja n A. F a w ce tt, 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.

Neurocognítive Disorders DILIP V. JESTE, M.D. (2007-2011)

Chair Emeritus D a n G. B lazer, M.D., Ph.D., M.P.H.

Chair R o n a ld C. Petersen , M.D., Ph.D.

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

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

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

Neurodevelopmental Disorders Susan E. Sw edo , 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 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. Cari 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 W illiam T. C arpenter Jr., M.D.

Chair Deartna M. Barch, Ph.D., Text

Coordinator Juan R. Bustillo, M.D. W olfgang 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, P h .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 Lángstróm, M.D., Ph.D. Heino F.L. Meyer-Bahlburg, Dr. rer. nat. Friedemann Pfáfflin, M.D. Robert Taylor Segraves, M.D., Ph.D.

SIeep-Wake Disorders C h a rle s F. Reynolds III, M.D.

Chair Ruth M. O'Hara, Ph.D., Text Coordinator Charles M. Morin, Ph.D. Alian I. Pack, Ph.D.

Kathy P. Parker, Ph.D., R.N. Susan Redline, M.D., M.P.Fí. 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 C h a r le s P. CXBrien, M .D ., Ph.D .

Chair Thomas J. Crow ley, M .D.

Co-Chair W ilson 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 D iagnostic Spectra and DSM/ICD Harmonization

Steven E. H ym an , 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 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. Daniel T. Mamah, M .D., M.P.E. F. Xavier Castellanos, M.D. Andrew E. Skodol II, M.D. Wilson M. Compton, M.D., M.P.E. Susan E. Swedo, M.D.

Gender and Cross-Cultural Issues K imberly A. Y onkers, M.D.

Chair R oberto Lewis-Fernández, M.D., M.T.S.

Co-Chair, Cross-Cultural Issues Renato D. Alarcon, M.D., M.P.H. Leslie C. Morey, Ph.D. Diana E. Clarke, Ph.D., M.Sc. William E. Narrow, M .D., M.P.H. Javier I. Escobar, M.D., M.Sc. Roger Peele, M.D. Ellen Frank, Ph.D. _ Philip Wang, M.D., Dr.P.H. (2007-2012) James S. Jackson, Ph.D. William M. Womack, M.D. Spiro M. Manson, Ph.D. (2007-2008) Kenneth J. Zucker, Ph.D. James P. McNulty, A.B., Sc.B.

Psychiatric/General Medical Interface Lawson R. W ulsin , M.D.

Chair Ronald E. Dahl, M.D. Richard E. Kreipe, M.D. Joel E. Dimsdale, M.D. Ronald C. Petersen, Ph.D., M.D. Javier I. Escobar, M.D., M.Sc. Charles F. Reynolds III, M.D. Dilip V. Jeste, M.D. (2007-2011) Robert Taylor Segraves, M.D., Ph.D. Walter E. Kaufmann, M.D. B. Timothy Walsh, M.D.

Impairment and Disability Jane S. Paulsen, Ph .D.

Chair J. Gavin Andrews, M.D. Hans W. Hoek, M.DV Ph.D. Glorisa Canino, Ph.D. Helena C. Kraemer, Ph.D. Lee Anna Clark, Ph.D. William E. Narrow, M.D., M.P.H. Diana E. Clarke, Ph.D., M.Sc. David Shaffer, M.D. Michelle G. Craske, Ph.D.

Diagnostic Assessment Instruments Ja c k D. Burke Jr., M.D., M.P.H.

Chair Lee Anna Clark, Ph.D. Helena C. Kraemer, Ph.D. Diana E. Clarke, Ph.D., M.Sc. William E. Narrow, M.D., M.P.H. Bridget F. Grant, Ph.D., PhD. David Shaffer, M.D.

DSM-5 Research Group W illiam E. N arrow , M.D., M.P.H.

Chair Jack D. Burke Jr., M.D., M.P.H. David J. Kupfer, M.D. Diana E. Clarke, PhD., M.Sc. Darrel A. Regier, M.D., M.P.H. Helena C. Kraemer, PhD. David Shaffer, M.D.

Course Specifiers and Glossary WOLFGANG GAEBEL, M.D.

Chair Ellen Frank, PhD. Dan J. Stein, M.D., Ph.D. Charles P. O'Brien, M.D., Ph.D. Eric A. Taylor, M.B. Norman Sartorius, M.D., PhD ., David J. Kupfer, M.D.

Consultant Darrel A. Regier, M.D., M.P.H. Susan K. Schultz, M.D.

DSM-5 Classification

Before each disorder ñame, 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-XO-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 ñames, page numbers for the corresponding text or criteria are included in parentheses.

Note for all mental disorders due to another medical condition: Indícate the ñame of the other medical condition in the ñame of the mental disorder due to [the medical condi- tion]. The code and ñame 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) 319 (..........) Intellectual Disability (Intellectual Developmental Disorder) (33)

Specify current severity: |F70} Mild fP71) Moderate (FT2) Severe (F73) Profound

315.8 (F88) Global Developmental Delay (41)

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

Communication Disorders (41) 315.39 (f£v ' Language Disorder (42)

315.39 tíT'C Speech Sound Disorder (44)

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

disorder. 315.39 {FEO ,89) Social (Pragmatic) Communication Disorder (47)

307.9 (FUt, ̂ 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 catatonía (use additional code 293.89 [F06.1])

Attention-Deficit/Hyperactivity Disorder (59) __ «__ |...........) Attention-Deficit /Hyperactivity Disorder (59)

Specify whether: 314.01 '/ Combined presentation 314.00 ' Predominantly inattentive presentation 314.01 ' Predominantly hyperactive/impulsive presentation

Specify if: In partial remission Specify cmrevá. severity: Mild, Moderate, Severe

314.01 í *r' 'J;} Other Specified Attention-Deficit/Hyperactivity Disorder (65)

314.01 i-' *0 Unspecified Attention-Deficit/Hyperactivity Disorder (66)

Specific Learning Disorder (66) __.__ f,__ .__i Specific Learning Disorder (66)

Specify if: 315.00 ” With impairment in reading (specify if with word reading

accuracy, reading rate or fluency, reading comprehension) 315.2 ' , K ¿ With impairment in written expression (specify if with spelling

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

315.1 ' ' > ; 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 ‘ Developmental Coordination Disorder (74)

307.3 ,* 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 *' ^5.2) Tourette’s Disorder (81)

307.22 Persisten! (Chronic) Motor or Vocal Tic Disorder (81) Specify if: With motor tics only, With vocal tics only

DSM-5 Classification xv

307.21 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 *v'}Vv 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; Múltiple episodes, currently in acute episode; Múl­ tiple episodes, currently in partial remission; Múltiple episodes, currently in full remission; Continuous; Unspecified

b Specify if: With catatonía (use additional code 293.89 [FOó.l]) cSpecify current severity of delusions, hallucinations, disorganized speech, abnormal psycho-

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

301.22 Schizotypal (Personality) Disorder (90)

297.1 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 contení

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

postpartum onset 295*40 ; , Schizophreniform Disorderb/ c (96)

Specify if: With good prognostic features, Without good prognostic fea- tures

295.90 >, ■ . Schizophreniaa/ D/ c (99)

___? ; Schizoaffective Disorder3' b/ c (105) Specify whether:

295.70 ; > Bipolar type 295.70 Depressive type

___.__ í__ ....J Substance/Medication-Induced Psychotic Disorder0 (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 Condition0 (115) Specify whether:

293.81 With delusions 293.82 With hallucinations

xvi DSM-5 Classification

293.89 Catatonía Associated With Another Mental Disorder (Catatonía Specifier) (119)

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

293.89 *í Unspecified Catatonía (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 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, mpderate-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 catatonía (use additional code 293.89 [F06.1]); With peripartum onset; With seasonal pattem

__ ■__i___*__1 Bipolar I Disorder3 (123) ___( _ . _ J Current or most recent episode manic 296.41 i?.: Mild 296.42 r:l* Moderate 296.43 / Severe 296.44 With psychotic features 296.45 - , In partial remission 296.46 In full remission 296.40 ?r.V 7 Unspecified 296.40 {F31.0) Current or most recent episode hypomanic 296.45 f In partial remission 296.46 In full remission 296.40 'fr*;. Unspecified __ .__ ' _.. _ Current or most recent episode depressed 296.51 Mild 296.52 ^ Moderate 296.53 ff 31.4) Severe 296.54 With psychotic features 296.55 v ' 1* , In partial remission 296.56 ' In full remission 296.50 .''W ^ Unspecified 296.7 :* Current or most recent episode unspecified

296.89 ' í Bipolar II Disorder3 (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 not currently met:

Mild, Moderate, Severe

DSM-5 Olassiíication

301,13 Cyclothymic Disorder (139) Specify if: With anxious di stress

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

substance-specific codes and 1CD-9-CM and ICD-10-CiVÍ coding. Specify if: With onset during intoxication, With onset during withdrawa!

293,83 i _ , I Bipolar and Related Disorder Due to Another Medical Condition (145)

Specify if: ' / , ' With manic features / :̂ ' With manic- or hypomanic-Tike episode

' -", * 7 With mixed features

296.89 T ̂/ Other Specified Bipolar and Related Disorder (148)

296.80 ' /' Unspecified Bipolar and Related Disorder (149)

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

severe); With mixed features; With melancholic features; With atypical features; With mood- congruent psychotic features; With mood-incongment psychotic features; With catatonía (use additional code 293.89 [F06.1]); With peripartum onset; With seasonal parlera

296=99 (F34ÍÍ) Disruptive Mood Dysregulation Disorder (156) ,.a ,Major Depressive Disordera (160)

Single episode 296.21 ;V?/2áÍ¡ Mild 296.22 F32, i) Moderate 296.23 fF3P/

" . í Recurren! episode 296.31 Mild 296.32 Moderate 296.33 7 -37^ Severe 296.34 (P3&2Í With psychotic features 296.35 'F3SA1) ín partial remission 296,36 r33/42| ín full remission 296.30 Unspecified

300.4 < ̂*í * Persistent Depressive Disorder 'sthymia)a (168) Specify if: In partial remission, In full remission Specify if: Eariy onset, Late onset Specify i*: With puré dysthvmic syndrome; With persisten! major depres-

sive episode; With intermittent major depressive episode.s, with curren!

xviii DSM-5 Classification

625.4

293.83

311

311

309.21

312.23

300.29

300.23

300.01

300.22

300.02

episode; With intermiiíent major depiessive episodes, wirhoat curren; episode

Specify current severity: Mild, Moderate, Severe ÍN94.3j Premenstrual Dysphoric Disorder (171)

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

substance-specifie codes and ICD-9-CM and ICD-10-CM coding. Specify if: With onset during intoxication, With onset during withdrawa i

Depressive Disorder Due to Another Medical Condition (18C) Specify if:

/ ' y' ‘ With depressive features '' 0C, Oo With major depressive-like episode Wz') ̂ , With mixed features

(F32.8) Other Specified Depressive Disorder (183)

l Unspecified Depressive Disorder (184)

Anxiety Disorders (189) (F9S,0) Separation Anxiety Disorder (190)

ÍF94,0) Selective Mutism (195)

(__■ j Specific Phobia (197) Specify if:

IF4C121 Sf Animal (F40.228) Natural environment I__ J Blood-injection-injury fF40.230| Fear of blood {F40,2r*, Fear of injections and transfusions (F4G.232? Fear of other medical care íf 40,233s Fear of injury

/ ' ' Situational Other

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

|F41 iJ| Panic Disorder (208)

' . _ i Panic Attack Specifier (214)

(P40*00f Agoraphobia (217)

lf4 íA ¡ Generalized Anxiety Disorder (222)

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

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

With onset after meciication use

DSM-5 Classification

293.84 i/- Anxiety Disorder Due to Another Medical Condition (230)

300.09 ,C; Other Specified Anxiety Disorder (233)

300,00 \V Unspecified Anxiety Disorder (233)

Obsessive-Compulsive and Related Disorders (235) The following specifier applies to Obsessive-Compulsive and Related Disorders where indicated: * Specify if: With good or fair insight, With poor insight, With absent ins igh l / d eiu s i ona i beHers

300.3 Obsessive-Compulsive Disordera (237) Specify if: Tic-related

300.7 ' ̂ — Body Dysmorphic Disordera (242) Specify if: With muscle dysmorphia

300.3 Hoarding Disorder3 (247) Specify if: With excessive acquisition

312.39 " * ¿ Trichotillomania (Hair-Pulling Disorder) (251)

698.4 , ^ ' Excoriation (Skin-Picking) Disorder (254)

___.__ i , f Substance/Medication-Induced Obsessive-Compulsive and Related Disorder (257)

Note: See the criteria set and corresponding recording procedures for substance-specific codes and ICD--9-CM and ÍCD-10-CM coding.

Specify if: With onset during intoxication, With onset during wiíhdrawol, With onset after medication use

294.8 ÍF06.S) Obsessive-Compulsive and Related Disorder Due to Another Medical Condition (260)

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