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A División of American PsychiatricAssodation

Washington, DC London, England

Copyright © 2013 American Psychiatric Association

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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.

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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