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Attention-Defici VHyper activity Disorder 63 Gender-Rela ted Diagno stic Is sues ADHD is more frequent in males than in females in the general population, with a ratio of approximately 2:1 in children and 1. 6:1 in adults. Females are more likely than males to present primarily with inattentive features. Func tional Co... |
64 Neurodevelopmental Disorders frequent multiple tics can be mistaken for the generalized fidgetiness of ADHD. Prolonged observation may be needed to differentiate fidgetiness from bouts of multiple tics. Specific learning disorder. Children with specific learning disorder may appear inat tentive because of frustrati... |
Other Specified Attention-Deficit/Hyper activity Disorder 65 Personality disorders. In adolescents and adults, it may be difficult to distinguish ADHD from borderline, narcissistic, and other personality disorders. All these disorders tend to share the features of disorganiza tion, social intrusiveness, emotional dysre... |
66 Neurodevelopmental Disorders the specific reason that the presentation does not meet the criteria for attention-deficit/ hyperactivity disorder or any specific neurodevelopmental disorder. This is done by re cording "other specified attention-deficit/hype ractivity disorder'' followed by the specific reason (e. g.,... |
Specific Learning Disorder 67 B. The affected academic skills are substantially and quantifiably below those expected for the individual's chronological age, and cause significant interference with academic or occupational performance, or with activities of daily living, as confirmed by individu ally administered stan... |
68 Neurodevelopmental Disorders Moderate: Marked difficulties learning skills in one or more academic domains, so that the individual is unlikely to become proficient without some intervals of intensive and specialized teaching during the school years. Some accommo dations or supportive services at least part of the da... |
Specific Learning Disorder 69 learning disorder. Evidence of persistent learning difficulties may be derived from cumulative school reports, portfolios of the child's evaluated work, curriculum-based measures, or clinical interview. In ad Ults, persistent difficulty refers to ongoing difficulties in literacy or numerac... |
70 Neurodevelopmental Disorders Finally, the learning difficulty may be restricted to one academic skill or domain (e. g., read ing single words, retrieving or calculating number facts). Comprehensive assessment is required. Specific learning disorder can only be diagnosed after formal education starts but can be diag... |
Specific Learning Disorder 71 mathematics. However, precursors such as language delays or deficits, difficulties in rhyming or courting, or difficulties with fine motor skills required for writing commonly occur in early childhood before the start of formal schooling. Manifestations may be be havioral (e. g., a reluct... |
72 Neurodevelopmental Disorders avoid activities that demand reading or arithmetic (reading for pleasure, reading instruc tions). Adults with specific learning disorder have ongoing spelling problems, slow and effortful reading, or problems making important inferences from numerical information in work-related written... |
Specific Learn ing Disorder 73 slow but accurate reading. In English-language learners, assessment should include con sideration of wether the source of reading difficulties is a limited proficiency with Eng lish or a specific learning disorder. Risk factors for specific learning disorder in English language learner... |
74 Neurodevelopmental Disorders Attention-deficit/hypera ctivity disorder. Specific learning disorder is distinguished from the poor academic performance associated with ADHD, because in the latter condition the problems may not necessarily reflect specific difficulties in learning academic skills but rather may reflec... |
Developmental Coordination Disorder 75 with age. Young children may be delayed in achieving motor milestones (i. e., sitting, crawling, walking), althouh many achieve typical motor milestones. They also may be delayed in de veloping skills such as negotiating stairs, pedaling, buttoning shirts, completing puzzles, and... |
76 Neurodevelopmental Disorders dina ted movements continue through adolescence in an estimated 50%-70% of children. Onset is in early childhood. Delayed motor milestones may be the first signs, or the disor der is first recognized when the child attempts tasks such as holding a knife and fork, but toning clothes, or... |
Stereotypic Movement Disorder 77 ity. However, if the motor difficulties are in excess of what could be accounted for by the intellectual di sability, and criteria for developmental coordination disorder are met, de velopmental coordination disorder can be diagnosed as well. Attention-de fici Vhyperactivity disorder. ... |
78 Neurodevelopmental Disorders Coding note: Use additional code to identify the associated medical or genetic condition, or neurodevelopmental disorder. Specify current severity: Mild: Symptoms are easily suppressed by sensory stimulus or distraction. Moderate: Symptoms require explicit protective measures and behavio... |
Stereotypic Movement Disorder 79 of stereotypic movements is in the early developmental period (Criterion C). Criterion D states that the repetitive, stereotyped behavior in stereotypic movement disorder is not at tributable to the'physiological effects of a subs tance or neurological condition and is not better expla... |
80 Neurodevelopmental Disorders ally resolves with age. Complex stereotypies are less common in typically developing children and can usually be suppressed by distraction or sensory stimulation. The indi vidual's daily routine is rarely affected, and the movements generally do not cause the child distress. The diagnos... |
Tic Disorders 81 Tic Disor ders Dia gnostic Criteria Note: A tic is a sudden, rapid, recurrent, nonrhythmic motor movement or vocalization. Tourette 's Disorder 307. 23 (F95. 2) A. Both multiple motor and one or more vocal tics have been present at some time during the illness, although not necessa rily concurrently. B... |
82 Neurodevelopmental Disorders other specified and unspecified tic disorders), such that once a tic disorder at one level of the hierarchy is diagnosed, a lower hierarchy diagnosis cannot be made (Criterion E). Tics are sudden, rapid, recurrent, nonrhythmic motor movements or vocalizations. An individual may have vari... |
Tic Disorders 83 Preva lenc e Tics are common in childhood but transient in most cases. The estimated prevalence of Tourette's disorder ranges from 3 to 8 per 1,000 in school-age children. Males are more commonly affected than females, with the ratio varying from 2:1 to 4:1. A national survey in the United States estim... |
84 Neurodevelopmen tal Disorders Gender-Rela ted Diag nos tic Is sues Males are more commonly affected than females, but there are no gender differences in the kinds of tics, age at onset, or course. Women with pers istent tic diso rders may be more likely to experience anxiety and depression. Functional Cons equences ... |
Other Specified Tic Disorder 85 Comor bidity Many medical and psychiatric conditions have been described as co-occurring with tic disor ders, with ADHD and obsessive-compulsive and related disorders being particularly com mon. The obsessive-compulsive symptoms observed in tic disorder tend to be characterized by more... |
86 Neurodevelopmen tal Disorders Other Neur ode velopm ental Disor der s Other Specified Neur odevelopmen tal Disorder 315. 8 (F88) This category applies to presentations in which symptoms characteristic of a neurodevel opmental disorder that cause impairment in social, occupational, or other important areas of functi... |
Schizophren ia Spectrum and Other Psychotic Disorders Sch izophr enia spe ctru m and other psychotic disorders include schizophrenia, other psychotic disorders, and schizotypal (personality) disorder. They are defined by ab normalities in one or more of the following five domains: delusions, hallucinations, disor gan... |
88 Schizophrenia Spectrum and Other Psychotic Disorders (hypnopompic) are considered to be within the range of normal experience. Hallucinations may be a normal part of religious experience in certain cultural contexts. Disorganized Thinking (Speech) Disorganized thinking (formal thought disorder) is typically inferred... |
Schizophrenia Spectrum and Other Psychotic Disorders 89 domain of psychopathology. Then they should consider time-limited conditions. Finally, the diagnosis of a schizophrenia spectrum disorder requires the exclusion of another con dition that may give rise to psychosis. Schizotypal personality disorder is noted withi... |
90 Schizophrenia Spectrum and Other Psychotic Disorders disorder is not a distinct nosological category. Thus, dimensional assessments of depres sion and mania for all psychotic disorders alert clinicians to mood pathology and the need to treat where appropriate. The Section III scale also includes a dimensional asses... |
Delusional Disorder 91 Mixed type: This subtype applies when no one delusional theme predominates. Unspecified type: This subtype applies when the dominant delusional belief cannot be clearly determined or is not described in the specific types (e. g., referential delu sions without a prominent persecutory or grandios... |
92 Schizophrenia Spectrum and Other Psychotic Disorders dividual's belief of being conspired against, cheated, spied on, followed, poisoned, mali ciously maligned, harassed, or obstructed in the pursuit of long-term goals. Small slights may be exaggerated and become the focus of a delusional system. The affected indiv... |
Delusional Disorder 93 schizophrenia. Delusional disorder has a significant familial relationship with both schizophrenia and schizotypal personality disorder. Although it can occur in younger age groups, the condition may be more prevalent in older individuals. Culture-Rela ted Diagno stic Issue s An indiv idual's cul... |
94 Schizophrenia Spectrum and Other Psychotic Disorders Brie f Psycho tic Dis order Dia gnos tic Criteria 298. 8 (F23) A. Presence of one (or more) of the following symptoms. At least one of these must be (1 ), (2), or (3): 1. Delusions. 2. Hallucinations. 3. Disorganized speech (e. g., frequent derailment or incoheren... |
Brief Psychotic Disorder 95 terion B). The disturbance is not better explained by a depressive or bipolar disorder with psychotic features, by schizoaffective disorder, or by schizophrenia and is not attributable to the physiolo gtcal effects of a substance (e. g., a hallucinogen) or another medical condi tion (e. g.,... |
96 Schizophrenia Spectrum and Other Psychotic Disorders Differenti al Diagno sis Other medical conditions. A variety of medical disorders can manifest with psychotic symptoms of short duration. Psychotic disorder due to another medical condition or a de lirium is diagnosed when there is evidence from the history, phys... |
Schizophr eniform Disorder 97 B. An episode of the disorder lasts at least 1 month but less than 6 months. When the diagnosis must be made without waiting for recovery, it should be qualified as "provi-sional. " ' C. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out... |
98 Schizophr enia Spectrum and Other Psychotic Disorders Another distinguishing feature of schizophreniform disorder is the lack of a criterion requiring impaired social and occupational functioning. While such impairments may po tentially be present, they are not necessary for a diagnosis of schizophreniform disorder... |
Schizophrenia 99 nia; brief psychotic disor der; delus ional disorder; other specified or unspecified schizo phrenia spectrum and other psychotic disorder; schizotypal, schizoid, or paranoid personality disorders; autism spectrum diso rder; disorders presenting in childhood with disorganized speech; attention-def icit... |
100 Schizophrenia Spectrum and Other Psychotic Disorders First episode, currently in partial remission: Partial remission is a period of time during which an improvement after a previous episode is maintained and in which the defining criteria of the disorder are only partially fulfilled. First episode, currently in fu... |
Schizophr enia 101 Some signs of the disturbance must persist for a continuous period of at least 6 months (Criterion C). Podromal symptoms often precede the active phase, and residual symp toms may follow it, characterized by mild or subthreshold forms of hallucina tions or delusions. Individuals may express a variet... |
102 Schizophrenia Spectrum and Other Psychotic Disorders and persons with schizophrenia, including evidence from neuroimaging, neuropatholog ical, and neurophysiological studies. Differences are also evident in cellular architecture, white matter connectivity, and gray matter volume in a variety of regions such as the... |
Schizophrenia 103 hyperactivity disorder). These symptoms should not be attributed to schizophrenia with out due consideration of the more common disorders of childhood. Childhood-onset cases tend to resembl'e poor-outcome adult cases, with gradual onset and prominent negative symptom s. Children who later receive the... |
104 Schizophrenia Spectrum and Other Psychotic Disorders Other symptom differences include less frequent negative symptoms and disorganization. Finally, social functioning tends to remain better preserved in females. There are, how ever, frequent exceptions to these general caveats. Suicide Risk Approximately 5%--6% o... |
Schizoaffective Disorder 105 matic event and characteristic symptom features relating to reliving or reacting to the event are required to. make the diagnosis. \ Autism spectrum disorder or communication disorders. These disorders may also have symptoms resembling a psychotic episode but are distinguished by their resp... |
106 Schizophr enia Spectrum and Other Psychotic Disorders Spec ify whether: 295. 70 (F25. 0) Bipolar type: This subtype applies if a manic episode is part of the pre sentation. Major depressive episodes may also occur. 295. 70 (F25. 1) Depressive type: This subtype applies if only major depressive epi sodes are part ... |
Schizoaffective Disorder 107 has to be met. Criteria B (social dysfunction) and F (exclusion of autism spectrum disorder or other commlf1ication disorder of childhood onset) for schizophrenia do not have to be met. In addition to meeting Criterion A for schizophrenia, there is a major mood episode (major depressive or ... |
108 Schizophr enia Spectrum and Other Psychotic Disorders schizoaffective disorder is higher in females than in males, mainly due to an increased in cidence of the depressive type among females. Dev elop ment and Cou rse The typical age at onset of schizoaffective disorder is early adulthood, although onset can occur ... |
Schizoaffective Disorder 109 pared with schizoaffective disorder in African American and Hispanic popula tions, so care must be taen to ensure a culturally appropriate evaluation that includes both psy chotic and affective symptoms. Suicide Risk The lifetime risk of suicide for schizophrenia and schizoaffective disord... |
110 Schizophr enia Spectrum and Other Psychotic Disorders depressive or bipolar disorder with psychotic features. More specifically, schizoaffective disorder can be distinguished from a depressive or bipolar disorder with psychotic features based on the presence of prominent delusions and/ or hallucinations for at leas... |
Substance/Medication-Induced Psychotic Disorder 111 Coding note: The ICD-9-CM and ICD-10-CM codes for the [specific substance/medica tion]-induced psychotic disorders are indicated in the table below. Note that the ICD-10-CM code depends on whether or not there is a comorbid substance use disorder present for the same... |
112 Schizophrenia Spectrum and Other Psychotic Disorder s Recor ding Proced ures ICD-9-CM. The name of the substance/medicat ion-induced psychotic disorder begins with the specific substance (e. g., cocaine, dexamethasone) that is presumed to be causing the delusions or hallucinations. The diagnostic code is selected f... |
Substance/M edication-Induced Psychotic Disorder 113 or substance withdrawal with the accompanying specifier "with perceptual disturbances" (applies to alcohl withdrawal; cannabis intoxicat ion; sedative, hypnotic, or anxiolytic withdrawal; and stimulant intoxication). A substance/medication-induced psychotic disorder ... |
114 Schizophrenia Spectrum and Other Psychotic Disorders Dev elopme nt and Cour se The initiation of the disorder may vary considerably with the substan ce. For example, smoking a high dose of cocaine may produce psychosis within minutes, whereas days or weeks of high-dose alcohol or sedative use may be required to pro... |
Psychotic Disorder Due to Another Medical Condition 115 Primary psychotic disorder. A substan ce/medicat ion-induced psychotic disorder is distinguished from a primary psychotic disorder, such as schizophrenia, schizoaffective ' disorder, delusional disorder, brief psychotic disorder, other specified schizophrenia spec... |
116 Schizophrenia Spectrum and Other Psychotic Disorders severe). (See Clinician-Rated Dimensions of Psychosis Symptom Severity in the chap ter "Assessment Measures. ") Note: Diagnosis of psychotic disorder due to another medical condition can be made without using this severity specifier. Specif iers In addition to t... |
Psychotic Disorder Due to Another Medical Condition 117 been estimated to range from 0. 21% to 0. 54%. When the prevalence findings are stratified by age group, individuals older than 65 years have a significantly greater prevalence of 0. 74% compared with those in younger age group s. Rates of psychosis also vary acco... |
118 Schizophrenia Spectrum and Other Psychotic Disorders Suicide Risk Suicide risk in the context of psychotic disorder due to another medical condition is not clearly delineated, although certain conditions such as epilepsy and multiple sclerosis are associated with increased rates of suicide, which may be further inc... |
Catatonia Associated With Another Mental Disorder (Catatonia Specifier ) 119 Catato nia Catatonia can occur in the context of several disorders, including neurodevelopmental, psychotic, bipolar, depressive disorders, and other medical conditions (e. g., cerebral folate deficiency, rare autoimmune and paraneopla stic di... |
120 Schizophrenia Spectrum and Other Psychotic Disorders psychotic disorder, schizophreniform disorder, schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, or other mental disorder) (e. g., 295. 70 [F25. 1] schizoaffective disorder, depressive type; 293. 89 [F06. 1] catatonia associate... |
Unspecified Catatonia 121 Coding note: Include the name of the medical condition in the name of the mental disor der (e. g., 293. 89 [F06. 1]) catatonic disorder due to hepatic encephal opathy). The other medical condition should be coded and listed separately immediately before the cata tonic disorder due to the med... |
122 Schizophr enia Spectrum and Other Psychotic Disorders Other Specifi ed Schizophr enia Spe ctru m and Other Psychotic Disorder 298. 8 (F28) This category applies to presentations in which symptoms characteristic of a schizophre nia spectrum and other psychotic disorder that cause clinically significant distress or ... |
Bipolar and Related Disorders Bipolar and related disorders are separated from the depressive disorders in DSM-5 and placed between the chapters on schizophrenia spectrum and other psychotic disorders and depressive disorders in recognition of their place as a bridge between the two diagnostic classes in terms of sympt... |
124 Bipolar and Related Disorders Manic Epis ode A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospi talizat... |
Bipolar I Disorder 125 C. The episode is associated with an unequivocal change in functioning that is uncharac teristic of the individual when not symptomatic. D. The disturbance in mood and the change in functioning are observable by others. E. The episode is not severe enough to cause marked impairment in social or ... |
126 Bipolar and Related Disorders sadness, rumination about the loss, insomnia, poor appetite, and weight loss noted in Cri terion A, which may resemble a depressive episode. Although such symptoms may be un derstandable or considered appropriate to the loss, the presence of a major depressive episode in addition to ... |
Bipolar I Disorder Current or most recent episode Bipolar I disorder manic With psychotic 296. 44 features*** (F31. 2) (p. 152) In partial 296. 45 remission (p. 154) (F31. 73) In full remission 296. 46 (p. 154) (F31. 74) Unspecified 296. 40 (F31. 9) Current or most recent episode hypomanic* NA 296. 45 (F31. 73) 296. 46... |
128 Bipolar and Related Disorder s tion among euphoria, dysphoria, and irritability). In children, happiness, silliness and "goofiness" are normal in the context of special occasions; however, if these symptoms are recurrent, inappropriate to the context, and beyond what is expected for the developmen tallevel of the ... |
Bipolar I Disorder 129 neously. Some individuals write excessive letters, e-mails, text messages, and so forth, on many different topics to friends, public figures, or the media. The increased activity criterion can be difficult to ascertain in children; however, when the child takes on many tasks simultaneously, start... |
130 Bipolar and Related Disorders Preva lence The 12-month prevalence estimate in the continental United States was 0. 6% for bipolar I disorder as defined in DSM-IV. Twelve-month prevalence of bipolar I disorder across 11 countries ranged from 0. 0% to 0. 6%. The lifetime male-to-female prevalence ratio is ap proxima... |
Bipolar I Disorder 131 Suicide Risk The lifetime risk of suicide in individuals with bipolar disorder is estimated to be at least 15 times that of the general population. In fact, bipolar disorder may account for one-quar ter of all completed suicides. A past history of suicide attempt and percent days spent de press... |
132 Bipolar and Related Disorder s toms of mania, such as rapid speech, racing thoughts, distractibility, and less need for sleep. The "double counting" of symptoms toward both ADHD and bipolar disorder can be avoided if the clinician clarifies whether the symptom (s) represents a distinct episode. Personality disorder... |
Bipolar II Disorder 133 4. Flight of ideas or subjective experience that thoughts are racing. 5. Distractibility (i. e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed. 6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomo... |
134 Bipolar and Related Disorders Note: Criteria A-C above constitute a major depressive episode. Note: Responses to a significant loss (e. g., bereavement, financial ruin, losses from a nat ural disaster, a serious medical illness or disability) may include the feelings of intense sad ness, rumination about the loss... |
Bipolar II Disorder With rapid cycling (pp. 150-151) With mood-congruent psychotic features (p. 152) With mood-incongr uent psychotic features (p. 152) With catatonia (p. 152). Coding note: Use additional code 293. 89 (F06. 1 ). With peripartum onset (pp. 152-153) 135 With seasonal pattern (pp. 153-154): Applies only t... |
136 Bipolar and Related Disorder s A hypomanic episode should not be confused with the several days of euthymia and re stored energy or activity that may follow remission of a major depressive episode. Despite the substantial differences in duration and severity between a manic and hypomanic episode, bi polar II diso... |
Bipolar II Disorder 137 this pattern is present, it is noted by the specifier "with rapid cycling. " By definition, psy chotic symptom do not occur in hypomanic episodes, and they appear to be less frequent in the major depressive episodes in bipolar II disorder than in those of bipolar I disorder. Switching from a de... |
138 Bipolar and Related Disorders Suicide Risk Suicide risk is high in bipolar II disorder. Approximately one-third of individuals with bi polar II disorder report a lifetime history of suicide attempt. The prevalence rates of life time attempted suicide in bipolar II and bipolar I disorder appear to be similar (32. ... |
Cyclothymic Disorder 139 symptoms of ADHD, such as rapid speech, racing thoughts, distractibility, and less need for sleep, overlap with the symptoms of hypomania. The double counting of symptoms to ward both ADHD and bipolar II disorder can be avoided if the clinician clarifies whether the symptoms represent a distin... |
140 Bipolar and Related Disorders F. The symptoms cause clinically significant distress or impairment in social, occupa tional, or other important areas of functioning. Specify if: With anxious distress (see p. 149) Diagno stic Featu res The essential feature of cyclothymic disorder is a chronic, fluctuating mood dist... |
Cyclothymic Disorder 141 related disorder due to another medical condition and depressive disorder due to another medical conditin (e. g., multiple sclerosis) before the cyclothymic disorder diagnosis is as signed. Among children with cyclothymic disorder, the mean age at onset of symptoms is 6. 5 years of age. Risk a... |
142 Bipolar and Related Disorders Substance /Medication-Induced Bipola r and Rela ted Disorder Dia gnos tic Criteria A. A prominent and persistent disturbance in mood that predominates in the clinical picture and is characterized by elevated, expansiv e, or irritable mood, with or without depressed mood, or markedly di... |
Substance/Medication-Induced Bipolar and Related Disorder 143 ICD-10-CM With use With use disorder, Without disorder, moderate use ICD-9-CM mild or severe disorder Sedative, hypnotic, or anxiolytic 292. 84 F13. 14 F13. 24 F13. 94 Amphetamine (or other 292. 84 F15. 14 F15. 24 F15. 94 stimulant) Cocaine 292. 84 F14. 14 F... |
144 Bipolar and Related Disorders bipolar and related disorder, followed by the specification of onset (i. e., onset during in toxication, onset during withdra wal). For example, in the case of irritable symptoms oc curring during intoxication in a man with a severe cocaine use disorder, the diagnosis is F14. 24 seve... |
Bipolar and Related Disorder Due to Another Medical Condition 145 This condition follows the ingestion or inhalation quickly, usually within hours or, at the most, a few day S. In stimulant-induced manic or hypomanic states, the response is in min utes to 1 hour after one or several ingestions or injections. The episo... |
146 Bipolar and Related Disorders Specify if: (F06. 33) With manic features: Full criteria are not met for a manic or hypomanic ep isode. (F06. 33) With manic-or hypoman ic-like episode: Full criteria are met except Crite rion D for a manic episode or except Criterion F for a hypomanic episode. (F06. 34) With mixed f... |
Bipolar and Related Disorder Due to Another Medical Condition 147 ship. Finally, the condition may remit before or just after the medical condition remits, particularly whn treatment of the manic/hypomanic symptoms is effective. Culture-Rela ted Diagno stic Issues Culture-related differences, to the extent that there i... |
148 Bipolar and Related Disorders Other Spec ified Bipola r and Rela ted Disorder 296. 89 (F31. 89) This category applies to presentations in which symptoms characteristic of a bipolar and related disorder that cause clinically significant distress or impairment in social, occupa tional, or other important areas of fu... |
Unspecified Bipolar and Related Disorder 149 Unspecified Bipola r and Rela ted Disorder ' 296. 80 (F31. 9) This category applies to presentations in which symptoms characteristic of a bipolar and related disorder that cause clinically significant distress or impairment in social, occupa tional, or other important area... |
150 Bipolar and Related Disorders 4. Fatigue or loss of energy. 5. Feelings of worthlessness or excessive or inappropriate guilt (not merely self-reproach or guilt about being sick). 6. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ide ation without a specific plan, or a suicide attempt or a... |
Specifier s for Bipolar and Related Disorders 151 symptom number criteria for a major depressive, manic, or hypomanic episode and must be demarcated by either a period of full remission or a switch to an episode of the opposite polarity. Manic and hypomanic episodes are counted as being on the same pole. Except for the... |
152 Bipolar and Related Disorders C. Criteria are not met for "with melancholic features" or ''with catatonia" during the same episode. Note: "Atypical depression" has historical significance (i. e., atypical in contradis tinction to the more classical agitated, "endogenous" presentations of depression that were the n... |
Specifier s for Bipolar and Related Disorders 153 Peripartum-onset mood episodes can present either with or without psychotic features:, Infanticide is most often associated with postpartum psychotic episodes that are characterized by command hallucinations to kill the infant or delusions that the infant is possessed, ... |
154 Bipolar and Related Disorders are often characterized by prominent energy, hypersomnia, overeating, weight gain, and a craving for carbohydrates. It is unclear whether a seasonal pattern is more likely in recurrent major depressive disorder or in bipolar disor ders. However, within the bipolar disorders group, a se... |
Depressive Disorders Depr ess ive disorder s include disruptive mood dysregulation disorder, major depressive disorder (including major depressive episode), persistent depressive disorder (dysthymia), premenstrual dysphoric disorder, substance/medication-induced depres sive disorder, depressive disorder due to another... |
156 Depressive Disorders Disr uptive Mood Dysregulation Disorder Dia gnos tic Criteria 296. 99 (F34. 8 ) A. Severe recurrent temper outbursts manifested verbally (e. g., verbal rages) and/or be haviorally (e. g., physical aggression toward people or property) that are grossly out of proportion in intensity or duration... |
Disruptive Mood Dysregulation Disorder 157 The clinical presentation of disruptive mood dysregulation disorder must be carefully distinguished from presentations of other, related conditions, particularly pediatric bi polar disorder. In fact, disruptive mood dysregulation disorder was added to DSM-5 to address the con... |
158 Depressive Disorders common, typically manifesting before full criteria for the syndrome are met. Such predi agnostic presentations may have qualified for a diagnosis of oppositional defiant disorder. Many children with disruptive mood dysregulat ion disorder have symptoms that also meet criteria for attention-def... |
Disruptive Mood Dysregulation Disorder 159 many other syndromes, differentiation of disruptive mood dysregulation disorder from bi polar disorder and oppositional defiant disorder requires particularly careful assessment. Bipolar disorders. The central feature differentiating disruptive mood dysregulation disor der a... |
160 Depressive Disorders should receive one of those diagnoses rather than disruptive mood dysregulation disor der. Children with disruptive mood dysregulation disorder may have symptoms that also meet criteria for an anxiety disorder and can receive both diagnoses, but children whose ir ritability is manifest only i... |
Major Depressive Disorder 161 3. Significant weight loss when not dieting or weight gain (e. g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain. ) 4. Insomnia or hypersomnia nearly every day. 5.... |
162 Depressive Disorders Coding and Recording Procedures The diagnostic code for major depressive disorder is based on whether this is a single or recurrent episode, current severity, presence of psychotic features, and remission status. Current severity and psychotic features are only indicated if full criteria are cu... |
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