DSM-5 codes

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This article gives an overview of diagnostic codes from DSM-5, the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.

Chapters[edit]

The DSM-5 lists the following chapters:[1]

  • Neurodevelopmental disorders
  • Schizophrenia spectrum and other psychotic disorders
  • Bipolar and related disorders
  • Depressive disorders
  • Anxiety disorders
  • Obsessive-compulsive and related disorders
  • Trauma- and stressor-related disorders
  • Dissociative disorders
  • Somatic symptom disorders
  • Feeding and eating disorders
  • Elimination disorders
  • Sleep-wake disorders
  • Sexual dysfunctions
  • Gender dysphoria
  • Disruptive, impulse control and conduct disorders
  • Substance use and addictive disorders
  • Neurocognitive disorders
  • Personality disorders
  • Paraphilic disorders
  • Other disorders

Neurodevelopmental disorders[edit]

Neurodevelopmental disorders are disorders with onset in the developmental period, often before starting school, and that are characterized by a range of developmental deficits that impair normal functioning.[2]

Intellectual disabilities[edit]

Deficits in intellectual functioning and every day adaptive functioning with onset during the developmental period.
Specify current severity:
Mild
Moderate
Severe
Profound
  • 315.8 Global developmental delay
Pertains to those under 5 years old whose intellectual functioning can not be systematically assessed.
  • 319 Unspecified intellectual disability (Intellectual developmental disorder)
Used in exceptional circumstances for individuals over 5 years old whose intellectual disability cannot be assessed because of sensory or physical impairments.

there are updated codes for this disorder.

Communication disorders[edit]

Deficits in language, speech, or in any behaviors affecting verbal and nonverbal communications
Persistent deficits in comprehension or production of language (e.g. spoken, written, sign language) substantially below age level, beginning in the early developmental period, and not due to other disorders or conditions
Persistent deficits in speech sound production, below that expected of age and developmental level, not due to other impairments such a physical, neurological or hearing disorders or conditions
  • 315.35 Childhood-onset fluency disorder (stuttering)
Disturbance in normal speech patterns and fluency that interferes with normal achievement
Primary deficits in understanding and following social practices of verbal and nonverbal communication in normal settings that functionally impair the individual; not better explained by other deficits
  • 307.9 Unspecified communication disorder
Clinically significant symptoms of a communication disorder, but fails to meet the full criteria for any of the communication or neurodeveopmental disorders and the clinician does not specify the reason

Autism spectrum disorder[edit]

Persistent communication and social interaction deficits in multiple situations; restricted, repetitive behavior and interests, originally manifested in the early developmental period and causing significant impairment
Specify if:
With or without accompanying intellectual impairment
With or without accompanying language impairment
Associated with a known medical or genetic condition or environmental factor
Associated with another neurodevelopmental, mental, or behavioral disorder
293.89 With catatonia
Specify current severity:
Level 1 Requiring support
Level 2 Requiring substantial support
Level 3 Requiring very substantial support

Attention deficit hyperactivity disorder[edit]

"Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development" beginning in childhood, and present across more than one setting[3]
Specify whether:
  • 314.01 Combined presentation
  • 314.00 Predominantly inattentive presentation
  • 314.01 Predominantly hyperactive/impulsive presentation
Specify if:
In partial remission
Specify current severity:
Mild
Moderate
Severe
  • 314.01 Other specified attention-deficit/Hyperactivity disorder
Symptoms of ADHD are present and cause significant impairment in important functional areas, but do not meet the full criteria, and where the reason for failing the criteria is specified.
  • 314.01 Unspecified attention-deficit/Hyperactivity disorder
Same as 314.01 above but with no reason specified or insufficient information is available to provide one

Specific learning disorder[edit]

  • Specific learning disorder
A neurodevelopmental disorder of biological origin manifested in learning difficulty and problems in acquiring academic skills markedly below age level and manifested in the early school years, lasting for at least 6 months; not attributed to intellectual disabilities, developmental disorders, or neurological or motor disorders
Specify if:
  • 315.00 With impairment in reading
  • 315.2 With impairment in written expression
  • 315.1 With impairment in mathematics
Specify current severity:
Mild
Moderate
Severe

Motor disorders[edit]

Motor skill development substantially below age group, interfere with normal activities, and begin in "early developmental period". Not better accounted for by intellectual disabilities, visual problems, or a neurological condition such as cerebral palsy, or a degenerative disorder.
Repetitive, seemingly purposeless, often rhythmical motor behavior that interferes with normal activities, with onset in the "early developmental period".
Specify if:
With self-injurious behavior
Without self-injurious behavior
Specify if:
Associated with a known medical or genetic condition, neurodevelopmental disorder, or environmental factor
Specify current severity:
Mild
Moderate
Severe

Tic disorders[edit]

Main article: Tic disorders
"A tic is a sudden, rapid, recurrent, nonrhythmic motor movement or vocalization". Tic disorders are not due to use of a substance or to another medical condition; the diagnosis depends on the lack of any known cause.[4]
Multiple motor tics and at least one vocal tic present for more than one year, though not necessarily at the same time, with onset before age 18.
At least one motor or vocal tic, but not both; must be present for more than one year with onset before age 18.
Specify if:
With motor tics only
With vocal tics only
  • 307.21 Provisional tic disorder
One or more motor and/or vocal tics, present for less than one year; onset before age 18.
  • 307.20 Other specified tic disorder
Characteristic tic disorder symptoms causing distress or impairment but not meeting the "criteria for a tic disorder or any specific neurodevelopmental disorder"; the specific reason given e.g. onset over the age of 18
  • 307.20 Unspecified tic disorder[4]
Same as "307.20 Other specified tic disorder", but the reason is not specified

Other neurodevelopmental disorders[edit]

  • 315.8 Other specified neurodevelopmental disorder
A category that pertains to characteristic symptoms of a neurodevelopmental disorder causing significant impairment but does not fulfill the criteria of a specific diagnostic class.
Specify: Specific reason, such as "associated with prenatal alcohol exposure"
  • 315.9 Unspecified neurodevelopmental disorder
A category similar to 315.8, but without a specified reason.

Schizophrenia spectrum and other psychotic disorders[edit]

Key features that define the psychotic disorders in DSM-5 are:[5]

Delusions - fixed beliefs not open to change even when evidence contradicts them; termed bizarre if implausible and not derived from ordinary experience
Hallucinations - involuntary sensory experiences not related to external stimuli
Disorganized thinking (speech) - derailment of focal topic or loose associations, incoherence
Grossly disorganized or abnormal motor behavior (including catatonia)
Negative symptoms - reduced emotional expression, avolition, alogia, anhedonia, asociality
  • 297.1 Delusional disorder - presence of one or more fixed delusions, but otherwise functioning usually is not noticeably impaired.[6]
Specify whether:
Erotomanic type
Grandiose type
Jealous type
Persecutory type
Somatic type
Mixed type
Unspecified type
Specify if:
With bizarre content
Specify if:
First episode, currently in acute episode
First episode, currently in partial remission
First episode, currently in full remission
Multiple episodes, currently in acute episode
Multiple episodes, currently in partial remission
Multiple episodes, currently in full remission
Unspecified
Specify current severity:
Specify if:
With marked stressor(s)
Without marked stressor(s)
With postpartum onset
Specify if:
With catatonia
Specify currenty severity:
Symptoms identical to schizophrenia but lasting less that 6 months
Specify if:
With good prognostic features
Without good prognostic features
Specify if:
With catatonia
Specify current severity:
At least two of the following: (one of which must be delusions, hallucinations or disorganized speech), grossly disorganized or catatonic behavior, negative symptoms
Specify if:
First episode, currently in acute episode
First episode, currently in partial remission
First episode, currently in full remission
Multiple episodes, currently in acute episode
Multiple episodes, currently in partial remission
Multiple episodes, currently in full remission
Unspecified
Specify if:
With catatonia
Specify current severity
Major depressive or manic mood disorder concurrent with primary symptoms of schizophrenia
Specify whether:
Bipolar type
Depressive type
Specify if:
With catatonia
Specify if:
First episode, currently in acute episode
First episode, currently in partial remission
First episode, currently in full remission
Multiple episodes, currently in acute episode
Multiple episodes, currently in partial remission
Multiple episodes, currently in full remission
Continuous
Unspecified
Specify current severity
  • 291.9 Substance/Medication-induced psychotic disorder
Specify name of substance
Alcohol
Cannabis
Phencyclidine
Other hallucinogen
Inhalant
Sedative, hypnotic or anxioltic
Amphetamine (or other stimulant)
Cocaine
Other (or unknown) substance
then specify if:
With onset during intoxication
With onset during withdrawal
Specify current severity (optional)
0 (not present) to 4 (present and severe)
rated by primary symptoms of psychosis in the last 7 days, including delusions, hallucinations, abnormal psychomotor behavior, and negative symptoms.
  • Psychotic disorder due to another medical condition
293.81 With delusion as the predominant symptom
293.82 With hallucinations as the predominant symptom
Marked psychomotor disturbance including decreased motor activity, or excessive and peculiar motor activity, ranging from unresponsiveness to agitation. Can include stupor, catalepsy and waxy flexibility, mutism and other puzzling behaviors. Rather than being a separate diagnosis, catatonia is associated with other mental disorders, other medical conditions, or can be unspecified.

Catatonia associated with another mental disorder (Catatonia specifier)

Specifier is defined by three or more of 12 listed symptoms

Catatonic disorder due to another medical condition

Criteria include three or more of 12 listed symptoms

Unspecified catatonia

Characteristic symptoms of catatonia are present but the underlying disorder is unclear, the full criteria are not met, or the information available is insufficient
Coding note: Code first 781.99 "Other symptoms involving nervous and musculoskeletal systems", followed by 293.89
  • 298.8 Other specified schizophrenia spectrum and other psychotic disorder
Characteristic symptoms of schizophrenia spectrum and other psychotic disorder are present but full criteria for a diagnostic class are not met. The other specified is used to describe the presentation.
  • 298.9 Unspecified schizophrenia spectrum and other psychotic disorder
Characteristic symptoms of schizophrenia spectrum and other psychotic disorder are present but full criteria for a diagnostic class are not met, but the clinician does not specify the reason.

Bipolar and related disorders[edit]

Depressive disorders[edit]

Anxiety disorders[edit]

Obsessive-compulsive and related disorders[edit]

Trauma- and stressor-related disorders[edit]

A new category has been created for those disorders that explicitly list in their criteria exposure to a traumatic or catastrophic event, emphasizing the close connection between disorders listed in this category and those in the categories of anxiety disorders, obsessive-compulsive disorders, and dissociative disorders. However, in this category's disorders the dominating characteristics are symptoms of anhedonia and dysphoria, anger and aggression, or symptoms of dissociation, or some combination of these, and vary considerably with heterogeneous presentations.[7]

A disorder of infancy or early childhood in which the child, though thought to be capable of forming selective attachments, does not seek comfort, protection or other nurturance associated with attachment to caregiving adults, and does not respond adequately to nurturing behaviors from caregivers when it is offered.
Specify if:
Persistent (more than 12 months)
Specify current severity:
A behavioral pattern in children of overly familiar and culturally inappropriate interations with relative strangers that violated social boundaries.
Specify if:
Persistent (over 12 months)
Specify current severity:
There is a separate section for Posttraumatic stress disorder for children 6 years and younger
Specify whether:
With dissociative symptoms
  1. Depersonalization
  2. Derealization
Specify if:
With delayed expression (full criteria not expressed at least 6 months after traumatic event)
Specify whether:
309.0 With depressed mood
309.24 With anxiety
309.28 With mixed anxiety and depressed mood
309.3 With disturbance of conduct
309.4 With mixed disturbance of emotions and conduct
309.9 Unspecified
  • 309.89 Other specified Trauma- and stressor-related disorder
  • 309.9 Unspecified trauma- and stressor-related disorder[7]

Dissociative disorders in DSM-5.[edit]

Common to these disorders are disruptions or gaps in the normal integration of subjective experience resulting in discontinuities in affect, identity, memory, behavior, and motor control.[9][10]
The primary feature is the presence of two or more distinct personality states, self-reported or observed by others, resulting in failure to recall everyday events and/or important autobiographical information, and impairing continuity in the sense of self. The "experience of possession" is included as a cultural description of a fragmented identity.
The primary feature is the inability to remember important life history information, usually traumatic, that has been successfully stored but is inaccessible to the individual, causing significant distress or impairment in life functioning.
Specify if:
300.13 With dissociative fugue: Travel or wandering associated with amnesia for identity or important autobiographical information
The primary feature is recurrent episodes of depersonalization and/or derealization that have functional consequences.
Symptoms of a dissociative disorder are present but do not meet the full criteria for a specific disorder. The clinician specifies the reason.
As 300.15 above, but the clinician does not specify the reason

Somatic symptom disorders[edit]

Elimination disorders[edit]

  • The elimination disorders, included in the chapter on early diagnosis in DSM-IV, is an independent class in DSM-5.
  • 307.6 Enuresis
Specify if:
Nocturnal only
Diurnal only
Nocturnal and diurnal
  • 307.7 Encopresis
Specify if:
With constipation and overflow incontinence
Without constipation and overflow incontinence
  • Other specified elimination disorder[11]

Gender dysphoria in DSM-5[12][edit]

  • 302.6 Gender dysphoria in children
Specify if:
With a disorder of sex development (e.g. such as congenital adrenogenital disorder)
  • 302.85 Gender dysphoria in adolescents and adults
Specify if:
With a disorder of sex development (e.g. congenital medial conditions such as congenital adrenogenital disorder)
Posttransitional (the specifics of the person's degree of transition, medical procedures undergone or planned etc. to attain the desired gender)[13]
Comment on subtypes and specifiers
The sexual orientation subtyping has been removed as unrelated to gender dysphoria and therefore not useful clinically.
The posttransition specifier has been added because after gender transition, although many people no longer meet criteria for gender dysphoria they still remain in need of treatments to improve life in the desired gender and this specifier recognizes that need.[14]

Disruptive, impulse-control, and conduct disorders in DSM-5[edit]

DSM-5 has a new chapter on disruptive, impulse-control, and conduct disorders to bring under one unique category those behavioral conditions that violate the rights of others and/or cause significant conflict with society or draw the attention of authority figures.[15] This DSM-5 category contains the following:[15]

Frequent, persistent pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness exhibited over the course of at least six months, and with at least one non-sibling, and should exceed normal behavior for the individual's age, gender and culture.

Specify current severity:
Mild - symptoms occur in one setting only, such as home or school or work
Moderate - some symptoms present in at least two settings
Severe - some symptoms present in three or more settings
Rapid onset of recurrent impulsive, verbally or physically aggressive outbursts typically lasting less than 30 minutes, usually in response to minimal provocation by an intimate or associate, and causing marked impairment in functioning or legal consequences.
Repetitive pattern of behavior that violates the basic rights of others, falling in to four categories:
Aggressive behavior causing or threatening harm to people or animals
Non-aggressive behavior causing property damage or loss
Deceitfulness or theft
Serious violations of rules, such as running away from home
Specify whether:
312.81 Childhood-onset type - before age 10
312.82 Adolescent-onset type - no symptoms before age 10
312.89 Unspecified onset - not enough information available
Specify if:
With limited prosocial emotions:
Lack of remorse or guilt
Callous - lack of empathy
Unconcerned about performance
Shallow or deficient affect
Specify current severity:
Mild - causes relatively minor harm to others, such as lying, staying out late, etc.
Moderate - intermediate harm such as stealing without confrontation, vandalism
Severe - cause considerable harm to others (e.g. forced sex, physical cruelty, use of a weapon, breaking and entering, stealing while confronting victim)
Coded here as well as in "Personality disorders" because of this disorder's close connected with the "externalizing" conduct disorders in this chapter.[15]
  • 312.89 Other specified disruptive, impulse-control, and conduct disorder
  • 312.9 Unspecified disruptive, impulse-control, and conduct disorder[15]

Substance-Related and Addictive Disorders[edit]

Substance-Related Disorders[edit]

  • Alcohol-Related Disorders
Alcohol Use Disorders
Specify current severity:
305.00 Mild
303.90 Moderate
303.90 Severe
303.00 Alcohol Intoxication
With use disorder, mild
With use disorder, moderate or severe
Without use disorder
291.81 Alcohol Withdrawal
Without perceptual disturbances
With perceptual disturbances
291.81Other Alcohol-Induced Disorders
291.9 Unspecified Alcohol-Related Disorder
  • Caffeine-Related Disorders
305.90 Caffeine Intoxication
292.0 Caffeine Withdrawal
292.0 Other Caffeine-Induced Disorders
292.9 Unspecified Caffeine-Related Disorder
  • Cannabis-Related Disorders
Cannabis Use Disorder
Specify current severity:
305.20 Mild
304.30 Moderate
304.30 Severe
  • Non-Substance-Related Disorders
  • 312.31 Gambling Disorder
Specify if
Episodic, Persistent
Specify current severity
Mild
Moderate
Severe

Personality disorders[edit]

Criteria for a general personality disorder are provided with an emphasis on personality traits and the relationship of the specific personality disorder criteria to other mental disorders in which those behaviors also occur.

The multiaxial system has been dropped in favor of a system evaluating psychosocial and contextual factors, although the category classification remains. Under consideration is a new trait-specific diagnostic method that views personality traits on a continuum. The relationship of personality traits to general personality dysfunction is under active investigation in another section of DSM-5, entitled "Alternative DSM-5 Model for Personality Disorders".[16]

Paraphilic disorders in DSM-5[edit]

Eight disorders were chosen for listing in DSM-5 because of their frequency and because some of them are listed are criminal offenses due to their potential for public harm. It is recognized that many more paraphilias than those listed have been identified and described, and could be considered as paraphilic disorders because of their negative impact on the individual and others. The eight paraphilic disorders described in DSM-5 are the following:[17]

Specify if:
With fetishism
With autogynephilia
Specify if:
In a controlled environment
In full remission
  • 302.89 Other specified paraphilic disorder
  • 302.9 Unspecified paraphilic disorder

References[edit]

  1. ^ "The Organization of DSM-5". American Psychiatric Association. Retrieved 28 November 2013. 
  2. ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 31–86. ISBN 978-0-89042-555-8. 
  3. ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. p. 61. ISBN 978-0-89042-555-8. 
  4. ^ a b American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 81–85. ISBN 978-0-89042-555-8. 
  5. ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 87–122. ISBN 978-0-89042-555-8. 
  6. ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 90–93. ISBN 978-0-89042-555-8. 
  7. ^ a b American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 265–290. ISBN 978-0-89042-555-8. 
  8. ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 271–280. ISBN 978-0-89042-555-8. 
  9. ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 291–307. ISBN 978-0-89042-555-8. 
  10. ^ Black, Donald (2014). DSM-5 guidebook : the essential companion to the Diagnostic and statistical manual of mental disorders, fifth edition. Washington, DC: American Psychiatric Publishing. pp. 191–200. ISBN 1585624659. 
  11. ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 355–366. ISBN 978-0-89042-555-8. 
  12. ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 451–459. ISBN 978-0-89042-555-8. 
  13. ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth edition ed.). Arlington, VA: American Psychiatric Publishing. pp. 451–459. ISBN 978-0-89042-555-8. 
  14. ^ "Highlights of changes from DSM-IV-TR to DSM-5" (PDF). American Psychiatric Association. 2013. Retrieved on June 8, 2013.
  15. ^ a b c d American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 461–480. ISBN 978-0-89042-555-8. 
  16. ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 645–684, 761–781. ISBN 978-0-89042-555-8. 
  17. ^ American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing. pp. 685–705. ISBN 978-0-89042-555-8.