DSM-5 Neurodevelopmental Childhood-Onset Fluency ADHD Specific Learning Disorder Tourette’s Disorder

DSM-5
Disorder (Stuttering) • Inattention and/or hyperactivity- • Difficulties learning, with ≥1 of the • Both motor and vocal tics
Intellectual Disability
• Disturbances in normal fluency/time impulsivity that interferes with function, following difficulties for at least 6 (although no necessarily
• >1 Intellectual and adaptive functioning patterning of speech inappropriate for characterized by 1) and/or 2): months (despite provision of concurrent)
deficits in conceptual, social, and practical age and language skills, persists, onset in o 1) Inattention, ≥6 (for adults ≥ 5) of the interventions to target) • Onset before 18 years, tics
domains: following 3 must be met: early developmental, needs ≥1: following for ≥6 months, not solely o Inaccurate/slow reading wax/wane in freq, but ≥1 since tic
o Deficits in intellectual functions o Sound and syllable repetitions manifestation of oppositional behavior, o Understanding meaning of what is onset, not due to
confirmed by clinical assessment and defiance read substance/medical condition
o Sound prolongations of consonants
standardized intelligence tests ▪ Fails to give close attention to details o Spelling
o Deficits in adaptive functioning leading
o Broken words Persistent (Chronic) Motor
o Audible or silent blocking ▪ Difficulty sustaining attention o Written expression
to failure to meet developmental ▪ Doesn’t seem to listen when spoken to o Mastering number sense or or Vocal Tic Disorder
standards for independence and social o Circumlocutions
▪ Doesn’t follow instructions calculation • Motor OR vocal, but not both, for
responsibility o Words produced
o Monosyllabic whole-word repetitions ▪ Difficulty organizing o Mathematical reasoning ≥1 year since onset, onset before
o Onset during developmental period • The affected skills are quantifiably
• Anxiety about speaking ▪ Avoids tasks that require sustained 18 years, not due to
• Specifiers:
mental effort below expected for chronological substance/medical
o Mild, moderate, severe, profound Social (Pragmatic) age •
▪ Loses things Specifiers: with motor tics only OR
Global Developmental Delay Communication Disorder ▪ Easily distracted • Begin during school age years with vocal tics only
• Individuals ≤5 years when fails to meet • Difficulties in social use of verbal / non- ▪ Forgetful • Specify: with impairment in reading, Provisional Tic Disorder
o 2) Hyperactivity and impulsivity, ≥6 (for written expression, OR mathematics
developmental milestones in several verbal communication, onset in early
areas, and unable to undergo assessment developmental period, difficulties in: adults ≥5) for ≥6 months • Specify severity: mild (1-2 domains, • Single or multiple motor and/or
▪ Fidgets can compensate with services), tics, starting before age 18, present
of intellectual functioning (including kids o Communication for social purposes for <=1 year
too young to participate). Note: This o Changing communication to match ▪ Leaves seat when seated is expected moderate (1-2 domains, marked
category requires re-assessment context ▪ Runs/climbs when inappropriate difficulties), severe (sever Other Specified Tic
Unspecified Intellectual o following rules for conversation ▪ Unable to play quietly
difficulties in several domains) TIC
Disorder
o understand what isn’t explicitly stated ▪ “On the go” or “driven by a motor” Developmental Transient
Disability • Symptoms characteristic of tic
• Not attributable to medical/neuro ▪ Talks excessively Coordination Disorder Irresistible
disorder, cause significant distress,
• Individuals ≥5 years when assessment by condition, or low abilities in language ▪ Blurts answers before question Contraction
but don’t meet full criteria, and
means of locally available procedures is domains, or autism/ intellectual disability completed
• Motor skill execution is below
expected chronological age, you want to communicate the
difficult due to sensory/physical Autism Spectrum Disorder ▪ Difficulty waiting turn reason
impairments. Reserved for exceptional
▪ Interrupts/intrudes others
manifested as clumsiness and TouretteSyndrome
circumstances and requires re- • Deficits in social communication and inaccuracy Unspecified Tic Disorder
assessment after a period of time. social interaction across multiple • Several inattentive / hyperactive-impulsive • Significantly interferes with Twonette
symptoms present prior to age 12, in ≥2 • Symptoms characteristic of tic
Language Disorder contexts, present in early developmental
period, causing impairment in function, settings, interfering with function
activities of daily living, onset
during early development
Two forms
disorder, of ticsdistress,
cause significant
butMotor
don’t meet full criteria, and
• Persistent difficulties in acquisition/use demonstrated by deficits in: • Not exclusively during course of psychotic • Not better explained by intellectual vocal
you don’t want to communicate
of language, onset during developmental o Social-emotional reciprocity disorder, or another mental disorder disability, visual impairment, or a the reason
period, includes following: o Nonverbal communicative behaviors • Specifiers: neuro disorder
o Reduced vocab Other Specified
o Developing / maintaining relationships o Predominantly inattentive, Stereotypic Movement
o Limited sentence structure • predominantly hyperactive/impulsive, Neurodevelopmental
o Impairments in discourse
Restricted, repetitive patterns of
or combined Disorder
behavior, interests, activities, at least ≥2: Disorder
• Deficits quantifiably below expected for o Stereotyped or repetitive motor o In partial remission (fewer than full • Repetitive purposeless motor
age resulting in functional limitations movements, use of objects, or speech criteria met for past 6 months, still behavior • Symptoms characteristic of
causing dysfunction) neurodevelopmental disorder,
• Not attributable to sensory impairment, o Insistence on sameness • Behavior interferes with social,
motor dysfunction, medical/neuro o Restricted interests o Severity: mild (few symptoms, minor cause significant distress, but don’t
academic, or activities and may
impairment), moderate, severe (many meet full criteria, and you want to
conditions, and not better explained by o Hyper/hypo-reactivity to sensory input result in injury
intellectual disability or global symptoms, marked impairment) communicate the reason
• Specifiers: • Onset is early developmental period,
developmental delay o severity Other Specified ADHD not due to effects of substance or
Unspecified
Speech Sound Disorder
as o with / without accompanying ASD
• Symptoms characteristic of ADHD, cause neuro condition Neurodevelopmental
• Persistent difficulty with speech sound
intellectual impairment significant distress, but don’t meet full • Specifiers: Disorder
production that interferes with speech
o with / without accompanying language
impairment
A
criteria,Aloneness
reason
and you want to communicate the o With or without self-injurious
behavior • Symptoms characteristic of
intelligence or prevents communication,
onset during early developmental period
o assoc with a known medical or genetic
condition
5 Sameness
Unspecified ADHD o Associated with a known
condition
neurodevelopmental disorder,
cause significant distress, but don’t
• Interferes with social participation or
D
o assoc with another meet full criteria, and you don’t
performance neurodevelopmental, mental, or
• SymptomsDevelopmental
characteristic of ADHD, cause o Severity: mild (suppressible),
want to communicate the reason
significant distress, but don’t meet full moderate (requires behavior
• Not attributable to congenital/acquired behavioral disorder criteria, and you don’t want to modification), severe (continued
conditions o with catatonia communicate the reason monitoring required)
Brief Psychotic Disorder Schizoaffective Delusional Disorder
• >1 day, <1 month, with eventual full return to function • Major mood episode concurrent with Criterion A of schizophrenia • 1 month
DSM-5 Psychotic
• [Criterion A]: Presence of 1 of the following symptoms, at least • Delusions or hallucinations for ≥2 weeks in absence of major mood • Delusions but person doesn't meet Criterion A for
one must be bold episode schizophrenia Disorders
o delusions • Symptoms of major mood episode for majority of active/residual o hallucinations if present are not prominent and
o hallucinations illness related to delusional theme
o disorganized speech • Catatonia
• Specifiers: apart from impact of delusions, functioning is not
o grossly disorganized or catatonia behavior o bipolar type OR depressive type markedly impaired and behavior isn't bizarre Specifier
• Specifiers: o with catatonia • Specifiers
• 3 or more of the
o with marked stressor o first episode OR multiple episodes o erotomaniac following
o without marked stressor o currently in acute episode OR partial remission OR full remission ▪ theme of someone loving them symptoms
o with postpartum onset o Continuous o grandiose o stupor
o with catatonia o Unspecified o jealous o catalepsy
Schizophreniform o persecutory o waxy
o somatic flexibility
• >1 month, <6 months Psychotic Disorder Due to Another Medical o mixed o mutism
• Presence of at least 2 of the following symptoms (during a 1- Condition o unspecified o negativism
month period), at least one must be bold
• Delusions or hallucinations • More Specifiers: o posturing
o delusions o with bizarre content o mannerism
o hallucinations o developed due to another medical condition
• Not exclusively during delirium ▪ if implausible o stereotypy
o disorganized speech o first episode, in acute episode o agitation
o grossly disorganized or catatonia behavior • Specifiers: o first episode, partial remission o grimacing
• Specifiers: o with delusions o first episode, full remission o echolalia
o with good prognostic features o with hallucinations o multiple episodes, in acute / partial remission/ full o echopraxia
o 2 of the following features Substance/Medication Induced Psychotic Disorder remission • Coding: specify
▪ onset of prominent psychotic symptoms within 4 weeks of • Note: if met prior to onset of schizophrenia, add the associated
behavior change • Delusions or hallucinations "premorbid" mental disorder
▪ confusion or perplexity o developed after substance intoxication or withdrawal or
medication that can produce these symptoms Schizotypal (Personality) Disorder
▪ good premorbid social and occupational functioning
• Not exclusively during delirium
Catatonia
▪ absence of blunted or flat affect • A pervasive pattern of social and interpersonal
o without good prognostic features • Specifiers: deficits marked by acute discomfort with reduced Disorder Due
o with catatonia o with onset during intoxication capacity for close relationships and to Another
Schizophrenia o with onset during withdrawal cognitive/perceptual distortions and eccentricities of
behavior beginning early and in multiple contexts medical
Other Specified Schizophrenia Spectrum and requiring at least 5:
• 1 month of Criteria A symptoms, continuous signs for at least 6 Condition
months. o ideas of reference (excluding delusions of
2 Other Psychotic Disorder reference)
•
o delusions
o hallucinations
LmfTINetwork
Criterion A: 2 of the following, at least one must be bold
• Symptoms of schizophrenia spectrum that causes
distress/impairment, but doesn't meet full criteria
o odd beliefs or magical thinking inconsistent with
subcultural norms
• Catatonia, due
to a medical
condition
o unusual perceptual experiences
o disorganized speech • use when physician wants to communicate the reason criteria isn't
o odd thinking and speech • Coding:
o grossly disorganized or catatonia behavior met o add the
o suspiciousness or paranoid ideation
o negative symptoms • Specifiers: o inappropriate or constricted affected medical
• Specifiers: o persistent auditory hallucinations o behavior/appearance that is odd, eccentric, or condition
o first episode, acute episode / partial remission / full remission o delusions with significant overlapping and mood episodes peculiar
o multiple episodes, acute episode / partial remission / full o attenuated psychosis syndrome o lack of close friends other than first degree Unspecified
remission o delusional symptoms n partner of individual with delusional relatives
o continuous disorder o excessive social anxiety that does not diminish with
Catatonia
o unspecified familiarity and tends to be associated with
o with catatonia paranoid fear rather than negative judgement
• symptoms
Unspecified Schizophrenia Spectrum and Other about self
characteristic of
o than negative judgement about self
• Not exclusively during course of psychotic disorder
Psychotic Disorder • Not exclusively during course of psychotic disorder
catatonia but
doesn't meet full
• Note: if met prior to onset of schizophrenia, add "premorbid" • Symptoms of schizophrenia spectrum that causes • Note: if met prior to onset of schizophrenia, add criteria
distress/impairment, but doesn't meet full criteria "premorbid"
• use when physician doesn't want to communicate the reason
criteria isn't met
Bipolar Hypomanic Episode Major Depressive Disorder / Episode Disruptive Mood
• 1 manic episode (often preceded or followed • Elevated, expansive, or irritable • 5 of 9 SIGECAPS for 2 weeks (bereavement Dysregulation Disorder
by hypomania and depressive episodes mood ≥4 days exclusion removed) DSM-5 Mood Disorders
• Expansive, or irritable mood AND increase • 3 (or 4 if irritable) of DIGFAST o at least one is 1) depressed mood or 2) loss • Severe recurrent temper outbursts
goal-directed activity of pleasure (verbal/behavior) out of proportion to
• Disturbance in mood/function is situation Coding Bipolar &
o either >1 week OR requiring hospitalization observable by others, is ▪ Depressed mood (in kids: irritable)
• 3 symptoms of DIGFAST (or 4 if mood is only uncharacteristic, but not severe ▪ sleep • Inconsistent with developmental level Depression
irritable) enough to cause marked ▪ interest • 3 or more times/week
• Coding
o Distractible impairment ▪ guilt • Mood between outbursts is irritable or o By symptoms: Mild (2) vs
o Indiscretion o if psychosis or requires ▪ energy angry moderate (3), moderate
o Grandiose hospitalization, it's ▪ concentration • Present ≥12 months, never ≥3 months severe (4 or 5) vs severe (5
o Flight of ideas automatically mania without without with motor agitation)
good prognostic features
▪ appetite
o Activities ▪ psychomotor activity • In at least 2 settings o with psychotic features
o Sleep deficit • More Specifiers:
▪ suicidal ideation • Can’t be made before 6 or after 18 years o in partial remission vs in full
o Talkative o with catatonia old, but onset of criteria before 10 years remission
• Specifiers: See Right Column
• Manic episode that emerges during Cyclothymic Disorder • Can’t have >1 day meeting full
o unspecified
Depressive Disorder Due to Another
antidepressant treatment but persists beyond hypomania/mania criteria, and don’t • Specifiers:
the physiological effect is bipolar 1 • 2 years (1 year if <18), hypomanic Medical Condition occur exclusively during MDD or better o ex: bipolar 1 disorder, type
• Specifiers: See Right Column and depressive symptoms that explained by another disorder (can’t co- of current or most recent
never meet criteria for hypomania • Depressed mood or anhedonia secondary to exist with ODD, IED, or bipolar) episode,
or major depression another medical condition severity/psychotic/remissio
Bipolar 2
o symptoms half the time, and • Not better explained by another disorder n specifier and then:
• Hypomanic episode AND a major depressive never 2 months without o F.e.: adjustment disorder with depressed Premenstrual Dysphoric ▪ with anxious distress
episode symptoms ▪ with mixed features
mood, in which the stressor is a medical Disorder
• No manic episode • Specifiers: condition ▪ full criteria for manic or
• Specifiers:
o with anxious distress • Not exclusively during delirium • In most periods, ≥5 symptoms during hypomanic and 3
o current or most recent episode: hypomanic, Bipolar and Related Disorder • Specifiers: last week before starting period, start to symptoms of depression
depressed Due to Another Medical o With depressive features (full criteria not improve a few days after starting period, ▪ with rapid cycling (bipolar
Condition and become minimal week after menses only)
• More specifiers: met)
o with anxious distress o With major depressive like episode (full • ≥1 symptom ▪ ≥4 episodes in 1 year
o with mixed features • Bipolar criteria that's the criteria met) o Lability (either switch of polarity
consequence of another medical o With mixed features o Irritability or partial remission of at
o with rapid cycling least 2 months)
disorder Other Specified Depressive Disorder o Depressed
o with mood congruent psychotic features ▪ with melancholic features
o with mood incongruent psychotic • not exclusively during delirium o Anxiety
features • Coding • Depressive symptoms, clinical impairment, • ≥1 also present to total five including
▪ loss of pleasure OR lack
don’t meet criteria for another disorder, and of reactivity to
o with catatonia • Specify the medical condition above
pleasurable stimuli
o with peripartum onset Note: if met prior to onset of you want to communicate the reason o Interest, concentration, energy,
o with seasonal pattern schizophrenia, add "premorbid" Unspecified Depressive Disorder appetite, sleep, overwhelmed, physical ▪ 3 or more of
▪ applies only to the depressive episodes symptoms ▪ despair or morose or
• Depressive symptoms, clinical impairment, empty mood
• More Specifiers: Unspecified Bipolar and Substance / Medication-Induced
don’t meet criteria for another disorder, and ▪ worse in morning
o in partial remission vs in full remission Related Disorder you don’t want to communicate the reason Depressive Disorder ▪ early morning
• More Specifiers Persistent Depressive Disorder awakening (at least 2
o mild vs moderate vs severe • symptoms characteristic of • Depressed mood or anhedonia soon hours)
Substance/Medication Induced bipolar, causes (Dysthymia) after substance intoxication or ▪ psychomotor agitation
distress/impairment, but don't withdrawal or retardation
Bipolar and Related Disorder meet full criteria, and don't want • Depressed mood more days than not for ≥2 • Involved substance must be capable of
years (in kids can be irritable mood), requiring
▪ anorexia
• bipolar criteria developed during/after to specify the reason producing depression ▪ guilt
≥2 of the following, never >2 months without
intoxication/withdrawal of Other Specified Bipolar • Not exclusively during delirium ▪ with atypical features
o Appetite
substance/medication that produces
and Related o Insomnia • Specifiers: ▪ with mood congruent
symptoms (not exclusively during delirium) o Alcohol, phencyclidine, other psychotic features
o Energy
• Coding:
• symptoms characteristic of o Self-esteem hallucinogen, inhalant, opioid, ▪ with mood incongruent
o alcohol, PCP, hallucinogen, sedative, sedative/hypnotic/anxiolytic, psychotic features
bipolar, causes o Concentration amphetamine, cocaine, other
amphetamine, cocaine, other ▪ with catatonia
distress/impairment, but don't o Hopelessness o with onset during intoxication
• Specifiers: meet full criteria, and you want to • Clinically significant distress or impairment in ▪ with peripartum onset
o with onset during intoxication vs with onset specify the reason o with onset during withdrawal
function ▪ with seasonal pattern
during withdrawal
 DSM-5 Anxiety
Separation Anxiety
Disorder
DSM-5 Trauma & Stressor PTSD
7mmain Acute Stress Disorder
• Symptoms after trauma, persisting 3 days to 1
• Disturbance is ≥1 1 month
• 4 weeks in kids, 6 months in adults month
Generalized Anxiety Disinhibited Social • Criterion A: Exposure to actual or
• developmentally inappropriate threatened death, injury, or sex • Criterion A of PTSD
Disorder anxiety concerning separation Engagement Disorder violence in ≥1 of the following ways: • Presence of ≥9 symptoms
• 6 months of symptoms more days evidenced by 3 symptoms o Directly experiencing o Intrusion Symptoms
• child interacts with unfamiliar adults
than not Selective Mutism in ≥2 of the following
o Witnessing ▪ Recurrent intrusive distressing memories (in
o Learning a violent or accidental kids repetitive play)
• anxiety/worry about a number of • 1 month (not the first month of
o reduced reticence interacts with
event occurred to a close family ▪ Recurrent distressing dreams
events unfamiliar adults
school) member/friend ▪ Dissociative reactions (flashbacks)
• 3 of 6 symptoms of SITCOM (for o overly familiar verbal/physical
• failure to speak in specific social behavior
o Repeated exposure to aversive ▪ Intense psychological distress with
kids only 1) situations where there is an details of traumatic events
o diminished checking back with physiological responses to cues of event
o Sleep expectation, not the result of lack of • Presence of ≥1 of the following:
adult caregiver o Negative Mood
o Irritable knowledge or issues with language o Recurrent, involuntary/intrusive
o Tired o willingness to go off with unfamiliar ▪ Inability to experience positive emotions
o Concentrating
Specific Phobia adult without hesitation memories (in kids repetitive play) o Dissociative
• not limited to impulsivity (as in
o Recurrent dreams ▪ Altered sense of reality
o On edge • 6 months o Dissociative reactions
o Muscle Tension ADHD) ▪ Inability to remember aspects of event
• Anxiety/fear about a specific • extremes of insufficient care as
o Intense/prolonged distress at o Avoidance
Anxiety Disorder Due to object/situation exposure to cues that symbolize or
evidenced by 1 of the following:
resemble the event ▪ Efforts to avoid distressing memories,
Another Medical o immediate fear, actively avoided o Social neglect and lack of basic thoughts, or feelings about event
• Specifiers: o Physiological reactions to cues
Condition emotional needs, repeated changes o Arousal
o Animal of primary caregivers, rearing in • Persistent avoidance of stimuli
▪ Sleep disturbance
• Panic attacks or anxiety due to a o Natural environment unusual settings associated evidenced by: avoidance of
associations with the trauma AND/OR ▪ Irritable behavior and angry outbursts
medical issue o Blood Injection • Developmental age of at least 9 ▪ Hypervigilance
avoidance to avoid external reminds
• Not only during delirium o Situational months
that arouse memories ▪ Problems with Concentration
• Coding: include the name of the o Other • Specify: Persistent (if >1 year) and/or
• Negative alterations in cognition and ▪ Exaggerated startle response
medical condition Social Anxiety Disorder Severe (all symptoms at high levels)
mood as evidenced by 2 of the Adjustment Disorder
Other Specified Anxiety • 6 months Reactive Attachment following:
Disorder • Anxiety/fear in social situations Disorder o Can’t remember important aspects • Emotional/behavioral symptoms within 3
of event months of onset of identifiable stressor, and once
with possible scrutiny
• Significant, has anxiety, doesn't o fear of being negatively evaluated • Inhibited, emotionally withdrawn o Persistent negative beliefs about stressor stops symptoms don’t persistent >6 mo
meet criteria and you choose to
o for kids, can't be with adults
behavior toward adult caregivers oneself, others, or the world • Distress out of proportion to severity of stressor
communicate the reason it doesn't including both: child rarely seeks o Persistent distorted cognitions OR significant impairment in function
meet criteria, f.e.: Other Specified • Specifiers: comfort AND doesn’t respond to about event leading individual to
o Performance Only • Doesn’t meet criteria for another mental
Anxiety Disorder, generalized comfort when distressed blame themselves disorder, and doesn’t represent normal
anxiety not occurring more days • Persistent social/emotional o Persistent negative emotional state bereavement
than not Panic Disorder
FI
disturbance including at least 2 of the o Decreased interest in activities • Specifiers:
Unspecified Anxiety Disorder Eiiwieeanniees following o Feelings of detachment from others
• 1 month of concern o With depressed mood
o Minimal social/emotional o Inability to experience positive o With anxiety
• Significant, has anxiety, doesn't • Recurrent unexpected panic attacks responsiveness, limited positive emotions
meet criteria and you choose not with 4 symptoms affect, or episodes of unexplained o With mixed anxiety and depressed mood
to specify the reason • Alterations in arousal (2 of the o With disturbance of conduct
irritability/sadness/fearfulness following)
o includes when there's not even during non-threatening o With mixed disturbance of emotions and
enough info to make a more Panic Attack Specifier o Anger outbursts with aggression conduct
interactions with caregivers
specific diagnosis towards people or objects o Unspecified
• Same as panic attacks but it occurs • Pattern of extremes of insufficient o Self-destructive reckless behavior
Substance/Medication in context of another mental care evidence by one of the following: Unspecified Trauma and Stressor-
o Hypervigilance
Induced Anxiety Disorder disorder o Social neglect and lack of basic o Exaggerated startle response Related Disorder
Agoraphobia emotional needs, repeated changes o Difficulty concentrating
• Panic attacks or anxiety that occur of primary caregivers, rearing in o Trauma / Stressor disorder causing significant
soon after intoxication or unusual settings
o Sleep disturbance distress and you don’t want to communicate
withdrawal
• 6 months • Specify whether: with dissociative the reason
• fear/anxiety about 2 or more public • Not autism
• Not only during delirium symptoms Other Specified Trauma and
situations • Evidence before 5 years old, o depersonalization
• Specifiers: o fear is that escape is difficult developmental age of at least 9 Stressor-Related Disorder
o With onset during intoxication o derealization
o place is avoided months
o With onset during withdrawal • Specify if: with delayed expression (if o Trauma / Stressor disorder causing significant
• You can have agoraphobia and panic • Specify: Persistent (if >1 year) and/or ≥6 months after event) distress and you want to communicate the
o With onset after medication use disorder if criteria fits Severe (all symptoms at high levels) reason
 Body Dysmorphic Disorder
1.Preoccupation with perceived aws or defects: A person is
Hoarding Disorder
intensely focused on a small or imagined aw in their appearance, 1.Persistent dif culty discarding or parting with
which others may not notice or may see as minor. possessions, regardless of their actual value.
2.Repetitive behaviors or mental acts: The individual frequently 2.Strong urges or distress when trying to discard
engages in behaviors like checking mirrors, grooming, skin picking, or items, leading to the accumulation of items.
seeking reassurance to try to x or hide the perceived aw. 3.The hoarding leads to clutter that makes it
3.Signi cant distress or impairment: The preoccupation with dif cult to use living spaces properly (e.g., no
appearance causes signi cant distress or interferes with daily life, such room to eat, sleep, or move around comfortably).
as work, social activities, or relationships.
4.The hoarding causes signi cant distress or
4.Not explained by other conditions: The appearance concern is not
better explained by another mental health condition, such as an problems in social, occupational, or other
eating disorder. important areas of functioning.
5.Duration: The preoccupation and distress have been present for at 5.The behavior is not better explained by other
least 3 months. mental disorders (like OCD, depression, or
psychosis).

Speci ers
Trichotillomania HairPulling ExcoriationDisorder SkinPicking 1.With Excessive Acquisition: This means the
person not only hoards items but also constantly
1.Recurrent pulling out of one’s hair, acquires (collects or buys) more items, often
resulting in hair loss. 1.Recurrent skin picking, leading to noticeable unnecessarily.
2.Repeated attempts to stop or reduce the damage to the skin (like sores or scars). 2.With Animal Hoarding: The person hoards
hair-pulling behavior. 2.Repeated attempts to stop or reduce the skin- animals, leading to living conditions that are
3.The hair-pulling causes distress or picking behavior. unsafe or unsanitary, often with a large number
problems in important areas of life (like social 3.The skin-picking causes distress or problems in of pets.
or work functioning). important areas of life (social, work, etc.). 3.With Good or Fair Insight: The person
4.The behavior is not due to another medical 4.The behavior is not due to other medical or recognizes that their hoarding is a problem, but
they may still have dif culty stopping.
or psychiatric condition (like a skin condition psychiatric conditions (such as a skin disease or
4.With Poor Insight: The person is not aware
or psychotic disorder). substance use). that their hoarding behavior is a problem or does
5.It is not better explained by other conditions not believe it’s an issue.
(such as body-focused repetitive behaviors seen In simple terms, it involves picking at your skin over 5.With Absent Insight/Delusional Beliefs: The
in OCD or a mental disorder like depression). and over, causing harm, and leading to emotional or person is completely convinced that their
practical problems in your life. hoarding is not a problem, and they may have
In simple terms, it involves pulling out hair delusional beliefs about their possessions (e.g.,
repeatedly, leading to noticeable hair loss, and thinking that the items are extremely valuable or
causing distress or interference in daily life. necessary).

DissociationIdentityDisorder Dissociative Amnesia

1.Inability to recall important personal information
1.Disruption of identity characterized by two or (usually after a traumatic or stressful event). This is
more distinct personality states or identities, each more than ordinary forgetfulness and can include large
with its own way of thinking, feeling, and behaving. gaps in memory about signi cant aspects of one’s life.
These identities may have different names, 2.The memory loss is too extensive to be explained by
behaviors, memories, and even physical changes (like normal forgetfulness or medical conditions (e.g., head
different handwriting). injury, drugs, or alcohol).
2.Recurrent gaps in memory about everyday events, 3.The memory loss causes signi cant distress or
problems in social, occupational, or other important
personal information, or traumatic events that are areas of functioning.
too extensive to be explained by normal 4.The symptoms are not part of a culturally accepted
forgetfulness. This is more than just forgetting; it’s as response (such as religious rituals or social practices) and
if the person “loses time” when another identity is in are not due to other mental health conditions (like
control. PTSD or schizophrenia).
3.The symptoms cause signi cant distress or
problems in life, such as dif culties with Speci ers for Dissociative Amnesia:
relationships, work, or personal functioning.
4.The symptoms are not part of a cultural or 1.With Dissociative Fugue: The person wanders away
from home or their usual environment and may forget
religious practice, nor are they caused by a substance their identity, even adopting a new identity temporarily.
2.Localized Amnesia: The person forgets a speci c
eeper DREAMS period of time, often related to a stressful or traumatic
Depersonalisation event (e.g., forgetting details about a speci c event).
3.Selective Amnesia: The person may forget some
Derealization details of a traumatic event but remember other aspects
(e.g., forgetting the emotional details but remembering
RetrogradeAmnesia what happened).
ErrorsofCommission 4.Generalized Amnesia: The person forgets their entire
Absorption Astatehighlyengaged by a stimuli identity, including personal history, relationships, and
memories of their life.
YotomorAutomality 5.With Systematized Amnesia: The person forgets
Suggestibility speci c categories of information, like details related to
Depersonalization Derealization

1.Experiences of depersonalization, derealization, or both:

• Depersonalization: Feeling detached or outside of your own body, as if you are
observing yourself from the outside or like you are in a dream.
• Derealization: Feeling that the world around you is unreal, distant, or distorted
(like things around you seem foggy, dreamlike, or arti cial).
2.The experiences cause signi cant distress or impair your ability to function in
important areas of life (e.g., work, relationships, social life).
3.The symptoms are not due to the effects of a substance (such as drugs, alcohol,
or medications), nor can they be explained by another medical or psychiatric
condition (like schizophrenia or epilepsy).
4.The symptoms are not part of a culturally accepted experience (e.g., certain
religious or spiritual practices, or rituals like meditation).

Speci ers for Depersonalization/Derealization Disorder:

1.With Depersonalization: The person experiences a sense of detachment or

estrangement from their own thoughts, feelings, or body. They may feel as if
they’re observing themselves from outside their body or like their body isn’t their
own.
2.With Derealization: The person feels as though the world around them is unreal
or distorted. They may perceive their surroundings as dreamlike, foggy, or visually
distorted in some way.
3.With Both Depersonalization and Derealization: The person experiences both
feelings of detachment from themselves (depersonalization) and the world around

Somatic Symptom Disorder Illness Anxiety Disorder

1.One or more distressing physical symptoms: These can include pain, fatigue, digestive
issues, or other bodily symptoms that cause signi cant discomfort. 1.Preoccupation with having or acquiring a serious illness: The
2.Excessive thoughts, feelings, or behaviors related to the symptoms: This could include: person is extremely worried that they have or will develop a
•Constant worry about the symptoms or health.
•Excessive time spent thinking about the symptoms (e.g., always researching your symptoms serious medical condition, even though medical tests or
or visiting doctors). evaluations show no evidence of illness.
•Strong emotional reactions to the symptoms (e.g., feeling anxious or distressed about the 2.Somatic symptoms are not present or are very mild: Unlike
symptoms even if they are not severe).
3.The symptoms cause signi cant distress or problems in daily life (like affecting work, social in Somatic Symptom Disorder, the person does not have
life, or relationships). signi cant physical symptoms or their symptoms are minor.
4.The symptoms persist for 6 months or more.
The worry is about having a serious illness rather than the
Speci ers for Somatic Symptom Disorder: physical symptoms themselves.
3.High levels of anxiety about health: The person is constantly
1.With Predominant Pain: The person’s main symptom is pain (e.g., chronic headaches, back
pain, stomach pain), and the pain causes signi cant distress or dif culty. worried about their health and may frequently seek
2.With Severe (or Moderate) Somatic Symptoms: This refers to the severity of the symptoms: reassurance from doctors or constantly check their body for
•Severe: The person’s physical symptoms are very intense and cause high levels of distress or signs of illness.
impairment.
•Moderate: The person’s symptoms are noticeable but not as severe. 4.The preoccupation causes signi cant distress or problems in
•Mild: The person has only a few mild symptoms that cause some distress or dif culty. daily life, such as affecting relationships, work, or social
3.With or Without Pain: This refers to whether pain is the main symptom or if the person’s
distress is primarily caused by other physical symptoms (like fatigue or digestive issues).
activities.
5.The symptoms have lasted for at least 6 months.
SOME ATTIC
Speci ers for Illness Anxiety Disorder:
Symptoms Thikingabout 1.Care-seeking type: The person frequently seeks medical
One or more consuming attention or visits doctors for reassurance, often worried about
Medicallyunexplained Time their health and looking for a diagnosis.

Exessive city c Months 2.Care-avoidant type: The person avoids medical care due to
fear of discovering a serious illness. They may refuse to see
doctors, get tests, or receive treatment, even when advised.
 Conversion Disorder
1.One or more symptoms of altered voluntary motor or sensory function:
This means the person experiences physical symptoms (like paralysis,
tremors, dif culty walking, blindness, or numbness) that seem like
neurological problems but can’t be explained by any medical conditions.
2.The symptoms cause signi cant distress or problems in important areas of
life (like work, social life, or daily functioning).
3.The symptoms are not better explained by another medical or mental
health condition. For example, the symptoms cannot be explained by a
neurological disorder like epilepsy, or a medical illness like a stroke, and are
not intentionally produced (meaning the person is not faking the symptoms).
4.There is evidence of psychological stress or trauma that may have
contributed to the onset of the symptoms. In many cases, these symptoms
appear after a stressful or traumatic event.

Specify symptom type

1. With weakness or paralysis
2. With abnormal movement
3. With swallowing symptoms
4. With speech symptoms
5. With attacks or seizures
6. With anesthesia or sensory loss
7. With special sensory loss
8. With mixed symptoms

Tactitious Disorder
1.Falsi cation of physical or psychological symptoms: The person intentionally produces or
exaggerates symptoms of illness, injury, or psychological disorder. This can include pretending to
be ill or injured, or manipulating test results (e.g., taking medications to induce symptoms or
causing wounds).
2. Deceptive behavior is done without obvious external rewards: Unlike malingering, where there
is a clear external bene t (such as avoiding work or getting money), the person does this for
internal reasons like the desire to be seen as sick and receive attention, care, or sympathy.
3.The behavior leads to medical or psychological treatment: The person often seeks unnecessary
medical or psychiatric care, procedures, or hospitalizations, sometimes even undergoing tests or
treatments they don’t need.
4.The symptoms are not better explained by another mental disorder, such as a psychotic disorder
or a mood disorder, and the person’s actions are deliberate (not a product of confusion or
delusion).

Speci ers for Factitious Disorder:

1.Imposed on Self: The person intentionally fakes or produces symptoms in themselves, such as
feigning illness, causing self-harm, or exaggerating real symptoms.
2.Imposed on Another (Factitious Disorder by Proxy): The person produces or fakes symptoms in
another person, typically a child or vulnerable individual, to make them appear sick in order to
gain attention or sympathy. This is often done by a caregiver.
3.Severity Speci er: The speci er can indicate the severity of the disorder based on the intensity
of the behaviors (whether the person regularly engages in deceptive behaviors, or if it’s more
sporadic).
 Eating Disorders Avoidant Restrictive Food Intake
Rumination Disorder

Bulimia Nervosa
1.Recurrent episodes of binge eating: This means eating a large amount of food in a short
period, and feeling like you can’t control what or how much you’re eating. For example, eating a

Pica
large meal in one sitting, even if you’re not hungry.
2.Recurrent, inappropriate behaviors to prevent weight gain: After binge eating, the person
engages in behaviors to purge or compensate for the binge. This includes:
•Self-induced vomiting (throwing up food) Pica is an eating disorder where a person repeatedly eats non-food
•Excessive exercise
•Misuse of laxatives, diuretics, or enemas items (such as dirt, clay, chalk, or hair) for a period of at least one
3.Self-evaluation is unduly in uenced by body shape and weight: The person is overly month. The behavior is not developmentally normal (like a young
concerned with their weight or appearance and uses it to evaluate their self-worth. This means child who occasionally eats dirt), and it can cause harm or distress.
they may feel very bad about themselves if they gain even a small amount of weight.
4.The behaviors occur at least once a week for 3 months.
5.The disorder does not occur exclusively during episodes of anorexia nervosa. This means that Criteria for Pica (DSM-5):
while someone with anorexia might also binge or purge, in bulimia nervosa, these behaviors are
separate from the extreme restriction of food seen in anorexia. 1.Repeated eating of non-food substances: The person consistently
eats items that are not food, such as dirt, chalk, hair, clay, soap, or paint
Speci ers for Bulimia Nervosa:
chips. This can happen for a period of at least one month.
1.Current severity: 2. The eating behavior is inappropriate for the individual’s
•Mild: The person engages in 1-3 episodes of inappropriate compensatory behaviors (such as developmental level: This means that while young children or certain
purging or excessive exercise) per week. cultural practices might occasionally engage in this behavior, it
•Moderate: The person engages in 4-7 episodes of inappropriate compensatory behaviors per
week. becomes a concern if the person is older (like a child or adult) and it is
•Severe: The person engages in 8-13 episodes of inappropriate compensatory behaviors per not part of their normal development.
week. 3.The eating behavior is not part of a culturally supported or socially
•Extreme: The person engages in 14 or more episodes of inappropriate compensatory normative practice: The eating of non-food items must not be part of
behaviors per week.
2.In Partial Remission: This means the person still engages in some symptoms of bulimia a recognized cultural or religious practice.
nervosa, but they occur less frequently or are less severe. 4.If the behavior is in the context of another mental disorder (such as
3.In Full Remission: This means that the person no longer experiences binge eating episodes or autism spectrum disorder, intellectual disability, or schizophrenia), it
engages in inappropriate compensatory behaviors for a signi cant period of time (usually at should only be diagnosed as Pica if it is severe enough to cause harm
least 6 months).
or signi cant distress.

norexiaNervosa
Anorexia Nervosa is an eating disorder characterized by severe restriction of food intake, an intense fear of gaining weight, and a distorted view of
one’s body. People with this disorder often see themselves as overweight, even if they are dangerously underweight.

Criteria for Anorexia Nervosa (DSM-5):

1.Restriction of food intake: The person signi cantly limits the amount of food they eat, leading to a low body weight that is much lower than what is
healthy for their age, gender, and height.
2.Intense fear of gaining weight or becoming fat, even though the person is underweight: Despite being very thin, the person is extremely afraid of
gaining weight and may engage in behaviors to avoid gaining weight, such as exercising excessively or restricting food further.
3.Distorted body image: The person has a distorted view of their body size. They may see themselves as overweight, even when they are dangerously
thin. Alternatively, they may deny the seriousness of their low body weight.

Speci ers for Anorexia Nervosa:

1.Type of Anorexia Nervosa:

• Restricting type: The person restricts food intake and does not regularly engage in behaviors like vomiting or using laxatives. They try to maintain
a low weight primarily through dieting or excessive exercise.
•Binge-eating/purging type: The person may engage in binge eating (eating large amounts of food in a short period) followed by purging (like
vomiting or using laxatives) to prevent weight gain.
Binge Eating Disorder
Binge Eating Disorder (BED) is an eating disorder characterized by frequent episodes of eating large amounts of food (binge eating),
accompanied by a lack of control over eating. Unlike bulimia, people with BED do not engage in purging behaviors (like vomiting or excessive
exercise) after binge eating.

Criteria for Binge Eating Disorder (DSM-5):

1.Recurrent episodes of binge eating: The person eats a large amount of food in a short period (e.g., within 2 hours), more than what most
people would eat in a similar situation.
2.Lack of control during the binge: During the binge, the person feels that they cannot stop eating or control how much they eat.
3.Binge episodes are associated with at least 3 of the following:
•Eating much more quickly than normal.
•Eating until uncomfortably full.
•Eating large amounts of food when not hungry.
•Eating alone because of feeling embarrassed by how much is being eaten.
•Feeling disgusted, depressed, or guilty after overeating.
4.Distress: The binge eating causes signi cant distress or problems in the person’s life, like emotional distress, guilt, or dif culties in social or work
situations.
5.The binge eating occurs at least once a week for 3 months.
6.No regular compensatory behaviors: The person does not regularly engage in behaviors like vomiting, excessive exercise, or laxative use to
prevent weight gain (which distinguishes BED from bulimia nervosa).

Speci ers for Binge Eating Disorder:

1.Severity:
•Mild: 1-3 binge eating episodes per week.
•Moderate: 4-7 binge eating episodes per week.
•Severe: 8-13 binge eating episodes per week.
•Extreme: 14 or more binge eating episodes per week.

Elimination Disorders
Enuresis
Enuresis Disorder in the DSM-5 refers to involuntary urination (wetting oneself) that happens repeatedly. It
is typically seen in children but can sometimes affect adults as well. This condition is more than just
occasional accidents and can cause emotional distress for the person involved.

Criteria for Enuresis Disorder (DSM-5):

1.Repeated urination: The person urinates in their clothes or bed, either during the day or at night, at least
twice a week for 3 months or more.
2.Chronological age: The child (or adult) is at least 5 years old. This is because bedwetting can be normal
for younger children, but after age 5, it’s considered problematic if it continues.
3.The urination is not caused by a medical condition (such as diabetes, urinary tract infection, or
medication), and it’s not due to a developmental condition (like a delay in bladder control).
4.The behavior causes distress or problems in daily life, like embarrassment, family issues, or social
problems.

Speci ers for Enuresis Disorder:

1.Nocturnal Only: The person only wets the bed or clothes at night (bedwetting).
2.Diurnal Only: The person only has accidents during the day (like wetting pants while awake).
3.Mixed: The person has accidents both during the day and at night.
 Encopresis
Encopresis Disorder in the DSM-5 refers to repeatedly passing stool in inappropriate places,
such as in clothes or on the oor. This condition can occur whether the person is constipated or
not and is typically seen in children, although it can sometimes affect adults.

Criteria for Encopresis Disorder (DSM-5):

1.Repeated bowel movements in inappropriate places: The person defecates (passes stool) in
inappropriate places, such as in their clothes or in other areas where it’s not appropriate (e.g., in
public or at home).
2.At least once a month: The inappropriate bowel movements happen at least once a month for
3 months or longer.
3.The child is at least 4 years old: Encopresis is considered a disorder if it occurs in a child who
is older than 4, as younger children might still be learning bowel control.
4.Not caused by a medical condition: The behavior is not caused by a medical problem like
constipation, an illness, or a neurological disorder (although constipation can sometimes lead to
encopresis).
5.Distress or functional impairment: The behavior causes distress or dif culties in the person’s
life, such as embarrassment, social problems, or family issues.

Speci ers for Encopresis Disorder:

1.With Constipation and Over ow Incontinence: The person’s bowel movements are often
caused by constipation, which leads to over ow incontinence (stool leaking because the bowel is
too full).
2.Without Constipation and Over ow Incontinence: The person does not have constipation,
but still passes stool inappropriately, without any over ow leakage.