Intellectu # of Criteria

Disorder Overview Onset must be met Diagnostic Criteria Specifiers Differential Diagnosis
al
Disorders Mild -- difficulties in learning, need support,
A. deficits in intellectual functioning -- immaure and inaccurate perception of social cues,
reasoning problem solving planning, abstract limited understanding of risk, fx age-approp in
Deficits in intellectual, social, practical areas of
thinking, judgment, academic learning, personal care, need support MOD -- markeldly major and mild
functioning: manifest in reasoning, problem solving,
Intellectual Disability learning from experience, confirmed by behind in intellect, marked difference in social neurocogntive disorders,
abstract thinking, confirmed by intelligence tests. Developme All three:
(Intellectual intellgience tests B. deficits in domain, need support and teaching in practical communication disorders
Adaptive functioning deficits manifested in failure to nt ABC
Developmental Disorder) adaptive functioning across home, school, domain SEVERE -- attainment of and SLD, Autism Spectrum
live independently and to be socially responsible.
work, community C. Onset of conceptual skills is limited, spoken language is Disorder
defiticts limit fx in home, school, community
intellectual and adaptive deficits during limited, requires support in all activities
developmental period Profound -- physical world, limited understanding of
language, dependent in all areas

Under 5, when clinical severity level cannot be

relably assessed during early childhood. Diagnosed
when individual fails to meet expected
Global Developmental UNDER age requires reassessment
developmental milesetones in several areas of
Delay of 5 after a period of time
intellectual functioning and applies to individuals
who are unable to undergo systematic assessment
of intellecutail fx -- too young for IQ,

when assessment is difficult or impossible because

only used in exceptional
Unspecified Intellectual of associated sensory or physical impairments, as in
OVER the circumstances and
Disability (intelletual blindness, prelingual deafness, locomotor diaability,
age of 5 requires reassessment
development disorder) presence of severe problem behaviors or co-
after a period of time
occuring mental disorder

Commun
ication persistent difficulties with onset in early
Disorders development, in the learning and use of language in
its various forms, due to deficits in comprehension
or production. Defcitis manifested in rediuced
Language Disorder
vocab, inability to express oneself due to limited
sentence structure, and impaired discursive abilities.
Difficulties are not contributed to an underlying
medical condx
A. acquisition and use of langugae across
modalities due to deficits in comprehension
or production that include:
1. reduced vocab, 2. limited sentence
early
structure, 3. impairmens in discourse B.
developme All four: A-D
language abilities are substantially and
nt
quantifiably below expected for age C.
symptoms began in early development D. not
due to hearing or sensry, motor, or medical
or neuroloical or global developmental delay

A. difficulty with speech sound production B.

early
disturbance causes limitations in efective
speech sound disorder developme All four: A-D
comm C. onset is early development, D. not
nt
due to hearing loss, etc.

A. Disturbance in normal fluency and time

patterning of speech and can cause 1. sound
A- 1 or
Childhood-onset fluency syllable rep 2. prolongations of consonents,
more, B-
disorder broken words, etc.B. Causes anxiety, C. onset
D
is in early development D. not speech motor
etc

A. Persistent difficulties in social use of verbal

and nonverbal comm 1. social purposes,
greetings, etc. 2. impairment to change
early comm to match context of needs of listner 3.
developme dificulties following rules for conversation 4.
social (pragmatic)
nt but may A- All, B-D difficulties understanding what is not Autism spectrum disorder
communication disorder
manifest explcitly states B. deficits rresult in limitations
later of comm, social participation, C. Onset is
early developmental period, but may
manifest later D. not attributed to something
else

symptoms of communication disorder rthat cause

clinically significant distress in social, occ, or other fx
unspecified comm
but do not meet full criteria --when clinical chooses
disorder
NOT to specify the reason the criteria are not met --
insufficient information

persistent problems in social interaction and with or without accompanying intellectual

communiction across wide range of activities, impairment, with or withou accompanying language
A. Deficits in social comunication and
reduced ability to share emotions and interests, and early impairment, associated with known medical or Inellectual disability, global
interacton (3), B. Restricted and repetitive
poor ability to communicate and understand verbal developme genetic condition or environmental factor, associaed developmenta delay,
patterns of behavior (4), C. present in early
Autism Spectrum Disorder and nonverbal cues, and gestures repetitious nt but may All -- A-E with another neurodevelopmental mental, or frequently co-occur with
Autism behaviors and patterns, insistence on sameness in manifest
developmental period D. clinically significant
behavioral disorder, with catatonia Levels: intellectual disability,
Spectru impairment in social, occupational, or other
routines, fixations on restricted interests. later Level 1. requiring support 2. social
important areas E. not beter explained by...
m Heightened sensitivity or lack thereof to requiring substantial support 3.
environmnetal stimuli requiring very substantial support
Disorder
Combined presentation, Predominantly inattentive,
chronic inability to pay attention and Predominantly hyperactive/impulsive presentation,
impuslive/hyperactivity that impairs fx and A. inattention or hyperacitivity 1. inattention In patial remission,
Attention- development. Frequently unable to sustain interest A - 1 and/or 6 o more ( a - i) 2. hyper/impulsivity6 or more Mild: few symptoms in excess to those required ODD, intermittent
prior to age
Deficit/Hyperactivity in an activity or maintain mentl focus required by a 2; B- (a-i) B. several symptoms prior to age Mod: symptoms or fx impairment between mild and explosive, other
12
Disorder task. Easily distracted and forgetful of routine E 12 C. present in two or more settings D. severe severe: many neurodevelopmental
activities. inability to sit still or remain quiet. impaired fx E. not due to anything else symptoms in excess of those required to make the
garrulous and impatient diagnosis or several symptoms that are sever, are
prsesent and result in marked impairment
ADHD
Other Specified Attention symptoms characteristic of ADHD but do not meet
Deficit Hyperactivity full criteria and assessor chooses to state the reason
Disorder they do not meet criteria

do not meet full criteria, assessor chooses not to

Unspecified
specify why
 problems in learning across a rage of academic
activities. Manifested in poor writing skills and Scool-age; A. Difficulties in learning for at least six normal variations in ac.
with impairment in reading w/
reading comprehension, and/or learning numerical symptoms months (1-6; at least one) B. belowe Attainment, intellectual
A- 1 or impairment in written expression w/
Specific Learning Disorder concents. Condition persists despite intervention to persist for expected for choronological age C. behin disability, neurological
more; B-D impairment in mathematics Mild,
improved academci skils and not better explained by At least 6 during school-aged years, D. not better issues, neurocogntiive
Moderate, Severe
intellectual disabiltiies, specfic sensory deficits, or months explained by soemthing else disorders, ADHD
other extraneous factors
SLD
A. Acquisition and execution of coordinated
motor skills substantially below excpected
excessive clumsiness and awkwardness as
early given chron. Age; manifested in clumsiness, Rx, intellectual disorder,
Developmental manifested by poor learning and performance of
developme A-D slowness, and inaccuracy of performance of N/a ADHD, ASD, joint
Coordination Disorder coordinated motor skills, with performance
nt motor skills B. deficits significantly and hypermobility syndrome
significantly below accepted age norms
persistently intefere with DLA, C. Onset in
early development, D. not better explained...

early A. repetitive, seemingly driven, apparently W/ self-injurious bx or W/o If normal development, ASD,
Stereotypic Movement repetitive, seemingly driven, apparently purposeless
developme A-D purposeless motor bx B. interferes with fx C. assoc. w known med, genet, or neuro, or Tic Disorders, OCD,
Dsorder motor bx
nt early dev D. not attributable… environmental factor Mild, Mod, Sev neurological

Tourettes -- A. both multiple motor and one

tics are sudden, rapid, recurrent, nonrhythmic
Tic Disorders
motor movements or vocalizations
or more vocal tics present at some time,
althought not necessarily concurrent.B. Tics
Provisional vs. Tourettes:
wax and wane but persistent for more than a
Tourettes has both
year since first onset, C. onset before 18;
happening at the same
before 18 D. not attributable to anything else for PCMVTD -- specify motor or vocal only
time and provisional has
Persistent Chronic Motor or Vocal Tic
both but never active at
Disorder A. single or multiple motor OR tics
the same time
present, but not both (same B-D) Provisional
Tic Disorder A. single or multiple motor or
vocal tics -- not present at the same time

Other Specified Tic Do not meet full criteria, assessor CHOOSES to

Disorder specify why
Motor do not meet full criteria, assessor chooses not to
Unspecified Tic Disorder
Disorders specify why

ex: neurodevelopmental disorder associated with

Other
prenatal alcohol exposure
neurodevelop
mental
disorders
do not meet full criteria, assessor chooses not to
Unspecified
specify why
 # of Criteria
Disorder Overview Onset must be met Diagnostic Criteria Specifiers Differential Diagnosis Terms
Delusion
al
Disorder Delusions: • Promdromal phase
A. Presence of 1 or more delusions with – showing signs of deterioration prior to full blown symptoms
duration of 1 month or longer B. Criterion A • referential – belief that certain gestures, comments, environmental cues are directed at oneself
Enduring delusions that may be accompanied b non- Type of delusion (erotomanic, grandiose, jealous, Not schizophrenia if-- there is nothing • grandiose – when an individual believes he or she has exceptional abilities, wealth or fame
for schhizphrenia never met --hallucinations if
prominent hallucinations pertinent to the nature of persecutory, somatic, mixed, unspecified) other than delusions -- no hallucinations, • erotomanic -- when an individual believes falsely that another person is in love with him or her
present are not related to delusional theme C.
the delusion itself; fx is not significantly affected 1 month or with or without bixarre content, first episode disorganized behavior, etc. • jealous type – central theme of delusion is that his or her lover is unfaithful
Delusional Disorder A-E functioning is not markedly impaired and bx is
apart from bx specfiically related to delusions. Bx longer currently accute episode, first episode currently in Not depressive or bipolar or • nihilistic – a major catastrophe will occur
not bizarre or odd D. if manic or depressive
generally does not appear to be odd or peculiar. partial/full remission --> mult episodes same schizoaffective if mood epsiodes are brief • somatic – preoccupations regarding health and organ function
episodes occur, these are brief relative to
types of delusions are in column I current severity -- 0-4 scale mild to severe in compairson to all delusional episodes • mixed – no one delusional theme predominates
duration of delusional periods E. not explained
by anything else • unspecified – when dominand delusional belief cannot be clearly determined or is not described in the
specific types ex: referential without persecutory or grandiose component
• bizarre if clearly implausible and not understandable to same-culture peers
o ex: thought withdrawal, thought insertion, delusions of control

Schizoph
renia
At least two of the following symptoms are
manifested for a period lasting between 1 month &
six months: hallucinations, delsions, disorganized
incoherent speech, grossly disorganized or catatonic
Schizophrenia
behavior, negative symptoms, such as reduced
emotional expressiveness, or avolition. condition has
had a negative impact on the ability to fx in occ,
academia, interpseronal, or self-care
A. two or more each present for some of the
time in a 1 month period of delusions, hall,
disorg speech, grossly disorganized bx,
Early
negative symptoms B. level of fx in one seting
childhood,
is impaired C. continuous signs of distubance
adolescence,
for 6 months -- at least one month of criteria A
adulthood A. 2 or more;
D. rule out schizoaffective bc either no
total B-F
depressive or manic episodes, or mood
symptoms at
episodes are minorty of duration of active and
least 6
residual phases E. no physiological effects of
months
substance F. if ASD or comm disorder, must
have hallucinations or delusions for over a
month
First episode, currently acute episode First
6 months total of symptoms no
Episode, currently in partial remission First
mood episodes for the duration of active
episode, currently in full remission multiple
phase IF they
episodes, currently in acute episode multiple,
haven't met the six month mark, give
mult in partial remiss or mult in full remiss;
schizophreniform dx Hallucinations: – perception-like experiences that occur without an external stimulus. Vivid and clear, with the
specify if with catatonia and current severity
full force and impact of normal perceptions, and not under voluntary control
• hypnagogic—hallucinations occurring while falling asleep
• hypnopompic – waking up
• both considered normal

Brief
A. presents of at least one of the following -- if with marked stressor or without if Negative symptoms: • Avolition
Psychotic characterized by hallucinations, delusions, A- 1 or more
must be either 1. delusions, 2. hallucinations 3. with postpartum onset if with To be brief psychotic, has to be less than
– decreased motivation
Brief Psychotic disorganized incoherent speech, or grossly 1 day to one but must • Alogia – diminished speech output
Disorder Disorder month
disorganized speech and 4. grossly disorganzed catatonia provide current 1 month BRIEF -->
disorganized or catatonic bs. Duration of cx is 1 day have A1 A2 or • Anhedonia – decreased ability to experience pleasure
or catatonic bx B. duration I between 1 day severity -- 0-4 point scale symptoms that are Schizophreniform ---> Schizophrenia
to 1 month A3; B-C • Asociality – lack of interest in social interactions
and 1 month C. not better explained… culturally accepted can't be added

diagosis if -- episode lasts between 1 and

At least two of the following are manifested for a
period of 1 month to up to 6 months: hallucinations,
schizophreniform
delusions, disorganized incoherent speech, grossly
disorganized or catatonic bx, negative symptoms
A. Presence of 2 or more during a one-month With good prognostic features -- good premorbid
6 months and individual is already Course of schizophrenia: •
A- 1 or more period -- 1. delusions 2. hallucinations 3. fx, confusion or perplexity, onset of psychotic
recovered Promdromal phase – showing signs of deterioration prior to full blown symptoms
but must disorganized speech 4. grossly disorganized
symptomsbx within four weeks f first change in fx
1-6 months when an individual is symptomatic for less • Active symptoms phase – full blown symptoms are present
have A1 A2 or 5. negative symptoms B. epsidoe lasts more w/o good prognostic features -- if two or more of
than 6 mos required for schizophrenia but • Residual phase – some but not all symptoms remain, similar to prodromal phase
A3; B-D than a month but less than 6 C. others
the above
ruled not present w/ catatonia
has not yet recovered --on the way to
out D. not attributable to… current severity
schizo

Scizophreniform

A. Uninterrupted period with major mood

disorder and criterion A for schizophrenia B.
An illness characterized by a continuous period LIFETIME delusions or hallucinations for two or more Bipolar or Depressive Type; with Catatonia; first Has to have a mood episode present the
wherein the major symptoms of schizophrenia are uninterrupted weeks in the ABSENCE of a major mood episode acute or partial rem or full remis OR mult whole time has to
Schizoaffective
present and for the majority of the duration of the period of two A-D all episode during a LIFETIME duration of the episodes: acute, partial or full OR continuous: have psychotic features present with
Disorder
current mood epsiodes (depressive or manic) are or more illness C. symptoms that meet criteria for symptoms
a continue for full duration absence of mood episode for at least 2
present weeks major mood epsidode present for the majority severity 0-4 weeks
of the total dratio of active and residual
portions D. no attributable to other stuff
Schizoaffective Disorder
Catatonia associated with another mental disorder or
Substace induced med cond unspecified catatonia
psychotic disorder other specified schizophrenia spectrum or other
x
psychotic disorder due psychotic disorder or
to Rx unspecified schizophrenia spectrum and other
psychotic disorder
Others not studied
 Disorder Overview Onset # Criteria Diagnostic Criteria Specifiers Differential Diagnosis Terms
Separatio
n Anxiety Inordinate anxiety upon separation from parties the individual has
formed a close emotional attachment to, as manifested by the A. Developmentally inappropriate & excessive fear or anxiety about separation from home or
Disorder presence of at least three of the following: repeated intense anxiety attachment figures, needing 3 of 8 (page 190-191).
at least four
when anticipating or experiencing separation from home or significant B. The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and
weeks in children
Separation Anxiety other, incessiant rumination over the prospect of harm coming to adolescents and typically 6 or more months in adults.
or teens ; 6 or A- 3/8 B-D N/A other anxiety disorders, bereavement Fear – emotional response to real or perceived imminent threat
Disorder signfiicant attachments, chronic refusal or unwillingness to venture C. Causing clinically significant distress or impairment in social, occupational or other
more months in
out away from attachment figures, refuseal or unwillingness to sleep important areas of functioning.
adults
away from home while separated from attachment figures, recurring D. Not better explained by other mental disorder
nightmares about separation, recurring pysical problemms when
anticipating or experiencing separation

Selective A. Consistent failure to speak in situations where there is an expectation to speak despite
Mutism speaking in other situations.
Interferes with educational/occupational achievement or social communication.
Characterized by reticence in situations where speaking is expected;
At least one B. At least one month (not limited to the first month of school).
condition interferes with social, educational, or vocational aspects of
Selective Mutism month -- not first A-E C. Not attributable to lack of knowledge of, or comfort with, the spoken language required in Anxiety – anticipation of future threat
life, condition lasts at least one month, reticence is not due to
month of school the social situation.
dificulties w vocab or language
D. Not better explained by a communication disorder and E. does not occur exclusively during
ASD, schizophrenia, or another psychotic disorder.

F40.218 Animal
A. Marked fear or anxiety about a specific object or situation
F40.228 Natural Environment
characterized by a disproportionate fear response to a specfic object Note: In children, it may be expressed by crying, tantrums, freezing, or clinging. Natural environment – storms, water,
(storms, water, heights, etc.)
or situation; the fear response is almost always immediately elicited b B.The object/situation almost always provokes immediate fear or anxiety heights, etc.
F40.23x Blood-Injection-Injury
the presence of the phobic object or situation; the phobia-producing C.The object/situation is actively avoided or endured with intense fear or anxiety
at least six F40.248 Situational (airplanes,
Specific Phobia entity is actively avoided or only tolerated with great anxiety; the fear A-G D.Fear or anxiety is out of proportion to the actual danger and to the sociocultural context Situational – airplanes, elevators, etc. Panic Attack – type of fear response
months elevators, etc.)
is manifested out of proportion to the actual danger posed by the E.Typically lasting 6 months or more
F40.298 Other (loud sounds,
entity; fear and avoidance responses typically persist for at least 6 F.Causing clinically significant distress or impairment Other – loud sounds, clowns, etc.
clowns, etc.)
months G.Not better explained by another mental disorder
Specific
Phobia

A. Fear or anxiety of social situations in which the person may be scrutinized by others
B. Person fears their behaviors (symptoms) will be negatively evaluated by others
Indicated by inordinate fear of situations in which the person may be
C. The social situation almost always provokes fear or anxiety
subject to evaluation by others; such situations may include scenarios
D. Social situations are avoided or endured with intense fear or anxiety Specify if:
conisting of meetings, conversations with unfamiliar parties, being In children – symptoms must also happen in
E. It is out of proportion to the actual threat posed by situation and to the sociocultural Performance only – if restricted
Social Anxiety observed, or giving speeches or presentations. the person is greatly 6 months or the presence of other children, not just
A-J environment to speaking or performing in Avoidance behaviors
Disorder concerned that they will behave in inappropriate ways that would be more adults
F. Typically lasting 6 months or more public
negative construed and lead to rejection, embarrassment, ridicule, or
G. Causes clinically significant distress or impairment in social, occupational, or other
being offended. Social situations are avoided or endured with great
Social anxiety.
important areas of functioning
I. & J. Exclusions
Anxiety
Disorder
In order to qualify as a disorder, a condition must include repeated When the presence of a panic
panic attacks and at least FOUR of the following symptoms: rapid A. Recurrent unexpected panic attacks - Discrete period with a sudden onset and quick peak attack is identified, it should be
heartbeat, sweating, shaking, shortness of breath, choking sensation, (within 10 minutes) of intense fear and/or discomfort, needing 4 of 13 symptoms (page 208). noted as a specifier.
chest pain/discomfort, nausea / gastrointestinal distress, vertigo or B. At least 1 attack is followed by 1 month or more of one or both: Needs four of the 13 symptoms
1 attack + 1 A panic attack is a sudden, unexpected
sensation of loss of balance or feeling faint and light-headed, A- 4/13 B- 1.Persistent concern or worry about additional panic attacks or their consequences on page 214. Differ from fear or anxiety that is developmental appropriate or
Panic Disorder month of intense fear response during which anxiety
sensations of heat or cold, parathesias, derealization, fear of losing 1or2 C-D 2.Significant maladaptive change in behavior related to the attacks transient
symptoms rapidly escalates within a fiew minutes.
emotional control, fear of dying. AT LEAST ONE PANIC ATTACK HAS C.Not attributable to physiological effects of a substance effect or another medical condition NOTE: Culture-specific symptoms
BEEN FOLLOWED BY ONE MONTH Of one or both of following: chronic D.Not attributable to another mental disorder should not count as one of the 4
Panic worry about experiencing additional panic, a marked effort to engage
in bx to avoid panic attacks
required symptoms.

Disorder

A. Marked fear or anxiety about 2 or more of 5 situations:

significant anxiety about at least two of the following scenarios:
utilizing public transportation, being in open spaces, being in enclosed
spaces, being in a crowd, being alone outside one's home; these
typically at least
Agoraphobia situations are avoided and almost always elicit distress and anxiety.
six months
fear responses typically last at least six months and agoraphobic
scenarios typically require individuals to be accompanied or are
endured while experiencing intense fear
Agoraph
obia
inordinate worry about a variety of scenarios, occurring more days
than not and lasting AT LEAST six months. The person finds it difficult
to not ruminate about worry-causing scenarios. At east THREE
at least six
GAD
symptoms must be present with ONE lasting SIX MONTHS -- agitation,
loss of energy, difficulty focusing, irritability, muscle tension, difficulty
sleeping
1.Using public transportation2. Being in open spaces
3. Being in enclosed spaces 4. Standing in line or being in a crowd 5. Being outside of the
home alone
B. Person fears or avoids due to thoughts that escape might be difficult or help might not be
available if panic-like or other incapacitating or embarrassing symptoms occur Primary determination about symptoms being excessive is made by
A - 2+; B-I
C. Situation almost always provokes the fear or anxiety the clinician
D.Situations are avoided, require a companion, or are endured with intense fear or anxiety E.
Out of proportion to the situation and to the sociocultural context F.Typically lasting 6 months
or more
G.Causes clinically significant distress or impairment H.If another medical condition does exist,
response is excessive I. Exclusion
A. Excessive anxiety or worry, occurring more days than not for at least 6 months, about a
number of events or activities
B. Person finds it difficult to control the worry
Cognitive Behavioral Therapy (CBT)
C. Associated with 3 or more symptoms:
1. Restlessness or feeling keyed up or on edge Eye Movement Desensitization and Reprocessing
2. Being easily fatigued 3. Difficulty concentrating or mind going blank 4. Irritability 5. Muscle (EMDR)
months
tension 6. Sleep disturbance
Dialectical Behavior Therapy (DBT)
C. Causing clinically significant distress or impairment
Systematic Desensitization/Exposure Therapy
D. Not attributable to the physiological effects of a substance or another medical condition
E. Exclusion of another mental disorder

Generalized Anxiety Disorder

A. Panic attacks or anxiety is predominant in presentation
B. Evidence of both: With onset during
1. Symptoms in A developed during or soon after substance intoxication or intoxication Mindfulness therapies
evidence that panic attacks transpire concurrently with
withdrawal or exposure to medication With onset during Complementary and alternative practices
Rx Anxiety or following substance intoxication, withdrawal, or
2. Involved substance is capable of producing the symptoms in A withdrawal Stress and relaxation techniques
disorder following exposure to Rx, the substance/meds under
C. Not better explained by another anxiety disorder With onset after Meditation
consideration is capable of bringing about severe anxiety
D. Does not occur exclusively during a delirium medication use Yoga
E. Causes clinically significant distress or impairment Acupuncture
Substance/Rx Induced Anx Dis Medication
A. Panic attacks or anxiety is predominant in presentation
B. Evidence that the disturbance is the direct pathophysiological
consequence of another medical condition
Other Med Cx C. Not better explained by another mental disorder
D. Does not occur exclusively during a delirium
E. Causes clinically significant distress or impairment
Anx Dis due to other Med Cx

Used when symptoms cause clinically significant distress or impairment but

DO NOT meet full criteria for any anxiety disorders.
The clinician chooses to communicate the specific reason criteria is not met.
Examples: Limited-symptom attacks, Generalized anxiety NOT occurring
more days than not, Other cultural concepts of distress
Other Spec Anx Dis
Used when symptoms cause clinically significant distress or impairment but
DO NOT meet full criteria for any anxiety disorders.
The clinician chooses NOT to communicate the specific reason criteria is not
met.
Unspec Anx Dis
 Disorder Overview Onset # Criteria Diagnostic Criteria Specifiers Differential Diagnosis Terms

6-18; 1 yr with at A. severe recurrent verbal and bx temper outbursts that are grossly out of proprotion to the
Disruptiv Characterized by frequent outburts of temper over a period least 9 mos of situation or provocation B. inconsistent with developmental level C. avg of 3+ times/wk D. common feature is sad, empy or iritable
e Mood DMDD
lasting AT LEAST 1 YEAR with no mre than a 3-month period symptoms; onset
without outburts. On average, outbursts occur three or of symptoms has A-J
mood beween tantrums is irrituable or angry, most of the day, nearly every day, and
observable by others E. A-d have been present more than 12 months without 3 or more
mood ACCOMPANIED by somatic and
Dysregul more times weekly, and individual's mood is chronically to have been consecutive months without symptoms. F. Symptoms present in 2 or more settigs and cognitive cahnges that SIGNIFICANTLY affect
irritable and angry. Diagnosis is typically between ages 6-18 present before severe in at least 1 G. diagnosis between 6 and 18 H. onset present b efore age 10 I. the person's ability to fx
ation age 10 symptoms for hypomanic or manic have never been met for more than 1 day H/J Exclusions

code based on severity or course

A. two weeks of symtposm that represent a change in previous fx. Need 5 Grief -- the feelings of intense sadness,
specifier: mild, mod severe based on
of 9 sx with 1 being depressed mood or loss of interest of pleasure others: rumination, insomnia, poor appetite, weight
number and intensity of symptoms Beck's negative cognitive triad -- negative
weight change, insomnia or hypersomnia nearly every day, psychomotor loss may rememble dep ep -- may be
Major --with anxious distress, mixed view of self, future, world atypical --
agitation or retardation nearly every day; fatigue or losso f energy nearly understandable or considered appropriate to
Characterized by the symptoms of major A- 5 of 9 features, melancholic features, weight gain, hypersomnia, leaden paralysis,
Depressiv MDD
depressive episode
Two weeks
B-E
every day; feelings of worthlessness or guil; diminished ability to think or
atypical features, mood-congruent
the loss, the presnecne of MDE in addition to
interpersonal rejection sensitivity
e Disorder concentrate; recurrent thoughts of death B. cuase clinically significant the normal response may be carefully
or incongruent psuchotic features; w peripartum--during or in the four weeks
distress or impairment C. not attributable to effects of substance or other considered. this decision is based on clinical
catatonial with peripartum onset, after delivery
medical conditon D. not part of another mental disorder E. no histroy of judgment bsaed n the individual's hx and
with seasonal pattern -in partial or
manic or hypomanic episodes cultural norms
full remission

Persisten Symptoms represent an amalgamation of A. Depressed mood, most of the day, for more days than not, reported or
t symptoms of chronic major depressive disrder observed, for at least 2 yrs --kids = irritable and for 1 yr; B. 2 or more: ack
same as MDD but early or late onset: early
and dysthymic disorder. Chronic depressed of appetite or overeating, insomnia or hypersomnia, fatigue, low self-
Depressi moood persists at least 2 years while depressed, 2 year -- at esteem, difficulty concentrating and indecisive, hopeless C. In 2 yd period mood-congruent or incongruent
onset before 21 and late onset after 21; with
pure dysthymic syndrome: MDE not met in at
ve PDD at least two of the following occur: lack of least one year A, B- 2+, C-H never without symptoms for more than 2 mnths at a time, criteria for psuchotic ; w catatonial with
least 2 yrs; w persistent MDE; w intermittent
appetite or overeating, insomnia or for children MDD continuously present for 2 years;E never manic or hypanic or peripartum onset
Disorder hypersomnia, fatigue, low self-esteem, difficulty cyclothymic F not better explained by another mental disorder G. not
MDE, w current episode; w intermittent mde,
w/o current episode ALSO mid, mod, severe
(dysthym concentrating and indecisive, hopeless never attributable to the effects of substance or other med cx H. causes clin sig
w/o symptoms for more than 2 mos dis
ia)

premenst
rual symptoms present during the majority of
A, B 1+, C 1+
must have 5
dysphori PDD menstrual cycles, at least five sx met before
between b &
week of menses,
c C, D-G
disorder

disturbance in mood by depressed mood or

Substanc diminished interest or pleasure in all or almost
e all activities evidence -- during or soon after
with onset during intoxication or
Sub/Rx substance intoxication or withdrawal or
induced during withdrawal
exposure to meds involved substance is capable
MDD of proudcing symptoms - not better explained by
another depressive episode

Dep
Disorder
evidence that the disturbance is direct w depressed features with major
due to pathophysiological consequence of another depressive-like epsidoe; with mixed
another medical condition features
medical
condition

when symptoms or impairment do not meet

Other criteria, but clinician chooses to communicate
ex: recurrent brief depression; short-duration depressive episode,
specified depressive episode with insufficient symptoms
the reason criteria is not met

unspecifi
ed when distress do not meet full criteria for any
depressiv depressive disorders, but clinician chooses not to
communicate the specific reason
e
disorder
 Differential
Disorder Overview Onset # Criteria Diagnostic Criteria Specifiers Diagnosis Terms
1. inflated self-esteem or grandiosity
2. decreased need for sleep
Main feature of Bipolar disorders is a disturbance of mood 3. more talkative than usual or pressured speech
These disorders are dependent on the pattern of mood episodes 4. flight of ideas or racing thoughts
3 types of mood episodes: 5. distractibility
bipolar Manic episode
6. increase on goal-directed activity (social, work, or
Hypomanic episode
disorders Depressive episode sexually) or psychomotor agitation
Episodes - do not have codes, cannot be diagnosed separately, & are not diagnoses 7. excessive pleasurable activities (high potential for
painful consequences)

A distinct period of abnormally and persistently elevated , expansive, or irritable mood AND abnormally & persistently increased goal-directed activity or energy, lasting at least one week OR needing
hospitalization
3 or more symptoms (4 if mood is only irritable) which represent a noticeable change from usual behavior (on page 124)
Causes marked impairment OR necessitates hospitalization OR includes psychotic features
Exclusion

A manic episode may have been preceded or followed by a hypomanic or major depressive episode.
mani episode
Same as manic episode BUT lasting at least 4 consecutive days & present most of the day, nearly every day
3 or more symptoms (4 if mood is only irritable) which represent a noticeable change from usual behavior (page 124)
Change is unequivocally a change in functioning that is uncharacteristic of person
Disturbance & change in functioning is observable by others
Not severe enough to cause marked impairment or need for hospitalization NOTE: If there are psychotic features, the episode is, by
Exclusion definition, manic Note : Hypomanic
episodes are common in BPI disorder but are not
hypomanic required to make a diagnosis of BPI.

Coding & Recording is based on current or most recent episode Remission specifiers are only indicated if full criteria is
At least 1 manic episode Current severity & psychotic features are indicated only if FULL NOT currently met for manic, hypomanic, or major
Bipolar 1 BP1 Exclusion criteria are currently met for a manic or depressive episode depressive episode

Specify current or most recent episode:

Hypomanic or depressed
Specify if: (same specifiers – page 134-135)
Specify course if full criteria are not currently met:
In partial remission
Bipolar II Disorder – recurrent Major Depressive Episode with In full remission
Hypomanic Episodes. Conditions for a current or previous Specify severity if full criteria for a mood episode are
hypomanic episode are met and the conditions for a current or A. at least one hypomanic episode AND one major depressive currently met: Mild, Moderate, or Severe
previous major depressive disorder must also be met episode B. No history of a manic episdoe C. exclusion D. cuasing
Bipolar II Disorder
BP2 clinically significance or impairment

Numerous episodes with hypomanic & depressive symptoms that

a period of at least two years, the symptoms for a hypomania or
depression have appeared several times but the criteria for the
episode have never been met. During the two year period,
hypomanic and depressive episodes have occurred at least half
the time and the patient has not been symptom free for more
Cyclothymic disorder
cyclothymic than 2 months at a time
do not meet full criteria, for 2 years (1 in minors)
For at least half the time of last 2 years & person has not been
without symptoms for more than 2 months at a time
Full criteria for a mood episode have never been met
Exclusion
Causing clinically significant distress or impairment
Exclusion Specify if: with anxious distress

With anxious distress

With mixed features
Substance/Medication-Induced Bipolar & Related Disorder With rapid cycling
With melancholic features
Bipolar & Related Disorder Due to Another Medical Condition With atypical features
With mood-congruent psychotic features Chronic – full criteria met for 2 years of MD episode,
Other Specified Bipolar & Related Disorder With mood-incongruent psychotic features can be applied to most recent episode
With catatonia
Unspecified Bipolar & Related Disorder With peripartum onset Catatonic – 2 of 5 criteria, p. 418
Other disorders With seasonal pattern
 Disorder Overview Onset # Criteria Diagnostic Criteria Specifiers Differential Diagnosis Terms
"Main feature is a disruption in Consciousness Memory Identity
Perception" THE ESSENtial features of these disroders is the Amnesia – forget important personal events (usually traumatic), too extensive
disruption in the integration of consciousness as this relates to to be forgetfulness
memory, identity, and perception of the environment. Such Fugue – sudden travel away from home, inability to recall past or identity,
disturbances may be gradual, transient, or chronic. assuming new one
DID – multiple identities
Depersonalization – feeling of being detached from one’s mental processes or
body
NOS – possession trance disorder which is very controversial

A. 2 or more distinct personality states involving marked discontinuity in

sense of self and agency, accompanied by related alterations in affect,
behavior, consciousness, memory, perception, cognition, and/or sensory-
Dissociati essential features include rthe presencee of two or more distinct motor functioning
ve DID
personality states or identities that recurrently assume control of the
individual's bx, accompanied with the inability to recall important
2 or more
personality
B. Recurrent gaps in the recall of every day events, important personal
information, and/or traumatic events that are inconsistent with ordinary
Identity personal information that is too extensive to be accounted for by states forgetting
ordinary forgetfulness C. Causing clinically significant distress or impairment
Disorder D. Not a normal part of a broadly accepted cultural of religious practice
E. Exclusion

A. Inability to recall important personal information, usually of

traumatic or stressful nature, that is inconsistent with ordinary
forgetting
B. Causes significant distress or impairment if with dissociative
The inability to recall important personal information,
C. Exclusion -- no sub fugue: apparently
usually of a traumatic or stressful nature, that cannot be
DA A-D D. Exclusion -- not did, ptsd, acute stress, somatic system purposeful travel or "Localized - Events around a certain period of time, usually first few hours
explained with ordinary forgetfulness
disorder, or neurocognitive disorder bewildered wandering Selective - Recalls some but not all events around a period of time
that is assoc w LESS COMMON: Generalized -
amneisa for id or other Entire life
important autiobio Continuous - Subsequent to a specific time up to the present
Dissociative Amnesia info Systematized - For certain categories

A. Persistent or recurrent personalization, derealization, or

both
characterized by a persistent and recurring feeling of Depersonalization - Experience of unreality, detachment, or
depersonalization -- perceptual alterations, distorted sense
being estranged from oneself, of being a spectator of being an outside observer with respect to one’s thoughts,
of ime, unreal or absent self, emotional and/or physical
one's own life, and of being detached from one's mental A - 1 or both feelings, body, or action
numbing derealization
processes or boy that is accompanied by intact reality B-E Derealization – experiences of unreality or detachment with
-- eindividuals or objects are experienced as unreal,
Depersona testing (individual is aware that this is only a feeling of respect to surroundings
dreamlike, foggy, lifeless, or visually distorted
lization/de self-alienation and not reality as such) B. Reality testing remains intact
C. Causing clinically significant distress or impairment
realization D. Exclusion
disorder E. Exclusion
 Disorder Overview Onset # Criteria Diagnostic Criteria Specifiers Differential Diagnosis Terms
A. Obsessions, compulsions, or both With good or fair insight-- individual recongizes that obsessive-compulsive disorder obsessions: unwanted, intrusive
Obsessions are both beliefs are definitely or probably not true or that they may or may not be true. thoughts or images that are
1. recurrent and persistent thoughts, urges, or images, that are With poor insight: individual thinks obsessive-compulsive disorder beleifs are experiened repeatedly and bring
experienced, at some time during the disturbance, as intrusive and probably true With @ distress; person treis to
unwanted, and that in most individuals cause marked distress or absent insight/delusional beliefs: individual is completely convinced that the beliefs counteract and alleviate these
impairment 2. attempts to ignore or suppress to neutralize then with other are true thoughts and images with outher
thought or action thoughts and axns
Compulsions are both compulsions: repeptitive
indicated by the presence of obsessions ) and/or 1. repetitive behaviors that the individual feels driven to perform in ritualized actions that the
compulsions The reptitive rituals are causally response to and obsession or according to rules that must be applied 2. individual feels compelled to
unconnected to the obsessions they are attempting to The behavior or mental acts are aimed at preventing or reducing anxiety or perform in order to alleviate the
counteract and/or are excessive in their application. distress, or preventing some dreaded event or situationB. Time consuming distress caused by obsessions
obsessions and or compulsions endure, lasting at least A- ob or or cause clinically significant distress or impairment C. Exclusion D.
Obsessive Compulsive
OCD Disorder
an hour a day comp or both Exclusion

indicated by inordiante attention to at least one
perceived falw in physical appearance that is
unnoticeable or appears slight to other observers.
Individual engages in repetitive behaviors as a means of
Body Dysmorphic disorderobtaining reassurance about appearance concerns.
individual recognizes that the body dysmorphic disorder beliefs are definitely or
A. Preoccupation with one of more perceived defects of flaws in physical probably not true or that they may or may not be true With poor insight -- the
appearance that are not observable or appear slight to others indidiviual thinks the body With absent
B. Behaviors or mental acts in response to the appearance concerns insight/delusional beliefs Specify if With Muscle Dysphoria
C. Causing clinically significant distress or impairment
D. Exclusion

A. Persistent difficulty discarding or parting with possessions, regardless of

their actual value
B. Difficulty is due to a perceived need to save the items and to distress
associated with discarding them
C. Results in accumulation of possessions that congest and clutter active
indicated by chronic difficulty in getting rid of living areas and compromises their intended use.
possessions egardless of their value. The bx stems from a D. Causing clinically significant distress or impairment
need to save items and the associated distress of being E. Exclusion
without them. The accumulation of hoarded items is so E. Exclusion specify if with
Hoarding disorder excessive so as to make living areas difficult to inhabit. a-e excessive acquisition based on insight

Recurrent pulling out of one’s hair, resulting in hair loss

Repeated attempts to decrease or stop
Causing clinically significant distress or impairment
repetitive puling of one's own hair resulting in hair loss, Exclusion
accompanied by repeated attempts to cease this Exclusion
trichotillomania behavior
Recurrent skin picking, resulting in skin lesions
Repeated attempts to decrease or stop
Causing clinically significant distress or impairment
Exclusion
repeated skin-picking behaviors resulting in skin lesions, Exclusion
excoriation accompanied by repeated attempts to cease this bx
others: Obsessive-Compulsive and Related Disorder Due to Another
there is evidence that the symptoms of obsessive- Medical Condition
compulsive disorder transpire concurrently with or
following substance intoxiation, withdrawal, or following Other Specified Obsessive-Compulsive and Related Disorder
exposure to a medication; the substance/medication
under consideration is capable of bringing about severe Unspecified Obsessive-Compulsive and Related Disorder
substance/ med anxiety
 Disorder Overview Onset # Criteria Diagnostic Criteria Specifiers Differential Diagnosis Terms
persistent -- disorder has been present for more than 12 moths

chronic pattern of emotionally withdrawn bx wih adult
careetakers manifested before age 5, and child is
developmentally at least 9 months old. Cond is revealed by
presence of both the following: child rarely seeks comfort when
distressed, child is minimally responsive to the comfort provided
when distressed. At least two of the following:minimal social
responsiveness, minimal positive affect, periods of inexplicable
irritability, fear, or sadness during periods of nonthreatening
interaction with adult caretakers. extremely insufficient care:
severe neglect, instability and frequnet changes in adult
caretakers, being raised in settings that severely limit the
Reactive attachment
RAD disorder
availability of attachments to caretakers.
A. consistent pattern of inhibited, emotionally withdrawn behavior tward adult caregivers,
manifested by BOTH: child rarely seeks comfort when distressed, child is minimally responsive to
the comfort provided when distressed B. A persistent social and emotional distrubance
characterized by at least two of the following: 1. minimal social and emotional responsiveness to
others 2. limited positive affect 3. episodes of unexplained irritability, sadness, or fearfulness
that are evident even during nonthreatening interactions with adult caregivers C. experienced a
pattern of extremes of insufficient care as evidenced by at least one of the following: 1. social
neglect or deprivation inthe form of persistant lack of having basic emotional needs for comfort,
stimulation, or affection met by caregivers, 2, repeated changes in caregivers that limit ability to
9 mos - 5 yrs form stable attchments 3. rearing in unusual settings that severely limit opportunities to form
over 1 yr = A - both B- 2/, selective attachments D. criterion C is responsible for A. E. not ASD, F. disturbances evident
persistent C - at least 1 before 5 G. at least 9 months

manifested by a child's pattern of seeking out and interacting

with unfamiliar adults, and the presence of at least two of the A. pattern of bx child actively approaches and interacts wih unfamiliar aduts - reduced or
following: lack of retcence when interactign with unfamiliar absence retiecence in approaching or interacting withunfamiliar aduls, overly familiar verbal or
Disinhibited adults, overly familiar physical or verbal bx with unfamiliar physical bs diministhed or absent checking back with adult caregiver, willingness to go off with
Social adults, little regard for reconnecting with adult caretakers even an unfamiliar adult B. bx in A are not just impulsivity C. child is expereincing pattern of extremes
Engagement in un familiar enviornments, unhesitatingly accompanying over 9 A- 2+, B, C 1+, of insufficient care as evidenced by at least 1: social neglect to form attachment, repeated persistent -- over 12
Disorder DSED unfamiliar adults months D-E changes of caregivers, rearing in unusual setting, D. C is caused by A. E. 9 months or older months

intrusion symptoms: recurring distressing memories, frequent nightmares, flashbacks that may
have dissociative reactions, intense reactive distress whenin presence of cues that serve as a
reminder of traumatic event, severe physiological reactions upon exposure to cues resembling w dissociative
condition lasts at least a month and results from experiencing aspects of the traumatic event avoidance symptoms: attempts to avoid symptoms -
actual or threatened death, serious injury, or sexual violence as distressing thoughts, feelings, or memories reminiscient of event, avoidance of external stimuli derealization,
manifested by at least one: direclty experiencing or witnessing a that may serve as reminders of the traumatic events depersonalization,
traumatic event, becoming aware of close friends or family negative mood: dissociative amneisa, negative attitudes about self, others, world, self blame with delayed
suffering traumatic event, repeated exposure to aversive aspects must be over Arousal symptoms: unprovoked irritability and temper tantrums, irresponsible self-destructive expression -- don’t
of traumatic events; at least 1 intrusion symptom, avoidance 6 years old - A, B 1+, C 1+, activities, hypervigilance, heightened startle reaction, difficutly in focusing and concentrating, meet full criteria for 6
PTSD PTSD symptoms, negative mood; arousal symptoms lasts 1 month D 2+, E-J disrupted sleep patterns months after event

Same A, one or more intrusion, avoidance or negative mood or

congition, avoidance beginning or worsening after the event;
alterations in arousal or reactivity, needing two or more younger than
PTSD for under PTSD
6 alterations in arousal, lasts more than a month 6; lasts 1 yr same

symptoms of the disorder are the same as those for PTSD. At

least 9 symotms manifest starting immediately after the trauma 3 days to 1
Acute Stress Disorder
ASD and lasting from 3 days to a month month SAME AS ABOVE - acute stress is less than a month --> then PTSD

manifested by the papearance of emotional or behavioral with depressed mood,

symptoms as a reaction to definitieve sress-inducing events, with anxiety, mixed anxiety
such symptoms making their appearance within 3 months of the and depressed mood,
event. Symptoms include one or both of the following: severe within 3 disturbance of
distress disproportionate tothe intensity of the event, signficiant months of A. development of emo/bx probs in response to stressor, B. clinically significant evidenced by 1 conduct, mixed
deterioriation in key areas of functioning. once the stress- events for no or both: marked distress that is out of proportion to severity of stressor, significant impairment disturbance of
producing events or the consequences have ceased, symptoms longer than 6 C. symptoms do not meet other disorder D. not mormal bereavement E. stressor ro its emotions and conduct,
Adjustment disorder
AD endure for no longer than 6 months months consequences have terminated E unspecified

Other and
unspecified
trauma and
stress-related
disorder
 Differential
Disorder Overview Onset # Criteria Diagnostic Criteria Specifiers Diagnosis Terms
in remission
-- criteria has
A. Persistent eating of non-nutritive, non-food substances for at least not been met
one month one month B. for a
-- Inappropriate to developmental level C. sustained
minimum Culturally and socially inappropriate D. If period of
age of two the eating behavior occurs in the context of another mental disorder (e. time
years g. intellectual disability [intellectual developmental disorder], autism
spectrum disorder, schizophrenia, or medical condition (including
pregnancy), it is sufficiently severe to warrant additional clinical
PICA PICA attention
in remission
-- criteria has
A. Repeated regurgitation of food, at least one month. May be re- not been met
chewed, re-swallowed, or spit out. B. Not for a
attributable to GI or AMC C. sustained
Exclusion of other eating disorder D. period of
Rumination RUMIN sufficiency exclusion time
anorexia/bulimia

A. Disturbance of eating or feeeding AEB failing to meet appropriate

nutritional &/or energy needs, associated with one or more:
1. significant weight loss or failure to make expected gains 2.
A- 1+ significant nutritional deficiency 3.
dependence on enternal feeding or nutritional supplements
4. marked interference with psychosocial fx B.
eating or feeding disturbance --lack of interest in eating or food; not because lack of available food or cultural
avoidance based on the sensory characteristics of food; concern about C. other eating disorder exclusion D.
aversive consequences of eating; persistent failure to meet exclusions: not caused by other menta/medical conditions, or severe
Avoidant/Restrictive
Av/Res Food
appropriate
Intake Disorder
nutritional and/or energy needs associated A criterion enough to warrant additional clinical attention
restricting restricting type: during the three months not engaged
type or binge- in epsidoes of binging or purging behavior. Weight loss
eating type is accomplished primarily through dieting, fasting, or
A. restriction of required energy intake, leading to signficantly low body partial/full excessive exercise. Binge-eating/purging
coding
weight, taking into account age, sex, developmental trajectory, and remission type: for last three months, individiual engaged in
based on
physical health. Signficantly low weight. currenty recurrent episodes of binge eating or purging behavior
three
B. intense fear of gaining weight or of becoming fat OR persistent severity Mild, Mod, Severe, Extreme based on BMI
month
behavior that interferes with weight gain, even though at a significantly
periods
low weight. C. Disturbance in the way
one's weight or shape is experienced OR undue influence of weight or
shape on self-evaluation OR lack of recognition of the seriousness of low
Anorexia Nervosa
Anorexia body weight
in partial or
full remission
mild mod
A. recurrent episodes of binge eating. An episode is characterized by: severe
1. Binging during a discrete period of time (within any two hour period) extreme
bx occur an amount of food that is definitely larger than what most individuals
at least would eat in a similar period of time under similar circumstances.
1x wk for 2. sense of lack of control over eating during the episode (feeling that
3mos one cannot stop eating or control what or how much one is eating)
B. recurrent appropriate compensatory behaviors to prevent weight gain
-- self-induced vomiting, misuse of laxatives, diuretics, or orther
medications; fasting or excessive exercise
C. the binge eating and inappropriate compensatory behaviors both
BULIMIA NERVOSA
BULIMIA occur, on average, at least once a week for 3 months