Saturday, July 19, 2014

DSM5 Diagnostic Criteria and Coding

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From the list below there are 20 Diagnostic Criteria under the new DSM5 (2013). Which among the list would likely be included in the licensure exam? For us at TR Review we based our consideration from the Course Specifications provided by CHED which includes the following:

  • Disorders usually first diagnosed in infancy, childhood or adolescence                             
  • Cognitive Disorders                                                                                                      
  • Substance-related Disorders                                                                                                     
  • Schizophrenia and other Psychotic Disorders                                                                               
  • Mood Disorders                                                                                                                        
  • Anxiety Disorders                                                                                                                     
  • Dissociative Disorders                                                                                                              
  • Personality Disorders

Note:  we are not saying these will be the only topics (criteria) that  will be covered, but we suggest to give emphasis in your review. As future Psychometrician would you think these criteria will be useful? We think they are. 

But please do not limit yourself in learning only these criteria but also learn the rest of the criteria: the nuances, similarities and relatedness of some with the other criteria. We included in the description of each criteria a summary from wikipedia -

Diagnostic Criteria 

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1) Neurodevelopmental Disorders

a) Intellectual Disabilities
Intellectual Disability (Intellectual Developmental Disorder)
Global Developmental Delay
Unspecified Intellectual Disability (Intellectual Developmental Disorder)

b) Communication Disorders
Language Disorder
Speech Sound Disorder (previously Phonological Disorder)
Childhood-Onset Fluency Disorder (Stuttering)
Social (Pragmatic) Communication Disorder
Unspecified Communication Disorder

c)Autism Spectrum Disorder
Autism Spectrum Disorder

d) Attention-Deficit/Hyperactivity Disorder
Attention-Deficit/Hyperactivity Disorder
Other Specified Attention-Deficit/Hyperactivity Disorder
Unspecified Attention-Deficit/Hyperactivity Disorder

e) Specific Learning Disorder
Specific Learning Disorder

f) Motor Disorders
Developmental Coordination Disorder
Stereotypic Movement Disorder
Tic Disorders
Tourette’s Disorder
Persistent (Chronic) Motor or Vocal Tic Disorder
Provisional Tic Disorder
Other Specified Tic Disorder
Unspecified Tic Disorder

g) Other Neurodevelopmental Disorders
Other Specified Neurodevelopmental Disorder
Unspecified Neurodevelopmental Disorder

Neurodevelopmental disorders
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2) Schizophrenia Spectrum and Other Psychotic Disorders

Schizotypal (Personality) Disorder
Delusional Disorder
Brief Psychotic Disorder
Schizophreniform Disorder
Schizoaffective Disorder
Substance/Medication-Induced Psychotic Disorder
Psychotic Disorder Due to Another Medical Condition

a) Catatonia
Catatonia Associated With Another Mental Disorder (Catatonia Specifier)
Catatonic Disorder Due to Another Medical Condition
Unspecified Catatonia
Other Specified Schizophrenia Spectrum and Other Psychotic Disorder
Unspecified Schizophrenia Spectrum and Other Psychotic Disorder

Schizophrenia spectrum and other psychotic disorders
  • A major mood episode is required for schizoaffective disorder (for a majority of the disorder's duration after criterion A [related to delusions, hallucinations, disorganized speech or behavior, and negative symptoms such as avolition] is met).[2]
  • Catatonia in all contexts requires 3 of a total of 12 symptoms. Catatonia may be a specifier for depressive, bipolar, and psychotic disorders; part of another medical condition; or of another specified diagnosis.[2]

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3) Bipolar and Related Disorders

Bipolar I Disorder
Bipolar II Disorder
Cyclothymic Disorder
Substance/Medication-Induced Bipolar and Related Disorder
Bipolar and Related Disorder Due to Another Medical Condition
Other Specified Bipolar and Related Disorder
Unspecified Bipolar and Related Disorder

4) Depressive Disorders

Disruptive Mood Dysregulation Disorder
Major Depressive Disorder, Single and Recurrent Episodes
Persistent Depressive Disorder (Dysthymia)
Premenstrual Dysphoric Disorder
Substance/Medication-Induced Depressive Disorder
Depressive Disorder Due to Another Medical Condition
Other Specified Depressive Disorder
Unspecified Depressive Disorder

Depressive disorders
  • Specifiers were added for mixed symptoms and for anxiety, along with guidance to physicians for suicidality.[2]
  • The term dysthymia now also would be called persistent depressive disorder.

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5) Anxiety Disorders

Separation Anxiety Disorder
Selective Mutism
Specific Phobia
Social Anxiety Disorder (Social Phobia)
Panic Disorder
Panic Attack (Specifier)
Generalized Anxiety Disorder
Substance/Medication-Induced Anxiety Disorder
Anxiety Disorder Due to Another Medical Condition
Other Specified Anxiety Disorder
Unspecified Anxiety Disorder

Anxiety disorders
  • For the various forms of phobias and anxiety disorders, DSM-5 removes the requirement that the subject (formerly, over 18 years old) "must recognize that their fear and anxiety are excessive or unreasonable". Also, the duration of at least 6 months now applies to everyone (not only to children).[2]
  • Specific types of phobias became specifiers but are otherwise unchanged.[2]
  • The generalized specifier for social anxiety disorder (formerly, social phobia) changed in favor of a performance only (i.e., public speaking or performance) specifier.[2]

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6) Obsessive-Compulsive and Related Disorders

Obsessive-Compulsive Disorder
Body Dysmorphic Disorder
Hoarding Disorder
Trichotillomania (Hair-Pulling Disorder)
Excoriation (Skin-Picking) Disorder
Substance/Medication-Induced Obsessive-Compulsive and Related Disorder
Obsessive-Compulsive and Related Disorder Due to Another Medical Condition
Other Specified Obsessive-Compulsive and Related Disorder
Unspecified Obsessive-Compulsive and Related Disorder

7) Trauma- and Stressor-Related Disorders

Reactive Attachment Disorder
Disinhibited Social Engagement Disorder
Posttraumatic Stress Disorder
Acute Stress Disorder
Adjustment Disorders
Other Specified Trauma- and Stressor-Related Disorder
Unspecified Trauma- and Stressor-Related Disorder

8) Dissociative Disorders

Dissociative Identity Disorder
Dissociative Amnesia
Depersonalization/Derealization Disorder
Other Specified Dissociative Disorder
Unspecified Dissociative Disorder

Dissociative disorders
  • The criteria for dissociative identity disorder were expanded to include "possession-form phenomena and functional neurological symptoms". It is made clear that "transitions in identity may be observable by others or self-reported".[2]Criterion B was also modified for people who experience gaps in recall of everyday events (not only trauma).[2]

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9) Somatic Symptom and Related Disorders

Somatic Symptom Disorder
Illness Anxiety Disorder
Conversion Disorder (Functional Neurological Symptom Disorder)
Psychological Factors Affecting Other Medical Conditions
Factitious Disorder
Other Specified Somatic Symptom and Related Disorder
Unspecified Somatic Symptom and Related Disorder

10) Feeding and Eating Disorders

Rumination Disorder
Avoidant/Restrictive Food Intake Disorder
Anorexia Nervosa
Bulimia Nervosa
Binge-Eating Disorder
Other Specified Feeding or Eating Disorder
Unspecified Feeding or Eating Disorder

11) Elimination Disorders

Other Specified Elimination Disorder
Unspecified Elimination Disorder

12) Sleep-Wake Disorders

Insomnia Disorder
Hypersomnolence Disorder

a) Breathing-Related Sleep Disorders
Obstructive Sleep Apnea Hypopnea
Central Sleep Apnea
Sleep-Related Hypoventilation
Circadian Rhythm Sleep-Wake Disorders

b) Parasomnias
Non–Rapid Eye Movement Sleep Arousal Disorders
 Sleep Terrors
Nightmare Disorder
Rapid Eye Movement Sleep Behavior Disorder
Restless Legs Syndrome
Substance/Medication-Induced Sleep Disorder
Other Specified Insomnia Disorder
Unspecified Insomnia Disorder
Other Specified Hypersomnolence Disorder
Unspecified Hypersomnolence Disorder
Other Specified Sleep-Wake Disorder
Unspecified Sleep-Wake Disorder

13) Sexual Dysfunctions

Delayed Ejaculation
Erectile Disorder
Female Orgasmic Disorder
Female Sexual Interest/Arousal Disorder
Genito-Pelvic Pain/Penetration DisorderDSM-5 Table of Male Hypoactive Sexual Desire Disorder
Premature (Early) Ejaculation
Substance/Medication-Induced Sexual Dysfunction
Other Specified Sexual Dysfunction
Unspecified Sexual Dysfunction

14) Gender Dysphoria

Gender Dysphoria
Other Specified Gender Dysphoria
Unspecified Gender Dysphoria

15) Disruptive, Impulse-Control, and Conduct Disorders

Oppositional Defiant Disorder
Intermittent Explosive Disorder
Conduct Disorder
Antisocial Personality Disorder
Other Specified Disruptive, Impulse-Control, and Conduct Disorder
Unspecified Disruptive, Impulse-Control, and Conduct Disorder

16) Substance-Related and Addictive Disorders

a) Substance-Related Disorders
 Substance Use Disorders
 Substance-Induced Disorders
 Substance Intoxication and Withdrawal
 Substance/Medication-Induced Mental Disorders

b) Alcohol-Related Disorders
 Alcohol Use Disorder
 Alcohol Intoxication
 Alcohol Withdrawal
 Other Alcohol-Induced Disorders
 Unspecified Alcohol-Related Disorder

c) Caffeine-Related Disorders
 Caffeine Intoxication
 Caffeine Withdrawal
 Other Caffeine-Induced Disorders
 Unspecified Caffeine-Related Disorder

d) Cannabis-Related Disorders
 Cannabis Use Disorder
 Cannabis Intoxication
 Cannabis Withdrawal
 Other Cannabis-Induced Disorders
 Unspecified Cannabis-Related Disorder

e) Hallucinogen-Related Disorders
 Phencyclidine Use Disorder
 Other Hallucinogen Use Disorder
 Phencyclidine Intoxication
 Other Hallucinogen Intoxication
 Hallucinogen Persisting Perception Disorder
 Other Phencyclidine-Induced Disorders
 Other Hallucinogen-Induced Disorders
 Unspecified Phencyclidine-Related Disorder
 Unspecified Hallucinogen-Related Disorder

f) Inhalant-Related Disorders
 Inhalant Use Disorder
 Inhalant Intoxication
 Other Inhalant-Induced Disorders
 Unspecified Inhalant-Related Disorder

g) Opioid-Related Disorders
 Opioid Use Disorder
 Opioid Intoxication
 Opioid Withdrawal
 Other Opioid-Induced Disorders
 Unspecified Opioid-Related Disorder

h) Sedative-, Hypnotic-, or Anxiolytic-Related Disorders
 Sedative, Hypnotic, or Anxiolytic Use Disorder
 Sedative, Hypnotic, or Anxiolytic Intoxication
 Sedative, Hypnotic, or Anxiolytic Withdrawal
 Other Sedative-, Hypnotic-, or Anxiolytic-Induced Disorders
 Unspecified Sedative-, Hypnotic-, or Anxiolytic-Related Disorder

i) Stimulant-Related Disorders
 Stimulant Use Disorder
 Stimulant Intoxication
 Stimulant Withdrawal
 Other Stimulant-Induced Disorders
 Unspecified Stimulant-Related Disorder

j) Tobacco-Related Disorders
 Tobacco Use Disorder
 Tobacco Withdrawal
 Other Tobacco-Induced Disorders
 Unspecified Tobacco-Related Disorder

k) Other (or Unknown) Substance–Related Disorders
 Other (or Unknown) Substance Use Disorder
 Other (or Unknown) Substance Intoxication
 Other (or Unknown) Substance Withdrawal
 Other (or Unknown) Substance–Induced Disorders
 Unspecified Other (or Unknown) Substance–Related Disorder

l) Non-Substance-Related Disorders
Gambling Disorder

Substance-related and addictive disorders
  • Substance abuse and substance dependence from DSM-IV-TR have been combined into single substance use disorders specific to each substance of abuse within a new "addictions and related disorders" category.[23] "Recurrent legal problems" was deleted and "craving or a strong desire or urge to use a substance" was added to the criteria.[2]The threshold of the number of criteria that must be met was changed.[2] Severity from mild to severe is based on the number of criteria endorsed.[2] Criteria for cannabis and caffeine withdrawal were added.[2] New specifiers were added for early and sustained remission along with new specifiers for "in a controlled environment" and "on maintenance therapy".[2]

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17) Neurocognitive Disorders

Other Specified Delirium
Unspecified Delirium

a) Major and Mild Neurocognitive Disorders
Major Neurocognitive Disorder
Mild Neurocognitive Disorder
Major or Mild Neurocognitive Disorder Due to Alzheimer’s Disease
Major or Mild Frontotemporal Neurocognitive Disorder
Major or Mild Neurocognitive Disorder With Lewy Bodies
Major or Mild Vascular Neurocognitive Disorder
Major or Mild Neurocognitive Disorder Due to Traumatic Brain Injury
Substance/Medication-Induced Major or Mild Neurocognitive Disorder
Major or Mild Neurocognitive Disorder Due to HIV Infection
Major or Mild Neurocognitive Disorder Due to Prion Disease
Major or Mild Neurocognitive Disorder Due to Parkinson’s Disease
Major or Mild Neurocognitive Disorder Due to Huntington’s Disease
Major or Mild Neurocognitive Disorder Due to Another Medical Condition
Major or Mild Neurocognitive Disorder Due to Multiple Etiologies
Unspecified Neurocognitive Disorder

Neurocognitive disorders

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18) Personality Disorders

General Personality Disorder

a) Cluster A Personality Disorders
Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder

b) Cluster B Personality Disorders
Antisocial Personality Disorder
Borderline Personality Disorder
Histrionic Personality Disorder
Narcissistic Personality Disorder

c) Cluster C Personality Disorders
Avoidant Personality Disorder
Dependent Personality Disorder
Obsessive-Compulsive Personality Disorder

d) Other Personality Disorders
Personality Change Due to Another Medical Condition
Other Specified Personality Disorder
Unspecified Personality Disorder

Personality disorders
  • Personality disorder previously belonged to a different axis than almost all other disorders, but is now in one axis with all mental and other medical diagnoses.[26] However, the same ten types of personality disorder are retained.[26]

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19) Paraphilic Disorders

Voyeuristic Disorder
Exhibitionistic Disorder
Frotteuristic Disorder
Sexual Masochism Disorder
Sexual Sadism Disorder
Pedophilic Disorder
Fetishistic Disorder
Transvestic Disorder
Other Specified Paraphilic Disorder
Unspecified Paraphilic Disorder

20) Other Mental Disorders

Other Specified Mental Disorder Due to Another Medical Condition
Unspecified Mental Disorder Due to Another Medical Condition
Other Specified Mental Disorder
Unspecified Mental Disorder

Diagnostic Criteria Coding

Important notes on the new DSM5:

To increase the utility to the clinician, the new version replaces the NOS (not otherwise specified) categories with two options: 

1) other specified disorder  - allows the clinician to specify the reason that the criteria for a specific disorder are not met

2) unspecified disorder - allows the clinician the option to forgo specification.

DSM-5 has discarded the multiaxial system of diagnosis (formerly Axis I, Axis II, Axis III), listing all disorders in Section II. It has replaced Axis IV with significant psychosocial and contextual features and dropped Axis V (Global Assessment of Functioning, known as GAF). The World Health Organization's (WHO) Disability Assessment Schedule is added to Section III (Emerging measures and models) under Assessment Measures, as a suggested, but not required, method to assess functioning.[3]

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