What to review for BLEPP: DSM IV-TR or DSM5?

One of the frequently asked questions that we receive on our FB Page is "What to review DSM IV-TR or DSM5 for the BLEPP?" (DSM - Diagnostic and Statistical Manual of Mental Disorders / BLEPP - Board Licensure Examinations for Psychologists and Psychometricians).

In the 2016 proposed changes of the TOS (Table of Specifications) for Abnormal Psychology, comparing it with the 2014 TOS, nowhere will you find DSM or ICD 10 specifically or categorically stated as basis for identifying common psychological disorders and its specific symptoms. DSM was a creation of the American Psychiatric Association while the International Classifcation of Diseases (ICD) was made by the World Health Organization (WHO).

So how do we reply to the query. We would answer and reply back to study both DSM IV-TR and DSM5 and be familiarized as well with ICD10. The video below taken from APA link serves as an overview of the changes from the old DSM to the current one. There were reorganization/rearrangement made, some addition on specifier, comorbidity and the like. Some of the major changes, Schizophrenia got expanded through a spectrum;  Mood Disorder is now integrated among Depressive Disorder and Bipolar Disorder; and  Anxiety disorders is now split further into: Obsessive-compulsive and related disorders and Trauma- and stressor-related disorders. It appears that with all the expansion made in DSM5, ICD 10 serves to reflect the older DSM version.

With all those so many disorders so what one should focus into? No definite answer but we would suggest those who ask to refer  to the CHED Course Content since it is the mandated requirements by CHED which I hope the PRC-Board of Psychology would take into consideration when making the exam.

At least cover the following topics:
a) Disorders usually first diagnosed in infancy, childhood or adolescence
b) Cognitive Disorders
c) Substance-related Disorders
d) Schizophrenia and other Psychotic Disorder
e) Mood Disorders
f) Anxiety Disorders
g) Dissociative Disorders
h) Personality Disorders

Still a lot - better be prepared than regret later on.

Below is a video from APA website - http://www.apa.org/ed/precollege/topss/videos-teachers.aspx

 

Other related links:

http://psychometricpinas.blogspot.com/2015/06/dsm5-videos-from-taylor-study-method.html

http://psychometricpinas.blogspot.com/2014/03/dsm-5-update-for-counselors-students.html

http://psychometricpinas.blogspot.com/2015/03/dsm5-various-slide-presentations.html

 http://psychometricpinas.blogspot.com/2014/09/combined-course-specifications-and-tos.html

Mood Affective Disorders ICD10 F30

Image source -http://www.greatsaunas.com/images/HandsHoldingsunneededtotreatseasonalaffectivedisorder.jpg

International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) Version for 2010

Chapter V
Mental and behavioural disorders
(F00-F99)

Mood [affective] disorders
(F30-F39)

This block contains disorders in which the fundamental disturbance is a change in affect or mood to depression (with or without associated anxiety) or to elation. The mood change is usually accompanied by a change in the overall level of activity; most of the other symptoms are either secondary to, or easily understood in the context of, the change in mood and activity. Most of these disorders tend to be recurrent and the onset of individual episodes can often be related to stressful events or situations.

F30Manic episode

All the subdivisions of this category should be used only for a single episode. Hypomanic or manic episodes in individuals who have had one or more previous affective episodes (depressive, hypomanic, manic, or mixed) should be coded as bipolar affective disorder (F31.-).

Incl.:

bipolar disorder, single manic episode

F30.0Hypomania

A disorder characterized by a persistent mild elevation of mood, increased energy and activity, and usually marked feelings of well-being and both physical and mental efficiency. Increased sociability, talkativeness, over-familiarity, increased sexual energy, and a decreased need for sleep are often present but not to the extent that they lead to severe disruption of work or result in social rejection. Irritability, conceit, and boorish behaviour may take the place of the more usual euphoric sociability. The disturbances of mood and behaviour are not accompanied by hallucinations or delusions.

F30.1Mania without psychotic symptoms

Mood is elevated out of keeping with the patient's circumstances and may vary from carefree joviality to almost uncontrollable excitement. Elation is accompanied by increased energy, resulting in overactivity, pressure of speech, and a decreased need for sleep. Attention cannot be sustained, and there is often marked distractibility. Self-esteem is often inflated with grandiose ideas and overconfidence. Loss of normal social inhibitions may result in behaviour that is reckless, foolhardy, or inappropriate to the circumstances, and out of character.

F30.2Mania with psychotic symptoms

In addition to the clinical picture described in F30.1, delusions (usually grandiose) or hallucinations (usually of voices speaking directly to the patient) are present, or the excitement, excessive motor activity, and flight of ideas are so extreme that the subject is incomprehensible or inaccessible to ordinary communication.

Mania with:

• mood-congruent psychotic symptoms
• mood-incongruent psychotic symptoms

Manic stupor

F30.8Other manic episodes

F30.9Manic episode, unspecified

Mania NOS

F31Bipolar affective disorder

A disorder characterized by two or more episodes in which the patient's mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (hypomania or mania) and on others of a lowering of mood and decreased energy and activity (depression). Repeated episodes of hypomania or mania only are classified as bipolar.

Incl.:

manic-depressive:

• illness
• psychosis
• reaction

Excl.:

bipolar disorder, single manic episode (F30.-)

cyclothymia (F34.0)

F31.0Bipolar affective disorder, current episode hypomanic

The patient is currently hypomanic, and has had at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past.

F31.1Bipolar affective disorder, current episode manic without psychotic symptoms

The patient is currently manic, without psychotic symptoms (as in F30.1), and has had at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past.

F31.2Bipolar affective disorder, current episode manic with psychotic symptoms

The patient is currently manic, with psychotic symptoms (as in F30.2), and has had at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past.

F31.3Bipolar affective disorder, current episode mild or moderate depression

The patient is currently depressed, as in a depressive episode of either mild or moderate severity (F32.0 or F32.1), and has had at least one authenticated hypomanic, manic, or mixed affective episode in the past.

F31.4Bipolar affective disorder, current episode severe depression without psychotic symptoms

The patient is currently depressed, as in severe depressive episode without psychotic symptoms (F32.2), and has had at least one authenticated hypomanic, manic, or mixed affective episode in the past.

F31.5Bipolar affective disorder, current episode severe depression with psychotic symptoms

The patient is currently depressed, as in severe depressive episode with psychotic symptoms (F32.3), and has had at least one authenticated hypomanic, manic, or mixed affective episode in the past.

F31.6Bipolar affective disorder, current episode mixed

The patient has had at least one authenticated hypomanic, manic, depressive, or mixed affective episode in the past, and currently exhibits either a mixture or a rapid alteration of manic and depressive symptoms.

Excl.:

single mixed affective episode (F38.0)

F31.7Bipolar affective disorder, currently in remission

The patient has had at least one authenticated hypomanic, manic, or mixed affective episode in the past, and at least one other affective episode (hypomanic, manic, depressive, or mixed) in addition, but is not currently suffering from any significant mood disturbance, and has not done so for several months. Periods of remission during prophylactic treatment should be coded here.

F31.8Other bipolar affective disorders

Bipolar II disorder

Recurrent manic episodes NOS

F31.9Bipolar affective disorder, unspecified

F32Depressive episode

In typical mild, moderate, or severe depressive episodes, the patient suffers from lowering of mood, reduction of energy, and decrease in activity. Capacity for enjoyment, interest, and concentration is reduced, and marked tiredness after even minimum effort is common. Sleep is usually disturbed and appetite diminished. Self-esteem and self-confidence are almost always reduced and, even in the mild form, some ideas of guilt or worthlessness are often present. The lowered mood varies little from day to day, is unresponsive to circumstances and may be accompanied by so-called "somatic" symptoms, such as loss of interest and pleasurable feelings, waking in the morning several hours before the usual time, depression worst in the morning, marked psychomotor retardation, agitation, loss of appetite, weight loss, and loss of libido. Depending upon the number and severity of the symptoms, a depressive episode may be specified as mild, moderate or severe.

Incl.:

single episodes of:

• depressive reaction
• psychogenic depression
• reactive depression

Excl.:

adjustment disorder (F43.2)

recurrent depressive disorder (F33.-)

when associated with conduct disorders in F91.- (F92.0)

F32.0Mild depressive episode

Two or three of the above symptoms are usually present. The patient is usually distressed by these but will probably be able to continue with most activities.

F32.1Moderate depressive episode

Four or more of the above symptoms are usually present and the patient is likely to have great difficulty in continuing with ordinary activities.

F32.2Severe depressive episode without psychotic symptoms

An episode of depression in which several of the above symptoms are marked and distressing, typically loss of self-esteem and ideas of worthlessness or guilt. Suicidal thoughts and acts are common and a number of "somatic" symptoms are usually present.

Agitated depression Major depression Vital depression

single episode without psychotic symptoms

F32.3Severe depressive episode with psychotic symptoms

An episode of depression as described in F32.2, but with the presence of hallucinations, delusions, psychomotor retardation, or stupor so severe that ordinary social activities are impossible; there may be danger to life from suicide, dehydration, or starvation. The hallucinations and delusions may or may not be mood-congruent.

Single episodes of:

• major depression with psychotic symptoms
• psychogenic depressive psychosis
• psychotic depression
• reactive depressive psychosis

F32.8Other depressive episodes

Atypical depression

Single episodes of "masked" depression NOS

F32.9Depressive episode, unspecified

Depression NOS

Depressive disorder NOS

F33Recurrent depressive disorder

A disorder characterized by repeated episodes of depression as described for depressive episode (F32.-), without any history of independent episodes of mood elevation and increased energy (mania). There may, however, be brief episodes of mild mood elevation and overactivity (hypomania) immediately after a depressive episode, sometimes precipitated by antidepressant treatment. The more severe forms of recurrent depressive disorder (F33.2 and F33.3) have much in common with earlier concepts such as manic-depressive depression, melancholia, vital depression and endogenous depression. The first episode may occur at any age from childhood to old age, the onset may be either acute or insidious, and the duration varies from a few weeks to many months. The risk that a patient with recurrent depressive disorder will have an episode of mania never disappears completely, however many depressive episodes have been experienced. If such an episode does occur, the diagnosis should be changed to bipolar affective disorder (F31.-).

Incl.:

recurrent episodes of:

• depressive reaction
• psychogenic depression
• reactive depression

seasonal depressive disorder

Excl.:

recurrent brief depressive episodes (F38.1)

F33.0Recurrent depressive disorder, current episode mild

A disorder characterized by repeated episodes of depression, the current episode being mild, as in F32.0, and without any history of mania.

F33.1Recurrent depressive disorder, current episode moderate

A disorder characterized by repeated episodes of depression, the current episode being of moderate severity, as in F32.1, and without any history of mania.

F33.2Recurrent depressive disorder, current episode severe without psychotic symptoms

A disorder characterized by repeated episodes of depression, the current episode being severe without psychotic symptoms, as in F32.2, and without any history of mania.

Endogenous depression without psychotic symptoms

Major depression, recurrent without psychotic symptoms

Manic-depressive psychosis, depressed type without psychotic symptoms

Vital depression, recurrent without psychotic symptoms

F33.3Recurrent depressive disorder, current episode severe with psychotic symptoms

A disorder characterized by repeated episodes of depression, the current episode being severe with psychotic symptoms, as in F32.3, and with no previous episodes of mania.

Endogenous depression with psychotic symptoms

Manic-depressive psychosis, depressed type with psychotic symptoms

Recurrent severe episodes of:

• major depression with psychotic symptoms
• psychogenic depressive psychosis
• psychotic depression
• reactive depressive psychosis

F33.4Recurrent depressive disorder, currently in remission

The patient has had two or more depressive episodes as described in F33.0-F33.3, in the past, but has been free from depressive symptoms for several months.

F33.8Other recurrent depressive disorders

F33.9Recurrent depressive disorder, unspecified

Monopolar depression NOS

F34Persistent mood [affective] disorders

Persistent and usually fluctuating disorders of mood in which the majority of the individual episodes are not sufficiently severe to warrant being described as hypomanic or mild depressive episodes. Because they last for many years, and sometimes for the greater part of the patient's adult life, they involve considerable distress and disability. In some instances, recurrent or single manic or depressive episodes may become superimposed on a persistent affective disorder.

F34.0Cyclothymia

A persistent instability of mood involving numerous periods of depression and mild elation, none of which is sufficiently severe or prolonged to justify a diagnosis of bipolar affective disorder (F31.-) or recurrent depressive disorder (F33.-). This disorder is frequently found in the relatives of patients with bipolar affective disorder. Some patients with cyclothymia eventually develop bipolar affective disorder.

Affective personality disorder

Cycloid personality

Cyclothymic personality

F34.1Dysthymia

A chronic depression of mood, lasting at least several years, which is not sufficiently severe, or in which individual episodes are not sufficiently prolonged, to justify a diagnosis of severe, moderate, or mild recurrent depressive disorder (F33.-).

Depressive:

• neurosis
• personality disorder

Neurotic depression

Persistent anxiety depression

Excl.:

anxiety depression (mild or not persistent) (F41.2)

F34.8Other persistent mood [affective] disorders

F34.9Persistent mood [affective] disorder, unspecified

F38Other mood [affective] disorders

Any other mood disorders that do not justify classification to F30-F34, because they are not of sufficient severity or duration.

F38.0Other single mood [affective] disorders

Mixed affective episode

F38.1Other recurrent mood [affective] disorders

Recurrent brief depressive episodes

F38.8Other specified mood [affective] disorders

F39Unspecified mood [affective] disorder

Incl.:

Affective psychosis NOS

Source - http://apps.who.int/classifications/icd10/browse/2010/en#/F30-F39

Disorders of adult personality and behaviour ICD 10 F60

Image source - http://comps.canstockphoto.com/can-stock-photo_csp11801494.jpg 

International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) Version for 2010

Chapter V
Mental and behavioural disorders
(F00-F99)

Disorders of adult personality and behaviour
(F60-F69)

This block includes a variety of conditions and behaviour patterns of clinical significance which tend to be persistent and appear to be the expression of the individual's characteristic lifestyle and mode of relating to himself or herself and others. Some of these conditions and patterns of behaviour emerge early in the course of individual development, as a result of both constitutional factors and social experience, while others are acquired later in life. Specific personality disorders (F60.-), mixed and other personality disorders (F61.-), and enduring personality changes (F62.-) are deeply ingrained and enduring behaviour patterns, manifesting as inflexible responses to a broad range of personal and social situations. They represent extreme or significant deviations from the way in which the average individual in a given culture perceives, thinks, feels and, particularly, relates to others. Such behaviour patterns tend to be stable and to encompass multiple domains of behaviour and psychological functioning. They are frequently, but not always, associated with various degrees of subjective distress and problems of social performance.

F60Specific personality disorders

These are severe disturbances in the personality and behavioural tendencies of the individual; not directly resulting from disease, damage, or other insult to the brain, or from another psychiatric disorder; usually involving several areas of the personality; nearly always associated with considerable personal distress and social disruption; and usually manifest since childhood or adolescence and continuing throughout adulthood.

F60.0Paranoid personality disorder

Personality disorder characterized by excessive sensitivity to setbacks, unforgiveness of insults; suspiciousness and a tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous; recurrent suspicions, without justification, regarding the sexual fidelity of the spouse or sexual partner; and a combative and tenacious sense of personal rights. There may be excessive self-importance, and there is often excessive self-reference.

Personality (disorder):

• expansive paranoid
• fanatic
• querulant
• paranoid
• sensitive paranoid

Excl.:

paranoia (F22.0)

paranoia querulans (F22.8)

paranoid:

• psychosis (F22.0)
• schizophrenia (F20.0)
• state (F22.0)

F60.1Schizoid personality disorder

Personality disorder characterized by withdrawal from affectional, social and other contacts with preference for fantasy, solitary activities, and introspection. There is a limited capacity to express feelings and to experience pleasure.

Excl.:

Asperger syndrome (F84.5)

delusional disorder (F22.0)

schizoid disorder of childhood (F84.5)

schizophrenia (F20.-)

schizotypal disorder (F21)

F60.2Dissocial personality disorder

Personality disorder characterized by disregard for social obligations, and callous unconcern for the feelings of others. There is gross disparity between behaviour and the prevailing social norms. Behaviour is not readily modifiable by adverse experience, including punishment. There is a low tolerance to frustration and a low threshold for discharge of aggression, including violence; there is a tendency to blame others, or to offer plausible rationalizations for the behaviour bringing the patient into conflict with society.

Personality (disorder):

• amoral
• antisocial
• asocial
• psychopathic
• sociopathic

Excl.:

conduct disorders (F91.-)

emotionally unstable personality disorder (F60.3)

F60.3Emotionally unstable personality disorder

Personality disorder characterized by a definite tendency to act impulsively and without consideration of the consequences; the mood is unpredictable and capricious. There is a liability to outbursts of emotion and an incapacity to control the behavioural explosions. There is a tendency to quarrelsome behaviour and to conflicts with others, especially when impulsive acts are thwarted or censored. Two types may be distinguished: the impulsive type, characterized predominantly by emotional instability and lack of impulse control, and the borderline type, characterized in addition by disturbances in self-image, aims, and internal preferences, by chronic feelings of emptiness, by intense and unstable interpersonal relationships, and by a tendency to self-destructive behaviour, including suicide gestures and attempts.

Personality (disorder):

• aggressive
• borderline
• explosive

Excl.:

dissocial personality disorder (F60.2)

F60.4Histrionic personality disorder

Personality disorder characterized by shallow and labile affectivity, self-dramatization, theatricality, exaggerated expression of emotions, suggestibility, egocentricity, self-indulgence, lack of consideration for others, easily hurt feelings, and continuous seeking for appreciation, excitement and attention.

Personality (disorder):

• hysterical
• psychoinfantile

F60.5Anankastic personality disorder

Personality disorder characterized by feelings of doubt, perfectionism, excessive conscientiousness, checking and preoccupation with details, stubbornness, caution, and rigidity. There may be insistent and unwelcome thoughts or impulses that do not attain the severity of an obsessive-compulsive disorder.

Personality (disorder):

• compulsive
• obsessional
• obsessive-compulsive

Excl.:

obsessive-compulsive disorder (F42.-)

F60.6Anxious [avoidant] personality disorder

Personality disorder characterized by feelings of tension and apprehension, insecurity and inferiority. There is a continuous yearning to be liked and accepted, a hypersensitivity to rejection and criticism with restricted personal attachments, and a tendency to avoid certain activities by habitual exaggeration of the potential dangers or risks in everyday situations.

F60.7Dependent personality disorder

Personality disorder characterized by pervasive passive reliance on other people to make one's major and minor life decisions, great fear of abandonment, feelings of helplessness and incompetence, passive compliance with the wishes of elders and others, and a weak response to the demands of daily life. Lack of vigour may show itself in the intellectual or emotional spheres; there is often a tendency to transfer responsibility to others.

Personality (disorder):

• asthenic
• inadequate
• passive
• self-defeating

F60.8Other specific personality disorders

Personality (disorder):

• eccentric
• "haltlose" type
• immature
• narcissistic
• passive-aggressive
• psychoneurotic

F60.9Personality disorder, unspecified

Character neurosis NOS

Pathological personality NOS

F61Mixed and other personality disorders

This category is intended for personality disorders that are often troublesome but do not demonstrate the specific pattern of symptoms that characterize the disorders described in F60.-. As a result they are often more difficult to diagnose than the disorders in F60.-.

Examples include:

• mixed personality disorders with features of several of the disorders in F60.- but without a predominant set of symptoms that would allow a more specific diagnosis
• troublesome personality changes, not classifiable to F60.- or F62.-, and regarded as secondary to a main diagnosis of a coexisting affective or anxiety disorder.

Excl.:

accentuated personality traits (Z73.1)

F62Enduring personality changes, not attributable to brain damage and disease

Disorders of adult personality and behaviour that have developed in persons with no previous personality disorder following exposure to catastrophic or excessive prolonged stress, or following a severe psychiatric illness. These diagnoses should be made only when there is evidence of a definite and enduring change in a person's pattern of perceiving, relating to, or thinking about the environment and himself or herself. The personality change should be significant and be associated with inflexible and maladaptive behaviour not present before the pathogenic experience. The change should not be a direct manifestation of another mental disorder or a residual symptom of any antecedent mental disorder.

Excl.:

personality and behavioural disorder due to brain disease, damage and dysfunction (F07.-)

F62.0Enduring personality change after catastrophic experience

Enduring personality change, present for at least two years, following exposure to catastrophic stress. The stress must be so extreme that it is not necessary to consider personal vulnerability in order to explain its profound effect on the personality. The disorder is characterized by a hostile or distrustful attitude toward the world, social withdrawal, feelings of emptiness or hopelessness, a chronic feeling of "being on edge" as if constantly threatened, and estrangement. Post-traumatic stress disorder (F43.1) may precede this type of personality change.

Personality change after:

• concentration camp experiences
• disasters
• prolonged:
  • captivity with an imminent possibility of being killed
  • exposure to life-threatening situations such as being a victim of terrorism
• torture

Excl.:

post-traumatic stress disorder (F43.1)

F62.1Enduring personality change after psychiatric illness

Personality change, persisting for at least two years, attributable to the traumatic experience of suffering from a severe psychiatric illness. The change cannot be explained by a previous personality disorder and should be differentiated from residual schizophrenia and other states of incomplete recovery from an antecedent mental disorder. This disorder is characterized by an excessive dependence on and a demanding attitude towards others; conviction of being changed or stigmatized by the illness, leading to an inability to form and maintain close and confiding personal relationships and to social iso-lation; passivity, reduced interests, and diminished involvement in leisure activities; persistent complaints of being ill, which may be associated with hypochondriacal claims and illness behaviour; dysphoric or labile mood, not due to the presence of a current mental disorder or antecedent mental disorder with residual affective symptoms; and longstanding problems in social and occupational functioning.

F62.8Other enduring personality changes

Chronic pain personality syndrome

F62.9Enduring personality change, unspecified

F63Habit and impulse disorders

This category includes certain disorders of behaviour that are not classifiable under other categories. They are characterized by repeated acts that have no clear rational motivation, cannot be controlled, and generally harm the patient's own interests and those of other people. The patient reports that the behaviour is associated with impulses to action. The cause of these disorders is not understood and they are grouped together because of broad descriptive similarities, not because they are known to share any other important features.

Excl.:

habitual excessive use of alcohol or psychoactive substances (F10-F19)

impulse and habit disorders involving sexual behaviour (F65.-)

F63.0Pathological gambling

The disorder consists of frequent, repeated episodes of gambling that dominate the patient's life to the detriment of social, occupational, material, and family values and commitments.

Compulsive gambling

Excl.:

excessive gambling by manic patients (F30.-)

gambling and betting NOS (Z72.6)

gambling in dissocial personality disorder (F60.2)

F63.1Pathological fire-setting [pyromania]

Disorder characterized by multiple acts of, or attempts at, setting fire to property or other objects, without apparent motive, and by a persistent preoccupation with subjects related to fire and burning. This behaviour is often associated with feelings of increasing tension before the act, and intense excitement immediately afterwards.

Excl.:

fire-setting (by)(in):

• adult with dissocial personality disorder (F60.2)
• alcohol or psychoactive substance intoxication (F10-F19, with common fourth character .0)
• as the reason for observation for suspected mental disorder (Z03.2)
• conduct disorders (F91.-)
• organic mental disorders (F00-F09)
• schizophrenia (F20.-)

F63.2Pathological stealing [kleptomania]

Disorder characterized by repeated failure to resist impulses to steal objects that are not acquired for personal use or monetary gain. The objects may instead be discarded, given away, or hoarded. This behaviour is usually accompanied by an increasing sense of tension before, and a sense of gratification during and immediately after, the act.

Excl.:

depressive disorder with stealing (F31-F33)

organic mental disorders (F00-F09)

shoplifting as the reason for observation for suspected mental disorder (Z03.2)

F63.3Trichotillomania

A disorder characterized by noticeable hair-loss due to a recurrent failure to resist impulses to pull out hairs. The hair-pulling is usually preceded by mounting tension and is followed by a sense of relief or gratification. This diagnosis should not be made if there is a pre-existing inflammation of the skin, or if the hair-pulling is in response to a delusion or a hallucination.

Excl.:

stereotyped movement disorder with hair-plucking (F98.4)

F63.8Other habit and impulse disorders

Other kinds of persistently repeated maladaptive behaviour that are not secondary to a recognized psychiatric syndrome, and in which it appears that the patient is repeatedly failing to resist impulses to carry out the behaviour. There is a prodromal period of tension with a feeling of release at the time of the act.

Intermittent explosive disorder

F63.9Habit and impulse disorder, unspecified

F64Gender identity disorders

F64.0Transsexualism

A desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one's anatomic sex, and a wish to have surgery and hormonal treatment to make one's body as congruent as possible with one's preferred sex.

F64.1Dual-role transvestism

The wearing of clothes of the opposite sex for part of the individual's existence in order to enjoy the temporary experience of membership of the opposite sex, but without any desire for a more permanent sex change or associated surgical reassignment, and without sexual excitement accompanying the cross-dressing.

Gender identity disorder of adolescence or adulthood, nontranssexual type

Excl.:

fetishistic transvestism (F65.1)

F64.2Gender identity disorder of childhood

A disorder, usually first manifest during early childhood (and always well before puberty), characterized by a persistent and intense distress about assigned sex, together with a desire to be (or insistence that one is) of the other sex. There is a persistent preoccupation with the dress and activities of the opposite sex and repudiation of the individual's own sex. The diagnosis requires a profound disturbance of the normal gender identity; mere tomboyishness in girls or girlish behaviour in boys is not sufficient. Gender identity disorders in individuals who have reached or are entering puberty should not be classified here but in F66.-.

Excl.:

egodystonic sexual orientation (F66.1)

sexual maturation disorder (F66.0)

F64.8Other gender identity disorders

F64.9Gender identity disorder, unspecified

Gender-role disorder NOS

F65Disorders of sexual preference

Incl.:

paraphilias

F65.0Fetishism

Reliance on some non-living object as a stimulus for sexual arousal and sexual gratification. Many fetishes are extensions of the human body, such as articles of clothing or footwear. Other common examples are characterized by some particular texture such as rubber, plastic or leather. Fetish objects vary in their importance to the individual. In some cases they simply serve to enhance sexual excitement achieved in ordinary ways (e.g. having the partner wear a particular garment).

F65.1Fetishistic transvestism

The wearing of clothes of the opposite sex principally to obtain sexual excitement and to create the appearance of a person of the opposite sex. Fetishistic transvestism is distinguished from transsexual transvestism by its clear association with sexual arousal and the strong desire to remove the clothing once orgasm occurs and sexual arousal declines. It can occur as an earlier phase in the development of transsexualism.

Transvestic fetishism

F65.2Exhibitionism

A recurrent or persistent tendency to expose the genitalia to strangers (usually of the opposite sex) or to people in public places, without inviting or intending closer contact. There is usually, but not invariably, sexual excitement at the time of the exposure and the act is commonly followed by masturbation.

F65.3Voyeurism

A recurrent or persistent tendency to look at people engaging in sexual or intimate behaviour such as undressing. This is carried out without the observed people being aware, and usually leads to sexual excitement and masturbation.

F65.4Paedophilia

A sexual preference for children, boys or girls or both, usually of prepubertal or early pubertal age.

F65.5Sadomasochism

A preference for sexual activity which involves the infliction of pain or humiliation, or bondage. If the subject prefers to be the recipient of such stimulation this is called masochism; if the provider, sadism. Often an individual obtains sexual excitement from both sadistic and masochistic activities.

Masochism

Sadism

F65.6Multiple disorders of sexual preference

Sometimes more than one abnormal sexual preference occurs in one person and there is none of first rank. The most common combination is fetishism, transvestism and sadomasochism.

F65.8Other disorders of sexual preference

A variety of other patterns of sexual preference and activity, including making obscene telephone calls, rubbing up against people for sexual stimulation in crowded public places, sexual activity with animals, and use of strangulation or anoxia for intensifying sexual excitement.

Frotteurism

Necrophilia

F65.9Disorder of sexual preference, unspecified

Sexual deviation NOS

F66Psychological and behavioural disorders associated with sexual development and orientation

Note:

Sexual orientation by itself is not to be regarded as a disorder.

F66.0Sexual maturation disorder

The patient suffers from uncertainty about his or her gender identity or sexual orientation, which causes anxiety or depression. Most commonly this occurs in adolescents who are not certain whether they are homosexual, heterosexual or bisexual in orientation, or in individuals who, after a period of apparently stable sexual orientation (often within a longstanding relationship), find that their sexual orientation is changing.

F66.1Egodystonic sexual orientation

The gender identity or sexual preference (heterosexual, homosexual, bisexual, or prepubertal) is not in doubt, but the individual wishes it were different because of associated psychological and behavioural disorders, and may seek treatment in order to change it.

F66.2Sexual relationship disorder

The gender identity or sexual orientation (heterosexual, homosexual, or bisexual) is responsible for difficulties in forming or maintaining a relationship with a sexual partner.

F66.8Other psychosexual development disorders

F66.9Psychosexual development disorder, unspecified

F68Other disorders of adult personality and behaviour

F68.0Elaboration of physical symptoms for psychological reasons

Physical symptoms compatible with and originally due to a confirmed physical disorder, disease or disability become exaggerated or prolonged due to the psychological state of the patient. The patient is commonly distressed by this pain or disability, and is often preoccupied with worries, which may be justified, of the possibility of prolonged or progressive disability or pain.

Compensation neurosis

F68.1Intentional production or feigning of symptoms or disabilities, either physical or psychological [factitious disorder]

The patient feigns symptoms repeatedly for no obvious reason and may even inflict self-harm in order to produce symptoms or signs. The motivation is obscure and presumably internal with the aim of adopting the sick role. The disorder is often combined with marked disorders of personality and relationships.

Hospital hopper syndrome

Münchhausen syndrome

Peregrinating patient

Excl.:

factitial dermatitis (L98.1)

person feigning illness (with obvious motivation) (Z76.5)

F68.8Other specified disorders of adult personality and behaviour

Character disorder NOS

Relationship disorder NOS

F69Unspecified disorder of adult personality and behaviour



Source - http://apps.who.int/classifications/icd10/browse/2010/en#/F60