Diagnoses

What should be specified with Autism Spectrum Disorder (ASD)?

if with or without intellectual and language impairment.

What must be met in ASD

3 social deficits and 2/4 behavior symptoms

Social deficits in ASD

-Deficits in social emotional reciprocity

-deficits in nonverbal communication behaviors for social interaction

-deficits in developing, maintaining, and understanding relationships

examples of deficits in social-emotional reciprocity (ASD)

-abnormal social approach

-failure of normal back-and-forth conversation

-reduced sharing of interests, emotions, or affect

-failure to initiate or respond to social interactions.

examples of deficits in nonverbal communicative behaviors used for social interaction (ASD)

-poorly integrated verbal and nonverbal communication

-abnormalities in eye contact and body language

-deficits in understanding and use of gestures

-lack of facial expressions and nonverbal communication.

examples of deficits in developing, maintaining, and understanding relationships (ASD)

-difficulty adjusting behavior to social contexts

-difficulties in sharing imaginative play or in making friends

-absence of interest in peers.

Restricted, repetitive patterns of behavior, interests, or activities (at least two currently or in the past (ASD):

-Stereotyped or repetitive motor movements, use of objects, or speech.

-Insistence on sameness, adherence to routines, or ritualized patterns of verbal or nonverbal behavior

-Highly restricted/fixated interests that are abnormal in intensity or focus

-Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment

What is required for a attention-deficit/hyperactivity disorder (ADHD) diagnosis

-Six or more of the following symptoms have persisted for at least 6 months

-For those age 17 and older, at least five symptoms are required

inattention diagnostic criteria (ADHD)

-Fails to give close attention to details or makes careless mistakes

-has difficulty sustaining attention in tasks or play activities

-Does not seem to listen when spoken to directly

-Does not follow through on instructions and fails to finish tasks.

-Has difficulty organizing tasks and activities

-Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort

-Loses things necessary for tasks or activities telephones).

-Easily distracted by extraneous stimuli

-forgetful in daily activities

Hyperactivity and impulsivity (ADHD):

-Often fidgets with or taps hands or feet or squirms in their seat.

-Leaves seat in situations when remaining seated is expected

-Runs about or climbs in situations where it is inappropriate.

-Unable to play or engage in leisure activities quietly.

-"on the go," acting as if "driven by a motor"

-talks excessively.

-blurts out an answer before a question has been completed

-Has difficulty waiting his or her turn

-Interrupts or intrudes on others

specific learning disorder requirements for diagnosis

-Academic skills are low for an individual's chronological age, and cause interference with functioning.

-Diagnosed via clinical assessment. For those 17 and older, a documented history of impairment to replace the test.

-The learning difficulties begin during school-age years but may not become fully manifest until the demands exceed the individual's limited capacities

Symptoms of Specific learning disability

-presence of at least one of the following symptoms that have persisted for at least 6 months, despite the interventions :

-Inaccurate or slow and effortful word reading

-Difficulty understanding the meaning of what is read

-Difficulties with spelling

-Difficulties with written expression

-Difficulties mastering number sense, number facts, or calculation

-Difficulties with mathematical reasoning

bipolar 1 disorder

a type of bipolar disorder marked by full manic and major depressive episodes. at least one manic episode is required for diagnosis

Manic episode

distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).

During the period of manic episode mood disturbance 3 or more symptoms are present:

-Inflated self-esteem or grandiosity.

-Decreased need for sleep

-More talkative than usual or pressure to keep talking.

-Flight of ideas or subjective experience that thoughts are racing.

-Distractibility, as reported or observed.

-Increase in goal-directed activity or psychomotor agitation

-Excessive involvement in activities that have a high potential for painful consequences

hypomanic episode

distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day. not severe enough to cause marked impairment or hospitalization

Symptoms of hypomanic episode (3 or more have persisted and are a noticeable change and have been present to a significant degree)

-Inflated self-esteem or grandiosity.

-Decreased need for sleep

-More talkative than usual or pressure to keep talking.

-Flight of ideas or subjective experience that thoughts are racing.

-Distractibility as reported or observed.

-Increase in goal-directed activity or psychomotor agitation.

-Excessive involvement in activities that have a high potential for painful consequences

major depressive episode

Five (or more) of the following symptoms have been present during the same 2- week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

Symptoms of Major depressive episode

-Depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others (e.g., appears tearful). (Note: In children and adolescents, it can be an irritable mood.)

-Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).

-Significant weight loss when not dieting or weight gain , or decrease or increase in appetite nearly every day

-Insomnia or hypersomnia nearly every day.

-Psychomotor agitation or retardation nearly every day (observable by others).

-Fatigue or loss of energy nearly every day.

-Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).

-Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).

-Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

Bipolar 2 disorder

-Has had or is currently experiencing at least -Hypomania episode and at least 1 major depressive episode

-Has never had a manic episode

-Hypomania and MD episode are not better explained by psychotic disorder

-Depression or unpredictable alternation causes significant distress

Prevalence: 12 month= 0.8.1 late adolescence onset

major depressive disorder

Five (or more) of the following symptoms have been present during the same 2- week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

MDD symptoms

- Depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others.

-Diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day

-Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day.

-Insomnia or hypersomnia nearly every day.

-Psychomotor agitation or retardation nearly every day .

-Fatigue or loss of energy nearly every day.

-Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).

-Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).

-Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

Persistent depressive disorder

Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years. In children and adolescents, mood can be irritable and duration must be at least 1 year.

PDD symptoms (while depressed, of two (or more) of the following):

Poor appetite or overeating.

Insomnia or hypersomnia.

Low energy or fatigue.

Low self-esteem.

Poor concentration or difficulty making decisions.

Feelings of hopelessness.

Cyclothymic Disorder

-For at least 2 years (at least 1 year in children and adolescents) numerous periods with hypomanic and depressive symptoms that do not meet criteria for a hypomanic episode or major depressive episode.

-During a 2-year period (1 year in children and adolescents), Criterion A symptoms have been present for at least half the time and have not been without the symptoms for more than 2 months at a time.

-Criteria for a major depressive, manic, or hypomanic episode have never been met.

-Specify if:

With anxious distress

generalized anxiety disorder

Excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities .

difficult to control the worry.

GAD symptoms

Associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months). Note: Only one item is required in children.:

-Restlessness or feeling keyed up or on edge.

-Being easily fatigued.

-Difficulty concentrating or mind going blank.

-Irritability.

-Muscle tension.

-Sleep disturbance

specific phobia

-Marked fear or anxiety about a specific object or situation

Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, or clinging.

-almost always provokes immediate fear or anxiety.

-actively avoided or endured with intense fear or anxiety.

-The fear or anxiety is out of proportion to the actual danger .

-The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.

-significant distress or impairment

panic disorder

Recurrent unexpected panic attacks.

Note: The abrupt surge can occur from a calm state or an anxious state.

- Palpitations, pounding heart, or accelerated heart rate.

-Sweating.

-Trembling or shaking.

-Sensations of shortness of breath or smothering.

-Feelings of choking.

-Chest pain or discomfort.

-Nausea or abdominal distress.

-Feeling dizzy, unsteady, light-headed, or faint.

-Chills or heat sensations.

-Paresthesias (numbness or tingling sensations).

-Derealization (feelings of unreality) or depersonalization (being detached from oneself).

-Fear of losing control or "going crazy."

-Fear of dying.

At least one of the attacks has been followed by 1 month (or more) of one or both of the following:

-Persistent concern or worry about additional panic attacks or their consequences

-A significant maladaptive change in behavior related to the attacks

Adjustment disorder

-The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).

-These symptoms or behaviors are clinically significant, as evidenced by one or both of the following:

-Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context and the cultural factors that might influence symptom severity and presentation.

-Significant impairment.

obsessive-compulsive disorder

An anxiety disorder characterized by unwanted repetitive thoughts (obsession) and/ or actions (compulsions).

obsessions are defined by

-Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.

-The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action

Compulsions are defined by (1) and (2):

-Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.

-The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.

What to specify with OCD diagnosis

With good or fair insight:

With poor insight:

With absent insight/delusional beliefs:

Tic-related: The individual has a current or past history of a tic disorder.

Acute stress disorder cause

Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:

-Directly experiencing the traumatic event(s).

-Witnessing, in person, the event(s) as it occurred to others.

-Learning that the event(s) occurred to a close family member or close friend.

Note:

-In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.

-Experiencing repeated or extreme exposure to aversive details of the traumatic event(s)

Symptoms required for acute stress disorder diagnosis

nine (or more) of the following symptoms from any of the five categories

intrusion symptoms (acute stress disorder)

Note: In children, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed. or frightening dreams

-Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).

-Recurrent distressing dreams in which the content and/or affect of the dream are related to the event(s).

-Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring.

-Intense or prolonged psychological distress or marked physiological reactions in response to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

negative mood (acute stress disorder)

Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).

dissociative symptoms (acute stress diorder)

An altered sense of the reality of one's surroundings or oneself

Inability to remember an important aspect of the traumatic event(s) .

avoidance symptoms (acute stress disorder)

-Efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

-Efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

arousal symptoms (acute stress disorder)

-Sleep disturbance .

-Irritable behavior and angry outbursts (with little or no provocation), typically expressed as verbal or physical aggression toward people or objects.

-Hypervigilance.

-Problems with concentration.

-Exaggerated startle response.

Post traumatic Stress disorder cause

Exposure to actual or threatened death, serious injury or sexual violence in one or more of the following ways:

-Directly experiencing traumatic event

-Witnessing it occur to others

-Learning it occurred to someone close to you

-Repeated experience/exposure to details of traumatic events

components of PTSD diagnosis

intrusion symptoms, avoidance of cues, negative alterations in cognitions and mood, alterations in reactivity. must last over one month

intrusion symptoms (PTSD)

involuntary memories

recurrent distressing dreams

flashbacks, dissociative feeling as if it is reoccurring

intense distress when exposed to cues/reminders of trauma 5. marked physiological reactions to cues

negative alterations in cognitions and mood

inability to remember details of traumatic event

exaggerated negative beliefs about oneself and the world

blame for traumatic event

persistent negative mood

diminished interest in activities

detachment from others

inability to experience positive emotions

alterations in reactivity

Irritability

Recklessness

Hypervigilance

exaggerated startle response

concentration difficulties

sleep disturbance

anorexia nervosa

-Restriction of energy intake relative to requirements, leading to a significantly low body weight

-Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.

-Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.

F50.01 Restricting type:

During the last 3 months, the individual has not engaged in recurrent episodes of binge-eating or purging behavior. This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise.

F50.02 Binge-eating/purging type:

During the last 3 months, the individual has engaged in recurrent episodes of binge-eating or purging behavior .

bulimia nervosa

-Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

-Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances.

-A sense of lack of control over eating during the episode

-Recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise.

-The binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months.

-Self-evaluation is unduly influenced by body shape and weight.

-The disturbance does not occur exclusively during episodes of anorexia nervosa.

intermittent explosive disorder

A. Recurrent behavioral outbursts representing a failure to control aggressive impulses

B. aggression is out of proportion

C. not premeditated

D. marked distress

E. at least 6 years of age

intermittent explosive disorder symptoms

Either of the following

-Verbal aggression (e.g., temper tantrums, tirades, verbal arguments or fights) or physical aggression toward property, animals, or other individuals, occurring twice weekly, on average, for a period of 3 months. does not result in damage or destruction of property and does not result in physical injury to animals or other individuals.

-Three behavioral outbursts involving damage or destruction of property and/or physical assault involving physical injury against animals or other individuals occurring within a 12-month period.

Disruptive mood dysregulation disorder

-Severe recurrent temper outbursts expressed verbally or behaviorally

-Outbursts are inconsistent with developmental level

-Outbursts occur 3x/week

-Mood between outbursts presents as irritable/angry (difference from IED) e) -A-D present for over 12 months

-A-D present in at least 2 settings

-Diagnosis between age 6-18

conduct disorder

A repetitive and persistent pattern of behavior in which the basic rights of others

or major age-appropriate societal norms or rules are violated, as shown by the presence of at least three of the following 15 criteria in the past 12 months from any of the categories, at least one criteria in the last 6 months

categories of conduct disorder

Aggression to people and animals

Destruction of property

Deceitfulness or theft

Serious violations of rules

examples of aggression to people and animals (conduct disorder)

Often bullies, threatens, or intimidates others.

Often initiates physical fights.

Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun).

Has been physically cruel to people.

Has been physically cruel to animals.

Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery).

Has forced someone into sexual activity.

examples of deceitfulness and or theft conduct disorder

-Has broken into someone else's house, building, car

-Often lies to obtain goods or favors or to avoid obligations (i.e., cons others) 12.

-Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting)

examples of destruction of property in conduct disorder

-Has deliberately engaged in fire setting with the intention of causing damage

-Has deliberately destroyed other's property (other than fires)

examples of serious violation of rights conduct disorder

-Stays out past curfew, beginning before 13

-Run away from home overnight at least twice, or once for lengthy period

-Truant from school, beginning before 13

oppositional defiant disorder

A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms.

examples of angry/irritable mood oppositional defiant disorder

1. Often loses temper.

2. Is often touchy or easily annoyed.

3. Is often angry and resentful.

examples of argumentative/defiant behavior oppositional defiant disorder

Often argues with authority figures or, for children and adolescents, with adults.

Often actively defies or refuses to comply with requests from authority figures or with rules.

Often deliberately annoys others.

Often blames others for his or her mistakes or misbehavior.

examples of vindictiveness oppositional defiant disorder

Has been spiteful or vindictive at least twice within the past 6 months.

antisocial personality disorder

A. A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years

B. The individual is at least 18 years or older

C. There is evidence of conduct disorder with onset before age 15 years.

antisocial personality disorder

Must have 3 or more of the following:

1. Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.

2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.

3. Impulsivity or failure to plan ahead.

4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults.

5. Reckless disregard for safety of self or others.

6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.

7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

Borderline personality disorder

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts

BPD symptoms (five or more):

-Frantic efforts to avoid real or imagined abandonment.

-A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

-Identity disturbance: markedly and persistently unstable self-image or sense of self.

-Impulsivity in at least two areas that are potentially self-damaging

-Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.

-Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).

-Chronic feelings of emptiness.

-Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

-Transient, stress-related paranoid ideation or severe dissociative symptoms.

histrionic personality disorder

A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts

histrionic personality disorder symptoms (five or more)

-Is uncomfortable in situations in which he or she is not the center of attention.

-Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.

-Displays rapidly shifting and shallow expression of emotions.

-Consistently uses physical appearance to draw attention to self.

-Has a style of speech that is excessively impressionistic and lacking in detail.

-Shows self-dramatization, theatricality, and exaggerated expression of emotion.

-Is suggestible (i.e., easily influenced by others or circumstances).

-Consider relationships to be more intimate than they actually are.

narcissistic personality disorder

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts

narcissistic personality disorder symptoms

-Has a grandiose sense of self-importance

-Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.

-Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).

-Requires excessive admiration.

-Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).

-Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).

-Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.

-Is often envious of others or believes that others are envious of him or her.

-Shows arrogant, haughty behaviors or attitudes.

obsessive compulsive personality disorder

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts

obsessive compulsive personality disorder symptoms

-Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.

-Shows perfectionism that interferes with task completion

-Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships

-Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values

-Is unable to discard worn-out or worthless objects even when they have no sentimental value.

-Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.

-Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.

-Shows rigidity and stubbornness.

delayed ejaculation

delayed ability or complete inability to ejaculate in 75-100% of partnered interaction, can be either general or specific to certain situations

erectile disorder

the inability to have or maintain an erection

female orgasmic disorder

distress due to infrequently or never experiencing orgasm

female sexual interest/arousal disorder

reduced or absent interest in sexual activity, sexual thoughts, initiation or receptivity to sex, even in response to stimuli/cues

genio-pelvic/penetration disorder

vulvovaginal or pelvic pain during intercourse

male hypoactive sexual desire disorder

reduced or absent interest in sexual activity, sexual thought

premature ejaculation

ejaculating approx. 1 minute following penetration and without wishing for it

insomnia disorder

Dissatisfaction with sleep quantity/quality associated with difficulty falling asleep and staying asleep

Occurs at least 3 nights/week for at least 3 months

hypersomolence disorder

excessive sleepiness despite getting 7 hours of sleep, with at least one of the following

Recurrent lapses of sleep within the same day

9+ hours without feeling refreshed

Doesn't feel awake after abrupt awakening

narcolepsy

irrepressible need to sleep and lapses of sleep throughout the day

nightmare disorder

a type of sleep-wake disorder involving a pattern of frequent, disturbing nightmares

other sleep wake disorders

central sleep apnea, sleep related hypoventilation, circadian rhythm sleep wake disorder, non rapid eye movement sleep arousal disorders, restless leg syndrome, rapid eye movement sleep behavior disorder

somatic symptom disorder

excessive thoughts/feelings/behaviors related to somatic symptoms or associated health concerns

- Disproportionate and persistent thoughts about the seriousness of one's symptoms

- Persistent high anxiety about health/symptoms

illness anxiety disorder

-Preoccupation with having or acquiring a serious illness

-Somatic symptoms are not present or mild

-Preoccupation lasts 6 months+

-Excessive health related behaviors (e.g., checking for symptoms, seeking diagnosis) or avoidance behaviors (e.g. avoiding drs) o Specify: care-seeking or care-avoidant

conversion disorder

Altered motor or sensory function

Incompatibility between this symptom and medical conditions

Specify symptom type: e.g., weakness/paralysis, speech, seizure, mixed symptoms

factitious disorder

Imposed on self: falsification of physical or psychological symptoms or induction of injury/disease, even without obvious external rewards for this deceit

Imposed on another (by proxy): presenting another as ill or injured

dissociative identity disorder

two or more distinct personality states, recurrent gaps in recall of daily events, important information and/or traumatic events.

dissociative amnesia

inability to recall important autobiographical information, usually of a traumatic or stressful nature

depersonalization

experiencing unreality or detachment to one's self, as if being an outside observer to one's own thoughts, feelings, sensations

derealization

experiencing unreality or detachment to one's surroundings

voyeuristic disorder

arousal from watching unsuspecting/non-consenting parties have sexual relations

Exhibitionistic disorder

arousal from exposing oneself to unsuspecting/non consenting others

Frotteuristic disorder:

arousal from touching/ rubbing on unsuspecting/non consenting people

sexual masochism disorder

arousal from being humiliated, beaten, made to suffer

sexual sadism disorder

arousal from humiliating or making others suffer

pedophilic disorder

sexual arousal involving children (typically 13 under)

Fetishistic disorder

arousal from non-sexual objects/body parts