DSM-V Diagnostic Criteria

Major Depressive Disorder

5 "SIG E CAPSS" symptoms for at least 2 weeks [Sadness, Interest loss, Guilt or worthlessness, Energy loss, Concentration loss, Appetite change, Psychomotor agitation or retardation, Sleep change, Suicidal thoughts]

Persistent Depressive Disorder (Dysthymia)

- Sad most days for 2 years
- 2 or more of: sleep change, hopelessness, appetite change, low self-esteem, concentration loss
- Never 2 months symptom free in first 2 years
- Significant distress or impairment

Disruptive Mood Dysregulation Disorder

- Severe recurrent temper outbursts (verbal or physical)
- Out of proportion to context
- 3 or more per week, persists more than a year, began as child (6-18)
- Persistent irritability
- (not better explained by mania, depression, autism, substance abuse, etc)

Premenstrual Dysphoric Disorder

- Symptoms present one week prior to menses
- At least 1 of the 4 following: mood swings, irritability/anger, sadness, anxiety/tension
- At least 5 total: mood swings, irritability/anger, sadness, anxiety/tension, loss of interest, poor
concentration, fatigue, appetite change, sleep change, overwhelmed, physical symptoms (breast
tenderness, bloating, pain, weight gain)
- Significant distress or impairment

Bipolar I Disorder

- Euphoric or irritable mood and increased energy or activity for 1 week
- 3 out of 7: grandiose, decreased sleep, talkative, racing thoughts, distractibility, increased goaldirected
activity, impulsive)
- Social or work impairment

Bipolar II Disorder

- At least 1 Hypomanic episode and at least 1 Major Depressive episode
- No full Manic episodes

Hypomanic Episode

- Same as Bipolar I Manic episode except: at least 4 days duration (instead of 7)
- And NO marked impairment in social or occupational functioning

Cyclothymic Disorder

- Numerous hypomania and depression symptoms for most of the time for 2 years
- Never reaches full diagnosis for either hypomanic, manic or depressive episodes
- Not without symptoms for 2 months in 1st 2 years.
- Clinically significant distress or impairment

Schizophrenia

- Must have 1 positive symptom (hallucinations, delusions or disorganized speech) for 1 month
- 2 of the following: hallucinations, delusions, disorganized speech, disorganized behavior, or negative
symptoms (low emotion, low motivation)
- Prior or residual poor functioning for at least 6 months
- Social or work impairment

Schizophreniform Disorder

- Schizophrenic symptoms between 1-6 months duration

Schizoaffective Disorder, Bipolar type

- Schizophrenic symptoms and Bipolar I symptoms present most of the time.
- At least 2 weeks of delusions or hallucinations without Bipolar symptoms
- Must have Bipolar symptoms for the majority of time.

Schizoaffective Disorder, Depressive type

- Schizophrenic symptoms and Depression symptoms present most of the time.
- At least 2 weeks of delusions or hallucinations without Depression symptoms
- Must have Depression symptoms for the majority of time.

Delusional Disorder

- Moderate delusions at least 1 month, not Schizophrenic level
- Otherwise, good functioning and no bizarre behavior
• Erotomanic type
• Grandiose type
• Jealous type
• Persecutory type
• Somatic type
• Mixed type
• Unspecified type

Brief Psychotic Disorder

- Schizophrenic symptoms for less than 1 month
- Full return to premorbid level.
• with marked stressors
• without marked stressors
• with postpartum onset
• with Catatonia

Panic Disorder

- Recurrent, abrupt, unexpected intense fear or discomfort
- Persistent worry of additional attacks for 1 month
- 4 out of 13 symptoms: (palpitations, sweating, trembling, shortness of breath, choking, chest pain,
nausea, dizziness, derealization, fear of "going crazy", fear of dying, numbness/tingling, hot/cold
flashes)
- "Panic Attack" can also be a specifier for other diagnoses (i.e. "PTSD with Panic Attacks")

Agoraphobia

- Intense fear of 2 or more of: public transportation, open spaces (markets, bridges), enclosed spaced (theaters, shops), crowds, being away from home.
- Avoids these areas
- Greater than 6 months, interferes with work or social functioning

Generalized Anxiety Disorder

- Excessive worry most days for 6 months
- 3 out of 6: (restless, fatigue, decreased concentration, irritability, tense, insomnia)
- Interferes with work / social functioning

Specific Phobia

- Intense unreasonable fear
- Interferes with work / social functioning
• Animal fear (insects, snakes, dogs, etc)
• Natural environment (heights, thunderstorms, etc)
• Needle injections
• Situational (elevators, planes, tight spaces)
• Other

Social Anxiety Disorder

- Formerly "Social Phobia"
- Persistent fear of social interaction or performance
- Interferes with work / social functioning

Separation Anxiety Disorder

- Excessive anxiety over separation from home or parents

Selective Mutism

- Mute in some settings but not others

Obsessive-Compulsive Disorder

- Obsessions: persistent intrusive, inappropriate non-psychotic thoughts
- Compulsions: repetitive behaviors compelled to reduce distress
- Patient sees as excessive / unreasonable
- Marked distress / interference

Body Dysmorphic Disorder

- Preoccupation with imagined defect in physical appearance
- Repetitive checking, grooming, picking, comparing, or reassurance seeking
- Work / Social impairment

Trichotillomania

- Recurrent hair pulling and hair loss
- Failed attempts to stop hair pulling
- Marked distress or impairment

Hoarding Disorder

- Can't discard possessions regardless of value
- Possessions accumulate, cluttering living space
- Marked distress or impairment

Excoriation (Skin-Picking) Disorder

- Persistent skin picking causing lesions or infections
- Failed attempts to stop skin picking
- Marked distress or impairment

Alcohol Use Disorder

Symptom List: Mild (2-3), Mod (4-5), Sev (6+)
- Uses more than intended
- Failed attempts to cut back
- Excessive time spent in obtaining, using, or recovering from substance
- Cravings for substance
- Substance use leads to problems at work, school or home
- Important work, social or recreational activities are given up due to substance use
- Uses in dangerous situations
- Persistent use despite awareness of problem
- Tolerance (needs more substance for same effect)
- Withdrawals

Gambling Disorder

- Continued gambling despite distress or impairment
- 4 of the following: increasing amounts of money gambled, irritable when cuts back on gambling, failed attempts to cut back, preoccupied with gambling, gambles to feel better, "chases their losses" (gambles later to make their money back), lies about gambling, relationship/work/ school problems, others give them money to help desperate need caused by losses.

Attention-Deficit/Hyperactivity Disorder (ADHD)

- Persistent inattention or hyperactivity interfering with functioning for 6 months, began before age of 12
- Inattention - 6 or more of the following: inattention to details, difficulty sustaining attention, doesn't listen well, poor follow through on tasks, poor organization, avoids homework or large projects, often loses things, distractible, forgetful
- Hyperactivity - 6 or more of the following: fidgets or squirms, leaves seat often, runs around inappropriately, can't play quietly, driven, always moving, overly talkative, blurts out answers, difficulty waiting or taking turns, interrupts frequently

Autism Spectrum Disorder

Problems with social communication and social interaction, repetitive behaviors
2 of the following:
- Repetitive actions or speech
- Insistence on sameness
- Restricted fixated interests
- Increased or decreased sensitivity to sensory stimulation
3 Levels:
Level 1 - requiring support
Level 2 - requiring substantial support
Level 3 - requiring very substantial support

Language Disorder

- difficulty using language

Speech Sound Disorder

- difficulty speaking

Childhood Onset Fluency Disorder

- stuttering issues

Social (Pragmatic) Communication Disorder

- speaking difficulties in social context

Specific Learning Disorders (3 types)

- Learning Disorder in Reading
- Learning Disorder in Writing
- Learning Disorder in Mathematics

Intellectual Disability

- Decreased intellectual functioning
- Decreased developmental and social functioning
- Begins in childhood

Developmental Coordination Disorder

- Coordination impairment, clumsy, slow, inaccurate
- Marked distress / interference

Stereotypic movement Disorder

- Repetitive purposeless movement (head banging, rocking, biting, picking, hitting, etc.)
- Interferes with functioning or self-injurious

Tourette's Disorder

- Multiple motor tics + 1 vocal tic
- Persistent for 1 year
- Marked distress or impairment
- Onset before 18 years old

Persistent Motor or Vocal Tic Disorder

- Motor only or vocal only tics
- Persistent for 1 year
- Marked distress or impairment
- Onset before 18 years old

Provisional Tic Disorder

- Tics, 4 weeks to 1 year
- Marked distress or impairment
- Onset before 18 years old

Post Traumatic Stress Disorder (PTSD)

- Severe Trauma - experienced trauma, witnessed trauma, or learned about violent trauma to loved one
- Intrusive memories, nightmares, flashbacks
- Avoidance - (avoid memories, thoughts, feelings, reminders)
- Negative thoughts & feelings: amnesia to the event, exaggerated negative beliefs, self (or other) blame,
persistent fear/anger / horror/shame, low interest in activities, feeling detached, feeling numb
- Hyperarousal (insomnia, poor concentration, emotional lability, hypervigilance, exaggerated startle,
reckless or self-destructive behavior)
- Symptoms present for 1 month, and work / social impairment
Preschool Subtype (under 6 years of age)

Acute Stress Disorder

- PTSD, but less than one month since trauma.

Adjustment Disorders

- Stressor leading to excessive distress or work / social impairment
- Symptoms do not last greater than 6 months after resolution of stress
- Specify stress as acute or chronic (greater than 6 months)

Reactive Attachment Disorder

- Poor caregiving at early age (neglected, deprived, too numerous caregivers, or orphanage)
- Emotionally withdrawn behavior towards caregivers (doesn't seek or respond to comfort)
- Socially and emotionally unresponsive, inappropriately irritable/sad/fearful

Disinhibited Social Engagement Disorder

- Poor care-giving at early age (neglected, deprived, too numerous caregivers, or orphanage)
- Child inappropriately approaches or is overly familiar with unknown adult.

Dissociative Identity Disorder (Multiple Personality)

- 2 or more distinct personalities recurrently take control
- Compartmentalization of information.
- Marked distress or impairment

Dissociative Amnesia

- Trauma leading to inability to remember personal information
- Marked distress or impairment
- Specify if it includes Dissociative Fugue (travel)

Depersonalization/Derealization Disorder

- Recurrent subjective detachment (as if an "outside observer" or in a dream)
- Intact reality testing (not psychotic)
- Marked distress or impairment

Anorexia Nervosa

- Reducing food intake and refusal to maintain minimally healthy weight
- Strong fear of gaining weight or being "fat"
- Disturbance in body image (usually perceiving self as much heavier)
- Mild: BMI above 17, Moderate: BMI 16-16.99, Severe: BMI 15 - 15.99, Extreme: BMI <15
• Restricting Type - no binge eating or purging (purely uses fasting and exercising)
• Binge/Purge type - some binges or purging (vomiting, laxatives, etc.)

Bulimia Nervosa

- Binge-eating with minimal sense of control
- Purging or over-exercising

Binge Eating Disorder

- Binge eating with minimal sense of control
- No purging or over-exercising to try to compensate

Avoidant / Restrictive Food Intake Disorder

- Extreme food preferences leading to substantial psychosocial or nutritional problems

Pica

- Eating non-food items for 1 month or more
- Inappropriate for age

Rumination Disorder

- Persistent regurgitation of food (may be re-chewed or spit out)

Enuresis

- Loss of control of urine (day or night)

Encopresis

- Loss of control of stool (with or without constipation)

Delirium

- Quick onset disturbance in attention, orientation, and cognition (memory, language & perception)
- Evidence of a medical cause (substance intoxication or withdrawal, toxin, medication reaction, or
other physical illness)
- May also be more specific in coding to a specific cause

Major Neurocognitive Disorder

- Significant cognitive decline in one or more areas (learning and memory, language, executive functioning, complex attention, perceptual-motor, or social cognition)
- Interferes to the point of needing assistance
- Specify (and code) subtypes when possible: Alzheimer's, Vascular, Substance-Induced, Traumatic Brain Injury, HIV Infection, Parkinson's Disease, Lewy Bodies, Prion Disease, and Huntington's Disease.

Mild Neurocognitive Disorder

- Modest cognitive decline in one or more areas (learning and memory, language, executive functioning, complex attention, perceptual-motor, or social cognition)
- Does not interfere with functioning or independence
- Marked distress or impairment

Conduct Disorder

- Persistently violates other's rights or societal rules (hurting people or animals, property destruction, lying, theft, illegal activity)
- May code more specifically for Childhood or Adolescent onset

Intermittent Explosive Disorder

- Recurrent verbal or physical outbursts out of character for the person and disproportionate to the stress.

Kleptomania

- Recurrent impulsive stealing of un-needed items
- Buildup of tension prior to the act and relief following it

Pyromania

- Recurrent fire setting and attraction to fire
- Buildup of tension prior to the act and relief following it

Somatic Symptom Disorder

- Disproportionately excessive response (thoughts, feelings or behaviors) to a distressing physical symptom
- Usually persists at least 6 months

Illness Anxiety Disorder

- Excessive worry over having a serious illness, despite minimal medical evidence
- High anxiety around health overall
- Excessive health-related activities (symptom checking, tests, doctor visits, etc.) or avoids medical care

Psychological Factors Affecting Medical Condition

- Psychological factors adversely affect the course of a medical illness

Factitious Disorder

- Intentional faking to achieve a sick role
- No clear economic or legal motivators

Conversion Disorder (Functional Neurological Symptom Disorder)

- Abnormal voluntary motor or sensory functioning
- Symptoms are incompatible with recognized neurologic or medical conditions
- Marked distress or impairment

Insomnia Disorder

- Difficulty initiating or maintaining sleep, 3 nights a week for at least 3 months
- Marked distress or impairment

Hypersomnolence Disorder

- Excessive sleepiness despite sleeping at least 7 hours per night
- One of the following: non-restorative sleep lasting 9 hours or more, recurrent lapsing into sleep through the day or difficulty awakening
- Occurs 3 times a week for at least 3 months
- Marked distress or impairment
- Not better explained by sleep apnea, narcolepsy, parasomnias, etc.

Narcolepsy

- Irresistible sleep attacks, at least 3 times a week for 3 months
- At least one of the following:
• Cataplexy: sudden loss of muscle tone after laughing
• Hypocretin deficiency on spinal tap
• Sleep study showing reduced REM sleep latency

Circadian Rhythm Sleep-Wake Disorders

- Delayed Sleep Phase
- Advanced Sleep Phase
- Irregular Sleep-wake Type
- Non 24-hour Sleep-wake Type
- Shift work type
- Unspecified type

Nightmare Disorder

- Repeated terrifying awakenings with vivid recall and alertness
- Marked distress or impairment

Rapid Eye Movement Sleep Behavior Disorder

- Repeated sleep arousals with speaking or complex movements (walking, etc)
- Quickly awakens, fairly alert and not disoriented

Restless Legs Syndrome

- Urges to move legs, unpleasant restless sensation in legs, worse at night
- Occur at least 3 times a week for 3 months
- Marked distress or impairment

Non-REM Sleep Arousal Disorders

- No or little dream material recalled
Sleepwalking type: blank stare, relatively unresponsive, hard to awaken, no dream recall
Sleep Terror type: abrupt arousals, panic scream, intense fear and autonomic arousal

Gender Dysphoria

- Conflict between one's assigned gender and their experience of their gender. A strong preference for characteristics of the opposite gender to which they were assigned.
- Clinically significant distress or impairment

Female Sexual Interest/Arousal Disorder

- Absent or reduced sexual interest or arousal

Female Orgasmic Disorder

- Delayed or absence of orgasm

Exhibitionistic Disorder

- Fantasies or behavior to expose genitals to unsuspecting others
- Marked distress or impairment

Fetishistic Disorder

- Intense sexual fantasies or behavior with non-living object or non-genital body part
- Marked distress or impairment

Frotteuristic Disorder

- Fantasies or behaviors of touching or rubbing again an unsuspecting adult
- Marked distress or impairment

Pedophilic Disorder

- Fantasies or behavior of sexual activity with a prepubescent child (usually 12 and under)
- The perpetrator is 16 years of age or older, and is 5 years older than victim
- Marked distress or impairment

Sexual Masochism Disorder

- Fantasies or behaviors of experiencing sexual humiliation or suffering
- Marked distress or impairment

Sexual Sadism Disorder

- Fantasies or behaviors of inflicting suffering on others
- Marked distress or impairment

Transvestic Disorder

- Fantasies or behaviors of cross-dressing
- Marked distress or impairment

Voyeuristic Disorder

- Arousal from observing unsuspecting person in sexual context or disrobed
- Marked distress or impairment

Other Specified Paraphilic Disorder

- Other paraphilias such as telephone scatologia (obscene calls), necrophilia (dead body), zoophilia (animals), coprophilia (feces), klismaphilia (enemas), urophilia, etc.
- Marked distress or impairment

Paranoid Personality Disorder

- Distrust since early adulthood
- 4 out of 7 symptoms: suspects deception, doubts loyalty of friends, reluctant to confide, reads hidden meanings, bears grudges, perceives personal attacks on character, unwarranted suspicions of partner

Schizoid Personality Disorder

- Detached social relationships
- 4 out of 7 symptoms: doesn't desire close relationships, solitary activities, no interest in a sex partner, few close friends, little pleasure in activities, indifferent to praise or criticism, emotional coldness or flat affect

Schizotypal Personality Disorder

- Eccentricities and few close relationships
- 5 out of 9 symptoms: odd behavior, magical thinking (ESP, superstitions), ideas of reference, illusions, odd thinking and speech, paranoia, inappropriate or constricted affect, few close friends, excessive social anxiety

Borderline Personality Disorder

- Unstable relationships, unstable self-image, unstable affects and impulsivity
- 5 out of 9 symptoms: frantically avoids abandonment, idealizes then devalues relationships, identity disturbance, dangerous impulsivity, recurrent suicidal thoughts or self-mutilation, affective instability, chronic empty feeling, anger control problems, transient dissociation or paranoia

Histrionic Personality Disorder

- Excessive emotions and attention seeking
- 5 out of 8 symptoms: center of attention, sexually seductive, shallow and unstable emotions, dresses to draw attention, emotional speech without substance, theatrical, suggestible and easily influenced, feels relationships are more intimate then they really are

Narcissistic Personality Disorder

- Grandiosity, need for admiration and lack of empathy since early adulthood
- 5 out of 9 symptoms: grandiosity, fantasies of unlimited power and success, sees self as "special" and only associates with others of high status, needs admiration, sense of entitlement, interpersonally exploitative, lacks empathy, envious of others, arrogant

Antisocial Personality Disorder

- Evidence of conduct disorder before age 15
- Disregards other's rights since age 15
- 3 out of 7 symptoms: repeated unlawful acts, deceitfulness, impulsivity, repeated physical fights, disregard for safety, consistent irresponsibility, lack of remorse

Avoidant Personality Disorder

- Inhibited, inadequate and hypersensitive
- 4 out of 7 symptoms: avoids occupations dealing with people, avoids people unless they'll be liked, restrained in close relationships, fears social rejection, social inhibition, feels socially inept, few new activities or risks

Dependent Personality Disorder

- Excessive need to be taken care of
- Submissive and clingy behavior
- Fears of separation
- 5 out of 8 symptoms: difficulty making decisions, doesn't take responsibility, avoids conflict, poor initiation of projects, craves nurturance, helpless when alone, urgently seeks out relationships when one ends, fears being left to take care of themselves

Obsessive-Compulsive Personality Disorder

- Orderly, perfectionistic and in control
- 4 out of 8 symptoms: overly preoccupied by details, interfering perfectionism, workaholic, overly strict values, pack rat, micromanages others, miserly, rigid and stubborn