DSM-IV-TR Classification
Disorders Usually First Diagnosed In Infancy, Childhood, or
Adolescence
MENTAL RETARDATION (41) Note There are coded on Axis II
317 Mild mental retardation (43) 318.0 Moderate mental retardation (43) 318.1 Severe mental retardation (43) 318.2 Profound mental retardation (44)
319 Mental retardation, severity unspecified (44)
LEARNING DISORDER (49)
315.0 Reading disorder (51) 315.1 Mathemathics disorder (53)
315.2 Disorder of written expression (54) 315.9 Learning disorder NOS (56)
MOTOR SKILL DISORDER
315.4 Developmental coordination disorder (56)
COMUNICATION DISORDER
315.31 Expressive language disorder (58)
315.32 Mixed receptive expressive language disorder (62) 315.39 Phonological disorder (65)
307.0 Stuttering (67)
307.9 Communication disorder NOS (69)
PERVASIVE DEVELOPMENTAL DISORDER ()69
299.00 Autistic disorder (70) 299.80 Rett’s disorder (76)
299.10 Childhood disintegrated disorder (77) 299.80 Asperger’s disorder (80)
ATTENTION DEFICIT AND DISRUPTIVE BEHAVIOR DISORDER (85)
314.xx .01 .00 .01
Attention deficit/Hyperactivity disorder (85) Combined type
Predominantly inattentive type
Predominantly hyperactive impulsive type 314.9 Attention deficit/Hyperactinity disorder NOS (93) 312.xx
.81 .82 .89
Conduct disorder (93) Childhood onset type Adolescence onset type Unspecified onset
313.81 Oppositional defiant disorder (100) 312.9 Disruptive behavior disorder NOS (103)
FEEDING AND EATING DISORDERS OF INFANCY OR EARLY CHILDHOOD(103)
307.52 Pica (103)
307.52 Rumination Disorder (105)
307.59 Feeding disorder of infacy or early childhood (107)
TIC DISORDER (108)
307.23 Tourette’s disorder (111)
307.22 Chronic motor or vocal tic disorder (114) 307.21 Transient tic disorder (115)
specify if : single episode / recurrent 307.20 Tic disorder NOS (116)
ELIMINATION DISORDER (116)
-.- Encopresis (116)
787.6 With constipation and overflow incontinence 307.7 Without constipation and overflow incontinence 307.6 Enuresis (not due to a general medical condition) (118)
specify type : nocturnal only / diurnal only / nocturnal and diurnal
OTHER DISORDER OF INFANCY, CHILDHOOD, OR ADOLESCENCE (121)
309.21 Separation anxiety disorder (121) specify if : early onset
313.23 Selective mutism (125)
313.89 Reactive attachment disorder of infancy or early childhood (127) 307.3 Stereotypic movement disorder (131)
specify if : with self injurious behavior
Delirium, Dementia, and Amnestic and Other Cognitive Disorder
DELIRIUM293.0 Delirium due to ……(indicate the general medical condition) (141) -.- Substance intoxication delirium (refer to substance-related disorder for
substance specific codes) (143)
-.- Substance withdrawal delirium (refer to substance-related disorder for substance specific code) (143)
-.- Delirium due to multiple etiologies (code each of the specific etiologies) (146) 780.09 Delirium NOS (147)
DEMENTIA (147)
294.xx .10 .11
Dementia of the alzheimer’s type with early onset (also code 331.0 alzheimer’s disease on Axis III) (154)
Without behavioral disturbance With behavioral disturbance 294.xx
.10 .11
Dementia of the alzheimer’s type with late onset (also code 331.0 alzheimer’s disease on Axis III) (154)
Without behavioral disturbance With behavioral disturbance 290.xx .40 .41 .42 .43 Vascular dementia (158) Uncomplicated With delirium With delusion
With depressed mood
294.1x Dementia due to HIV disease (also code 042 HIV on Axis III) (163)
294.1x Dementia due to head trauma (also code 854.00 haed injury on Axis III) (164) 294.1x Dementia due to parkinson’s disease disease (also code 332.0 parkinson’s
disease on Axis III) (164)
294.1x Dementia due to huntington’s disease (also code 333.4 huntington’s disease on Axis III) (165)
294.1x Dementia due to pick’s disease (also code 331.1 pick’s disease on Axis III) (165)
294.1x Dementia due to creutzfeldt’s jakob disease (also code 046.1 creutzfeldt’s jakob disease on Axis III) (166)
294.1x Dementia due to …(indicated the general medical condition not listen above) (also code the general medical condition on Axis III) (167)
-.- Substance induced persisting dementia (refer to substance-related disorder for substance specific code) (168)
-.- Dementia due to multiple etiologies (code each of the specific etiologies) (170)
294.8 Dementia NOS (171)
294.0 Amnestic disorder due to ……(indicate the general medical condition (175)
Specify if : transient / chronic
-.- Substance induced persisting amnestic disorder (refer to substance-related disorder for substance specific codes) (177)
780.09 Amnestic disorder NOS (179)
OTHER COGNITIVE DISORDER (179)
294.9 Cognitive disorder NOS (179)
Mental Disorder Due To A Generaal Medical Condition Not Elsewhere
Classified (181)
293.89 Catatonic disorder due to ……(indicate the general medical condition (185) 310.1 Personality change disorder due to ……(indicate the general medical
condition (187)
Specify type : labile type / disinhibited type / aggressive type / apathetic type / paranoid type / other type / combined type / unspecified type
780.09 Mental disorder NOS due to ……(indicate the general medical condition (190)
Substance Related Disorders
(191)The following specifiers apply to substance dependence as noted :
a with physiological dependence / without physiological dependence
b early full remission / early partial remission / sustained full remission / sustained
partial remission
c in a controlled environment d on agonist therapy
the following specifiers apply to substance inducted disorders as noted :
I with onset during intoxication / W during with onset withdrawal ALCOHOL RELATED DISORDER (212)
Alcohol use disorder (213)
303.90 Alcohol dependencea,b,c (213)
305.00 Alcohol abuse (214)
303.00 Alcohol intoxication (214) 291.81 291.0 291.0 291.2 291.1 291.x .5 .3 291.89 291.89 291.89 291.89 291.9
Alcohol withdrawal (215) specify if : with perceptual disturbance Alcohol intoxication delirium (143)
Alcohol withdrawal delirium (143)
Alcohol induced persisting dementia (168)
Alcohol induced persisting amnestic disorder (177) Alcohol induced psychotic disorder (338)
With delusions I,W
With hallucinations I,W
Alcohol induced mood disorder I,W (405)
Alcohol induced anxiety disorder I,W (479)
Alcohol induced sexual dysfunction I (562)
Alcohol induced sleep disorder I,W (655)
Alcohol related disorder NOS (223)
AMPHETAMINE (OR AMPHETAMINE LIKE) RELATED DISORDERS (223)
Amphetamine use disorders (224)
340.40 Amphetamine dependence a,b,c (224)
Amphetamine abuse (225) Amphetamine induced disorder (226)
292.89 292.0 292.81 292.xx .11 .12 292.84 292.89 292.89 292.89 292.9
Amphetamine intoxication (226) specify if : with perceptual disturbance Amphetamine withdrawal (227)
Amphetamine intoxication delirium (143) Amphetamine induced psychotic disorder (338)
With delusions I
With hallucinations I
Amphetamine induced mood disorder I,W (405)
Amphetamine induced anxiety disorder I (479)
Amphetamine induced sexual dysfunction I (562)
Amphetamine induced sleep disorder I,W (655)
Amphetamine related disorder NOS (231)
CAFFEINE RELATED DISORDER (231)
Caffeine induced disorders (232) 305.90
292.89 292.89 292.9
Caffeine intoxication (232)
Caffeine induced anxiety disorder I (479)
Caffeine induced sleep disorder I (655)
Caffeine related disorder NOS (234)
CANNABIS RELATED DISORDERS (234)
Cannabis use disorders (236) 304.30
304.20 Cannabis dependence
a,b,c (236)
Cannabis abuse (236) Cannabis induced disorders (237)
292.89 292.81 292.xx .11 .12 292.89 292.9
Cannabis intoxication (237) specify if : with perceptual disturbance Cannabis intoxication delirium (143)
Cannabis induced psychotic disorder (338) With delusions I
With hallucinations I
Cannabis induced anxiety disorder I (479)
Cannabis related disorder NOS (241)
COCAINE RELATED DISORDER (241)
Cocaine use disorder (242) 304.20
304.60
Cocaine dependence a,b,c (242)
Cocaine abuse (243) Cocaine induced disorder (244) 292.89 292.0 292.81 292.xx .11 .12 292.84 292.89 292.89 292.89 292.9
Cocaine intoxication (244) specify if : with perceptual disturbance Cocaine withdrawal (245)
Cocaine intoxication delirium (143) Cocaine induced psychotic disorder (338)
With delusions I
With hallucinations I
Cocaine induced mood disorder I,W (405)
Cocaine induced anxiety disorder I,W (479)
Cocaine induced sexual dysfunction I (562)
Cocaine induced sleep disorder I,W (655)
Cocaine related disorder NOS (250)
HALLUCINOGEN RELATED DISORDERS (251)
Hallucinogen use disorder (251) 304.50
305.30 Hallucinogen dependence
b,c (251)
Hallucinogen abuse (252) Hallucinogen induced disorder (252) 292.89 292.89 292.81 292.xx .11 .12 292.84 292.89 292.9 Hallucinogen intoxication (252)
Hallucinogen persisting perception disorder (flashback)(253) Hallucinogen intoxication delirium (143)
Hallucinogen induced psychotic disorder (338) With delusions I,W
With hallucinations I,W
Hallucinogen induced mood disorder I (405)
Hallucinogen induced anxiety disorder I (479)
Alcohol related disorder NOS (256)
Inhalant use disorders (258) 304.60
305.90
Inhalant dependence b,c (258)
Inhalant abuse (259) Inhalant induced disorders (259) 292.89 292.89 292.81 292.xx .11 .12 292.84 292.89 292.9 Inhalant intoxication (259)
Inhalant intoxication delirium (143) Inhalant indued persisting dementia (168) Inhalant induced psychotic disorder (338)
With delusions I,W
With hallucinations I,W
Inhalant induced mood disorder I (405)
Inhalant induced anxiety disorder I (479)
Inhalant related disorder NOS (263)
NICOTINE RELATED DISORDERS (264)
Nicotine use disorder (264)
305.1 Nicotine dependence b,c (264)
Nicotine induced disorder (265) 292.0
292.9
Nicotine withdrawal (265)
Nicotine related disorder NOS (269)
OPIOID RELATED DISORDER (269)
Opioid use disorder (270)
Note There are coded on Axis II 304.00
305.50
Opioid dependence a,b,c (258)
Opioid abuse (259) Opioid induced disorders (271) 292.89 292.0 292.81 292.xx .11 .12 292.84 292.89 292.89 292.9
Opioid intoxication (271) specify if : with perceptual disturbance Opioid withdrawal (272)
Opioid intoxication delirium (143) Opioid induced psychotic disorder (338)
With delusions I
With hallucinations I
Opioid induced mood disorder I,W (405)
Opioid induced sexual dysfunction I (562)
Opioid induced sleep disorder I,W (655)
Opioid related disorder NOS (277)
Phencyclidine use disorder (279) 304.60
305.90
Phencyclidine dependence b,c (279)
Phencyclidine abuse (279) Phencyclidine induced disorders (280) 292.89 292.81 292.xx .11 .12 292.84 292.89 292.9
Phencyclidine intoxication (280) specify if : with perceptual disturbance Phencyclidine intoxication delirium (143)
Phencyclidine induced psychotic disorder (338) With delusions I
With hallucinations I
Phencyclidine induced mood disorder I (405)
Phencyclidine induced anxiety disorder I (479)
Phencyclidine related disorder NOS (283)
SEDATIVE, HYPNOTIC, OR ANXIOLYTIC RELATED DISORDERS (284)
Sedative, hypnotic, or anxiolytic use disorders (285) 304.60
305.90 Sedative, hypnotic, or anxiolytic dependence
a,b,c (285)
Sedative, hypnotic, or anxiolytic abuse (286) Sedative, hypnotic, or anxiolytic induced disorders (286) 292.89 292.0 292.81 292.81 292.82 292.83 292.xx .11 .12 292.84 292.89 292.89 292.89 292.9
Sedative, hypnotic, or anxiolytic intoxication (286) Sedative, hypnotic, or anxiolytic withdrawal (287) specify if : with perceptual disturbance
Sedative, hypnotic, or anxiolytic intoxication delirium (143) Sedative, hypnotic, or anxiolytic withdrawal delirium (143)
Sedative, hypnotic, or anxiolytic induced persisting dementia (168) Sedative, hypnotic, or anxiolytic induced persisting amnestic disorder (177)
Sedative, hypnotic, or anxiolytic induced psychotic disorder (338) With delusions I,W
With hallucinations I,W
Sedative, hypnotic, or anxiolytic induced mood disorder I,W (405)
Sedative, hypnotic, or anxiolytic induced anxiety disorder W (479)
Sedative, hypnotic, or anxiolytic induced sexual dysfunction I (562)
Sedative, hypnotic, or anxiolytic induced sleep disorder I,W (655)
Sedative, hypnotic, or anxiolytic related disorder NOS (283)
POLYSUBSTANCE RELATED DISORDER (293)
Note There are coded on Axis II
304.80 Polysubstance dependence a,b,c (293)
OTHER ( OR UNKNOWN) SUBSTANCE RELATED DISORDERS (294)
Other (or unknown) substance use disorders (295) 304.60
305.90
Other (or unknown) substance dependence a,b,c (192)
Other (or unknown) substance abuse (198) Other (or unknown) substance induced disorders (295)
292.89 292.0 292.81 292.82 292.83 292.xx .11 .12 292.84 292.89 292.89 292.89 292.9
Other (or unknown) substance intoxication (199) specify if : with perceptual disturbance
Other (or unknown) substance withdrawal (201) Other (or unknown) substance delirium (143)
Other (or unknown) substance induced persisting dementia (168)
Other (or unknown) substance induced persisting amnestic disorder (177) Other (or unknown) substance induced psychotic disorder (338)
With delusions I,W
With hallucinations I,W
Other (or unknown) substance induced mood disorder I,W (405)
Other (or unknown) substance induced anxiety disorder I,W (479)
Other (or unknown) substance induced sexual dysfunction I (562)
Other (or unknown) substance induced sleep disorder I,W (655)
Other (or unknown) substance related disorder NOS (223)
Schizophrenia and Other Psycotic Disorder (297)
295.xx Schizophrenia (298)
The following classification of longitudinal course apply to all sub types of schizophrenia Episodic with interepisode residual symptoms (specify if : prominent negative symptoms) / Episodic with no interepisode residual symptoms
Continuous (specify if : prominent negative symptoms)
Single episode in partial remission (specify if : prominent negative symptoms) / Single episode in full remission
Other or unspecified pattern .30 paranoid type (313) .10 disorganized type (314) .20 catatonic type (315) .90 undifferentiated type (316) .60 residual type (316) 295.40 Schizopheniform disorder (317)
specify if : without good prognostic features / with good prognostic features 295.70 Schizoaffective disorder (319)
specify if : bipolar type/depressive type 297.1 Delusional disorder (323)
specify if : erotomaniac type / grandiose type / jealous type / persecutory type / somatic type / mixed type / unspecified type
298.8 Brief psychotic disorder (329)
specify if : with marked stressor / without marked stressor/ with postpartum onset 297.3 Shared psychotic disorder (332)
293.xx .81 .82
Psychotic disorder due to …(indicated the general medical condition) With delutions
With hallucinations
-.- Substance induced psychotic disorder (refer to substance related disorders for substance specific codes) (338)
specify if : with onset during intoxication / with onset during withdrawal 298.9 Psychotic disorder NOS (343)
Mood Disorder (345)
DEPRESSIVE DISORDER (369) 296.xx
.2x .3x
Major depressive disorder (369) Single episode a,b,c,d,e,f
Recurrent a,b,c,d,e,f,g,h
300.4 Dysthymic disorder (376)
Specify if : early onset / late onset. Specify with atypical features
311 Depressive disorder NOS (381)
BIPOLAR DISORDER (382) 296.xx .0x .40 .4x .6x .5x .7 Bipolar I depressive (382)
Single manic episode a,c,f specify if m: mixed
Most recent episode hypomanic g,h,i
Most recent episode manic a,cf,g,h,i
Most recent episode mixed a,cf,g,h,i
Most recent episode depressed a,b,c,d,e,f,g,h,i
Most recent episode unspecified g,h,i
296.89 Bipolar II depressive a,b,c,d,e,f,g,h (392)
Specify if : (current or most recent episodes) hipyomanic / depressed 301.13 Cyclothymic disorder (398)
296.80 Bipolar disorder NOS (400)
293.83 Mood disorder due to ….(indicate the general medical condition) (401) Specify type with depressive features / with major depressive-like episode / with manic features / with mixed features
-.- Substance induced mood disorder (refer to substance related disorder for substances specific codes) (405)
Specify type with depressive features / with manic features / with mixed features specify if : with onset during intoxication / with onset during withdrawal 296.90 Mood disorder NOS (410)
300.01 Panic disorder without agoraphobia (433) 300.21 Panic disorder with agoraphobia (433)
300.22 Agoraphobia without history of panic disorder (411) 300.29 Specific phobia (443)
Specify type : animal type / natural environment type / blood injection injury type / situasional type / other type
300.23 Social phobia (450) Specify type : generalized
300.3 Obsessive compulsive disorder (456) specify if : with poor insight
309.81 Posttraumatic stress disorder (463) Specify if : acute / chronic
Specify if : with delayed onset 308.3 Acute stress disorder (469)
300.02 Generalized anxiety disorder (469)
293.84 Anxiety disorder due to ….(indicate the general medical condition) Specify if : with generalized anxiety / with panic attack / with obsessive compulsive symptoms
-.- Substance induced anxiety disorder (refer to substance related disorder for substances specific codes) (479)
Specify if : with generalized anxiety / with panic attack / with obsessive compulsive symptoms / with phobia symptoms
specify if : with onset during intoxication / with onset during withdrawal 300.00 Anxiety disorder NOS (484)
Somatoform Disorder (485)
300.81 Somatization disorder (486)
300.82 Undifferentiated somatoform disorder (490) 300.11 Conversion disorder (492)
Specify type : with motor symptoms or deficit / with sensory symptoms or deficit / with seizure or convulsion / with mixed presentation
307.xx 80 89
Pain disorder (498)
Associated with psychological factor
Associated with both psychological factor and a general medical condition
Specify if : acute / chronic
300.7 Hypochondriasis (504)
specify if : with poor insight
300.7 Body dysmorphic disorder (507) 300.82 Somatoform disorder NOS (484)
300.xx .16 .19 .19
Factitious disorder (513)
With predominantly psychological sign and symptoms With predominantly physical sign and symptoms
With combined psychological and physical sign and symptoms 300.19 Factitious disorder NOS (517)
Dissociative Disorders (519)
300.12 Dissociative disorder (520) 300.13 Dissociative fugue(523)
300.14 Dissociative identity disorder (526) 307.6 Depersonalization disorder (530) 300.15 Dissociative disorder NOS (532)
Sexual and Gender identity Disorders (535)
SEXUAL DYSFUNCTION (535)Sexual desire disorder (539)
302.71 Hypoactive sexual desire disorder (539) 302.79 Sexual aversion disorder (541)
Sexual arousal disorder (543)
302.72 Female sexual arousal disorder (543) 302.72 Male erectile disorder (543)
Orgasmic disorder (547)
302.73 Female orgasmic disorder (547) 302.74 Male orgasmic disorder (550) 302.75 Premature ejaculation (552) Sexual pain disorder (554)
302.76 Dyspareunia (not due to a general medical condition) (554) 306.51 Viginismus (not due to a general medical condition) (556)
625.58 Female hypoactive sexual desire disorder due to.. (indicate the general medical condition) (558)
608.89 Male hypoactive sexual desire disorder due to.. (indicate the general medical condition) (558)
607.84 Male erectile disorder due to.. (indicate the general medical condition) (558)
625.0 Female dyspareunia due to.. (indicate the general medical condition) (558)
608.89 Male dyspareunia due to.. (indicate the general medical condition) (558) 625.8 Other female sexual dysfunction due to.. (indicate the general medical
condition) (558)
608.89 Other male sexual dysfunction due to.. (indicate the general medical condition) (558)
-.- Substance induced Sexual dysfunction (refer to substance related disorder for substances specific codes) (562)
Specify if : with impaired desire / with impaired arousal / with impaired orgasm / with sexual pain
specify if : with onset during intoxication 302.70 Sexual dysfunction NOS (565)
PARAPHILAS (566)
302.4 Exhibisionism (569)
302.81 Fetishism (569)
302.89 Frotteurism (570)
302.2 Phedophilia (571)
Specify if : sexual attracted to males / sexual attracted to females / sexual attracted to both
Specify if : limited to incest
Specify type : exclusive type / nonexclusive type 302.83 Sexual masochism (572)
302.84 Sexual sadism (573) 302.3 Transfertic fetishism (574)
Specify if : with gender dysphoria
302.82 Voyeurism (575)
302.9 Paraphilia NOS (576)
GENDER IDENTITY DISORDER (576)
302.xx .6 .85
Gender identity disorder (576) In children
In adolescence or adult
Specify if : sexual attracted to males / sexual attracted to females / sexual attracted to both / sexual attracted to neither
302.6 Gender identity disorder NOS (576) 302.9 Sexual identity disorder NOS (576)
307.1 Anorexia nervosa (583)
Specify type : restricting type, binge-eating / purging type 307.51 Bulimia nervosa (589)
Specify type : purging type / nonpurging type 307.50 Eating disorder NOS (594)
Sleep Disorders (597)
PRIMARY SLEEP DISORDER (598)
Dyssomnia (598)
307.42 Primary insomnia (599) 307.44 Primary hypersomnia
347 Narcolepsy (609)
782.59 Breathing related sleep disorder (615) 307.45 Circadian rhytm sleep disorder (622)
Specify type : delayed sleep phase type / jet lag type / shift work type / unspecified type
307.47 Dyssomnia NOS (629)
Parasomnia (630)
307.47 Nightmare disorder (631) 307.46 Sleep terror disorder (634) 307.46 Sleep walking disorder (639)
307.47 Parasomnia NOS (644)
SLEEP DISORDER RELATED TO ANOTHER MENTAL DISORDER (645)
307.42 Insomnia related to.. (indicate the Axis I or Axis II disorder) (645) 307.44 Hypersomnia related to.. (indicate the Axis I or Axis II disorder) (645)
OTHER SLEEP DISORDERS (651)
780.xx .52 .54 .59 .59
Sleep disorder due to.. (indicate the general medical condition) (651) Insomnia type
Hypersomnia type Parasomnia type Mixed type
-.- Substance induced sleep disorder (refer to substance related disorder for substances specific codes) (655)
Specify type : Insomnia type / Hypersomnia type / Parasomnia type / Mixed type specify if : with onset during intoxication / with onset during withdrawal
312.34 Intermittent explosive disorder (663)
312.32 Kleptomania (667)
312.33 Pyromania (669)
312.31 Pathological gambling (671) 312.39 Trichotilomania (674)
312.30 Impulse control disorder NOS (677)
Adjustment Disorders (679)
309.xx .0 .24 .28 .3 .4 .9 Adjustment disorder (679) With depressed mood With anxietyWith mixed depressed mood and anxiety With disturbance of conduct
With mixed disturbance of emotions and conduct Unspecified
Specify if : acute / chronic
Personality Disorder (685)
301.0 Paranoid personality disorder (690) 301.20 Schizoid personality disorder (694) 301.22 Schizotipal personality disorder (697) 301.7 Antisocial personality disorder (701) 301.83 Borderline personality disorder (706) 301.30 Histrionic personality disorder (711) 301.81 Narcisstic personality disorder (714) 301.82 Avoidant personality disorder (718) 301.6 Dependent personality disorder (721)
301.4 Obsessive compulsive personality disorder (725) 301.9 Personality disorder NOS (729
PSYCHOLOGICAL FACTORS AFFECTING MEDICAL CONDITION (731)
316 ..(specified psychological factor)affecting …(indicate the general medical condition) (731)
Choose named based on nature of factors Mental disorder affecting medical condition
Psychological symptoms affecting medical condition
Personality traits or coping style affecting medical condition Maladaptive health behaviors affecting medical condition
Stress related physiological response affecting medical condition Other or unspecified psychological factors affecting medical condition
MEDICATION INDUCED MOVEMENT DISORDERS (734)
Note There are coded on Axis II
332.1 Neuroleptic induced parkinsonism (735) 333.92 Neuroleptic malignant syndrom (735) 333.7 Neuroleptic induced acute dystenia (735) 333.99 Neuroleptic induced acute akathisia (735) 333.82 Neuroleptic induced tardive diskinesia (736) 333.1 Neuroleptic induced postural tremor (736)
333.90 Medication induced movement disorder NOS (736)
OTHER MEDICATION INDUCED ISORDERS (736)
995.2 Adverse effects of medication NOS (736)
RELATIONAL PROBLEMS
V61.9 Relational problems related to a mental disorder or a general medical condition (737)
V61.20 Parent child relational problem (737) V61.10 Partner relational problem (737) V61.8 Sibling relational problem (737) V62.81 Relational problem NOS (737)
PROBLEM RELATED TO ABUSE OR NEGLECT (738)
(code 995.54 if focus of attention is on victim) V61.21 Sexual abuse of child (738)
(code 995.53 if focus of attention is on victim) V61.21 Neglect of child (738)
(code 995.52 if focus of attention is on victim) -.- Physical abuse of adult (738)
(code 995.54 if focus of attention is on victim) V61.12 (if by partner)
V62.83 (if by person other than partner) (code 995.81 if focus of attention is on victim) -.- Sexual abuse of adult (738)
V61.12 (if by partner)
V62.83 (if by person other than partner) (code 995.83 if focus of attention is on victim)
ADITIONAL CONDITIONS THAT MAY BE A FOCUS OF CLINICAL ATTENTION (739)
V15.81 Noncompliance with treatment (739)
V665.2 Malingering (739)
V71.01 Adult antisocial behavior (740)
V62.89 Child or adolescence antisocial behavior (740) 780.9 Borderline intellectual functioning (740)
Note : this is code on Axis II
V62.82 Age related cognitive decline (740)
V62.3 Academic problems (741)
V62.2 Occupational problems (741) 313.82 Identity problems (741)
V62.89 Religious or spiritual problems (741) V62.4 Acculturation problems (741)
V62.89 Phase of life problems (742)
Additional Codes (743)
300.9 Unspecified mental disorder (nonpsychotic) (743) V71.09 No diagnosis or condition on Axis I (743)
799.9 Diagnosis or condition deffered on Axis I (743) V71.09 No diagnosis on Axis II (743)
799.9 Diagnosis deffered on Axis II (743)
Axis I Clinical disorder
Other conditions that may be a focus of clinical attention Axis II Personality disorder
Mental retardation
Axis III General medical conditions
Axis IV Psychosocial and environmental problems Axis V Global assessment of functioning
KRITERIA DIAGNOSTIK DSM-IV-TR
diambil dari Kaplan & Sadock’s Pocket
Handbook of CLINICAL PSYCHIATRY 4th ed
Delirium karena kondisi medis umum
A. Disturbance of consciousness (ie, reduced clarity of awareness of the environment) with reduced ability to focus, sustain, or shift attention.
Gangguan kesadaran (penurunan tingkat kewaspadaan terhadap keadaan sekitar) disertai penurunan kemampuan memusatkan,mempertahankan atau mengalihkan perhatian. B. A change in cognition (eg, memory deficit, disorientation, language disturbance,
perceptual disturbance) or the development of perceptual disturbance that is not better accounted for by a preexisting, established, or evolving demensia.
Perubahan kemampuan kognitif (spt penurunan daya ingat,disorientasi,gangguan berbahasa dan persepsi) atau pembentukan gangguan persepsi yang bukan ok sebelumnya ada,menetap atu merupakan dementia.
C. The disturbance develops over a short period (usually hours to days) and tends to fluctuate during the course of the day.
Gangguan ini terjadi dalam waktu yang singkat (biasanya dlm beberapa jam atau hari)dan cenderung berubah-ubah
sepanjang hari.
D. There is evidence from the history, physical examination, or laboratory findings that the disturbance is caused by the direct physiologic consequence of a general medical condition.
Adanya bukti dari riwayat,pemeriksaan fisik atau temuan laboratories yg menunjukan behwa gangguan ini adalah konsekuensi fisiologis drari kondisi medis umum.
From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association,
Copyright 2000, with permission
A. Disturbance of consciousness (ie, reduced clarity of awareness of the
environment) occurs, with reduced ability to focus, sustain, or shift attention.
Gangguan kesadaran (penurunan tingkat kewaspadaan terhadap keadaan sekitar) disertai penurunan kemampuan memusatkan,mempertahankan atau mengalihkan perhatian.
B. A change in cognition (eg, memory deficit, disorientation, language disturbance, perceptual disturbance) occurs that is not better accounted for by a preexisting, established, or evolving demensia.
Perubahan kemampuan kognitif (spt penurunan daya ingat,disorientasi,gangguan berbahasa dan persepsi) atau pembentukan gangguan persepsi yang bukan ok sebelumnya ada,menetap atu merupakan dementia.
C. The disturbance develops over a short period (usually hours to days) and tends to fluctuate during the course of the day.
Gangguan ini terjadi dalam waktu yang singkat (biasanya dlm beberapa jam atau hari) dan cenderung berubah-ubah sepanjang hari.
D. There is evidence from the history, physical examination, or laboratory findings of either (1) or (2):
1. The symptoms in criteria A and B developed during substance intoxication 2. Medication use is etiologically related to the disturbance.
Adanya bukti dari riwayat,pemeriksaan fisik atau temuan laboratories antara (1) atau (2):
1.Gejala-gejala pada criteria A dan B terjadi selama intoksikasi zat.
2.Obat medikasi berkaitan secara etiologis dengan gangguan ini.
From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association,
Copyright 2000, with permission
A. The development of multiple cognitive deficits manifested by both
1. Memory impairment (impaired ability to learn new information or to recall previously learned information)
2. One (or more) of the following cognitive disturbances : a. aphasia (language disturbance)
b. apraxia (impaired ability to carry out motor activities despite intact motor function)
c. agnosia (failure to recognize or identify ojects despite intact sensory function)
d. disturbance in executive functioning (i.e., planning, organizing, sequencing, abstracting)
Terjadinya berbagai deficit kognitif yg bermanifestasi sebagai berikut:
1. Penurunan memori (penurunan kemampuan
mempelajari informasi baru atau mengingat informasi yang pernah dipelajari).
2. Satu atau lebih dari gangguan kognitif berikut: a. Aphasia.
b. Apraxia. c. Agnosia.
d. Gangguan dalam pengambilan keputusan
(perencanaan,pengorganisasian,kesinambungan, abstraksi).
B. The cognitive deficits in criteria A1 and A2 each cause significant impairment in social or occupational functioning and represent a significant decline from a previous level of function
Defisit. Kognitif pada criteria A1 dan A2 menyebabkan
penderitaan yang bermakna pada fungsi2 sosial dan pekerjaan serta menunjukan penurunan yang berarti dari keaadan
sebelumnya.
C. There is evidence from the history, physical examination or laboratory findings that the disturbance is the direct physiologic consequence of a general medical condition other than Alzheimer’s disease or cerebrovascular disease (e.g. HIV infection, traumatic brain injury, Parkinson’s disease, Huntington’s disease, Pick’s disease, Creutzfeldt-Jakob disease, normal-pressure hydrocephalus, hypothyroidism, brain tumor or vitamin B12 deficiency)
Adanya bukti2 dari riwayat,pemeriksaan fisik atau temuan laboratoris yang menunjukan bahwa gangguan ini adalah konsekuensi langsung dari suatu kondisi medis umum selain penyakit Alzheimer atau serebrovaskuler (mis. Infeksi
HIV,trauma serebral,penyakit2
Parkinson,Huntington,Pick,Creutzfeldt-Jakob,Hidrosefalus tekanan normal,Hipotiroidism,tumor otak atau defisiensi vitamin B12).
D. The deficits do not occur exclusively during the course of delirium Deficit-defisit ini terutama tidak terjadi selama adanya delirium.
Code based on presence or absence of a clinically significant behavioral disturbance: Without behavioral disturbance : if the cognitive disturbance is not accompanied
by any clinically significant behavioral disturbance
Without behavioral disturbance : if the cognitive disturbance is accompanied by a clinically significant behavioral disturbance (e.g., wandering, agitation)
Kode berdasarkan ada tidaknya ggn perilaku y bermakna klinis:
Tanpa gangguan perilaku: jika gangguan kognitif tidak disertai oleh gangguan perilaku yang bermakna klinis.
Dengan gangguan perilaku: jika gangguan kognitif disertai
oleh gangguan perilaku yang bermakna klinis.
Coding note : Also code the general medical condition on Axis III (e.g., HIV infection, head injury, Parkinson’s disease, Huntington’s disease, Pick’s disease, Creutzfeldt-Jakob disease.
Catatan: Pada axis III tuliskan penyakit penyebab.
Dementia tipe Alzheimer
A. The Development of Multiple cognitive deficits manifested by both Terjadinya
berbagai deficit kognitif yg bermanifestasi sebagai berikut:
2. Penurunan memori (penurunan kemampuan mempelajari
informasi baru atau mengingat informasi yang pernah dipelajari).
3. Satu atau lebih dari gangguan kognitif berikut:
a. Aphasia. b. Apraxia. c. Agnosia.
d. Gangguan dalam pengambilan keputusan
(perencanaan,pengorganisasian,kesinambungan,abstraksi).
B. The cognitive deficits in criteria A1 and A2
each cause significant impairment in social or occupational functioning and represent a significant decline from a previous level of functioning.Defisit. Kognitif pada criteria A1 dan A2 menyebabkan penderitaan yang bermakna pada fungsi2 sosial dan pekerjaan serta menunjukan penurunan yang berarti dari keaadan sebelumnya.
C. The course is characterized by gradual onset
and continuing cognitive decline.Perjalanan penyakit ditandai dengan onset
yang bertahap dan penurunan kognitif berlanjut
D. The cognitive deficits in criteria A1 and A2
(1) other central nervous system conditions that cause progressive deficits in memory and cognition (e.g., cerebrovascular disease, Parkinson’s disease, Humington’s disease, subdural hematoma, normal-pressure hydrocephalus, brain tumor)
(1) systemic conditions that are known to cause dementia (e.g.,hypothyroidism, vitamin B12 or folic acid deficiency, niacin deficiency, hypercalcemia, neurosyphilis, HIV infection) (2) substance-induced conditions.
Defisit. Kognitif pada criteria A1 dan A2 tidak disebabkan oleh: (1)Kondisi-kondisi sistim saraf pusat lainnya yang menyebabkan
deficit progresif memori dan kognitif (mis. Penyakit serebrovaskuler,Parkinson,Huntington,Pick,hematoma subdural,Hidrosefalus tekanan normal,tumor otak).
(2)Kondisi-kondis sistemik yang diketahui menyebabkan dementia (mis. Hipotiroidism,defisiensi vitamin ab12 atu asam
folat,niacin,hiperkalsemia,neurosifilis,infeksi HIV). (3)Kondisi-kondisi yang diinduksi zat.
E. The deficits do not occur exclusively during the course of a delirium.
Deficit-defisit ini terutama tidak terjadi selama adanya delirium.
F. The disturbance is not better accounted for by axis disorder (e.g., major depressive
disorder, schizophrenia).Gangguan ini bukan disebabkan oleh gangguan
axis I lainnya (mis.Gangguan Deprsif Mayor,Schizophrenia).
Code based on presence or absence of a clinically significant behavioral disturbance :
Without behavioral disturbance : if the cognitive disturbance is not accompanied by any clinically significant behavioral disturbance.
With behavioral disturbance : if the cognitive disturbance is accompanied by a clinically significant behavioral disturbance (e.g., wandering).
Kode berdasarkan ada tidaknya ggn perilaku yg bermakna klinis:
Tanpa gangguan perilaku: jika gangguan kognitif tidak
disertai oleh gangguan perilaku yang bermakna klinis.
Dengan gangguan perilaku: jika gangguan kognitif disertai oleh gangguan perilaku yang bermakna klinis (mis. suka jalan2)
Specify subtype :
With early onset : if onset is at age 65 years or below
With late onset : if onset is after age 65 years
Tentukan subtype:
Onset dini: jika muncul sebelum usia 65 tahun.
Onset lambat: : jika muncul sesudah usia 65 tahun.
Coding note : Also code the general medical condition on Axis III (e.g., HIV infection, head injury, Parkinson’s disease, Huntington’s disease, Pick’s disease, Creutzfeldt-Jakob disease
From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders,
text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with
permission
Amnesia karena kondisi medis umum
A. The development of memory impairment as manifested by impairment in the ability to learn
new information or the inability to recall previously learned information. Terjadinya gangguan memori yang bermanifestasi sebagai gangguan kemampuan mempelajari informasi baru atau ketidakmampuan mengingat informasi yang pernah dipelajari.
B. The memory disturbance causes significant impairment in social or occupational functioning
and represents a significant decline from a previous level of functioning.Gangguan memori menyebabkan penderitaan yang bermakna pada fungsi2 sosial dan pekerjaan serta menunjukan penurunan yang berarti dari keaadan sebelumnya.
C. The memory disturbance does not occur exclusively during the course of a delirium or a
dementia.Gangguan memori ini tidak hanya terjadi bersamaan dengan
delirium atau dementia.
D. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct physiologic consequence of a general medical condition (including
physical trauma).Adanya bukti2 dari riwayat,pemeriksaan fisik atau
temuan laboratoris yang menunjukan bahwa gangguan ini adalah konsekuensi fisiologis langsung dari suatu kondisi medis umum (termasuk trauma fisik).
Specify if :
Transient : if memory impairment lasts for 1 month or less
Chronic : if memory impairment lasts for more than 1 month
Tentukan jika:
Transient: jika gangguan memori berlangsung selama 1
bulan atau kurang.
bulan lamanya.
Coding note : include the name of the general medical condition on Axis I (e.g., amnestic disorder due to head trauma); also code the general medical condition on Axis III.
Catatan: Masukan nama kondisi medis umum pada axis I (mis.Gangguan Amnesia ok TraumaCapitis) dan cantumkan itu pada axis III.
From American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders
text revision, 4th ed. Washington DC : American Psychiatric Association. Copyright 2000. with
permission.
GGN MOOD DISEBABKAN KONDIS MEDIS UMUM
A. Ggn mood yg menonjol dan menetap mendominasi gambaran klinis dan di karakterisir oleh 1 atau kedua hal berikut:
1. adanya mood depresi atau penrunan nyata minat atau kesenangan pada hampir atau semua aktifitas.
2. adanya mood yg elevasi, expansif atau irritable. B. Adanya bukti berdasarkan riwayat, pemeriksaan fisik atau temuan2
laboratoris bhw ggn ini adalah konsekunsi fisilogis lsg dari suatu kondis medis umum.
C. Ggn ini tdk dpt digolongkan sebagai ggn mental lainnya (spt. Ggn Penyesuaian dgn mod depresi sbg respons thd beban menderita suatu kondis medis umum).
D. Ggn ini tdk hanya terjadi dlm perjalanan suatu Delirium.
E. Gejala2 diatas menyebabkan penderitaan atau hambatan yg bermakna klinis dlm bidang2 sosial, okupasional, atau fungsional penting lainnya. Tentukan tpenya:
Dgn gambaran depresif: diwarnai mood depresi tetapi tdk memenuhi kriteria penuh episode Depresi Mayor.
Dgn episode mirip Depresi Mayor: memenuhi kriteria penuh kecuali poin D dari Episode Depresi Mayor
Dgn gambara Mania: jika diwarnai mood2 elevasi, euforia atau irritable. Dgn gambaran Campuran: jika gejala2 Depresi dan Mania ada tetapi
tdk satupun yg menonjol.
DSM-IV-TR Diagnostic Criteria for Psychotic Dissorder due to a general medical condition
A. Halusinasi2 atau waham2nya menonjol.
B. Adanya bukti dari riwayat,pemeriksaan fisik atau temuan laboratories yg menunjukan behwa gangguan ini adalah
C. Gangguan ini tidak dapat dijelalaskan oleh gangguan mental lainnya.
D. Gangguan ini tidak terjadi selama perjalanan suatu delirium. Kode berdasarkan gejala2 predominan:
Dgn waham2 : jika gambaran wahamnya menonjol.
Dgn halusinasi2 : jika halusinasinya yang menonjol.
Cat. pengkodean: tuliskan nama dari kondisi medis umum. Pada axis I mis. Gangguan Psikotik ok Neoplasma ganas paru dgn waham; juga tuliskan nama kondisi medis umumnya pd axis III.
Jika wahm yg ada sbg bagian dari Demntia vaskuler maka tunjkan sesuai dgn subtipe, mis. Demntia Vaskuler dgn waham.
From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association,
Copyright 2000, with permission
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Diagnostic Criteria for Substance Dependence ( Alcohol and Other Substances)
A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occuring at any time in the same 12-month period:
Suatu pola pengguanaan zat yang maladaptif mengarah pada gangguan atau penderitaan yng bermakna klinis, bermanifestasi sebagai 3 (tiga) atau lebih hal-hal berikut yang terjadi pada tiap saat dalam periode 12 bulan:
1. tolerance, as defined by either of the following:
a. a need for markedly increased amounts of the substance to achieve intoxication or desired effect
b. markedly diminished effect with continued use of the same amount of the substance
toleransi yang didefinisikan sbb:
a. peningkatan nyata jumlah kebutuhan zat untuk mendapatkan efek yang didamba atau mencapai intoksikasi.
b. Penurunan efek yang nyata dengan penggunaan kontinyu jumlah yang sama dari zat.
2. withdrawal, as manifested by either of the following:
a. the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets from withdrawal from the specific substances)
b. the same (or a closely related) substance is taken relieve or avoid withdrawal symptoms
putus zat, bermanifestasi sebagai salah satu dari:
a. sindroma withdrwal khas untuk zat penyebab ( criteria A dan B dari gejala withdrawal zat dimaksud). b. zat yanga sama atau sejenis digunakan untuk
menghilangkan atau menghindari gejala-gejala withdrawal.
3. The substance is often taken in larger amounts or over a larger paeriod than was intended
Zat yng dimaksud sering digunakan dalam jumlah yang besar atau lewat dari batas waktu pemakaiannya.
4. there is a persistent desire or unsuccesful efforts to cut down or control substance use
adanya hasrat menetap atau ketidakberhasilan mengurangi atau mengendalikan pemakaian zat.
5. a great deal of time is spent in activities necessary to obtain the substance (e.g. visiting multiple doctors or driving distances), use the substance (e.g. chain-smoking), or recover from its effects
Adanya aktifitas yang menyita waktu untuk kebutuhan mendapatkan zat (mis.mendatangi berbagai dokter atau sampai melakukan perjalan jauh), untuk menggunakan zat (merokok tiada sela) atau untuk pulih dari efek2nya.
6. Important social, occupational, or recreational activities are given up or reduced because of substance use
Kegiatan-kegiatan soial yang penting,pekerjaan atau rekreasi dilalaikan atau dikurangi karena penggunaan zat.
7. the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g. current cocaine use despiterecognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption).
penggunaan zat tetap berlanjut meskipun mengetahui bahwa problem2 fisik dan fisiologis menetap atau berulang disebabkan oleh penggunaan zat (mis.sementara menggunakan kokain meskipun mengetahui itu menginduksi depresi atau tetap meneguk-alkohol- meskipun mengetahui hal itu memperburuk ulcus gaster).
Specify if:
With physiologic dependence; evidence of tolerance or withdrawal (i.e., either item 1 or 2 is present)
Without physiologic dependence; no evidence of tolerance or withdrawal (i.e., neither item 1 or 2 is present
Tentukan jika:
Dengan ketergantungan fisiologis: terbukti adanya toleransi atau putus zat (adanya item 1 atau 2).
Tanpa ketergantungan fisiologis: tidak terbukti adanya toleransi atau putus zat zat (tidaka adanya item 1 atau 2).. Course specifiers.
Early full remission Early partial reemission Sustained full remission Sustained partial remission On against therapy
In a controlled environment Tentukan perlangsunganya:
Remisi dini penuh
Pemisi dini parsial
Remisi penuh menetap
Remisi parsial menetap
Dalam terapi agonis
Dalam lingkungan yang diatur
From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association,
Copyright 2000, with permission
DSM-IV-TR Diagnostic Criteria for Substance Abuse (Alcohol and Other Substances)
A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occuring within a 12-month period Suatu pola pengguanaan zat yang maladaptif mengarah pada gangguan atau penderitaan yng bermakna klinis, bermanifestasi sebagai 1 (satu) atau lebih hal-hal berikut yang terjadi dalam periode 12 bulan:
(1) recurrent substance use resulting in failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household) penggunaan berulang zat menyebabkan kegagalan memenuhi tugas utama ditempat kerja,sekolah atau dirumah (mis. berulangkali bolos hasil kerja yang buruk karena penggunaan zat, bolos,diganjar atu dikeluarkan dari sekolah karena penggunaan zat,mengabaikan anak atau anggota keluarga
(2)recurrent substance use in situations in which it is physically hazardous (e.g., driving on automobile or operating a machine when impaired by substance use
berulangkali menggunakn zat dalm situasi yang
membahayakan fisik (mis.mengemudikan kendaraan atau mengoperasikan mesin saat terganggu oleh pemakaiannya)
(3)recurrent substance-related legal problems (e.g., arrest for substance-related disorderly conduct) berulangkali berurusan dengan hukum karena penggunaan zat (ditangkap karena ulah berkaitan dengan penggunaannya).
(4)continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights) meneruskan penggunaan zat meskipun tetap atau berulang memiliki problem sosial atau interpersonal
disebabkan atau kambuhnya efek2 dari zat (mis.berdebat dengan pasangan tentang akibat intoksikasi,berkaelahi).
B. The symptoms have never met the criteria for substance dependence for the class of substance. Gejala-gejalanya tidak memenuhi kriteria
ketergantungan zat yang digunakan.
DSM-IV-TR Diagnostic Criteria for Substance Intoxication
A. Development of a reversible substance-specific syndrome due to recent ingestion of (or exposure to) a substance. Note: different substances may produce similar or identical syndromeTerjadinya sindroma reversible zat spesifik karena barusan menelannya atau terpapar olehnya.cat. zat yang berbeda dapat memberi sindroma yang mirip atau sama.
B. Clinically significant maladaptive behavioral or psychological changes that are due to the effect of the substance on the central nervous system (e.g. belligerence, mood lability, cognitive impairment, impaired judgment, impaired social or occupational function), and develop during or shortly other use of the substance Tingkah laku maladaptif yang bermakna secara klinis atau perobahan psikologis karena efek dari zat terhadap sitim saraf pusat (mis. keadaan siap
tempur,labilitas mood,gangguan kognitif, penilaian,sosial dan fungsi pekerjaan) yang terjadi segera setelah penggunaan zat. C. The symptoms are not due to a general medical condition and are not better accounted for
by another mental disorder Gejala-gejalanya tidak karena kondisi medis umum ataupun gangguan mental lainnya.
DSM-IV-TR Diagnostic Criteria for Substance withdrawal
A. The development of a substance-specific syndrome due to the cessation of (or reduction in) substance use that has been heavy and prolonged Terjadinya sindroma zat spesifik karena penghentian mendadak (atau pengurangan) penggunaan zat yang lama dan berat.
B. The substance-specific syndrome causes clinically significant distress or impairment in social, occupational, or other important areas of function Sindroma zat spesifik diatas menyebabkan penderitaan yang bermakna secara klinis
atau gangguan dalam hal sosial,pekerjaan atau area fungsi-fungsi penting lainnya
C. The symptoms are not due to a general medical conditions and are not better accounted for by another mental disorder Gejala-gejalanya tidak karena kondisi medis umum ataupun gangguan mental lainnya
DSM-IV-TR- Diagnostic Criteria for opioid Intoxification A. Recent use of an opioid.Barusan menggunakan Opioid.
B. Clinically significant maladaptive behavioral of psycological change (e.g.,initial euphoria followed by apathy, dysphoria, psycomotor agitation or retardation, impaired judgement, or impaire social or impair occupation functioning) that developed during or shorty after opioid use.Tingkah laku maladaptif yang bermakna secara klinis atau perubahan psikologis (mis. mulanya euforia disusul apatis,disforia,agitasi atau retardasi psikomotor,gangguan penilaian atau fungsi sosial atau pekerjaan) yang terjadi selama atau segera setelah pemakaian opioid.
C. Pupil constriction or pupilary dilation due to anoxia from severe overdose) and one (or more) of the following:
1. drowsiness or coma. 2. slureed speech.
3. impairment of attention or memory.
Kostriksi pupil (atau dilatasi ok anoxia akibat overdosis) disertai satu atau lebih tanda2 berikut yang terjadi selama atau segera setelah pemakaian opioid.
yang terjadi selama atau segera setelah pemakaian opioid. 1. drowsiness atau coma.
2. bicara spt orang mabuk
3. gangguan perhatian dan memori.
D. The symptom are not due to general medical condition and are not better accounted for by another mental disorder.Gejala-gejalanya tidak karena kondisi medis umum ataupun gangguan mental lainnya.
Specify it : with perceptual disturbances.
DSM-IV-TR kriteria diagnosis Putus Zat Opioid
A. Either of the following:
1. cessation of (or reduction) opioid use that have been heavy prolonged (seveeral weeks or longer).
2. administration of an opioid antagonist after a period of opioid use.
Salah satu dari berikut ini:
1. penghentian mendadak (atau reduksi) penggunaan yang berat dan lama (beberapa minggu atau lebih) 2. pemberian antagonis opioid setelah suatu periode
penggunaan opioid.
B. Three or more following, developing within minute to several days after criteria A : 1. Disphoric mood.
2. Nausea and vomitting. 3. Muscle aches.
4. Lacrimation and rhinorea.
5. Pupillary erection, pillorecction or sweating. 6. Diarrhea.
7. Yawning. 8. Fever. 9. Insomnia.
Tiga atau lebih hal-hal berikut terjadi dalam hitungan menit sampai beberapa hari setelah kriteria A:
1. mood disforik.
2. nausea atau vomitus 3. nyeri otot.
4. lakrimasi atau rhinorrhea.
5. midriasis,piloerction atau persipirasi. 6. diare.
7. sering menguap. 8. febris.
9. insomnia.
C. The symptoms in criteria B cause clinically sigificant distres or impairment in social, occupational or other important areas of functioning.Gejala-gejala kriteria B diatas menyebabkan penderitaan yang bermakna secara klinis atau gangguan dalam hal sosial,pekerjaan atau area fungsi-fungsi penting lainnya
D. The symptoms are not due to general medical condition and are not better encounted by another mental disorder.Gejala-gejalanya tidak karena kondisi medis umum ataupun gangguan mental lainnya.
DSM-IV-TR Diagnostik Criteria for Amphetamine Intoxication
A. Recent use of amphetamine or a related substance (e.g.,
methylphenidate)Barusan menggunakan amfetamin atau zat sejenis (mis. methylphenidate).
B. Clinically significant maladaptive behavioral or psycological changes (e.g., euforia or affective blunting; changes in sociability; hypervigilance; interpersonal sensitivity; anxiety; tension, or anger; stereotyped behaviour; impaired judgment; impaired social or occupational fungtioning) that developed during, or shortly after use of amphetamin or related substance
Tingkah laku maladaptif yang bermakna secara klinis atau perubahan psikologis (mis. euforia atau afek tumpul,perubahan kemampuan sosial,sensitifitas interpersonal,hiperwaspada, anxietas, ketegangan atau gusar ,perilaku sterotipik, psikomotor,gangguan penilaian atau fungsi sosial atau pekerjaan) yang terjadi selama atau segera setelah pemakaian amfetamin dan sejenisnya.
C. Two (or more) of the following developing during or shorty after use of amphetamin or related substance
1. Tachycardia or bradycardia 2. pupilary dilatation
3. elevated or lowered blood presure 4. Perpiration or chill
5. Nausea or vomiting 6. Evidence of wight loss
7. Psycomotor agitation or retardation
8. muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias
9. Confusion, seizures, dyskinesias, dystonias, or coma
Adanya dua atau lebih tanda-tanda berikut ) yang terjadi selama atau segera setelah pemakaian amfetamin dan sejenisnya:
1. taki- atau bradikardi 2. midriasis.
3. tekanan darah meningkat atau turun. 4. persipirasi atau menggigil.
5. nausea atau vomitus. 6. penurunan berat badan
7. agitasi atau retardasi psikomotor
8. kelemahan otot,depresi respirasi,nyeri dada atau aritmia
9. kebingungan,kejang,diskinesia, distonia atau koma. D. The symptoms are not due to a general medical condition and are not better
accounted for by another mental disorder.Gejala-gejalanya tidak karena kondisi medis umum ataupun gangguan mental lainnya.
Spcify if: With perceptual disturbances Tentukan jika: dgn ggn persepsi
DSM-IV-TR Diagnostik Criteria for Amphetamine Withdrawal
A. Cessation of (or reduction in) amphetamin (or related substance) use that has been heavy and prolonged Penghentian mendadak (atau
pengurangan) dari pengguanaan amfetamin (atau sejenisnya) yang berat dan lama
B. Dysphoric mood and two (or more) of following physiologic changes, developing within a few hous to several days after Criterion A:
1. Fatigue
2. Vivid, unpleasant dreams 3. imsomnia or hypersomnia 4. increase appetite
5. Psycomotor retardation or agitation
Mood disforik dan 2 atua lebih perubahan fisiologis berikut terjadi dlm beberapa jam atau hari setelah kriteria A:
1. keletihan
2. mimpi2 tak menyenangkan yg terasa hidup 3. insomnia atau hipersomnia
4. nafsu makan meningkat
5. retardasi atu agitasi psikomotor
C. The symptoms in Criterion B cause clinically significant distress or impairement in social, occupational, or other important areas of
functioning.Gejala-gejala kriteria B diatas menyebabkan penderitaan yang bermakna secara klinis atau gangguan dalam hal
sosial,pekerjaan atau area fungsi-fungsi penting lainnya
D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder.Gejala-gejalanya tidak karena kondisi medis umum ataupun gangguan mental lainnya.
GGN MOOD DIINDUKSI ZAT
A. Ggn mood yg menonjol dan menetap mendominasi gambaran klinis dan di karakterisir oleh 1 atau kedua hal berikut:
1. adanya mood depresi atau penrunan nyata minat atau kesenangan pada hampir atau semua aktifitas.
2. adanya mood yg elevasi, expansif atau irritable.
B. Adanya bukti berdasarkan riwayat, pemeriksaan fisik atau temuan2 laboratoris:
1. gejala2 pd kriteria A selama atau dlm sebulan setelah intoksikasi atau putus zat.
2. penggunaan medikasi berhubungan etiologis dgn ggn ini.
C. Ggn ini tdk dpt digolongkan sbg ggn mood yg tdk diinduksi zat dgn pembuktian sbb: geja2 mendahului sebelum onset penggunaan zat (atau medikasi); gejala2 menetap utk wkt yg jelas (mis. 1 bulan) sesudah
berhentinya putus zat akut atau intoksikasi berat atau berlebihan dari yg diduga dgn jumlah atau lamanya pemakaian zat; atau adanya bukti keberadaan ggn mood yg bukan diinduksi zat (mis. Ada riwayat episode Depresi Mayor rekuren).
D. Ggn ini tdk hanya terjadi dlm perjalanan suatu Delirium.
E. Gejala2 diatas menyebabkan penderitaan atau hambatan yg bermakna klinis dlm bidang2 sosial, okupasional, atau fungsional penting lainnya.
Cat: diagnosa sebaiknya dibuat meskipun ada dignosa Intoksikasi atau Putus Zat ketika gejal2 mood muuncul
berlebihan dibanding biasanya dgn intoksikasi atau putus zat dan ketika gejala2 cukup berat utk menjadi perhatian klinis tersendiri.
Tentukan tipe:
Dgn gambaran depresif: diwarnai mood depresi tetapi tdk memenuhi kriteria penuh episode Depresi Mayor.
Dgn episode mirip Depresi Mayor: memenuhi kriteria penuh kecuali poin D dari Episode Depresi Mayor
Dgn gambara Mania: jika diwarnai mood2 elevasi, euforia atau irritable.
Dgn gambaran Campuran: jika gejala2 Depresi dan Mania ada tetapi tdk satupun yg menonjol.
Tentukan jika:
Dgn onset sewaktu intoksikasi: jika memenuhi kriteria intoksikasi zat dan gejala2 terjadi selama sindroma
intoksikasi.
Dgn onset sewaktu putus zat: jika memenuhi kriteria putus zat dan gejala2 terjadi selama atau segera sesudah sindroma putus zat.
DSM-IV TR: GANGGUAN PSIKOTIK YG DIINDUKSI ZAT
A. Halusinasi2 atau waham2nya menonjol.Cat.: jangan masukan halusinasi jika oranya mempunyai tilikan bhw dia dipengaruhi zat. B. Adanya bukti dari riwayat,pemeriksaan fisik atau temuan
laboratories yg menunjukan (1) atau (2):
C. Gangguan ini tidak dpt dijelaskan oleh gangguan psikotik yg tidak diiduksi zat yg dibuktikan dgn gejala2 sudah ada sebelum
menggunakan zat (atau medikasi), menetap dlm jangka waktu tertentu setelah berhentinya putus zat akut atau intoksikasi berat, atau timbulnya berlebihan dibanding jumlah atau durasi pemakaian zat, atau adanya bukti lain yg menunjukan suatu gangguan psikotik lepas yang dinduksi oleh bukan zat.
D. Gangguan ini tidak terjadi selama perjalanan suatu delirium.
Cat.: Diagnosis ini sebaiknya dibuat sebagai ganti Intoksikasi Zat atau Putus Zat hanya ketika gejala2nya berlebihan dari ke2 gangguan ini dan ketika cukup berat untuk menghasilkan perhatian klinis.
Kode (zat spesifik) menginduksi gangguan psikotik:292.11 Inhalan, dgn waham; 292.12 Inhalan, dgn halusinasi; 292.11 Opioid, dgn waham; 292.12 Opioid, dgn halusinasi; 292.11 Phencyclidine (sejenisnya), dgn waham; 292.12 Phencyclidine (sejenisnya), dgn halusinasi; 291.5 Alkohol,dgn waham; 291.3 Alkohol,dgn halusinasi; 292.11 Amfetamin (sejenisnya), dgn waham; 292.12 Amfetamin (sejenisnya), dgn halusinasi; 292.11 Kanabis, dgn waham; 292.12 Kanabis, dgn
halusinasi; 292.11 Kokain, dgn waham;292.12 Kokain, dgn halusinasi; 292.11 Halisinogen dgn waham; 292.12 Halusinogen dgn halusinasi; 292.11 Sedatif,Hipnotik atau Anxiolitik, dgn waham; 292.12
Sedatif,Hipnotik atau Anxiolitik, dgn halusinasi; 292.11 Zat lain, dgn waham; 292.12 Zat lain, dgn halusinasi.
Tentukan jika:
Dgn onst sewaktu intoksikasi: jika kriteria intoksikasi zat terpenuhi
dan gejala2nya terjadi bersamaan.
Dgn onset sewaktu putus zat: jika kriteria putus zat terpenuhi dan gejala2nya terjadi bersamaan, segera sesudahnya.
DSM-IV-TR Diagnostic Criteria for Schizophrenia Disorder
A. Characteristic symptoms: two or more of the following, each presnt for a significant portion of time during a month period (or les if successfull treated) Gejala-gejala yang khas : 2 atau lebih dari gejala berikut yang bermakna dalam periode 1 bulan (atau kurang jika berhasil diterapi):
1. delusions 2. hallucinations
3. disorganized speech (e.g frequent derailment or incohorentia) 4. grossly disorganized or catatonic behaviour
5. negative symptoms (i.e affective falttening, alogia, or avolition)
1. waham. 2. halusinasi.
3. pembicaraan yang janggal (mis. Sering derailment atau incohorensia).
4. perilaku janggal atau katatonik
5. adanya gejala negatif (spt afek datar,alogia,abulia).
Note: only one criterion A symptom is required if delusions are bizzare or hallucinations consist of voice keeping up of a running comentary on the person’s behaviour or thoughts or two or more voices conversing each other.
Cat. : Hanya satu dari kriteria A yang diperlukan jika waham-nya janggal atau jika halusinasinya berupa suara yang terus menerus mengomentari tingkah laku atau pikiran yang bersangkutan atau berisi 2 (atau lebih) suara-suara yang saling bercakap-cakap.
B. Social / occupational dysfunction: for a significant portion of the time since the onset of the disturbance, one or more major area of functioning, such as work, interpersonal relations, or self care, are markedly below the level achieved prior to the onset (or when the onset is in the childhood or adolescence, failure to achieved expected level of interpersonal, academic or occupational achievement)Disfungsi sosial atau pekerjaan: 1 atau lebih dari area fungsional utama menunjukkan penurunan nyata di bawah tingkat yang dicapai sebelum onset dalam suatu rentang waktu yang bermakna sejak onset gangguan seperti pekerjaan, hubungan interpersonal atau perawatan diri (atau bila onset pada masa anak-anak atau remaja terdapat kegagalan pencapaian tingkat interpersonal, akademik atau okupasional lainnya) .
C. Duration: contnuous sign of the disturbance persist at least for 6 months.This 6 months periode must include at 1 month of symptoms (or les if successfull treated) that are meet criterion A (i.e active phase symptoms) and may include prodormal and residual symptoms.During these prodormal and residual symptoms, the signs of the disturbance may be manifested by only negative symptoms or 2 or more symptoms list in criterion A present in attenuated form (e.g odd beliefs, unusual perceptual experiences) Durasi: tanda-tanda gangguan terus berlanjut dan menetap sedikitnya 6 bulan. Periode 6 bulan ini meliputi 1 bulan gejala-gejala fase aktif yang memenuhi kriteria A (atau kurang bila
berhasil diterapi) dan dapat juga mencakup fase prodromal atau residual. Selama berlangsung. fase prodormal atau residual ini, tanda-tanda gangguan dapat bermanifestasi hanya sebagai gejala-gejala negatif saja atau lebih dariatau=2 dari gejala-gejala-gejala-gejala dalam kriteria A dalam bentuk yang lebih ringan (seperti kepercayaan – kepercayaan ganjil, pengalaman perseptual yang tidak biasa). D. Schizoaffective and mood dissorde exclusion: Schizoaffective and mood dissorder
with psychotic features have been rule out because of either (1) no major depressive, manic or mixed episodes have occured concurently with the active phase symptoms, or (2) if mood episode have occured during the active phase symptoms ,their total duration has beeen relative to the duration of the active and residual peroiods.
Penyingkiran skizofektif dan gangguan mood: Gangguan skizoafektif dan mood dengan gambaran psikotik dikesampingkan karena : (1) tidak ada episode depresi, mania atau campuran keduanya yang terjadi bersamaan dengan gejala-gelala fase aktif, (2) jika episode mood terjadi intra fase aktif maka perlangsungannya relatif singkat dibanding periode fase aktif dan residual.
E. Substances/general medical conditions exclusion: the disturbance is not due to the direct physiologic effects of a substance (e.g., a drug abuse, a medication) or a
general medical condition. Penyingkiran kondisi medis dan zat: Gangguan ini bukan disebabkan oleh efek fisiologis langsung dari suatu zat (seperti obat-obatan medikasi atau yang disalah gunakan) atau oleh suatu kondisi medis umum.
F. Relationship to a pervasive developmental dissorder: if there is a history of Autistic dissorde or another pervasive developmental disorder, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations are also present for at least 1 month (or les if successfull treated). Hubungan dengan suatu gangguan perkembangan pervasif: Jika terdapat riwayat autistik atau gangguan pervasif lainnya maka tambahan diagnosa
skizofernia hanya dibuat bila juga terdapat delusi atau halusinasi yang menonjol dalam waktu sedikitnya 1 bulan (atau kurang jika berhasil diterapi).
Classification of longitudinal course (can be applied only after at least 1 year has elapsed since the initial onset of active phase symptoms
Klasifikasi berdasarkan perjalanannya (longitudinal;hanya dipakai setelah minimal 1 tahun berlalu semenjak onset dari gejala-gejala fase aktif pertama):
- Episodik dengan gejala-gejala residual interepisode (episode ditandai dengan keadaan kekambuhan dari gejala-gejala psikosis) juga tentukan jika disertai gejala-gejala negatif yang menonjol.
- Kontinyu (gejala-gejala psikosis jelas ada sepanjang periode observasi) juga tentukan jika disertai gejala-gejala negatif yang menonjol.
- Episode tunggal dengan remisi parsial; juga tentukan jika disertai gejala-gejala negatif yang menonjol.
- Episode tunggal dengan remisi penuh - Pola lainnya atau yang tidak ditentukan.
From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC:
American Psychiatric Association, Copyright 2000, with permission Tipe PARANOID
Suatu tipe skizofrenia yg memenuhi kriteria:
A. Preokupasi dgn 1 atau lebih waham atau sering berhalusinasi auditorik.
B. Gejala2 berikut tidak menonjol: pembicaraan atau perilaku yang janggal atau katatonik atau afek datar atau inappropriate.
Tipe KACAU (DISORGANIZED)
Suatu tipe skizofrenia yg memenuhi kriteria: A. Semua gejala berikut menonjol:
1. pembicaraan yang janggal. 2. perilaku yang janggal.
3. afek datar atau inappropriate. B. Kriteria tipe katatonik tidak terpenuhi. Tipe KATATONIK
Suatu tipe skizofrenia dimana gambaran klinisnya didominasi ole 2 ataulebih hal2 berikut:
1. imobilitas motorik yg dibuktikan dgn catalepsy (termasuk waxy flexibility) atau stupor.
2. aktfitas2 motorik yg berlebihan (yg tampak tak bertujuan dan tidak dipengaruhi oleh stimuli external).
3. negativisme yg nyata (yg tampaknya penolakan tanpa motif thd semua perintah atau mempertahankan suatu postur kaku
melawan usaha untuk menggerakannya) atau mutisme. 4. gerakan spontan yg aneh spt melakukan postur tertentu
(berlagak spontan yg inappropriate atau postur ganjil),gerakan stereotipik,menojolnya manerisme atau menyerigai.
5. echolalia atau echopraxia. Tipe tak tergolongkan
