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35 Cards in this Set
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Intellectual Disability (Intellectual Developmental Disorder) |
A disorder with onset during the developmental period that includes both intellectual & adaptive functioning deficits in conceptual, social, and practical domains. The following three criteria must be met: A. Deficits in intellectual functions, such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, & learning from experience, confirmed by both clinical assessment & individualized, standardized intelligence testing B. Deficits in adaptive functioning that result in failure to meet developmental & sociocultural standards for personal independence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, & independent living, across multiple environments, such as home, school, work, & community C. Onset of intellectual & adaptive deficits during the developmental period |
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Global Developmental Delay |
This diagnosis is reserved for individuals UNDER the age of 5 years when the clinical severity level cannot be reliably assessed during early childhood. This category is diagnosed when an individual fails to meet expected developmental milestones in several areas of intellectual functioning, & applies to individuals who are unable to undergo systematic assessments of intellectual functioning, including children who are too young to participate in standardized testing. This category requires reassessment after a period of time. |
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Language Disorder |
A. Persistent difficulties in the acquisition & use of language across modalities (i.e., spoken, written, sign language, or other) due to deficits in comprehension or production that include the following: 1. Reduced vocabulary (word knowledge & usage) 2. Limited sentence structure (ability to put words & word endings together to form sentences based on the rules of grammar and morphology) 3. Impairments in discourse (ability to use vocabulary & connect sentences to explain or describe a topic or series of events or have a conversation) B. Language abilities are substantially & quantifiably below those expected for age, resulting in functional limitations in effective communication, social participation, academic achievement, or occupational performance, individually or in any combination. C. Onset of symptoms is in the early developmental period D. The difficulties are not attributable to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition & are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. |
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Speech Sound Disorder |
A. Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages. B. The disturbance causes limitations in effective communication that interfere with social participation, academic achievement, or occupational performance, individually or in any combination C. Onset of symptoms is in the early developmental period. D. The difficulties are not attributable to congenital or acquired conditions, such as cerebral palsy, cleft palate, deafness or hearing loss, traumatic brain injury, or other medical or neurological conditions. |
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Childhood-Onset Fluency Disorder (Stuttering) |
A. Disturbances in the normal fluency & time patterning of speech that are inappropriate for the individual's age & language skills, persist over time, & are characterized by frequent & marked occurrences of one (or more) of the following: 1. Sound & syllable repetitions 2. Sound prolongations of consonants as well as vowels 3. Broken words (e.g., pauses within a word) 4. Audible or silent blocking (filled or unfilled pauses in speech) 5. Circumlocations (word substitutions to avoid problematic words) 6. Words produced with an excess of physical tension 7. Monosyllabic whole-word repetitions (e.g., "I-I-I-I see him.") B. The disturbance causes anxiety about speaking or limitations in effective communication, social participation, or academic or occupational performance, individually or in any combination C. The onset of symptoms is in the early developmental period. D. The disturbance is not attributable to a speech-motor or sensory deficit, dysfluency associated with neurological insult (e.g., stroke, tumor, trauma), or another medical condition & is not better explained by another mental disorder. |
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Social (Pragmatic) Communication Disorder |
A. Persistent difficulties in the social use of verbal & nonverbal communication as manifest by all of the following: 1. Deficits in using communication for social purposes, such as greeting & sharing information, in a manner that is appropriate for the social context. 2. Impairment of the ability to change communication to match context or the needs of the listener, such as speaking differently in a classroom than on a playground, talking differently to a child than to an adult, & avoiding use of overly formal language 3. Difficulties following rules for conversation & storytelling, such as taking turns in conversation, rephrasing when misunderstood, & knowing how to use verbal & nonverbal signals to regulate interaction 4. Difficulties understanding what is not explicitly stated (e.g., making inferences) & nonliteral or ambiguous meanings of language (e.g., idioms, humor, metaphors, multiple meanings that depend on the context for interpretation) B. The deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance, individually or in combination. C. The onset of the symptoms is in the early developmental period (but deficits may not become fully manifest until social communication demands exceed limited capacities) D. The symptoms are not attributable to another medical or neurological condition or to low abilities in the domains of word structure & grammar, & are not better explained by autism spectrum disorder, intellectual disability (intellectual developmental disorder), global developmental delay, or another mental disorder. |
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Autism Spectrum Disorder |
A. Persistent deficits in social communication & social interaction across multiple contexts, as manifest by the following, currently or by history: 1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach & failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions 2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal & nonverbal communication; to abnormalities in eye contact & body language or deficits in understanding & use of gestures; to a total lack of facial expressions & nonverbal communication. 3. Deficits in developing, maintaining, & understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers. B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history: 1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases) 2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day) 3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests) 4. Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement) C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life) D. Symptoms must cause clinically significant impairment in social, occupational, or other important areas of current functioning E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. |
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Attention Deficit/Hyperactivity Disorder (ADHD) |
A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by 1 and/or 2: 1. Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level & that negatively impacts directly on social & academic/occupational activities: a. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate) b. Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading) c. Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction) d. Often does not follow through on instructions & fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus & is easily sidetracked) e. Often has difficulty organizing tasks & activities (e.g., difficulty managing sequential tasks; difficulty keeping materials & belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines) f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents & adults, preparing reports, completing forms, reviewing lengthy papers) g. Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones) h. Is often easily distracted by extraneous stimuli (for older adolescents & adults, may include unrelated thoughts) i. Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents & adults, returning calls, paying bills, keeping appointments) 2. Hyperactivity and Impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level & that negatively impacts directly on social & academic/occupational activities a. Often fidgets with or taps hands or feet or squirms in seat b. Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place) c. Often runs about or climbs in situations where it is inappropriate (Note: in adolescents or older adults, may be limited to feeling restless) d. Often unable to play or engage in leisure activities quietly e. Is often "on the go," acting as if "driven by a motor" (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with) f. Often talks excessively g. Often blurts out an answer before a question has been completed (e.g., completes people's sentences; cannot wait for turn in conversation) h. Often has difficulty waiting his or her turn (e.g., while waiting in line) i. Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people's things without asking or receiving permission; for adolescents & adults, may intrude into or take over what others are doing) B. Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years C. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities) D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder & are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal) |
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Specific Learning Disorder |
A. Difficulties learning & using academic skills, as indicated by the presence of at least one of the following symptoms that have persisted for at least 6 months, despite the provision of interventions that target those difficulties: 1. Inaccurate or slow & effortful word reading (e.g., reads single words aloud incorrectly or slowly & hesitantly, frequently guesses words, has difficulty sounding out words) 2. Difficulty understanding the meaning of what is read (e.g., may read text accurately but not understand the sequence, relationships, inferences, or deeper meanings of what is read) 3. Difficulties with spelling (e.g., may add, omit, or substitute vowels or consonants) 4. Difficulties with written expression (e.g., makes multiple grammatical or punctuation errors within sentences; employs poor paragraph organization; written expression of ideas lacks clarity) 5. Difficulties mastering number sense, number facts, or calculation (e.g., has poor understanding of numbers, their magnitude, & relationships; counts on fingers to add single-digit numbers instead of recalling the math fact as peers do; gets lost in the midst of arithmetic computation & may switch procedures) 6. Difficulties with mathematical reasoning (e.g., has severe difficulty applying mathematical concepts, facts, or procedures to solve quantitative problems) B. The affected academic skills are substantially & quantifiably below those expected for the individual's chronological age, & causes significant interference with academic or occupational performance, or with activities of daily living, as confirmed by individually administered standardized achievement measures & comprehensive clinical assessment. For individuals age 17 years & older, a documented history of impairing learning difficulties may be substituted for the standardized assessment. C. The learning difficulties begin during school-age years but may not become fully manifest until the demands for those affected academic skills exceed the individual's limited capacities (e.g., as in timed tests, reading or writing lengthy complex reports for a tight deadline, excessively heavy academic loads) D. The learning difficulties are not better accounted for by intellectual disabilities, uncorrected visual or auditory acuity, other mental or neurological disorders, psychosocial adversity, lack of proficiency in the language of academic instruction, or inadequate educational instruction |
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Developmental Coordination Disorder |
A. The acquisition & execution of coordinated motor skills is substantially below that expected given the individual's chronological age & opportunity for skill learning & use. Difficulties are manifested as clumsiness (e.g., dropping or bumping into objects) as well as slowness & inaccuracy of performance of motor skills (e.g., catching an object, using scissors or cutlery, handwriting, riding a bike, or participating in sports) B. The motor skills deficit in Criterion A significantly & persistently interferes with activities of daily living appropriate to chronological age (e.g., self-care & self-maintenance) and impacts academic/school productivity, prevocational & vocational activities, leisure & play C. Onset of symptoms is in the early developmental period D. The motor skills deficits are not better explained by intellectual disability (intellectual developmental disorder) or visual impairment & are not attributable to a neurological condition affecting movement (e.g., cerebral palsy, muscular dystrophy, degenerative disorder) |
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Stereotypic Movement Disorder |
A. Repetitive, seemingly driven, & apparently purposeless motor behavior (e.g., hand shaking or waving, body rocking, head banging, self-biting, hitting own body) B. The repetitive motor behavior interferes with social, academic, or other activities & may result in self-injury C. Onset is in the early developmental period.
D. The repetitive motor behavior is not attributable to the physiological effects of a substance or neurological condition & is not better explained by another neurodevelopmental or mental disorder (e.g., trichotillomania [hair-pulling disorder], obsessive-compulsive disorder) |
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Tourette's Disorder |
A. Both multiple motor & one or more vocal tics have been present at some time during the illness, although not necessarily concurrently B. The tics may wax & wane in frequency but have persisted for more than 1 year since first tic onset C. Onset is before age 18 years D. The disturbance is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., Huntington's disease, postviral encephalitis) |
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Persistent (Chronic) Motor or Vocal Tic Disorder |
A. Single or multiple motor or vocal tics have been present during the illness, but not both motor & vocal B. The tics may wax & wane in frequency but have persisted for more than 1 year since first tic onset C. Onset is before age 18 years D. The disturbance is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., Huntington's disease, postviral encephalitis) E. Criteria have never been met for Tourette's disorder |
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Provisional Tic Disorder |
A. Single or multiple motor and/or vocal tics B. The tics have been present for less than 1 year since the first tic onset C. Onset is before age 18 years D. The disturbance is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., Huntington's disease, postviral encephalitis) E. Criteria have never been met for Tourette's disorder or persistent (chronic) motor or vocal tic disorder |
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Pica |
A. Persistent eating of nonnutrutive, nonfood substances over a period of at least 1 month B. The eating of nonnutritive, non food substances is inappropriate to the developmental level of the individual C. The eating behavior is not part of a culturally supported or socially normative practice D. If the eating behavior occurs in the context of another mental disorder (e.g., intellectual disability [intellectual developmental disability], autism spectrum disorder, schizophrenia) or medical condition (including pregnancy), it is sufficiently severe to warrant additional clinical attention |
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Rumination Disorder |
A. Repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re-chewed, re-swallowed, or spit out B. The repeated regurgitation is not attributable to an associated gastrointestinal or other medical condition (e.g., gastroesophageal reflux, pyloric stenosis) C. The eating disturbance does not occur exclusively during the course of anorexia nervosa, bulimia nervosa, binge-eating disorder, or avoidant/restrictive food intake disorder D. If the symptoms occur in the context of another mental disorder (e.g., intellectual disability [intellectual developmental disorder] or another neurodevelopmental disorder), they are sufficiently sever to warrant additional clinical attention |
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Enuresis |
A. Repeated voiding of urine into bed or clothes, whether involuntary or intentional B. The behavior is clinically significant as manifested by either a frequency of at lease twice a week for at least 3 consecutive months or the presence of clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning C. Chronological age is at least 5 years (or equivalent developmental level) D. The behavior is not attributable to the physiological effects of a substance (e.g., a diuretic, an antipsychotic medication) or another medical condition (e.g., diabetes, spina bifida, a seizure disorder) |
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Encopresis |
A. Repeated passage of feces into inappropriate places (e.g., clothing, floor), whether involuntary or intentional B. At least one such event occurs each month for at least 3 months C. Chronological age is at least 4 years (or equivalent developmental level) D. The behavior is not attributable to the physiological effects of a substance (e.g., laxatives) or another medical condition except through a mechanism involving constipation |
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Oppositional Defiant Disorder |
A. A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidence by at least four symptoms from any of the following categories, & exhibited during interaction with at least on individual who is not a sibling Angry/Irritable Mood 1. Often loses temper 2. Is often touchy or easily annoyed 3. Is often angry & resentful Argumentative/Defiant Behavior 4. Often argues with authority figures or, for children & adolescents, with adults 5. Often actively defies or refuses to comply with requests from authority figures or with rules 6. Often deliberately annoys others 7. Often blames others for his or her mistakes or misbehavior Vindictiveness 8. Has been spiteful or vindictive at least twice within the past 6 months Note: The persistence & frequency of these behaviors should be used to distinguish a behavior that is within normal limits from a behavior that is symptomatic. For children younger than 5 years, the behavior should occur on most days for a period of at least 6 months unless otherwise noted (Criterion A8). For individuals 5 years or older, the behavior should occur at least once per week for at least 6 months, unless otherwise noted (Criterion A8). While these frequency criteria provide guidance on a minimal level of frequency & intensity of the behaviors are outside a range that is normative for the individual's developmental level, gender, & culture B. The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning. C. The behaviors do not occur exclusively during the course of a psychotic, substance use, depressive, or bipolar disorder. Also, the criteria are not met for disruptive mood dysregulation disorder |
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Intermittent Explosive Disorder |
A. Recurrent behavioral outbursts representing a failure to control aggressive impulses as manifested by either of the following: 1. 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. The physical aggression does not result in damage or destruction of property & does not result in physical injury to animals or other individuals 2. 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 B. The magnitude of aggressiveness expressed during the recurrent outbursts is grossly out of proportion to the provocation or to any precipitating psychosocial stressors C. The recurrent aggressive outbursts are not premeditated (i.e., they are impulsive and/or anger-based) & are not committed to achieve some tangible objective (e.g., money, power, intimidation) D. The recurrent aggressive outbursts cause either marked distress in the individual or impairment in occupational or interpersonal functioning, or are associated with financial or legal consequences E. Chronological age is at least 6 years (or equivalent developmental level) F. The recurrent aggressive outbursts are not better explained by another mental disorder (e.g., major depressive disorder, bipolar disorder, disruptive mood dysregulation disorder, a psychotic disorder, antisocial personality disorder, borderline personality disorder) & are not attributable to another medical condition (e.g., head trauma, Alzheimer's disease) or to the physiological effects of a substance (e.g., a drug of abuse, a medication). For children ages 6-18 years, aggressive behavior that occurs as part of an adjustment disorder should not be considered for this diagnosis. Note: This diagnosis can be made in addition to the diagnosis of attention-deficit/hyperactivity disorder, conduct disorder, oppositional defiant disorder, or autism spectrum disorder when recurrent impulsive aggressive outbursts are in excess of those usually seen in these disorders & warrant independent clinical attention |
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Conduct Disorder |
A. A repetitive & persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least three of the following 15 criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months: Aggression to People & Animals 1. Often bullies, threatens, or intimidates others 2. Often initiates physical fights 3. Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun) 4. Has been physically cruel to people 5. Has been physically cruel to animals 6. Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery) 7. Has forced someone into sexual activity Destruction of Property 8. Has deliberately engaged in fire setting with the intention of causing serious damage 9. Has deliberately destroyed others' property (other than by fire setting) Deceitfulness or Theft 10. Has broken into someone else's house, building, or car 11. Often lies to obtain good or favors or to avoid obligations (i.e., "cons" others) 12. Has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking & entering, forgery) Serious Violations of Rules 13. Often stays out at night despite parental prohibitions, beginning before age 13 years 14. Has run away from home overnight at least twice while living in the parental or parental surrogate home, or once without returning for a lengthy period 15. Is often truant from school, beginning before age 13 years B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning C. If the individual is age 18 years or older, criteria are not met for antisocial personality disorder |
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Bipolar I Disorder |
For a diagnosis, it is necessary to meet the following criteria for a manic episode. The manic episode may have been preceded by and may be followed by hypomanic or major depressive episodes. |
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Manic Episode |
A. A distinct period of abnormally & persistently elevated, expansive, or irritable mood & abnormally & persistently increase goal-directed activity or energy, lasting at least 1 week & present most of the day, nearly every day (or any duration if hospitalization is necessary) B. During the period of mood disturbance & increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree & represent a noticeable change from usual behavior: 1. Inflated self-esteem or grandiosity 2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep) 3. More talkative than usual or pressure to keep talking 4. Flight of ideas or subjective experience that thoughts are racing 5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed 6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e., purposeless non-goal-directed activity) 7. Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments) C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features D. The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or to another medical condition |
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Hypomanic Episode |
A. A distinct period of abnormally & persistently elevated, expansive, or irritable mood & abnormally & persistently increased activity or energy, lasting at least 4 consecutive days & present most of the day, nearly every day B. During the period of mood disturbance & increased energy & activity, three (or more) of the following symptoms (four if the mood is only irritable) have persisted, represent a noticeable change from usual behavior, & have been present to a significant degree: 1. Inflated self-esteem or grandiosity 2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep) 3. More talkative than usual or pressure to keep talking 4. Flight of ideas or subjective experience that thoughts are racing 5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed 6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation 7. Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments) C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic D. The disturbance in mood & the change in functioning are observable by others E. The episode is not sever enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic F. The episode is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) |
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Major Depressive Episode |
A. Five (or more) of the following symptoms have been present during the same 2-week period & represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure Note: Do not include symptoms that are clearly attributable to another medical condition 1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, or hopeless) or observation made by others (e.g., appears tearful) (Note: In children & adolescents, can be irritable mood) 2. 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) 3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day (Note: In children, consider failure to make expected weight gain) 4. Insomnia or hypersomnia nearly every day 5. Psychomotor agitation or retardation nearly every day (observable by others; not merely subjective feelings of restlessness or being slowed down) 6. Fatigue or loss of energy nearly every day 7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick) 8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) 9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a specific plan for committing suicide B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning C. The episode is not attributable to the physiological effects of a substance or another medical condition |
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Bipolar II Disorder |
For a diagnosis, it is necessary to meet the following criteria for a current or past hypomanic episode and the following criteria for a current or pat major depressive episode. |
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Cyclothymic Disorder |
A. For at least 2 years (at least 1 year in children & adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode & numerous periods with depressive symptoms that do not meet criteria for a major depressive disorder B. During the above 2-year period (1 year in children & adolescents), the hypomanic & depressive periods have been present for at least half the time & the individual has not been without the symptoms for more than 2 months at a time C. Criteria for a major depressive, manic, or hypomanic episode have never been met D. The symptoms in Criterion A are not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum & other psychotic disorder E. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism) F. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning |
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Substance/Medication-Induced Bipolar & Related Disorder |
A. A prominent & persistent disturbance in mood that predominates in the clinical picture & is characterized by elevated, expansive, or irritable mood, with or without depressed mood, or markedly diminished interest or pleasure in all, or almost all, activities B. There is evidence from the history, physical examination, or laboratory findings of both (1) and (2): 1. The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication 2. The involved substance/medication is capable of producing the symptoms in Criterion A C. The disturbance is not better explained by a bipolar or related disorder that is not substance/medication-induced. Such evidence of an independent bipolar or related disorder could include the following: The symptoms precede the onset of the substance/medication use; the symptoms persist for a substantial period of time (e.g., about 1 month) after the cessation of acute withdrawal or sever intoxication; or there is other evidence suggesting the existence of an independent non-substance/medication-induced bipolar & related disorder (e.g., a history of recurrent non-substance/medication-related episodes) D. The disturbance does not occur exclusively during the course of a delirium E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
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Bipolar & Related Disorder Due to Another Medical Condition |
A. A prominent & persistent period of abnormally elevated, expansive, or irritable mood & abnormally increased activity or energy that predominates in the clinical picture B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition C. The disturbance is not better explained by another mental disorder D. The disturbance does not occur exclusively during the course of a delirium E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning, or necessitates hospitalization to prevent harm to self or others, or there are psychotic features |
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Disruptive Mood Dysregulation Disorder |
A. Severe recurrent temper outbursts manifested verbally (e.g., verbal rages) and/or behaviorally (e.g., physical aggression toward people or property) that are grossly out of proportion in intensity or duration to the situation or provocation B. The temper outbursts are inconsistent with developmental level C. The temper outbursts occur, on average, three or more times per week D. The mood between temper outbursts is persistently irritable or angry most of the day, nearly every day, and is observable by others (e.g., parents, teachers, peers) E. Criteria A-D have been present for 12 or more months. Throughout that time, the individual has not had a period lasting 3 or more consecutive months without all of the symptoms in Criteria A-D F. Criteria A & D are present in at least two of three settings (i.e., at home, at school, with peers) and are severe in at least one of these G. The diagnosis should not be made for the first time before age 6 years or after age 18 years H. By history or observation, the age at onset of Criteria A-E is before 10 years I. There has never been a distinct period lasting more than 1 day during which the full symptom criteria, except duration, for a manic or hypomanic episode have been met. Note: Developmentally appropriate mood elevation, such as occurs in the context of a highly positive event or its anticipation, should not be considered as a symptom of mania or hypomania J. The behaviors do not occur exclusively during an episode of major depressive disorder and are not better explained by another mental disorder (e.g., autism spectrum disorder, PTSD, separation anxiety disorder, persistent depressive disorder [dysthymia]). Note: This diagnosis cannot coexist with oppositional defiant disorder, intermittent explosive disorder, or bipolar disorder, though it can coexist with others, including major depressive disorder, ADHD, conduct disorder, and substance use disorders. Individuals whose symptoms meet criteria and oppositional defiant disorder should only be given the diagnosis of this disorder. If an individual has every experienced a manic or hypomanic episode, the diagnosis of this disorder should not be assigned. K. the symptoms are not attributable to the physiological effects of a substance or to another medical or neurological condition |
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Major Depressive Disorder |
A. 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. Note: Do not include symptoms that are clearly attributable to another medical condition. 1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood) 2. 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) 3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain) 4. Insomnia or hypersomnia nearly every day 5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down) 6. Fatigue or loss of energy nearly every day 7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guild about being sick) 8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) 9. 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 B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning C. The episode is not attributable to the physiological effects of a substance or to another medical condition Note: Criteria A-C represent a major depressive episode Note: Responses to a significant loss (e.g., bereavement, financial ruin, losses from a natural disaster, a serious medical illness or disability) may include the feelings of intense sadness, rumination about the loss, insomnia, poor appetite and weight loss noted in Criterion A, which may resemble a depressive episode. Although such symptoms may be understandable or considered appropriate to the loss, the presence of a major depressive episode in addition to the normal response to a significant loss should also be carefully considered. This decision inevitably requires the exercise of clinical judgment based on the individual's history and the cultural norms for the expression of distress in the context of loss D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders E. There has never been a manic episode or a hypomanic episode Note: This exclusion does not apply if all of the manic-like or hypomanic-like episodes are substance-induced or are attributable to the physiological effects of another medical condition |
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Persistent Depressive Disorder (Dysthymia) |
A. 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. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year B. Presence, while depressed, of two (or more) of the following: 1. Poor appetite or overeating 2. Insomnia or hypersomnia 3. Low energy or fatigue 4. Low self-esteem 5. Poor concentration or difficulty making decisions 6. Feelings of hopelessness C. During the 2-year period (1 year for children or adolescents) of the disturbance, the individual has never been without the symptoms in Criteria A and B for more than 2 months at at time D. Criteria for a major depressive disorder may be continuously present for 2 years E. There has never been a manic episode or a hypomanic episode, and criteria have never been met for cyclothymic disorder F. The disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder G. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hypothyroidism) H. The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning. |
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Premenstrual Dysphoric Disorder |
A. In the majority of menstrual cycles, at least five symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week post-menses B. One (or more) of the following symptoms must be present: 1. Marked affective lability (e.g., mood swings; feeling suddenly sad or tearful, or increased sensitivity to rejection) 2. Marked irritability or anger or increased interpersonal conflicts 3. Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts 4. Marked anxiety, tension, and/or feelings of being keyed up or on edge C. One (or more) of the following symptoms must additionally be present, to reach a total of five symptoms when combined with symptoms from Criterion B above. 1. Decreased interest in usual activities (e.g., work, school, friends, hobbies) 2. Subjective difficulty in concentration 3. Lethargy, easy fatigability, or marked lack of energy 4. Marked change in appetite; overeating; or specific food cravings 5. Hypersomnia or insomnia 6. A sense of being overwhelmed or out of control 7. Physical symptoms such as breast tenderness or swelling, joint oo muscle pain, a sensation of "bloating" or weight gain Note: The symptoms in Criteria A-C must have been met for most menstrual cycles that occurred in the preceding year D. The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others (e.g., avoidance of social activities; decreased productivity and efficiency at work school, or home) E. The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, persistent depressive disorder (dysthymia), or a personality disorder (although it may co-occur with any of these disorders) F. Criterion A should be confirmed by prospective daily ratings during at least two symptomatic cycles (Note: The diagnosis may be made provisionally prior to this confirmation) G. The symptoms are not attributable to the physiological effects of a substance (e.g., drug of abuse, medication, other treatment) or another medical condition (e.g., hyperthyroidism) |
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Substance/Medication-Induced Depressive Disorder |
A. A prominent and persistent disturbance in mood that predominates in the clinical picture and is characterized by depressed mood or markedly diminished interest or pleasure in all, or almost all, activities B. There is evidence from the history, physical examination, or laboratory findings of both (1) and (2): 1. The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication 2. The involved substance/medication is capable of producing the symptoms in Criterion A C. The disturbance is not better explained by a depressive disorder that is not substance/medication-induced. Such evidence of an independent depressive disorder could include the following: The symptoms preceded the onset of the substance/medication use; the symptoms persist for a substantial period of time (e.g., about 1 month) after the cessation of acute withdrawal or sever intoxication; or there is other evidence suggesting the existence of an independent non-substance/medication-induced depressive disorder (e.g., a history of recurrent non-substance/medication-related episodes) D. The disturbance does not occur exclusively during the course of a delirium E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning |
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Depressive Disorder Due to Another Medical Condition |
A. A prominent and persistent period of depressed mood or markedly diminished interest or pleasure in all, or almost all, activities that predominates in the clinical picture. B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition C. The disturbance is not better explained by another mental disorder (e.g., adjustment disorder, with depressed mood, in which the stressor is a serious medical condition) D. The disturbance does not occur exclusively during the course of a delirium E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning |
