DSM 5 made easy, the clinician’s guide to diagnosis

ebook THE GUILFORD PRESS DSM-5 Made Easy ® Also from James Morrison Diagnosis Made Easier: Principles and Techniques for Mental Health Clinicians, Second Edition The First Interview, Fourth Edition When Psychological Problems Mask Medical Disorders: A Guide for Psychotherapists For more information, see www.guilford.com/morrison DSM-5 Made Easy ® The Clinician’s Guide to Diagnosis James Morrison THE GUILFORD PRESS New York  London © 2014 The Guilford Press A Division of Guilford Publications, Inc 72 Spring Street, New York, NY 10012 www.guilford.com All rights reserved No part of this book may be reproduced, translated, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the publisher Printed in the United States of America This book is printed on acid-free paper Last digit is print number: 9 8 7 6 5 4 3 2 1 The author has checked with sources believed to be reliable in his effort to provide information that is complete and generally in accord with the standards of practice that are accepted at the time of publication However, in view of the possibility of human error or changes in behavioral, mental health, or medical sciences, neither the author, nor the editor and publisher, nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or the results obtained from the use of such information Readers are encouraged to confirm the information contained in this book with other sources Library of Congress Cataloging-in-­Publication Data Morrison, James R., author DSM-5 made easy : the clinician’s guide to diagnosis / James Morrison   p ;  cm Includes bibliographical references and index ISBN 978-1-4625-1442-7 (hardcover : alk paper) I Title [DNLM: 1.  Diagnostic and statistical manual of mental disorders 5th ed  2.  Mental Disorders—diagnosis—Case Reports.  3.  Mental Disorders— classification—Case Reports.  WM 141] RC469 616.89′075—dc23 2014001109 DSM-5 is a registered trademark of the American Psychiatric Association The APA has not participated in the preparation of this book For Mary, still my sine qua non About the Author James Morrison, MD, is Affiliate Professor of Psychiatry at Oregon Health and Science University in Portland He has extensive experience in both the private and public sectors With his acclaimed practical books—including, most recently, Diagnosis Made Easier, Second Edition, and The First Interview, Fourth Edition—Dr Morrison has guided hundreds of thousands of mental health professionals and students through the complexities of clinical evaluation and diagnosis His website (www.guilford.com/jm) offers additional discussion and resources related to psychiatric diagnosis and DSM-5 vi Acknowledgments Many people helped in the creation of this book I want especially to thank my wife, Mary, who has provided unfailingly excellent advice and continual support Chris Fesler was unsparing with his assistance in organizing my web page Others who read portions of the earlier version of this book, DSM-IV Made Easy, in one stage or another included Richard Maddock, MD, Nicholas Rosenlicht, MD, James Picano, PhD, K H Blacker, MD, and Irwin Feinberg, MD I am grateful to Molly Mullikin, the perfect secretary, who contributed hours of transcription and years of intelligent service in creating the earlier version of this book I am also profoundly indebted to the anonymous reviewers who provided input; you know who you are, even if I don’t My editor, Kitty Moore, a keen and wonderful critic, helped develop the concept originally, and has been a mainstay of the enterprise for this new edition I also deeply appreciate the many other editors and production people at The Guilford Press, notably Editorial Project Manager Anna Brackett, who helped shape and speed this book into print I would single out Marie Sprayberry, who went the last mile with her thoughtful, meticulous copyediting David Mitchell did yeoman service in reading the manuscript from cover to cover to root out errors I am indebted to Ashley Ortiz for her intelligent criticism of my web page, and to Kyala Shea, who helped get it web borne A number of clinicians and other professionals provided their helpful advice in the final revision process They include Alison Beale, Ray Blanchard, PhD, Dan G Blazer, MD, PhD, William T Carpenter, MD, Thomas J Crowley, MD, Darlene Elmore, Jan Fawcett, MD, Mary Ganguli, MD, Bob Krueger, PhD, Kristian E Markon, PhD, William Narrow, MD, Peter Papallo, MSW, MS, Charles F Reynolds, MD, Aidan Wright, PhD, and Kenneth J Zucker, PhD To each of these, and to the countless patients who have provided the clinical material for this book, I am profoundly grateful vii Global Assessment of Functioning (GAF) Scale Consider psychological, social, and occupational functioning on a hypothetical continuum of mental health-­illness Do not include impairment in functioning due to physical (or environmental) limitations Code (Note: Use intermediate codes when appropriate, e.g., 45, 68, 72.) 100 | 91 Superior functioning in a wide range of activities, life’s problems never seem to get out of hand, is sought out by others because of his or her many positive qualities No symptoms 90 | 81 Absent or minimal symptoms (e.g., mild anxiety before an exam), good functioning in all areas, interested and involved in a wide range of activities socially effective, generally satisfied with life, no more than everyday problems or concerns (e.g an occasional argument with family members) 80 | 71 If symptoms are present, they are transient and expectable reactions to psychosocial stressors (e.g., difficulty concentrating after family argument); no more than slight impairment in social, occupational or school functioning (e.g., temporarily falling behind in schoolwork) 70 | 61 Some mild symptoms (e.g., depressed mood and mild insomnia) OR some difficulty in social, occupational, or school functioning (e.g., occasional truancy, or theft within the household), but generally functioning pretty well, has some meaningful interpersonal relationships 60 | 51 Moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) OR moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or co-­workers) 50 | 41 Serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) OR any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job) 40 | 31 Some impairment in reality testing or communication (e.g., speech is at times illogical, obscure, or irrelevant) OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g., depressed man avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home, and is failing at school) 30 | 21 Behavior is considerably influenced by delusions or hallucinations OR serious impairment in communication or judgment (e.g., sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) OR inability to function in almost all areas (e.g., stays in bed all day; no job, home, or friends) 20 | 11 Some danger of hurting self or others (e.g., suicide attempts without clear expectation of death; frequently violent; manic excitement) OR occasionally fails to maintain minimal personal hygiene (e.g., smears feces) OR gross impairment in communication (e.g., largely incoherent or mute) 10 | Persistent danger of severely hurting self or others (e.g., recurrent violence) OR persistent inability to maintain minimal personal hygiene OR serious suicidal act with clear expectation of death Inadequate information Note Reprinted by permission from the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev (p. 34), by the American Psychiatric Association, 2000, Washington, DC: Author Copyright 2000 by the American Psychiatric Association 638 Physical Disorders That Affect Mental Diagnosis Medical disorder Pers Sex Anx Depr Mania Psych Delir Dem Cata chg Erect Ejac Pain Anorg Cardiovascular Anemia × Angina × Aortic aneurysm Arrhythmia × × × A-V malformation Congestive heart failure × × × × Hyperthyroidism × Myocardial infarction × Mitral valve prolapse × Paroxysmal atrial tachycardia × Shock × × × Endocrine Addison’s (adrenal insufficiency) × Carcinoid tumor × Cushing’s disease × Diabetes × × × × × × × × Hyperparathyroidism × Hyperthyroidism × × Hypoglycemia × × Hypoparathyroidism × × Hypothyroidism × × Inappropriate ADH secretion × × × × × × × × × × × Pancreatic tumor × × Pheochromocytoma × Premenstrual syndrome × Hyperprolactinemia × × Klinefelter’s syndrome Menopause × × (cont.) Note Key to column heads: Anx, anxiety; Depr, depression; Psych, psychosis; Delir, delirium; Dem, dementia (major neurocognitive disorder); Cata, catatonia symptoms; Pers chng, personality change; Erect, erectile dysfunction; Ejac, ejaculatory dysfunction; Sex pain, sexual pain syndromes (male or female); anorg, anorgasmia 639 Physical Disorders That Affect Mental Diagnosis (cont.) Medical disorder Pers Sex Anx Depr Mania Psych Delir Dem Cata chg Erect Ejac Pain Anorg Infections AIDS × × × × Brain abscess × × Subacute bacterial endocarditis × Systemic infection × × Urinary tract infection × Vaginitis × Viral infections × Toxicity Aminophylline × Antidepressants × Aspirin intolerance × × Bromide × × × Cimetidine × Digitalis × Disulfiram × × Estrogens × Fluorides Heavy metals × × × Herbicides × l-dopa × Steroids × Theophylline × × Metabolic Electrolyte imbalance × Hepatic disease × × × Hypercarbia × × Hyperventilation × Hypocalcemia × Hypokalemia × × Hypoxia × Malnutrition × Porphyria × Renal disease × 640 × × × × × × × × × Medical disorder Pers Sex Anx Depr Mania Psych Delir Dem Cata chg Erect Ejac Pain Anorg Neurological Alzheimer’s/ frontotemporal × Amyotrophic lateral sclerosis × Brain tumor × × × Cerebellar degeneration Cerebrovascular accident × × × × × Creutzfeldt-Jakob × × Encephalitis × Epilepsy, seizures × × Extradural hematoma × × × × × × × Head trauma × Huntington’s × × × Intracerebral hematoma Ménière’s × × × × × × × × × × × × × × Meningitis × Migraine × Multiple sclerosis × × × Multi-­infarct × Neurosyphilis × × × Normal-­pressure hydrocephalus × Parkinson’s × Post-­anoxia × Progressive supranuclear palsy × × Spinal cord disease × × Subarachnoid hemorrhage × Subdural hematoma × Transient ischemic attack × Wilson’s disease × × × × × × (cont.) 641 Physical Disorders That Affect Mental Diagnosis (cont.) Medical disorder Pers Sex Anx Depr Mania Psych Delir Dem Cata chg Erect Ejac Pain Anorg Pulmonary Asthma × Chronic obstructive lung disease × Hyperventilation × Pulmonary embolus × × × Other Collagen × Endometriosis × Pelvic disease × Peyronie’s disease × Postoperative states × Systemic lupus erythematosus × Temporal arteritis × × × × × Vitamin deficiency B12 (pernicious anemia) × × × Folic acid × Niacin (pellagra) × × Thiamin (B1) (Wernicke’s) × × 642 × × Classes (or Names) of Medications That Can Cause Mental Disorders Anxiety Mood Psychosis Delirium Analgesics × × × × Anesthetics × × × × Antianxiety agents × Anticholinergics × × × Anticonvulsants × × × × Antidepressants × × × × Antihistamines × × × Antihypertensives/ cardiovascular drugs × × × × × × × × × Antimicrobials Antiparkinsonian agents × × Antipsychotics × × Antiulcer agents Bronchodilators × × × Chemotherapeutic agents Corticosteroids × × × Disulfiram (Antabuse ) × × × × Gastrointestinal agents × × × Histamine agonists × Immunosuppressants × Insulin × Interferon × Lithium × Muscle relaxants × × × × NSAIDs × × Oral contraceptives × Thyroid replacements × × Note Adapted from Morrison J: Diagnosis Made Easier (2nd ed.) New York: Guilford Press, 2014 Copyright 2014 by The Guilford Press Adapted by permission 643 Index In this index, boldfaced numbers denote Essential Features diagnostic material Italicized page numbers indicate a definition The letter t after a page number denotes a table Abuse of child or adult (ICD code), 594 Academic problem, 591 Acculturation problem (ICD code), 598 Acute dystonia (ICD code), 597 Acute stress disorder, 224–228, 226 Addiction disorders, 393–473 Adjustment disorder, 228–231, 229 Adult antisocial behavior, 593 Affect, 112 See also Mood disorders Affective disorders See Mood disorders Agnosia, 490 Agoraphobia, 179–182, 180 Akathisia, 597 Alcohol disorders, 397–416 and intoxication, 412–315, 413 unspecified, 415 and withdrawal, 406–49, 407 Alexithymia, 259 Alzheimer’s disease, neurocognitive disorder due to, 498–504, 500 Amnesia, 239 dissociative, 239–244, 241 Amok (dissociative disorder), 248 Amphetamine disorders, 450–461 and intoxication, 453, 454–455 and withdrawal, 457, 458–459 Anabolic steroids and substance disorder, 463 Angel dust, 426 Anomia, 512 Anorexia nervosa, 277–281, 278 Anticipatory anxiety, 182 Antisocial behavior, adult, 593 Antisocial personality disorder, 541–545, 542 Anxiety disorders, 171–198 and agoraphobia, 179–182, 180 generalized, 191–193, 191 medical condition with, 195–198, 196 and panic attack, 173–176, 174 and panic disorder, 176–179, 177 and selective mutism, 187, 188 separation, 188–190, 189 and social anxiety, 185–187, 185 and specific phobia, 182–185, 183 substance-induced, 193–195, 194 unspecified, 198 Anxiety, adaptive, 172 Anxiolytic drug, 445 Anxious distress (mood specifier), 159 Aphasia, 491 Apnea, 318 Asperger’s disorder (in DSM-IV), 28, 32 Associations, loose, 59 Astasia-abasia, 263 Attention, complex, as cognitive deficit, 488 Attention-deficit/hyperactivity disorder (ADHD), 33–38, 34 in adults, 33 unspecified, 38 Atypical features (mood specifier), 160 Autism spectrum disorder, 26–33, 28 severity, 28, 29 Autogynephilia, 584 Avoidant personality disorder, 553–556, 554 Avoidant/restrictive food intake disorder, 291 Avolition, 60 Axis system in DSM, 10 Bath salts, 453 Behavior, disorganized, 59 Behavioral problem (ICD code), 592 Belle indifférence, 266 Bereavement mood disorder exclusion (in DSM-IV), 116 persistent complex, 234 uncomplicated, 590 Betel nut, 463 Binge eating disorder, 284–287, 285 Bipolar disorders and bipolar I, 129–134, 131 and bipolar II, 135–138, 135 childhood, 150 coding of, 167t and cyclothymia, 143–146, 143 and hypomanic episode, 120–122, 122 and major depressive episode, 112–116, 115 and manic episode, 116–120, 119 medical condition with, 153–157, 155 peripartum onset in, 163 psychotic features in, 164 rapid cycling in, 165 seasonal pattern in, 165 645 646 Index Bipolar disorders (cont.) specifiers with, 158–166 substance-induced, 151–153, 151 unspecified, 167 Bizarre delusions, 61 Body dysmorphic disorder, 204–207, 205 Boilerplate verbiage, Borderline intellectual functioning (ICD code), 598 Borderline personality disorder, 545–548, 545 Brainwashing, 248 Breathing-related sleep disorders, 318–323 Brief psychotic disorder, 80–82, 81 Briquet’s syndrome, 253 Bulimia nervosa, 281–284, 282 Caffeine disorders, 416–420 and intoxication, 416–418, 417 unspecified, 420 and withdrawal, 418–419, 418 Callous unemotional conduct disorder, 383 Cannabis disorders, 420–426 and intoxication, 421–424, 422 unspecified, 426 and withdrawal, 424–426, 424 Capgras phenomenon, 57 Carpenter, Dr William, 88 Catalepsy, 101 Cataplexy, 313 Catatonia medical condition with, 100–106, 104 mental disorder with, 100–104, 102 and schizophrenia, 67 symptoms of, 59, 101 unspecified, 107 Central sleep apnea, 318–321, 320 Character disorder See Personality disorders Charles Bonnet syndrome, 59, 107 Childhood disorder, 17–54 bipolar, 150 disintegrative (in DSM-IV), 28 onset fluency (stuttering), 47–48, 48 phobia, 185 posttraumatic stress, 223 separation anxiety, 188–190 Chronic traumatic encephalopathy, 509 Circadian rhythm sleep–wake disorder, 323–329, 325 Clumsy child syndrome, 43 Cocaine disorders, 450–461 and intoxication, 453, 456–457 and withdrawal, 457, 459–460 Coercive disorder, paraphilic, 588 Cognition, 477 social, as cognitive deficit, 491 Cognitive disorders, 474–527 delirium, 477–487 neurocognitive disorder, 492– 527 Communication disorders, 46–50 childhood onset fluency (stuttering), 47, 48 language, 46 social communication, 49 speech sound, 47 unspecified, 50 Complex attention, as cognitive deficit, 488 Compliance, exaggerated, 101 Compulsions, 200 Conduct disorder, 381–384, 382 limited prosocial emotions type, 383 Confusion, 492 Confusional arousal, 330, 335 Conversion disorder, 262–266, 263 Coprolalia, 39 Coprophilia (paraphilia), 588 Course modifiers, substance use disorder, 409–410 Course of illness, in psychosis, 62 Cross-dressing, 583 Cryptogenic disease, 306 Cultural issues, 14 Cyclothymic disorder, 143–146, 143 subthreshold, 169 Delayed ejaculation, 359–361, 360 Delirium, 477–487, 480 medical cause of, 480–483, 480 and multiple etiologies, 486–487 sedative/hypnotic/anxiolytic, 450 substance-induced, 480, 483–486 symptoms of, compared to dementia, 485 synonyms, 479 unspecified, 487 Delusional disorder, 82–88, 84 shared type of, 83, 107 Delusions, 58 bizarre, 61 mood congruent/incongruent, 114, 117 Dementia, 492–527, 495 See also Neurocognitive disorder symptoms of, compared to delirium, 485 Dependent personality disorder, 556, 556–558 Depersonalization/derealization disorder, 237–239, 238 Depression (quality of mood), 113 Depressive disorders atypical features in, 160 coding, 167t disruptive mood, 149–151, 150 major depressive disorder, 122–129, 123 major depressive episode, 112–116, 115 medical condition with, 153–157, 154 melancholic features in, 161 peripartum onset in, 163 and persistent (dysthymia), 138–143, 140 postpsychotic, 170 premenstrual dysphoric, 146–149, 147 psychotic features in, 164 seasonal pattern in, 165 specifiers, 158–66 substance-induced, 151, 151–153 subthreshold episode of, 170 unspecified, 169 Developmental coordination disorder, 43, 44 Developmental disability, 26 Diagnosis differential, principles of, 601–602 safety principle of, severity of, 11 uncertain, 11 Differential diagnosis, Disinhibited social engagement disorder, 231–233, 233 Disorganized schizophrenia (in DSM-IV), 72 Disorganized speech, 59, 61 Disruptive disorders, 378–392 and conduct disorder, 381–384, 382 and intermittent explosive disorder, 384–387, 385 and kleptomania, 390–392, 391 and mood dysregulation, 149–151, 150 oppositional defiant type, 380, 381 and pyromania, 387–390, 388 unspecified behavior, 392 Dissociation, 236 Dissociative disorders, 235–248 and amnesia, 239–244, 241 and depersonalization/ derealization, 237–239, 238 and fugue, 240 identity (DID) , 245, 245–247 and trance, 248 unspecified, 248 Distress, Domains, symptom, 488–492 Drugs that cause mental disorders, 643t Dyscalculia, 51 Dyslexia, 51 Dyspareunia (in DSM-IV), 364 Dysphoric disorder, premenstrual, 146–149, 147 Dyspraxia, 43 Dyssomnia, 299 Dysthymic disorder, 138–143, 140 Dystonia, acute (ICD code), 597 Early ejaculation, 357–59, 358 Eating disorders, 276–292 and anorexia nervosa, 277–281, 278 and avoidant/restrictive food intake, 291 and binge eating, 284–287, 285 and bulimia nervosa, 281–284, 282 eating disorders compared, 283t and pica, 288, 289 and rumination, 289, 290 unspecified, 292 Echolalia, echopraxia, 101 Ecstasy (MDMA), 451 Elimination disorders, 293–295 and encopresis, 294, 295 and enuresis, 293, 294 unspecified, 295 Encephalopathy, chronic traumatic, 509 Encopresis, 294, 295 Enuresis, 293, 294 Environmental codes, 12, 589–600 Index 647 Erectile disorder, 355–357, 356 Essential disease, 306 Essential features of diagnosis, Excoriation disorder, 212–214, 213 Executive functioning, as cognitive deficit, 478, 491 Exhibitionistic disorder, 567, 567– 569 Factitious disorder, 268–275, 271 imposed on another, 269 imposed on self, 268 Family history, in schizophrenia, 63 Feeding disorders, 276–292 and avoidant/restrictive food intake, 291 and pica, 288, 289 and rumination, 289, 290 unspecified, 292 Female orgasmic disorder, 368, 368–370 Female sexual interest/arousal disorder, 362, 362–364 Fetishistic disorder, 569–571, 570 Financial problem (ICD code), 592 Fire setting, 387–390, 388 Flashbacks (hallucinogen), 433, 433–434 Flight of ideas, 118 Folie deux, 57, 83, 107 Foraging behavior, 214 Free-running sleep phase syndrome, 324 Frontotemporal neurocognitive disorder, 512–515, 513 Frotteuristic disorder, 571–573, 572 Fugue, dissociative, 240 Functional disease, 305 G ambling disorder, 470–473, 471 Gates, Bill, 45 Gender dysphoria, 372–377 adolescent or adult, 372 child, 374 post-transition specifier for, 373 unspecified, 377 Generalized anxiety disorder, 191, 191–193 Genito-pelvic pain/penetration disorder, 364–367, 365 Gerstmann’s syndrome, 52 Global assessment of functioning (GAF), 7, 638t Global developmental delay, 26 Grandin, Temple, 30 Hair-pulling disorder, 210–212, 211 Hallucinations, 59 in narcolepsy, 314 Hallucinogen disorders, 426 and intoxication, 430–433, 431 and persisting perception disorder, 433, 433–434 use disorder, 428 Health care problem (ICD code), 593 Hebephrenic schizophrenia (in DSM-IV), 67, 72 Hecker, Ewald, 145 Histrionic personality disorder, 548–550, 549 HIV, cause of neurocognitive disorder, 519–522, 520 Hoarding disorder, 207–210, 208 Housing problem (ICD code), 592 Huntington’s disease, cause of neurocognitive disorder, 519, 520 Hyperactivity, childhood, 33 Hypersomnolence, 297 Hypersomnolence disorder, 309–313, 310 and Kleine–Levin syndrome, 312 and narcolepsy/hypocretin deficiency, 313–317, 315 unspecified, 349 Hypnagogic (hypnopompic) imagery, 59, 315 Hypnotic drug, 445 Hypoactive sexual desire disorder, male, 352–355, 353 Hypochondriasis, 260 Hypocretin, 314 Hypomania and bipolar II disorder, 135, 135–138 episode of, 120–122, 122 cf manic episode, 120t subthreshold, 167, 169 Hypopnea, 318 Hysteria, 253 ICD (International Classification of Disease), Ideopathic disease, 306 Illness anxiety disorder, 260, 260–262 Illness, medical model of, 13 648 Index Illusions, 59 Impulse-control disorders, 378–392 and conduct disorder, 381–384, 382 and intermittent explosive disorder, 384–387, 385 and kleptomania, 390–392, 391 oppositional defiant, 380, 381 and pyromania, 387–390, 388 Incest, 574 Indifference to symptoms, 266 Infantilism (paraphilia), 588 Inhalant disorders, 435–439 and intoxication, 436–439, 437 unspecified, 439 Insomnia disorder, 299–309, 300 medical condition with, 300, 301–303 mental disorder with, 300, 303–307 and primary insomnia, 300 unspecified, 349 Intellectual disability, 20–26, 22 and global developmental delay, 26 unspecified, 26 Intellectual functioning, borderline (ICD code), 598 Intelligence quotient (IQ), 20, 22 Intermittent explosive disorder, 384–387, 385 International Classification of Disease (ICD), Intoxication, substance, 411, 412 alcohol, 412–415, 413 amphetamine, 453, 454–455 caffeine, 416–418, 417 cannabis, 421–424, 422 cocaine, 453, 456–457 hallucinogen, 430–433, 431 inhalant, 436–439, 437 opioid, 440–443, 441 phencyclidine, 428, 428–430 sedative/hypnotic/anxiolytic, 446, 446–448 stimulant, 453, 453–457 symptoms of, 403t Involutional melancholia, 161 Irregular circadian rhythm sleep disorder, 325 J anet, Pierre, 239 Jet lag (in DSM-IV), 323 Johnson, Samuel, 290 K ahlbaum, Karl, 100, 145 Kanner, Leo, 27 Kava, 463 Khat, 452 Kleine–Levin syndrome, 312 Kleptomania, 390–392, 391 Klismaphilia (paraphilia), 588 Koro (dissociative disorder), 248 Kosilek, Michelle, 373 Kraepelin, Emil, 100, 161 Krafft-Ebing, Richard, 583 La belle indifférence, 266 Langfeldt, Gabriel, 76 Language disorder, 46 Language, as cognitive deficit, 478, 491 Latah (dissociative disorder), 248 Learning disorder, specific, 50–53, 52 mathematics type, 51 reading (dyslexia) type, 51 written expression type, 52 Learning, as cognitive deficit, 489 Legal problem (ICD code), 592 Lewy body disease, neurocognitive disorder due to, 504–508, 505 Lisping, 47 Loose associations, 59 Lysergic acid diethylamide (LSD), 427 Macropsia (micropsia), 433 Major depressive disorder, 122–129, 123 atypical features in, 160 coding of, 167t melancholic features in, 161 peripartum onset in, 163 recurrent, 123 somatic symptom disorder with, 127 Major depressive episode, 112–116, 115 Male hypoactive sexual desire disorder, 352–355, 353 Malingering, 270, 599 Mania and bipolar I disorder, 129–134, 131 episode, 116–120, 119 cf hypomanic episode, 120t quality of mood, 117 unipolar, 130 Mannerisms, 101 Manning, Bradley (Chelsea), 373 Marquis de Sade, 581 Masochism disorder, sexual, 578, 578–580 Mathematics learning disorder, 51 MDMA (Ecstasy), 451 Medical condition anxiety disorder due to, 195–198, 196 catatonia due to, 100, 100–106 delirium due to, 480, 480–483 mood disorder due to, 153–157, 154 neurocognitive disorder due to, 518–522, 520 obsessive–compulsive disorder due to, 215 personality change due to, 560–563, 561 psychological factors affecting, 266–268, 267 psychotic disorder due to, 97–100, 98 Medical model of illness, 13 Medication-induced movement disorders (ICD code), 596 Medications that cause mental disorders, 643t Melancholic features, 161 Memory, as cognitive deficit, 478, 489 Mental disorder, 12 catatonia associated with, 100–104, 102 discriminating from normal, 287 insomnia with, 300, 303–307 medications that cause, 643t Mental retardation (in DSM-IV), 20 Microdepressions, 118 Mind, theory of, 491 Mixed features (mood specifier), 161 Mood, 112 Mood disorders, 108–170 anxious distress in, 159 atypical features in, 160 and bipolar I, 129–134, 131 and bipolar II, 135, 135–138 and cyclothymia, 143, 143–146 disruptive mood, 149–151, 150 major depressive, 122–129, 123 medical condition with, 153–157, 154 melancholic features in, 161 mixed features in, 161 peripartum onset in, 163 persistent depressive (dysthymic), 138–143, 140 premenstrual dysphoric, 146–149, 147 psychotic features in, 164 rapid cycling in, 165 seasonal pattern in, 165 specifiers, 158–166, 168t substance-induced, 151, 151–153 Mood episodes hypomanic, 120–122, 122 major depressive, 112–116, 115 manic, 116–120, 119 Movement disorders, medicationinduced (ICD code), 596 Multiple personality disorder, 245 Multiple sleep latency test (MSLT), 317 Münchausen syndrome, 269 Muscle dysmorphia, 205 Narcissistic personality disorder, 550–553, 551 Narcolepsy/hypocretin deficiency, 313–317, 315 Narrow, Dr William, Necrophilia (paraphilia), 588 Negative symptoms (of psychosis), 60 Negativism, 101 Neglect of child or adult (ICD code), 594 Neurocognitive disorder, 492–527, 495 and Alzheimer’s disease, 498–504, 500 and frontotemporal lobar degeneration, 512–515, 513 and HIV disease, 519–522, 520 and Huntington’s disease, 519, 520 and Lewy body disease, 504–508, 505 major, 492 medical causes of, other, 518–522, 520 mild, 498 and multiple etiologies, 526–527 and Parkinson’s disease, 519, 520 and prion disease, 519, 520 recording diagnoses, 496–498, 497t substance-induced, 522, 522–526 Index 649 and traumatic brain injury, 508–512, 509 unspecified, 527 vascular, 516–518, 517 Neurodevelopmental disorders, 17–54 See also specific disorders Neuroleptic malignant syndrome (ICD code), 596 Nicotine disorders See Tobacco disorders Night eating syndrome, 292 Nightmare disorder, 340–343, 341 Nitrous oxide, 463 Non-REM sleep arousal disorder, 329–336, 330 sleep terror type, 330, 3333–35 sleepwalking type, 330, 330–333 Non-REM sleep, enuresis with, 293 Normality, discriminating from mental disorder, 287 O bsessions, 200 Obsessive–compulsive disorder, 200–204, 202 insight in, 201 medical condition with, 215 substance-induced, 214 unspecified, 216 Obsessive–compulsive personality disorder, 558–560, 559 Obstructive sleep apnea syndrome, 318–321, 319 Occupational problem (ICD code), 591, 592 Ondine’s curse, 322 Opioid disorders, 439–445 and intoxication, 440–443, 441 unspecified, 445 and withdrawal, 443, 443–445 Oppositional defiant disorder, 380, 381 Orexin (hypocretin), 314 Orientation, as cognitive deficit, 478 P ain disorder, 252, 257–259 Palmomental reflex, 500 Panic attack, 173–176, 174 cued and uncued, 174 Panic disorder, 176–179, 177 Paralysis, sleep, 314, 330 Paranoid personality disorder, 533, 533–535 Paranoid schizophrenia, 67 Paraphilia, 565 Paraphilic disorders, 564–588 coercive, 588 exhibitionistic, 567, 567–569 fetishistic, 569–571, 570 frotteuristic, 571–573, 572 pedophilic, 574–577, 575 sexual masochism, 578, 578–580 sexual sadism, 580–583, 581 specifiers, 566 transvestic, 583–585, 584 unspecified, 588 voyeuristic, 586, 586–588 Parasomnia, 299 Parkinson’s disease, cause of neurocognitive disorder, 519, 520 Parkinsonism, medication-induced (ICD code), 596 Partialism (paraphilia), 569 Pathological gambling, 470–473, 471 Pathological substance use, 395 Pedophilic disorder, 574–577, 575 Perception, as cognitive deficit, 478 Peripartum onset (mood specifier), 163 Persistent depressive disorder, 138–143, 140 Persisting perception disorder (hallucinogen) , 433, 433–434 Personality change due to medical condition, 560–563, 561 cyclothymic, 145 premorbid (in schizophrenia), 62 Personality disorders, 528–563 antisocial, 541–545, 542 avoidant, 553–556, 554 borderline, 545, 545–548 dependent, 556, 556–558 generic features, 531 histrionic, 548–550, 549 narcissistic, 550–553, 551 obsessive–compulsive, 558–560, 559 paranoid, 533, 533–535 schizoid, 535–538, 536 schizotypal, 538–541, 539 steps to diagnose, 531 unspecified, 563 Phase of life problem (ICD code), 598 650 Index Phencyclidine, 426 and intoxication, 428, 428–430 Phobia, in children, 185 Phobia, specific, 182–185, 183 Phobic anxiety depersonalization syndrome, 239 Physical disorders affecting mental diagnosis, 639t how to evaluate, 97 Pibloktoq (dissociative disorder), 248 Pica, 288, 289 Pick’s disease, 512 Polysubstance dependence (in DSM-IV), 397 Postpartum psychosis, 80 Postpsychotic depression, 170 Posttraumatic stress disorder (PTSD), 219–224, 220 cf acute stress disorder, 225t Posturing, 101 Prader-Willi syndrome, 215 Pragmatics (as communication disorder), 49 Premature ejaculation, 357–359, 358 Premenstrual dysphoric disorder, 146–149, 147 Premenstrual tension, 147 Premorbid personality (in schizophrenia), 62 Primary disease, 305 Primary insomnia, 300 Prion disease, cause of neurocognitive disorder, 519, 520 Prosocial emotions (conduct disorder), 383 Prototype, diagnostic, Pseudocyesis, 275 Pseudoneurological symptoms, 256, 262 Psychedelic drugs, 426 Psychological factors affecting medical condition, 266–268, 267 Psychosis, 55–107 See also Psychotic disorders postpartum, 80 severity rating scale, symptoms of, 58–60 Psychosocial codes, 12, 589–600 abuse, 594 academic problem, 591 bereavement (uncomplicated), 590 borderline intellectual functioning, 598 financial problem, 592 health care problem, 593 housing problem, 592 legal/behavioral problem, 592 malingering, 599 movement disorders, 596 neglect, 594 occupational problem, 591 phase of life problem, 598 relational problem, 589 spiritual problem, 598 Psychostimulant disorders See Stimulant disorders Psychotic disorders brief, 80–82, 81 and delusional disorder, 82–88, 84 medical condition with, 97–100, 98 schizoaffective, 88–93, 90 and schizophrenia, 64–75, 66 and schizophreniform psychosis, 75–79, 77 substance-induced, 93–97, 94 Psychotic features (mood specifier), 164 Punding, 44 Purging disorder, 292 Pyromania, 387–390, 388 Quality of mood, 113, 117 Rapid cycling (mood specifier), 165 Rapid eye movement (REM) sleep, 314 behavior disorder, 343–345, 344 and non-REM sleep arousal disorder, 343–345 Reactive attachment disorder, 231–233, 232 Reading disorder (dyslexia), 51 Relational problem (ICD code), 589 Religious problem (ICD code), 598 Residual symptoms in schizophrenia, 62 Restless legs syndrome, 336–339, 337 Rett’s disorder (in DSM-IV), 28 Rumination disorder, 289, 290 S acher-Masoch, Leopold von, 583 Sade, Marquis de, 581 Sadism disorder, sexual, 580–583, 581 Safety principle of diagnosis, Savantism, 28 Scatologia, telephone (paraphilia), 588 Schizoaffective disorder, 88–93, 90 Schizoid personality disorder, 535–538, 536 Schizophrenia, 64–75, 66 disorganized (in DSM-IV), 72 DSM-IV subtypes, 67 residual symptoms in, 62 severity of, 74 spectrum disorder (unspecified), 106 Schizophreniform disorder, 75–79, 77 Schizotypal personality disorder, 538–541, 539 Seasonal pattern (mood specifier), 165 Sedative drug, 445 Sedative/hypnotic/anxiolytic disorders, 445–450 and delirium, 450 and intoxication, 446, 446–448 unspecified, 450 use disorder, 446 and withdrawal, 448, 448–450 Selective mutism, 187, 188 Separation anxiety disorder, 188–190, 189 Severity coding for mood episodes, 158 for schizophrenia, 74 for substance use disorders, 402 Sexual dysfunctions, 350–371 and delayed ejaculation, 359–361, 360 and early ejaculation, 357–359, 358 and erectile disorder, 355–357, 356 and female orgasmic disorder, 368, 368–370 and female sexual interest/arousal disorder, 362, 362–364 and genito-pelvic pain/penetration disorder, 364–367, 365 and male hypoactive sexual desire disorder, 352–355, 353 specifiers, 351 substance-induced, 370 unspecified, 371 Sexual masochism disorder, 578, 578–580 Sexual sadism disorder, 580–583, 581 Shared psychotic disorder (in DSM-IV), 57, 83, 107 Shift work sleep disorder, 325 Skin-picking (excoriation) disorder, 212–214, 213 Sleep See also Sleep–wake disorders drunkenness, 335 hypoventilation related to, 321, 322 latency test, multiple (MSLT), 317 paralysis, 314, 330 terror disorder, 333 Sleep–wake disorders, 296–349 breathing-related, 318–323 and central sleep apnea, 318–321, 320 circadian rhythm, 323–329, 325 advanced sleep phase syndrome, 324 delayed sleep phase syndrome, 324 free-running type, 324 irregular sleep–wake type, 325 shift work type, 325 confusional arousal, 330, 335 and hypersomnolence, 309–313 and insomnia, 299–309, 300 with medical condition, 300, 301–303 with mental disorder, 300, 303–307 and Kleine–Levin syndrome, 312 and narcolepsy/hypocretin deficiency, 313–317, 315 nightmare, 340–343, 341 and non-REM sleep arousal disorder, 329–336, 330 and obstructive sleep apnea, 318–321, 319 and primary insomnia, 300 and REM sleep behavior, 343–345, 344 and restless legs syndrome, 336–339, 337 and sleep terror, 330, 333–335 and sleep-related hypoventilation, 321, 322 and sleepwalking, 330, 330–333 substance-induced, 346, 346–349 unspecified, 349 Social anxiety disorder, 185, 185–187 Social cognition, as cognitive deficit, 491 Social communication disorder, 49 Somatic symptom disorders, 249–275 conversion type, 262–266, 263 factitious disorder, 268–275, 271 illness anxiety disorder, 260, 260–262 Index 651 major depression with, 127 and pain, 252, 257–259 and psychological factors affecting medical condition, 266–268, 267 somatic symptom disorder type, 251–259, 252 unspecified, 275 Somatization disorder (in DSM-IV), 253, 256 Somnambulism, 330, 330–333 Specific learning disorder, 50–53, 52 Specific phobia, 182–185, 183 Speech sound disorder, 47 Speech, disorganized, 59 Spiritual problem (ICD code), 598 Stereotypic movement disorder, 44–45, 45 Stereotypies, 44, 101 Steroids (anabolic) and substance disorder, 463 Stimulant disorders, 450–461 and intoxication, 453 unspecified, 461 use disorder, 453 and withdrawal, 457, 457–460 Stress disorder, 217–234 acute, 224–228, 226 comparison of types, 225t posttraumatic, 219–224, 220 Stuttering, 47, 48 Substance intoxication, 411, 412 alcohol, 412–415, 413 amphetamine, 453, 454–455 caffeine, 416–418, 417 cannabis, 421–424, 422 cocaine, 453, 456–57 hallucinogen, 430–433, 431 inhalant, 436–439, 437 opioid, 440–443, 441 phencyclidine, 428, 428–430 sedative/hypnotic/anxiolytic, 446, 446–448 stimulant, 453, 453–457 symptoms, 403t Substance use disorder, 395 alcohol, 396–402, 398 cannabis, 398, 420–426 cocaine, 398, 453 course modifiers for, 409, 409–410 features of, 400–401 generic, 396–402, 398 hallucinogen, 398, 428 inhalant, 398, 435–439 opioid, 398, 439–445 phencyclidine, 398 sedative/hypnotic/anxiolytic, 398, 446 severity of, 402 stimulant, 398, 453 tobacco, 398, 462 Substance withdrawal, 402, 402–407 alcohol, 406–409, 407 amphetamine, 457, 458–459 caffeine, 418, 418–419 cannabis, 424, 424–426 cocaine, 457, 459–460 opioid, 443, 443–445 sedative/hypnotic/anxiolytic, 448, 448–450 stimulant, 457, 457–460 symptoms of, 403t tobacco, 462 Substance-induced disorders anxiety, 193–195, 194 delirium, 480, 483–486 mood, 151, 151–153 mood episodes and, 118 neurocognitive, 522, 522–526 obsessive–compulsive, 214 psychotic, 93–97, 94 sexual dysfunction, 370 sleep–wake, 346, 346–349 Substance-related disorders, 393– 473 evaluating symptoms of, 95 ICD-10 codes for, 465t ICD-9 codes for, 468t Subthreshold mood episodes, 167– 170 Sundowning, 479 Symptom domains, 488–492 Synesthesia, 431 Synucleinopathies, 344 T ardive dyskinesia (ICD code), 596 Telephone scatologia (paraphilia), 588 Tension and release (impulse control disorders), 392 Theory of mind, 491 Tic, 38 specifier in OCD, 201, 202 Tic disorder, 38–43, 40 persistent motor or vocal, 42 provisional, 42 unspecified, 43 652 Index uploaded by [stormrg] Tobacco disorders, 461–462 unspecified, 462 use disorder, 462 and withdrawal, 462 Tourette, Georges Gilles de la, 39 Tourette’s disorder, 39–42, 40 Trance, dissociative, 248 Transsexualism, 373 Transvestic disorder, 583–585, 584 Trauma, disorders resulting from, 217–234 Traumatic brain injury (TBI) and chronic encephalopathy, 509 neurocognitive disorder due to, 508–512, 509 Trichotillomania, 210–212, 211 U nipolar mania, 130 Unspecified disorder alcohol-related, 415 anxiety, 198 attention-deficit/hyperactivity, 38 bipolar, 167–169 caffeine-related, 420 cannabis-related, 426 catatonic, 107 communication, 50 conduct, 392 delirium, 487 depressive, 169–170 disruptive, 392 dissociative, 248 eating or feeding, 292 elimination, 295 gender dysphoria, 377 generic mental (ICD code), 600 hallucinogen-related, 434 hypersomnolence, 349 impulse-control, 392 inhalant-related, 439 insomnia, 349 intellectual disability, 26 neurocognitive, 527 neurodevelopmental, 54 obsessive–compulsive, 216 opioid-related, 445 other (or unknown) substancerelated, 470 paraphilic, 588 personality, 563 phencyclidine-related, 434 psychotic, 107 sedative/hypnotic/anxiolyticrelated, 450 sexual dysfunction, 371 sleep–wake, 349 somatic symptom, 275 stimulant-related, 461 tic, 43 tobacco-related, 462 trauma/stressor-related, 233 Urophilia (paraphilia), 588 V aginismus (in DSM-IV), 364 Vascular neurocognitive disorder, 516–518, 517 Vasovagal response, 182 Visuospatial construction, as cognitive deficit, 490 Voyeuristic disorder, 586, 586–588 W axy flexibility, 101 WHODAS (disability rating), Winokur, Dr George, 15 Withdrawal, substance, 402 alcohol, 406–409, 407 amphetamine, 457, 458–459 caffeine, 418, 418–419 cannabis, 424 cocaine, 457, 459–460 opioid, 443, 443–445 sedative/hypnotic/anxiolytic, 448, 448–450 stimulant, 457, 457–460 symptoms of, 403t tobacco, 462 Written expression learning disorder, 52 Zoophilia (paraphilia), 588 ... student Essential Features OK, that’s the name I’ve given them in in DSM- 5 Made Easy, but they’re also known as prototypes I’ve used them in an effort to make the DSM- 5 criteria more accessible For... Guide for Psychotherapists For more information, see www.guilford.com/morrison DSM- 5 Made Easy ® The Clinician’s Guide to Diagnosis James Morrison THE GUILFORD PRESS New York  London © 2014 The. .. vignette the Essential Features I’ve listed for each diagnosis But when you want to follow the thinking of the folks who wrote the actual DSM- 5, I’ve also included references (in parentheses) to the