Приводим классификацию МКБ-10 в которой нет ни слова о постабортном синдроме, ни о постабортной психической травме, ни вообще даже о депрессивных реакциях на утрату ребенка в утробе. До 70-х годов существование постабортных психических осложнений признавали большинство специалистов на Западе.
В 70-х годах проводилась легализация абортов в США и не должно было быть никаких этических препятствий для этого. Поэтому всякое упоминание о психических осложнениях абортов убрали из официальных классификаций.
F00-F99
Включено:
нарушения психологического развития
Исключено:
симптомы, отклонения от нормы, выявленные при клинических и лабораторных исследованиях, не классифицированные в других рубриках
(R00-R99)
ОРГАНИЧЕСКИЕ, ВКЛЮЧАЯ СИМПТОМАТИЧЕСКИЕ,
ПСИХИЧЕСКИЕ РАССТРОЙСТВА (F00-F09)
F00* Деменция при болезни Альцгеймера (G30.-+)
F00.0* Деменция при болезни Альцгеймера с ранним началом
(G30.0+)
F00.1* Деменция при болезни Альцгеймера с поздним началом
(G30.1+)
F00.2* Деменция при болезни Альцгеймера атипичная или смешанного типа (G30.8+)
F00.9* Деменция при болезни Альцгеймера неуточненная (G30.9+)
F01 Сосудистая деменция
Включено: атеросклеротическая деменция
F01.0 Сосудистая деменция с острым началом
F01.1 Мультиинфарктная деменция
F01.2 Подкорковая сосудистая деменция
F01.3 Смешанная корковая и подкорковая сосудистая деменция
F01.8 Другая сосудистая деменция
F01.9 Сосудистая деменция неуточненная
F02* Деменция при других болезнях, классифицированных в других рубриках
F02.0* Деменция при болезни Пика (G31.0+)
F02.1* Деменция при болезни Крейтцфельдта-Якоба (A81.0+)
F02.2* Деменция при болезни Гентингтона (G10+)
F02.3* Деменция при болезни Паркинсона (G20+)
F02.4* Деменция при болезни, вызванной вирусом иммунодефицита
человека [ВИЧ] (B22.0+)
F02.8* Деменция при других уточненных болезнях, классифицированных в других рубриках
F03 Деменция неуточненная
Исключено:
сенильная деменция с делирием или острой спутанностью сознания
(F05.1)
старость БДУ (R54)
F04 Органический амнестический синдром, не вызванный алкоголем или
другими психоактивными веществами
Исключено:
амнезия:
— БДУ (R41.3)
— антероградная (R41.1)
— диссоциативная (F44.0)
— ретроградная (R41.2)
корсаковский синдром:
— алкогольный или неуточненный (F10.6)
— вызванный употреблением других психоактивных веществ (F11-F19
c общим четвертым знаком .6)
F05 Делирий, не вызванный алкоголем или другими психоактивными веществами
Включено:
острый(ое)(ая) или подострый(ое)(ая):
— инфекционный психоз
— мозговой синдром
— органическая реакция
— психоорганический синдром
— состояние спутанности сознания (неалкогольной этиологии)
Исключено: белая горячка алкогольная или неуточненная (F10.4)
F05.0 Делирий не на фоне деменции, так описанный
F05.1 Делирий на фоне деменции
F05.8 Другой делирий
F05.9 Делирий неуточненный
F06 Другие психические расстройства, обусловленные повреждением и
дисфункцией головного мозга или соматической болезнью
Исключено:
вследствие употребления алкоголя и других психоактивных веществ
(F10-F19)
связанные с:
— делирием (F05.-)
— деменцией, классифицированной в рубриках F00-F03
F06.0 Органический галлюциноз
Исключено:
алкогольные галлюцинозы (F10.5)
шизофрения (F20.-)
F06.1 Органическое кататоническое состояние
Исключено:
кататоническая шизофрения (F20.2)
ступор:
— БДУ (R40.1)
— диссоциативный (F44.2)
F06.2 Органическое бредовое [шизофреноподобное] расстройство
Исключено:
расстройство:
— острое или преходящее психотическое (F23.-)
— психотическое, вызванное лекарственными средствами
(F11-F19 с общим четвертым знаком .5)
— устойчивое бредовое (F22.-)
шизофрения (F20.-)
F06.3 Органические расстройства настроения [аффективные]
Исключено: расстройства настроения неорганические или неуточненные (F30-F39)
F06.4 Органическое тревожное расстройство
Исключено: тревожные расстройства неорганические или неуточненные (F41.-)
F06.5 Органическое диссоциативное расстройство
Исключено: диссоциативные [конверсионные] расстройства не-
органические или неуточненные (F44.-)
F06.6 Органическое эмоционально лабильное [астеническое] расстройство
Исключено: соматоформные расстройства неорганические или
неуточненные (F45.-)
F06.7 Легкое когнитивное расстройство
F06.8 Другие уточненные психические расстройства, обусловленные
повреждением и дисфункцией головного мозга или соматической болезнью
F06.9 Психическое расстройство, обусловленное повреждением и
дисфункцией головного мозга или соматической болезнью,
неуточненное
F07 Расстройства личности и поведения, обусловленные болезнью, повреждением или дисфункцией головного мозга
F07.0 Расстройство личности органической этиологии
Исключено:
постконтузионный синдром (F07.2)
постэнцефалитный синдром (F07.1)
специфические расстройства личности (F60.-)
стойкое изменение личности после:
— переживания катастроф (F62.0)
— психического заболевания (F62.1)
F07.1 Постэнцефалитный синдром
Исключено: расстройство личности органической этиологии
(F07.0)
F07.2 Постконтузионный синдром
F07.8 Другие органические расстройства личности и поведения,
обусловленные болезнью, травмой и дисфункцией головного
мозга
F07.9 Органическое расстройство личности и поведения, обусловленное болезнью, повреждением или дисфункцией головного
мозга, неуточненное
F09 Органическое или симптоматическое психическое расстройство неуточненное
Исключено: психоз БДУ (F29)
ПСИХИЧЕСКИЕ РАССТРОЙСТВА И РАССТРОЙСТВА ПОВЕДЕНИЯ,
СВЯЗАННЫЕ С УПОТРЕБЛЕНИЕМ ПСИХОАКТИВНЫХ ВЕЩЕСТВ
(F10-F19)
Исключено: злоупотребление веществами, не вызывающими зависимость
(F55)
Следующие четвертые знаки используются в рубриках F10-F19:
.0 Острая интоксикация
.1 Пагубное употребление
.2 Синдром зависимости
Хронический алкоголизм
Дипсомания
Наркомания
.3 Абстинентное состояние
.4 Абстинентное состояние с делирием
.5 Психотическое расстройство
Исключено: алкогольные или вызванные употреблением другого психоактивного вещества резидуальные и отсроченные психотические
расстройства (F10-F19 с общим четвертым знаком .7)
.6 Амнестический синдром
Исключено: неалкогольный корсаковский психоз или синдром (F04)
.7 Резидуальные и отсроченные психотические расстройства
Исключено: алкогольный или наркотический:
— корсаковский синдром (F10-F19 с общим четвертым знаком .6)
— психотическое состояние (F10-F19 с общим четвертым знаком .5)
.8 Другие психические расстройства и расстройства поведения
.9 Психическое расстройство и расстройство поведения неуточненное
F10.- Психические и поведенческие расстройства, вызванные употребле-
нием алкоголя
F11.- Психические и поведенческие расстройства, вызванные употреблением опиоидов
F12.- Психические и поведенческие расстройства, вызванные употреблением каннабиоидов
F13.- Психические и поведенческие расстройства, вызванные употреблением седативных или снотворных средств
F14.- Психические и поведенческие расстройства, вызванные употреблением кокаина
F15.- Психические и поведенческие расстройства, вызванные употреблением других стимуляторов (включая кофеин)
F16.- Психические и поведенческие расстройства, вызванные употреблением галлюциногенов
F17.- Психические и поведенческие расстройства, вызванные употреблением табака
F18.- Психические и поведенческие расстройства, вызванные употреблением летучих растворителей
F19.- Психические и поведенческие расстройства, вызванные одновременным употреблением нескольких наркотических средств и использованием других психоактивных веществ
Включено: злоупотребление наркотиками БДУ
ШИЗОФРЕНИЯ, ШИЗОТИПИЧЕСКИЕ И БРЕДОВЫЕ РАССТРОЙСТВА
(F20-F29)
F20 Шизофрения
Исключено:
шизотипическое расстройство (F21)
шизофреническая реакция (F23.2)
шизофрения:
— острая (недифференцированная) (F23.2)
— циклическая (F25.2)
F20.0 Параноидная шизофрения
Исключено:
инволюционное параноидное состояние (F22.8)
паранойя (F22.0)
F20.1 Гебефреническая шизофрения
F20.2 Кататоническая шизофрения
F20.3 Недифференцированная шизофрения
Исключено:
острое шизофреноподобное психотическое расстройство
(F23.2)
постшизофреническая депрессия (F20.4)
хроническая недифференцированная шизофрения (F20.5)
F20.4 Постшизофреническая депрессия
F20.5 Остаточная шизофрения
F20.6 Простой тип шизофрении
F20.8 Другой тип шизофрении
Исключено: краткое шизофреноформное расстройство (F23.2)
F20.9 Шизофрения неуточненная
F21 Шизотипическое расстройство
Исключено:
синдром Аспергера (F84.5)
шизоидное расстройство личности (F60.1)
F22 Хронические бредовые расстройства
F22.0 Бредовое расстройство
Исключено: параноидное(ый)(ая):
— психоз психогенный (F23.3)
— расстройство личности (F60.0)
— реакция (F23.3)
— шизофрения (F20.0)
F22.8 Другие хронические бредовые расстройства
F22.9 Хроническое бредовое расстройство неуточненное
F23 Острые и преходящие психотические расстройства
F23.0 Острое полиморфное психотическое расстройство без симптомов шизофрении
F23.1 Острое полиморфное психотическое расстройство с симптомами
шизофрении
F23.2 Острое шизофреноподобное психотическое расстройство
Исключено:
органическое бредовое [шизофреноподобное] расстройство
(F06.2)
шизофреноформное расстройство БДУ (F20.8)
F23.3 Другие острые преимущественно бредовые психотические расстройства
F23.8 Другие острые и преходящие психотические расстройства
F23.9 Острое и преходящее психотическое расстройство неуточненное
F24 Индуцированное бредовое расстройство
F25 Шизоаффективные расстройства
F25.0 Шизоаффективное расстройство, маниакальный тип
F25.1 Шизоаффективное расстройство, депрессивный тип
F25.2 Шизоаффективное расстройство, смешанный тип
F25.8 Другие шизоаффективные расстройства
F25.9 Шизоаффективное расстройство неуточненное
F28 Другие неорганические психотические расстройства
F29 Неорганический психоз неуточненный
Исключено:
органический или симптоматический психоз БДУ (F09)
психическое расстройство БДУ (F99)
РАССТРОЙСТВА НАСТРОЕНИЯ [АФФЕКТИВНЫЕ РАССТРОЙСТВА]
(F30-F39)
F30 Маниакальный эпизод
Включено: биполярное расстройство, одиночный маниакальный эпизод
F30.0 Гипомания
F30.1 Мания без психотических симптомов
F30.2 Мания с психотическими симптомами
F30.8 Другие маниакальные эпизоды
F30.9 Маниакальный эпизод неуточненный
F31 Биполярное аффективное расстройство
Включено: маниакально-депрессивное(ый)(ая):
— заболевание
— психоз
— реакция
Исключено:
биполярное расстройство, единственный маниакальный эпизод
(F30.-)
циклотимия (F34.0)
F31.0 Биполярное аффективное расстройство, текущий эпизод гипомании
F31.1 Биполярное аффективное расстройство, текущий эпизод мании
без психотических симптомов
F31.2 Биполярное аффективное расстройство, текущий эпизод мании
с психотическими симптомами
F31.3 Биполярное аффективное расстройство, текущий эпизод легкой
или умеренной депрессии
F31.4 Биполярное аффективное расстройство, текущий эпизод тяжелой депрессии без психотических симптомов
F31.5 Биполярное аффективное расстройство, текущий эпизод тяжелой депрессии с психотическими симптомами
F31.6 Биполярное аффективное расстройство, текущий эпизод смешанного характера
Исключено: одиночный аффективный эпизод смешанного характера (F38.0)
F31.7 Биполярное аффективное расстройство, текущая ремиссия
F31.8 Другие биополярные аффективные расстройства
F31.9 Биполярное аффективное расстройство неуточненное
F32 Депрессивный эпизод
Включено: одиночный эпизод:
— депрессивной реакции
— психогенной депрессии
— реактивной депрессии
Исключено:
депрессивный эпизод, связанный с расстройствами поведения, классифицированными в рубриках F91.- (F92.0)
расстройство приспособительных реакций (F43.2)
рекуррентное депрессивное расстройство (F33.-)
F32.0 Депрессивный эпизод легкой степени
F32.1 Депрессивный эпизод средней степени
F32.2 Депрессивный эпизод тяжелой степени без психотических
симптомов
F32.3 Депрессивный эпизод тяжелой степени с психотическими симптомами
F32.8 Другие депрессивные эпизоды
F32.9 Депрессивный эпизод неуточненный
F33 Рекуррентное депрессивное расстройство
Включено:
повторные эпизоды:
— депрессивной реакции
— психогенной депрессии
— реактивной депрессии
сезонное депрессивное расстройство
Исключено: рекуррентные краткие депрессивные эпизоды (F38.1)
F33.0 Рекуррентное депрессивное расстройство, текущий эпизод
легкой степени
F33.1 Рекуррентное депрессивное расстройство, текущий эпизод
средней степени
F33.2 Рекуррентное депрессивное расстройство, текущий эпизод тяжелой степени без психотических симптомов
F33.3 Рекуррентное депрессивное расстройство, текущий эпизод тяжелой степени с психотическими симптомами
F33.4 Рекуррентное депрессивное расстройство, текущее состояние
ремиссии
F33.8 Другие рекуррентные депрессивные расстройства
F33.9 Рекуррентное депрессивное расстройство неуточненное
F34 Устойчивые расстройства настроения [аффективные расстройства]
F34.0 Циклотимия
F34.1 Дистимия
Исключено: тревожная депрессия (легкая или неустойчивая)
(F41.2)
F34.8 Другие устойчивые расстройства настроения [аффективные]
F34.9 Устойчивое расстройство настроения [аффективное] неуточненное
F38 Другие расстройства настроения [аффективные]
F38.0 Другие одиночные расстройства настроения [аффективные]
F38.1 Другие рекуррентные расстройства настроения [аффективные]
F38.8 Другие уточненные расстройства настроения [аффективные]
F39 Расстройство настроения [аффективное] неуточненное
НЕВРОТИЧЕСКИЕ, СВЯЗАННЫЕ СО СТРЕССОМ И
СОМАТОФОРМНЫЕ РАССТРОЙСТВА
(F40-F48)
Исключено: связанные с расстройствами поведения, классифицированными
в рубриках F91.- (F92.8)
F40 Фобические тревожные расстройства
F40.0 Агорафобия
F40.1 Социальные фобии
F40.2 Специфические (изолированные) фобии
Исключено:
боязнь заболеть (нозофобия) (F45.2)
дисморфофобия (небредовая) (F45.2)
F40.8 Другие фобические тревожные расстройства
F40.9 Фобическое тревожное расстройство неуточненное
F41 Другие тревожные расстройства
F41.0 Паническое расстройство [эпизодическая пароксизмальная
тревожность]
Исключено: паническое расстройство с агорафобией (F40.0)
F41.1 Генерализованное тревожное расстройство
Исключено: неврастения (F48.0)
F41.2 Смешанное тревожное и депрессивное расстройство
F41.3 Другие смешанные тревожные расстройства
F41.8 Другие уточненные тревожные расстройства
F41.9 Тревожное расстройство неуточненное
F42 Обсессивно-компульсивное расстройство
Включено:
ананкастический невроз
обсессивно-компульсивный невроз
Исключено: обсессивно-компульсивная личность (расстройство)
(F60.5)
F42.0 Преимущественно навязчивые мысли или размышления
F42.1 Преимущественно компульсивное действие [навязчивые ритуалы]
F42.2 Смешанные навязчивые мысли и действия
F42.8 Другие обсессивно-компульсивные расстройства
F42.9 Обсессивно-компульсивное расстройство неуточненное
F43 Реакция на тяжелый стресс и нарушения адаптации
F43.0 Острая реакция на стресс
F43.1 Посттравматическое стрессовое расстройство
F43.2 Расстройство приспособительных реакций
Исключено: тревожное расстройство у детей, вызванное разлукой
(F93.0)
F43.8 Другие реакции на тяжелый стресс
F43.9 Реакция на тяжелый стресс неуточненная
F44 Диссоциативные [конверсионные] расстройства
Включено:
истерический психоз
истерия
конверсионная:
— истерия
— реакция
Исключено: симуляция [сознательная симуляция] (Z76.5)
F44.0 Диссоциативная амнезия
Исключено:
амнезия:
— БДУ (R41.3)
— антероградная (R41.1)
— ретроградная (R41.2)
амнезия после приступа эпилепсии (G40.-)
амнестическое расстройство, вызванное употреблением алкоголя или другого психоактивного вещества (F10-F19 c общим
четвертым знаком .6)
неалкогольный органический амнестический синдром (F04)
F44.1 Диссоциативная фуга
Исключено: фуга после приступа эпилепсии (G40.-)
F44.2 Диссоциативный ступор
Исключено:
органическое кататоническое расстройство (F06.1)
ступор:
— БДУ (R40.1)
— депрессивный (F31-F33)
— кататонический (F20.2)
— маниакальный (F30.2)
F44.3 Транс и одержимость
Исключено: состояния, связанные с:
— интоксикацией, вызванной употреблением психоактивных веществ (F10-F19 с общим четвертым знаком .0)
— острыми или преходящими психотическими расстройствами
(F23.-)
— постконтузионным синдромом (F07.2)
— расстройством личности органической этиологии (F07.0)
— шизофренией (F20.-)
F44.4 Диссоциативные двигательные расстройства
F44.5 Диссоциативные конвульсии
F44.6 Диссоциативная анестезия или потеря чувственного восприятия
F44.7 Смешанные диссоциативные [конверсионные] расстройства
F44.8 Другие диссоциативные [конверсионные] расстройства
F44.9 Диссоциативное [конверсионное] расстройство неуточненное
F45 Соматоформные расстройства
Исключено:
выдергивание волос (F98.4)
детская форма речи [лепет] (F80.0)
диссоциативные расстройства (F44.-)
кусание ногтей (F98.8)
психологические и поведенческие факторы, связанные с нарушениями
или болезнями, классифицированными в других рубриках (F54)
сексуальная дисфункция, не обусловленная органическими нарушениями или болезнями (F52.-)
синдром де ла Туретта (F95.2)
сосание пальца (F98.8)
сюсюканье (F80.8)
тики (в детстве и подростковом возрасте) (F95.-)
трихотилломания (F63.3)
F45.0 Соматизированное расстройство
Исключено: симуляция [сознательная симуляция] (Z76.5)
F45.1 Недифференцированное соматоформное расстройство
F45.2 Ипохондрическое расстройство
Исключено:
бред, фиксированный на функционировании или внешнем виде
собственного тела (F22.-)
бредовая дисморфофобия (F22.8)
F45.3 Соматоформная дисфункция вегетативной нервной системы
Исключено: психологические и поведенческие факторы, связанные с нарушениями или болезнями, классифицированными в
других рубриках (F54)
F45.4 Устойчивое соматоформное болевое расстройство
Исключено:
боль:
— БДУ (R52.9)
— неустранимая (R52.1)
— острая (R52.0)
— хроническая (R52.2)
боль в спине БДУ (M54.9)
головная боль напряженного типа (G44.2)
F45.8 Другие соматоформные расстройства
F45.9 Соматоформное расстройство неуточненное
F48 Другие невротические расстройства
F48.0 Неврастения
Исключено:
астения БДУ (R53)
недомогание и утомляемость (R53)
психастения (F48.8)
синдром утомляемости после перенесенной вирусной болезни
(G93.3)
состояние истощения жизненных сил (Z73.0)
F48.1 Синдром деперсонализации-дереализации
F48.8 Другие уточненные невротические расстройства
F48.9 Невротическое расстройство неуточненное
ПОВЕДЕНЧЕСКИЕ СИНДРОМЫ, СВЯЗАННЫЕ С
ФИЗИОЛОГИЧЕСКИМИ НАРУШЕНИЯМИ И
ФИЗИЧЕСКИМИ ФАКТОРАМИ
(F50-F59)
F50 Расстройства приема пищи
Исключено:
анорексия БДУ (R63.0)
полифагия (R63.2)
расстройство приема пищи в младенческом и детском возрасте
(F98.2)
трудности вскармливания и введения пищи (R63.3)
F50.0 Нервная анорексия
Исключено:
потеря аппетита (R63.0)
— психогенная (F50.8)
F50.1 Атипичная нервная анорексия
F50.2 Нервная булимия
F50.3 Атипичная нервная булимия
F50.4 Переедание, связанное с другими психологическими расстройствами
Исключено: ожирение (E66.-)
F50.5 Рвота, связанная с другими психологическими расстройствами
Исключено:
рвота БДУ (R11)
тошнота (R11)
F50.8 Другие расстройства приема пищи
Исключено: поедание несъедобного [извращенный аппетит] у
младенцев и детей (F98.3)
F50.9 Расстройство приема пищи неуточненное
F51 Расстройства сна неорганической этиологии
Исключено: расстройства сна (органической этиологии) (G47.-)
F51.0 Бессонница неорганической этиологии
Исключено: бессонница (органической этиологии) (G47.0)
F51.1 Сонливость [гиперсомния] неорганической этиологии
Исключено:
гиперсомния (органической этиологии) (G47.1)
нарколепсия (G47.4)
F51.2 Расстройство режима сна и бодрствования неорганической
этиологии
Исключено: нарушения цикличности сна и бодрствования (органической этиологии) (G47.2)
F51.3 Снохождение [сомнамбулизм]
F51.4 Ужасы во время сна [ночные ужасы]
F51.5 Кошмары
F51.8 Другие расстройства сна неорганической этиологии
F51.9 Расстройство сна неорганической этиологии неуточненное
F52 Сексуальная дисфункция, не обусловленная органическими нарушениями или болезнями
Исключено: синдром Дата (F48.8)
F52.0 Отсутствие или потеря сексуального влечения
F52.1 Отвращение к половым сношениям и отсутствие полового удовольствия
F52.2 Недостаточность генитальной реакции
Исключено: импотенция органического происхождения (N48.4)
F52.3 Оргазмическая дисфункция
F52.4 Преждевременная эякуляция
F52.5 Вагинизм неорганического происхождения
Исключено: вагинизм (органический) (N94.2)
F52.6 Диспареуния неорганического происхождения
Исключено: диспареуния (органическая) (N94.1)
F52.7 Повышенное половое влечение
F52.8 Другая сексуальная дисфункция, не обусловленная органическим нарушением или болезнью
F52.9 Сексуальная дисфункция, не обусловленная органическим нарушением или болезнью, неуточненная
F53 Психические расстройства и расстройства поведения, связанные с
послеродовым периодом, не классифицированные в других рубриках
F53.0 Легкие психические расстройства и расстройства поведения,
связанные с послеродовым периодом, не классифицированные
в других рубриках
F53.1 Тяжелые психические расстройства и расстройства поведения,
связанные с послеродовым периодом, не классифицированные
в других рубриках
F53.8 Другие психические расстройства и расстройства поведения,
связанные с послеродовым периодом, не классифицированные
в других рубриках
F53.9 Послеродовое психическое расстройство неуточненное
F54 Психологические и поведенческие факторы, связанные с нарушениями
или болезнями, классифицированными в других рубриках
Исключено: головная боль напряженного типа (G44.2)
F55 Злоупотребление веществами, не вызывающими зависимость
Исключено: злоупотребление психоактивными веществами (F10-F19)
F59 Поведенческие синдромы, связанные с физиологическими нарушениями
и физическими факторами, неуточненные
РАССТРОЙСТВА ЛИЧНОСТИ И ПОВЕДЕНИЯ В
ЗРЕЛОМ ВОЗРАСТЕ
(F60-F69)
F60 Специфические расстройства личности
F60.0 Параноидное расстройство личности
Исключено:
параноидный(ая)(ое):
— психоз (F22.0)
— состояние (F22.0)
— шизофрения (F20.0)
паранойя (F22.0)
— кверулянтная (F22.8)
F60.1 Шизоидное расстройство личности
Исключено:
бредовое расстройство (F22.0)
синдром Аспергера (F84.5)
шизоидное расстройство в детском возрасте (F84.5)
шизотипическое расстройство (F21)
шизофрения (F20.-)
F60.2 Диссоциальное расстройство личности
Исключено:
расстройства поведения (F91.-)
эмоционально неустойчивое расстройство личности (F60.3)
F60.3 Эмоционально неустойчивое расстройство личности
Исключено: диссоциальное расстройство личности (F60.2)
F60.4 Истерическое расстройство личности
F60.5 Ананкастическое расстройство личности
Исключено: обсессивно-компульсивное расстройство (F42.-)
F60.6 Тревожное (уклоняющееся) расстройство личности
F60.7 Расстройство типа зависимой личности
F60.8 Другие специфические расстройства личности
F60.9 Расстройство личности неуточненное
F61 Смешанные и другие расстройства личности
Исключено: акцентуированные личностные черты (Z73.1)
F62 Стойкие изменения личности, не связанные с повреждением или болезнью головного мозга
Исключено: расстройство личности и поведения обусловленное болезнью, повреждением или дисфункцией головного мозга (F07.-)
F62.0 Стойкое изменение личности после переживания катастрофы
Исключено: посттравматическое стрессовое расстройство
(F43.1)
F62.1 Стойкое изменение личности после психического заболевания
F62.8 Другие стойкие изменения личности
F62.9 Стойкое изменение личности неуточненное
F63 Расстройства привычек и влечений
Исключено:
привычное чрезмерное употребление алкоголя или психоактивных веществ (F10-F19)
расстройство влечений и привычек, затрагивающих сексуальное поведение (F65.-)
F63.0 Патологическое влечение к азартным играм
Исключено:
пристрастие к азартным играм лиц с маниакальным эпизодом
(F30.-)
склонность к азартным играм и пари БДУ (Z72.6)
склонность к азартным играм при диссоциальном расстройстве
личности (F60.2)
F63.1 Патологическое влечение к поджогам [пиромания]
Исключено:
поджог (совершенный):
— взрослым человеком с диссоциальным расстройством личности (F60.2)
— как повод для наблюдения за лицом с подозрением на пси-
хическое расстройство (Z03.2)
при:
— интоксикации алкоголем или психоактивным веществом
(F10-F19 с общим четвертым знаком .0)
— органических психических расстройствах (F00-F09)
— расстройствах поведения (F91.-)
— шизофрении (F20.-)
F63.2 Патологическое влечение к воровству [клептомания]
Исключено:
депрессивное расстройство с воровством (F31-F33)
ограбление магазина как повод для наблюдения за лицом с
подозрением на психическое расстройство (Z03.2)
органические психические расстройства (F00-F09)
F63.3 Трихотилломания
Исключено: стереотипное двигательное расстройство с выдергиванием волос (F98.4)
F63.8 Другие расстройства привычек и влечений
F63.9 Расстройство привычек и влечений неуточненное
F64 Расстройства половой идентификации
F64.0 Транссексуализм
F64.1 Трансвестизм двойной роли
Исключено: фетишистский трансвестизм (F65.1)
F64.2 Расстройство половой идентификации в детском возрасте
Исключено:
расстройство сексуальной сформированности (F66.0)
эгодистоническая половая ориентация (F66.1)
F64.8 Другое расстройство половой идентификации
F64.9 Расстройство половой идентификации неуточненное
F65 Расстройства сексуального предпочтения
Включено: парафилии
F65.0 Фетишизм
F65.1 Фетишистский трансвестизм
F65.2 Эсгибиционизм
F65.3 Вуайеризм
F65.4 Педофилия
F65.5 Садомазохизм
F65.6 Множественные расстройства сексуального предпочтения
F65.8 Другие расстройства сексуального предпочтения
F65.9 Расстройство сексуального предпочтения неуточненное
F66 Психологические и поведенческие расстройства, связанные с половым развитием и ориентацией
Примечание: сама по себе сексуальная ориентация не рассматривается как расстройство.
F66.0 Расстройство сексуального созревания
F66.1 Эгодистоническая половая ориентация
F66.2 Расстройство сексуальных отношений
F66.8 Другие расстройства психосексуального развития
F66.9 Расстройство психосексуального развития неуточненное
F68 Другие расстройства личности и поведения в зрелом возрасте
F68.0 Преувеличение соматической симптоматики по психологическим
причинам
F68.1 Умышленное вызывание или симулирование симптомов или инвалидности физического или психологического характера [под-
дельное нарушение]
Исключено:
искусственный [артифициальный] дерматит (L98.1)
личность, симулирующая болезнь (с очевидной мотивацией)
(Z76.5)
F68.8 Другие уточненные расстройства личности и поведения в зрелом возрасте
F69 Расстройство личности и поведения в зрелом возрасте неуточненное
УМСТВЕННАЯ ОТСТАЛОСТЬ
(F70-F79)
Для идентификации степени умственной недостаточности рубрики F70-F79
употребляются со следующим четвертым знаком:
.0 С указанием на отсутствие или слабую выраженность нарушения поведения
.1 Значительное нарушение поведения, требующее ухода и лечения
.8 Другое нарушение поведения
.9 Без указаний на нарушение поведения
F70 Умственная отсталость легкой степени
Включено:
слабо выраженная умственная субнормальность
слабоумие
F71 Умственная отсталость умеренная
Включено: умственная субнормальность средней тяжести
F72 Умственная отсталость тяжелая
Включено: резко выраженная умственная субнормальность
F73 Умственная отсталость глубокая
Включено: глубокая умственная субнормальность
F78 Другие формы умственной отсталости
F79 Умственная отсталость неуточненная
Включено: умственная:
— недостаточность БДУ
— субнормальность БДУ
РАССТРОЙСТВА ПСИХОЛОГИЧЕСКОГО РАЗВИТИЯ
(F80-F89)
F80 Специфические расстройства развития речи и языка
F80.0 Специфическое расстройство речевой артикуляции
Исключено:
недостаточность речевой артикуляции:
— апраксия (R48.2)
— афазия БДУ (R47.0)
— вследствие:
— потери слуха (H90-H91)
— умственной отсталости (F70-F79)
— в сочетании со связанным с развитием расстройством языка:
— рецептивного типа (F80.2)
— экспрессивного типа (F80.1)
F80.1 Расстройство экспрессивной речи
Исключено:
дисфазия и афазия БДУ (R47.0)
первазивные нарушения, связанные с развитием (F84.-)
приобретенная афазия с эпилепсией [Ландау-Клеффнера]
(F80.3)
связанная с развитием дисфазия или афазия рецептивного типа (F80.2)
умственная отсталость (F70-F79)
элективный мутизм (F94.0)
F80.2 Расстройство рецептивной речи
Исключено:
аутизм (F84.0-F84.1)
дисфазия и афазия:
— БДУ (R47.0)
— экспрессивного типа (F80.1)
приобретенная афазия при эпилепсии [Ландау-Клеффнера]
(F80.3)
умственная отсталость (F70-F79)
элективный мутизм (F94.0)
языковая задержка вследствие глухоты (H90-H91)
F80.3 Приобретенная афазия с эпилепсией [Ландау-Клеффнера]
Исключено: афазия:
— БДУ (R47.0)
— вследствие дезинтегративных расстройств детского возраста (F84.2-F84.3)
— при аутизме (F84.0-F84.1)
F80.8 Другие расстройства развития речи и языка
F80.9 Расстройства развития речи и языка неуточненные
F81 Специфические расстройства развития учебных навыков
F81.0 Специфическое расстройство чтения
Исключено:
алексия БДУ (R48.0)
дислексия БДУ (R48.0)
трудности чтения вторичного характера у лиц с эмоциональными расстройствами (F93.-)
F81.1 Специфическое расстройство спеллингования
Исключено:
аграфия БДУ (R48.8)
трудности спеллингования:
— вследствие неадекватного обучения (Z55.8)
— связанные с расстройством чтения (F81.0)
F81.2 Специфическое расстройство арифметических навыков
Исключено:
акалькулия БДУ (R48.8)
трудности счета:
— вследствие неадекватного обучения в школе (Z55.8)
— связанные с расстройством чтения или спеллингования
(F81.3)
F81.3 Смешанное расстройство учебных навыков
Исключено: специфическое:
— расстройство арифметических навыков (F81.2)
— расстройство спеллингования (F81.1)
— расстройство чтения (F81.0)
F81.8 Другие расстройства развития учебных навыков
F81.9 Расстройство развития учебных навыков неуточненное
F82 Специфические расстройства развития моторной функции
Исключено:
нарушение координации (R27.-)
— вторичное по отношению к умственной отсталости (F70-F79)
нарушения походки и подвижности (R26.-)
F83 Смешанные специфические расстройства психологического развития
F84 Общие расстройства психологического развития
F84.0 Детский аутизм
Исключено: аутическая психопатия (F84.5)
F84.1 Атипичный аутизм
F84.2 Синдром Ретта
F84.3 Другое дезинтегративное расстройство детского возраста
Исключено: синдром Ретта (F84.2)
F84.4 Гиперактивное расстройство, сочетающееся с умственной отсталостью и стереотипными движениями
F84.5 Синдром Аспергера
F84.8 Другие общие расстройства развития
F84.9 Общее расстройство развития неуточненное
F88 Другие расстройства психологического развития
F89 Расстройство психологического развития неуточненное
ЭМОЦИОНАЛЬНЫЕ РАССТРОЙСТВА И РАССТРОЙСТВА
ПОВЕДЕНИЯ, НАЧИНАЮЩИЕСЯ ОБЫЧНО В ДЕТСКОМ И
ПОДРОСТКОВОМ ВОЗРАСТЕ
(F90-F98)
F90 Гиперкинетические расстройства
Исключено:
общие расстройства психологического развития (F84.-)
расстройства настроения [аффективные] (F30-F39)
тревожные расстройства (F41.-)
шизофрения (F20.-)
F90.0 Нарушение активности и внимания
Исключено: гиперкинетическое расстройство, связанное с
расстройством поведения (F90.1)
F90.1 Гиперкинетическое расстройство поведения
F90.8 Другие гиперкинетические расстройства
F90.9 Гиперкинетическое расстройство неуточненное
F91 Расстройства поведения
Исключено:
общие расстройства развития (F84.-)
расстройства настроения [аффективные] (F30-F39)
расстройства поведения, связанные с:
— гиперкинетическими расстройствами (F90.1)
— эмоциональными расстройствами (F92.-)
шизофрения (F20.-)
F91.0 Расстройство поведения, ограниченное рамками семьи
F91.1 Несоциализированное расстройство поведения
F91.2 Социализированное расстройство поведения
F91.3 Вызывающее оппозиционное расстройство
F91.8 Другие расстройства поведения
F91.9 Расстройство поведения неуточненное
F92 Смешанные расстройства поведения и эмоций
F92.0 Депрессивное расстройство поведения
F92.8 Другие смешанные расстройства поведения и эмоций
F92.9 Смешанное расстройство поведения и эмоций неуточненное
F93 Эмоциональные расстройства, начало которых специфично для детского возраста
Исключено: связанные с расстройством поведения (F92.-)
F93.0 Тревожное расстройство у детей, вызванное разлукой
Исключено:
невротические расстройства (F40-F48)
расстройства настроения [аффективные расстройства]
(F30-F39)
социальное тревожное расстройство в детском возрасте
(F93.2)
фобическое тревожное расстройство в детском возрасте
(F93.1)
F93.1 Фобическое тревожное расстройство в детском возрасте
Исключено: генерализованное тревожное расстройство (F41.1)
F93.2 Социальное тревожное расстройство в детском возрасте
F93.3 Расстройство сиблингового соперничества
F93.8 Другие эмоциональные расстройства в детском возрасте
Исключено: расстройство половой идентичности в детском
возрасте (F64.2)
F93.9 Эмоциональное расстройство в детском возрасте неуточненное
F94 Расстройства социального функционирования, начало которых характерно для детского и подросткового возрастов
F94.0 Элективный мутизм
Исключено:
общие нарушения психологического развития (F84.-)
преходящий мутизм как составляющая часть боязни разлуки у
детей раннего возраста (F93.0)
специфические расстройства развития речи и языка (F80.-)
шизофрения (F20.-)
F94.1 Реактивное расстройство привязанностей в детском возрасте
Исключено:
нормальная вариация в структуре селективной привязанности
расстройство привязанностей в детском возрасте по растор-
моженному типу (F94.2)
сексуальное или физическое насилие в детстве, приводящее к
психосоциальным проблемам (Z61.4-Z61.6)
синдром Аспергера (F84.5)
синдром жестокого обращения (T74.-)
F94.2 Расстройство привязанностей в детском возрасте по расторможенному типу
Исключено:
гиперкинетические расстройства (F90.-)
госпитализм у детей (F43.2)
реактивное расстройство привязанностей в детском возрасте
(F94.1)
синдром Аспергера (F84.5)
F94.8 Другие расстройства социального функционирования в детском
возрасте
F94.9 Расстройство социального функционирования в детском возрасте неуточненное
F95 Тики
F95.0 Транзиторные тики
F95.1 Хронические моторные тики или вокализмы
F95.2 Комбинирование вокализмов и множественных моторных тиков
[синдром де ла Туретта]
F95.8 Другие тики
F95.9 Тики неуточненные
F98 Другие эмоциональные расстройства и расстройства поведения, начинающиеся обычно в детском и подростковом возрасте
Исключено:
обсессивно-компульсивное расстройство (F42.-)
приступы задержки дыхания (R06.8)
расстройство половой идентификации в детском возрасте (F64.2)
расстройства сна вследствие эмоциональных причин (F51.-)
синдром Клейне-Левина (G47.8)
F98.0 Энурез неорганической природы
Исключено: энурез БДУ (R32)
F98.1 Энкопрез неорганической природы
Исключено: энкопрез БДУ (R15)
F98.2 Расстройство приема пищи в младенческом и детском возрасте
Исключено:
нервная анорексия и другие расстройства приема пищи
(F50.-)
поедание несъедобного младенцами и детьми (F98.3)
проблемы новорожденного (P92.-)
трудности вскармливания и введения пищи (R63.3)
F98.3 Поедание несъедобного младенцами и детьми
F98.4 Стереотипные двигательные расстройства
Исключено:
аномальные непроизвольные движения (R25.-)
двигательные расстройства органической природы (G20-G25)
ковыряние в носу (F98.8)
кусание ногтей (F98.8)
сосание пальца (F98.8)
стереотипии, являющиеся частью более глубокого психического заболевания (F00-F95)
тики (F95.-)
трихотилломания (F63.3)
F98.5 Заикание [запинание]
Исключено:
речь взахлеб (F98.6)
тики (F95.-)
F98.6 Речь взахлеб
Исключено:
заикание (F98.5)
тики (F95.-)
F98.8 Другие уточненные эмоциональные расстройства и расстройства поведения с началом, обычно приходящимся на детский и
подростковый возраст
F98.9 Эмоциональное расстройство и расстройство поведения с началом, обычно приходящимся на детский и подростковый воз-
раст, неуточненное
НЕУТОЧНЕННЫЕ ПСИХИЧЕСКИЕ РАССТРОЙСТВА
(F99)
F99 Психическое расстройство без дополнительных уточнений
Исключено: органическое психическое расстройство БДУ (F06.9)
НЕВРОЛОГИЯ
(G00-G99)
Исключено:
болезни эндокринной системы, расстройства питания и нарушения обмена
веществ (E00-E90)
врожденные аномалии, деформации и хромосомные нарушения (Q00-Q99)
некоторые инфекционные и паразитарные болезни (A00-B99)
новообразования (C00-D48)
осложнения беременности, родов и послеродового периода (O00-099)
отдельные состояния, возникающие в перинатальном периоде (P00-P96)
симптомы, признаки и отклонения от нормы, выявленные при клинических
и лабораторных исследованиях, не классифицированные в других рубриках (R00-R99)
травмы, отравления и некоторые другие последствия воздействия внешних причин (S00-T98)
Примечание: при необходимости используют дополнительный код внешних
причин (класс XX).
ВОСПАЛИТЕЛЬНЫЕ БОЛЕЗНИ ЦЕНТРАЛЬНОЙ НЕРВНОЙ СИСТЕМЫ
(G00-G09)
G00 Бактериальный менингит, не классифицированный в других рубриках
Включено:
арахноидит }
лептоменингит } бактериальный
менингит }
пахименингит }
Исключено: бактериальный:
— менингомиелит (G04.2)
— менингоэнцефалит (G04.2)
G00.0 Гриппозный менингит
G00.1 Пневмококковый менингит
G00.2 Стрептококковый менингит
G00.3 Стафилококковый менингит
G00.8 Менингит, вызванный другими бактериями
G00.9 Бактериальный менингит неуточненный
G01* Менингит при бактериальных болезнях, классифицированных в других рубриках
Исключено: менингоэнцефалит и менингомиелит при бактериальных
болезнях, классифицированных в других рубриках (G05.0*)
G02* Менингит при других инфекционных и паразитарных болезнях, классифицированных в других рубриках
Исключено: менингоэнцефалит и менингомиелит при инфекционных и
паразитарных болезнях, классифицированных в других рубриках
(G05.1-G05.2*)
G02.0* Менингит при вирусных болезнях, классифицированных в
других рубриках
G02.1* Менингит при микозах
G02.8* Менингит при других уточненных инфекционных и паразитарных болезнях, классифицированных в других рубриках
G03 Менингит, обусловленный другими и неуточненными причинами
Включено:
арахноидит }
лептоменингит } вследствие других и
менингит } неуточненных причин
пахименингит }
Исключено:
менингомиелит (G04.-)
менингоэнцефалит (G04.-)
G03.0 Непиогенный менингит
G03.1 Хронический менингит
G03.2 Доброкачественный рецидивирующий менингит [Молларе]
G03.8 Менингит, вызванный другими уточненными возбудителями
G03.9 Менингит неуточненный
G04 Энцефалит, миелит и энцефаломиелит
Включено:
менингомиелит
менингоэнцефалит
острый восходящий миелит
Исключено:
доброкачественный миалгический энцефалит (G93.3)
миелит:
— острый поперечный (G37.3)
— подострый некротизирующий (G37.4)
рассеянный склероз (G35)
энцефалопатия:
— БДУ (G93.4)
— алкогольного генеза (G31.2)
— токсическая (G92)
G04.0 Острый диссеминированный энцефалит
G04.1 Тропическая спастическая параплегия
G04.2 Бактериальный менингоэнцефалит и менингомиелит, не классифицированные в других рубриках
G04.8 Другой энцефалит, миелит и энцефаломиелит
G04.9 Энцефалит, миелит или энцефаломиелит неуточненный
G05* Энцефалит, миелит и энцефаломиелит при болезнях, классифицированных в других рубриках
Включено: менингоэнцефалит и менингомиелит при болезнях, классифицированных в других рубриках
G05.0* Энцефалит, миелит и энцефаломиелит при бактериальных болезнях, классифицированных в других рубриках
G05.1* Энцефалит, миелит и энцефаломиелит при вирусных болезнях, классифицированных в других рубриках
G05.2* Энцефалит, миелит и энцефаломиелит при других инфекционных и паразитарных болезнях, классифицированных в других рубриках
G05.8* Энцефалит, миелит и энцефаломиелит при других болезнях,
классифицированных в других рубриках
G06 Внутричерепной и внутрипозвоночный абсцесс и гранулема
При необходимости уточнить инфекционный возбудитель используют
дополнительный код (B95-B97).
G06.0 Внутричерепной абсцесс и гранулема
G06.1 Внутрипозвоночный абсцесс и гранулема
G06.2 Экстрадуральный и субдуральный абсцесс неуточненный
G07* Внутричерепной и внутрипозвоночный абсцесс и гранулема при болезнях, классифицированных в других рубриках
G08 Внутричерепной и внутрипозвоночный флебит и тромбофлебит
Исключено:
внутричерепные флебиты и тромбофлебиты:
— негнойного происхождения (I67.6)
— осложняющие:
— аборт, внематочную или молярную беременность (O00-O07,
O08.7)
— беременность, роды или послеродовой период (O22.5, O87.3)
негнойные внутрипозвоночные флебиты и тромбофлебиты (G95.1)
G09 Последствия воспалительных болезней центральной нервной системы
Примечание: эту рубрику следует использовать для обозначения
состояний, первично классифицированных в рубриках G00-G08 (иск-
лючая те, которые отмечены значком *) как причина последствий,
которые сами отнесены к другим рубрикам. Понятие «последствия»
включает состояния, уточненные как таковые или как поздние проявления или последствия, существующие в течение года или более
после начала вызвавшего их состояния.
СИСТЕМНЫЕ АТРОФИИ, ПОРАЖАЮЩИЕ ПРЕИМУЩЕСТВЕННО
ЦЕНТРАЛЬНУЮ НЕРВНУЮ СИСТЕМУ
(G10-G13)
G10 Болезнь Гентингтона
G11 Наследственная атаксия
Исключено:
детский церебральный паралич (G80.-)
нарушения обмена веществ (E70-E90)
наследственная и идиопатическая невропатия (G60.-)
G11.0 Врожденная непрогрессирующая атаксия
G11.1 Ранняя мозжечковая атаксия
Примечание: начинается обычно у лиц моложе 20 лет
G11.2 Поздняя мозжечковая атаксия
Примечание: начинается обычно у лиц старше 20 лет
G11.3 Мозжечковая атаксия с нарушением репарации ДНК
Исключено:
пигментная ксеродермия (Q82.1)
синдром Коккейна (Q87.1)
G11.4 Наследственная спастическая параплегия
G11.8 Другая наследственная атаксия
G11.9 Наследственная атаксия неуточненная
G12 Спинальная мышечная атрофия и родственные синдромы
G12.0 Детская спинальная мышечная атрофия, I тип [Верднига-Гоффмана]
G12.1 Другие наследственные спинальные мышечные атрофии
G12.2 Болезнь двигательного неврона
G12.8 Другие спинальные мышечные атрофии и родственные синдромы
G12.9 Спинальная мышечная атрофия неуточненная
G13* Системные атрофии, поражающие преимущественно центральную нервную систему при болезнях, классифицированных в других рубриках
G13.0* Паранеопластическая невромиопатия и невропатия
G13.1* Другие системные атрофии, влияющие преимущественно на
центральную нервную систему, при опухолевых заболеваниях
G13.2* Системная атрофия при микседеме, влияющая преимущественно на центральную нервную систему (E00.1+, E03.-+)
G13.8* Системная атрофия, влияющая преимущественно на центральную нервную систему, при прочих заболеваниях, классифицированных в других рубриках
ЭКСТРАПИРАМИДНЫЕ И ДРУГИЕ ДВИГАТЕЛЬНЫЕ НАРУШЕНИЯ
(G20-G26)
G20 Болезнь Паркинсона
G21 Вторичный паркинсонизм
G21.0 Злокачественный нейролептический синдром
G21.1 Другие формы вторичного паркинсонизма, вызванного лекарственными средствами
G21.2 Вторичный паркинсонизм, вызванный другими внешними факторами
G21.3 Постэнцефалитический паркинсонизм
G21.8 Другие формы вторичного паркинсонизма
G21.9 Вторичный паркинсонизм неуточненный
G22* Паркинсонизм при болезнях, классифицированных в других рубриках
G23 Другие дегенеративные болезни базальных ганглиев
Исключено: полисистемная дегенерация (G90.3)
G23.0 Болезнь Галлервордена-Шпатца
G23.1 Прогрессирующая надъядерная офтальмоплегия [Стила-Ричардсона-Ольшевского]
G23.2 Стриатонигральная дегенерация
G23.8 Другие уточненные дегенеративные болезни базальных ганглиев
G23.9 Дегенеративная болезнь базальных ганглиев неуточненная
G24 Дистония
Включено: дискинезия
Исключено: атетоидный церебральный паралич (G80.3)
G24.0 Дистония, вызванная лекарственными средствами
G24.1 Идиопатическая семейная дистония
G24.2 Идиопатическая несемейная дистония
G24.3 Спастическая кривошея
Исключено: кривошея БДУ (M43.6)
G24.4 Идиопатическая рото-лицевая дистония
G24.5 Блефароспазм
G24.8 Прочие дистонии
G24.9 Дистония неуточненная
G25 Другие экстрапирамидные и двигательные нарушения
G25.0 Эссенциальный тремор
Исключено: тремор БДУ (R25.1)
G25.1 Тремор, вызванный лекарственным средством
G25.2 Другие уточненные формы тремора
G25.3 Миоклонус
Исключено:
лицевая миокимия (G51.4)
миоклоническая эпилепсия (G40.-)
G25.4 Хорея, вызванная лекарственным средством
G25.5 Другие виды хореи
Исключено:
ревматическая хорея (I02.-)
хорея БДУ с вовлечением сердца (I02.0)
хорея Гентингтона (G10)
хорея Сиденхема (I02.-)
G25.6 Тики, вызванные лекарственными средствами, и другие тики
органического происхождения
Исключено:
синдром де ла Туретта (F95.2)
тик БДУ (F95.9)
G25.8 Другие уточненные экстрапирамидные и двигательные нарушения
G25.9 Экстрапирамидное и двигательное расстройство неуточненное
G26* Экстрапирамидные и двигательные нарушения при болезнях, классифицированных в других рубриках
ДРУГИЕ ДЕГЕНЕРАТИВНЫЕ БОЛЕЗНИ НЕРВНОЙ СИСТЕМЫ
(G30-G32)
G30 Болезнь Альцгеймера
Включено: сенильная и пресенильная формы
Исключено:
сенильная:
— дегенерация головного мозга НКД (G31.1)
— деменция БДУ (F03)
сенильность БДУ (R54)
G30.0 Ранняя болезнь Альцгеймера
Примечание: начало болезни обычно у лиц в возрасте до 65
лет
G30.1 Поздняя болезнь Альцгеймера
Примечание: начало болезни обычно у лиц в возрасте старше
65 лет
G30.8 Другие формы болезни Альцгеймера
G30.9 Болезнь Альцгеймера неуточненная
G31 Другие дегенеративные болезни нервной системы, не классифицированные в других рубриках
Исключено: синдром Рейе (G93.7)
G31.0 Ограниченная атрофия головного мозга
G31.1 Сенильная дегенерация головного мозга, не классифицированная в других рубриках
Исключено:
болезнь Альцгеймера (G30.-)
сенильность БДУ (R54)
G31.2 Дегенерация нервной системы, вызванная алкоголем
G31.8 Другие уточненные дегенеративные болезни нервной системы
G31.9 Дегенеративная болезнь нервной системы неуточненная
G32* Другие дегенеративные нарушения нервной системы при болезнях,
классифицированных в других рубриках
G32.0* Подострая комбинированная дегенерация спинного мозга при
болезнях, классифицированных в других рубриках
G32.8* Другие уточненные дегенеративные нарушения нервной системы при болезнях, классифицированных в других рубриках
ДЕМИЕЛИНИЗИРУЮЩИЕ БОЛЕЗНИ ЦЕНТРАЛЬНОЙ
НЕРВНОЙ СИСТЕМЫ
(G35-G37)
G35 Рассеянный склероз
G36 Другая форма острой диссеминированной демиелинизации
Исключено: постинфекционный энцефалит и энцефаломиелит БДУ
(G04.8)
G36.0 Оптиконевромиелит [болезнь Девика]
Исключено: неврит зрительного нерва БДУ (H46)
G36.1 Острый и подострый геморрагический лейкоэнцефалит [болезнь
Харста]
G36.8 Другая уточненная форма острой диссеминированной демиелинизации
G36.9 Острая диссеминированная демиелинизация неуточненная
G37 Другие демиелинизирующие болезни центральной нервной системы
G37.0 Диффузный склероз
Исключено: адренолейкодистрофия [Аддисона-Шильдера]
(E71.3)
G37.1 Центральная демиелинизация мозолистого тела
G37.2 Центральный понтинный миелинолиз
G37.3 Острый поперечный миелит при демиелинизирующей болезни
центральной нервной системы
Исключено:
оптиконевромиелит [болезнь Девика] (G36.0)
рассеянный склероз (G35)
G37.4 Подострый некротизирующий миелит
G37.5 Концентрический склероз [Бало]
G37.8 Другие уточненные демиелинизирующие болезни центральной
нервной системы
G37.9 Демиелинизирующая болезнь центральной нервной системы неуточненная
ЭПИЗОДИЧЕСКИЕ И ПАРОКСИЗМАЛЬНЫЕ РАССТРОЙСТВА
(G40-G47)
G40 Эпилепсия
Исключено:
паралич Тодда (G83.8)
синдром Ландау-Клеффнера (F80.3)
судорожный припадок БДУ (R56.8)
эпилептический статус (G41.-)
G40.0 Локализованная (фокальная) (парциальная) идиопатическая
эпилепсия и эпилептические синдромы с судорожными припадками с фокальным началом
G40.1 Локализованная (фокальная) (парциальная) симптоматическая
эпилепсия и эпилептические синдромы с простыми парциальными припадками
G40.2 Локализованная (фокальная) (парциальная) симптоматическая
эпилепсия и эпилептические синдромы с комплексными парциальными судорожными припадками
G40.3 Генерализованная идиопатическая эпилепсия и эпилептические
синдромы
G40.4 Другие виды генерализованной эпилепсии и эпилептических
синдромов
G40.5 Особые эпилептические синдромы
G40.6 Припадки grand mal неуточненные (с малыми припадками [petit mal] или без них)
G40.7 Малые припадки [petit mal] неуточненные без припадков
grand mal
G40.8 Другие уточненные формы эпилепсии
G40.9 Эпилепсия неуточненная
G41 Эпилептический статус
G41.0 Эпилептический статус grand mal (судорожных припадков)
Исключено: эпилепсия парциальная непрерывная [Кожевникова]
(G40.5)
G41.1 Зпилептический статус petit mal (малых припадков)
G41.2 Сложный парциальный эпилептический статус
G41.8 Другой уточненный эпилептический статус
G41.9 Эпилептический статус неуточненный
G43 Мигрень
Исключено: головная боль БДУ (R51)
G43.0 Мигрень без ауры [простая мигрень]
G43.1 Мигрень с аурой [классическая мигрень]
G43.2 Мигренозный статус
G43.3 Осложненная мигрень
G43.8 Другая мигрень
G43.9 Мигрень неуточненная
G44 Другие синдромы головной боли
Исключено:
атипичная лицевая боль (G50.1)
головная боль БДУ (R51)
невралгия тройничного нерва (G50.0)
G44.0 Синдром «гистаминовой» головной боли
G44.1 Сосудистая головная боль, не классифицированная в других
рубриках
G44.2 Головная боль напряженного типа
G44.3 Хроническая посттравматическая головная боль
G44.4 Головная боль, вызванная применением лекарственных
средств, не классифицированная в других рубриках
G44.8 Другой уточненный синдром головной боли
G45 Преходящие транзиторные церебральные ишемические приступы [атаки] и родственные синдромы
Исключено: неонатальная церебральная ишемия (P91.0)
G45.0 Синдром вертебробазилярной артериальной системы
G45.1 Синдром сонной артерии (полушарный)
G45.2 Множественные и двусторонние синдромы церебральных артерий
G45.3 Преходящая слепота
G45.4 Транзиторная глобальная амнезия
Исключено: амнезия БДУ (R41.3)
G45.8 Другие транзиторные церебральные ишемические атаки и свя-
занные с ними синдромы
G45.9 Транзиторная церебральная ишемическая атака неуточненная
G46* Сосудистые мозговые синдромы при цереброваскулярных болезнях
(I60-I67+)
G46.0* Синдром средней мозговой артерии (I66.0+)
G46.1* Синдром передней мозговой артерии (I66.1+)
G46.2* Синдром задней мозговой артерии (I66.2+)
G46.3* Синдром инсульта в стволе головного мозга (I60-I67+)
G46.4* Синдром мозжечкового инсульта (I60-I67+)
G46.5* Чисто двигательный лакунарный синдром (I60-I67+)
G46.6* Чисто чувствительный лакунарный синдром (I60-I67+)
G46.7* Другие лакунарные синдромы (I60-I67+)
G46.8* Другие сосудистые синдромы головного мозга при цереброваскулярных болезнях (I60-I67+)
G47 Расстройства сна
Исключено:
кошмары (F51.5)
ночные ужасы (F51.4)
расстройства сна неорганической этиологии (F51.-)
снохождение (F51.3)
G47.0 Нарушения засыпания и поддержания сна [бессонница]
G47.1 Нарушения в виде повышенной сонливости [гиперсомния]
G47.2 Нарушения цикличности сна и бодрствования
G47.3 Апноэ во сне
Исключено:
апноэ во сне у новорожденных (P28.3)
пиквикский синдром (E66.2)
G47.4 Нарколепсия и катаплексия
G47.8 Другие нарушения сна
G47.9 Нарушение сна неуточненное
ПОРАЖЕНИЯ ОТДЕЛЬНЫХ НЕРВОВ, НЕРВНЫХ
КОРЕШКОВ И СПЛЕТЕНИЙ
(G50-G59)
Исключено:
невралгия } БДУ (M79.2)
неврит }
периферический неврит при беременности (O26.8)
радикулит БДУ (M54.1)
текущие травматические поражения нервов, нервных корешков и сплетений — см. травмы нервов по областям тела
G50 Поражения тройничного нерва
Включено: поражения 5-го черепного нерва
G50.0 Невралгия тройничного нерва
G50.1 Атипичная лицевая боль
G50.8 Другие поражения тройничного нерва
G50.9 Поражение тройничного нерва неуточненное
G51 Поражения лицевого нерва
Включено: поражения 7-го черепного нерва
G51.0 Паралич Белла
G51.1 Воспаление узла коленца
Исключено: постгерпетическое воспаление узла коленца
(B02.2)
G51.2 Синдром Россолимо-Мелькерссона
G51.3 Клонический гемифациальный спазм
G51.4 Лицевая миокимия
G51.8 Другие поражения лицевого нерва
G51.9 Поражение лицевого нерва неуточненное
G52 Поражения других черепных нервов
Исключено:
нарушения:
— зрительного (2-го) нерва (H46, H47.0)
— слухового (8-го) нерва (H93.3)
паралитическое косоглазие вследствие паралича нерва
(H49.0-H49.2)
G52.0 Поражения обонятельного нерва
G52.1 Поражения языкоглоточного нерва
G52.2 Поражения блуждающего нерва
G52.3 Поражения подъязычного нерва
G52.7 Множественные поражения черепных нервов
G52.8 Поражения других уточненных черепных нервов
G52.9 Поражение черепного нерва неуточненное
G53* Поражения черепных нервов при болезнях, классифицированных в
других рубриках
G53.0* Невралгия после опоясывающего лишая (B02.2+)
G53.1* Множественные поражения черепных нервов при инфекционных
и паразитарных болезнях, классифицированных в других
рубриках (A00-B99+)
G53.2* Множественные поражения черепных нервов при саркоидозе
(D86.8+)
G53.3* Множественные поражения черепных нервов при новообразо-
ваниях (C00-D48+)
G53.8* Другие поражения черепных нервов при других болезнях,
классифицированных в других рубриках
G54 Поражения нервных корешков и сплетений
Исключено:
невралгия или неврит БДУ (M79.2)
неврит или радикулит:
— грудной БДУ }
— 140 —
— плечевой БДУ }
— пояснично-крестцовый БДУ }
— поясничный БДУ } (M54.1)
радикулит БДУ }
радикулопатия БДУ }
спондилез (M47.-) }
поражения межпозвоночных дисков (M50-M51)
текущие травматические поражения нервных корешков и сплетений —
см. травму нервов по областям тела
G54.0 Поражения плечевого сплетения
G54.1 Поражения пояснично-крестцового сплетения
G54.2 Поражения шейных корешков, не классифицированные в других
рубриках
G54.3 Поражения грудных корешков, не классифицированные в других
рубриках
G54.4 Поражения пояснично-крестцовых корешков, не классифицированные в других рубриках
G54.5 Невралгическая амиотрофия
G54.6 Синдром фантома конечности с болью
G54.7 Синдром фантома конечности без боли
G54.8 Другие поражения нервных корешков и сплетений
G54.9 Поражение нервных корешков и сплетений неуточненное
G55* Сдавления нервных корешков и сплетений при болезнях, классифицированных в других рубриках
G55.0* Сдавления нервных корешков и сплетений при новообразованиях (C00-D48+)
G55.1* Сдавления нервных корешков и сплетений при нарушениях
межпозвоночных дисков (M50-M51+)
G55.2* Сдавления нервных корешков и сплетений при спондилезе
(M47.-+)
G55.3* Сдавления нервных корешков и сплетений при других дорсопатиях (M45-M46+, M48.-+, M53-M54+)
G55.8* Сдавления нервных корешков и сплетений при других болезнях, классифицированных в других рубриках
G56 Мононевропатии верхней конечности
Исключено: текущее травматическое поражение нервов — см. травму
нервов по областям тела
G56.0 Синдром запястного канала
G56.1 Другие поражения срединного нерва
G56.2 Поражение локтевого нерва
G56.3 Поражение лучевого нерва
G56.4 Каузалгия
G56.8 Другие мононевропатии верхней конечности
G56.9 Мононевропатия верхней конечности неуточненная
G57 Мононевропатии нижней конечности
Исключено: текущее травматическое поражение нервов — см. травму
нервов по областям тела
G57.0 Поражение седалищного нерва
Исключено: ишиас:
— БДУ (M54.3)
— связанный с поражением межпозвоночного диска (M51.1)
G57.1 Мералгия парестетическая
G57.2 Поражение бедренного нерва
G57.3 Поражение бокового подколенного нерва
G57.4 Поражение срединного подколенного нерва
G57.5 Синдром предплюсневого канала
G57.6 Поражение подошвенного нерва
G57.8 Другие мононевралгии нижней конечности
G57.9 Мононевропатия нижней конечности неуточненная
G58 Другие мононевропатии
G58.0 Межреберная невропатия
G58.7 Множественный мононеврит
G58.8 Другие уточненные виды мононевропатии
G58.9 Мононевропатия неуточненная
G59* Мононевропатия при болезнях, классифицированных в других рубриках
G59.0* Диабетическая мононевропатия (E10-E14+ с общим четвертым
знаком .4)
G59.8* Другие мононевропатии при болезнях, классифицированных в
других рубриках
ПОЛИНЕВРОПАТИИ И ДРУГИЕ ПОРАЖЕНИЯ
ПЕРИФЕРИЧЕСКОЙ НЕРВНОЙ СИСТЕМЫ
(G60-G64)
Исключено:
невралгия БДУ (M79.2)
неврит БДУ (M79.2)
периферический неврит при беременности (O26.8)
радикулит БДУ (M54.1)
G60 Наследственная и идиопатическая невропатия
G60.0 Наследственная моторная и сенсорная невропатия
G60.1 Болезнь Рефсума
G60.2 Невропатия в сочетании с наследственной атаксией
G60.3 Идиопатическая прогрессирующая невропатия
G60.8 Другие наследственные и идиопатические невропатии
G60.9 Наследственная и идиопатическая невропатия неуточненная
G61 Воспалительная полиневропатия
G61.0 Синдром Гийена-Барре
G61.1 Сывороточная невропатия
G61.8 Другие воспалительные полиневропатии
G61.9 Воспалительная полиневропатия неуточненная
G62 Другие полиневропатии
G62.0 Лекарственная полиневропатия
G62.1 Алкогольная полиневропатия
G62.2 Полиневропатия, вызванная другими токсическими веществами
G62.8 Другие уточненные полиневропатии
G62.9 Полиневропатия неуточненная
G63* Полиневропатия при болезнях, классифицированных в других рубриках
G63.0* Полиневропатия при инфекционных и паразитарных болезнях,
классифицированных в других рубриках
G63.1* Полиневропатия при новообразованиях (C00-D48+)
G63.2* Диабетическая полиневропатия (E10-E14+ с общим четвертым
знаком .4)
G63.3* Полиневропатия при других эндокринных болезнях и нарушениях обмена веществ (E00-E07+, E15-E16+, E20-E34+,
E70-E89+)
G63.4* Полиневропатия при недостаточности питания (E40-E64+)
G63.5* Полиневропатия при системных поражениях соединительной
ткани (M30-M35+)
G63.6* Полиневропатия при других костно-мышечных поражениях
(M00-M25+, M40-M96+)
G63.8* Полиневропатия при других болезнях, классифицированных в
других рубриках
G64 Другие расстройства периферической нервной системы
БОЛЕЗНИ НЕРВНО-МЫШЕЧНОГО СИНАПСА И МЫШЦ
(G70-G73)
G70 Myasthenia gravis и другие нарушения нервно-мышечного синапса
Исключено:
ботулизм (A05.1)
преходящая неонатальная myasthenia gravis (P94.0)
G70.0 Myasthenia gravis [тяжелая миастения]
G70.1 Токсические нарушения нервно-мышечного синапса
G70.2 Врожденная или приобретенная миастения
G70.8 Другие нарушения нервно-мышечного синапса
G70.9 Нарушение нервно-мышечного синапса неуточненное
G71 Первичные поражения мышц
Исключено:
артрогрипоз множественный врожденный (Q74.3)
миозит (M60.-)
нарушения обмена веществ (E70-E90)
G71.0 Мышечная дистрофия
Исключено:
врожденная мышечная дистрофия:
— БДУ (G71.2)
— с уточненными морфологическими поражениями мышечного волокна (G71.2)
G71.1 Миотонические расстройства
G71.2 Врожденные миопатии
G71.3 Митохондриальная миопатия, не классифицированная в других
рубриках
G71.8 Другие первичные поражения мышц
G71.9 Первичное поражение мышцы неуточненное
G72 Другие миопатии
Исключено:
врожденный множественный артрогрипоз (Q74.3)
дерматополимиозит (M33.-)
ишемический инфаркт мышцы (M62.2)
миозит (M60.-)
полимиозит (M33.2)
G72.0 Лекарственная миопатия
G72.1 Алкогольная миопатия
G72.2 Миопатия, вызванная другим токсичным веществом
G72.3 Периодический паралич
G72.4 Воспалительная миопатия, не классифицированная в других
рубриках
G72.8 Другие уточненные миопатии
G72.9 Миопатия неуточненная
G73* Поражения нервно-мышечного синапса и мышц при болезнях, классифицированных в других рубриках
G73.0* Миастенические синдромы при эндокринных болезнях
G73.1* Синдром Итона-Ламберта (C80+)
G73.2* Другие миастенические синдромы при опухолевом поражении
(C00-D48+)
G73.3* Миастенические синдромы при других болезнях, классифицированных в других рубриках
G73.4* Миопатия при инфекционных и паразитарных болезнях, классифицированных в других рубриках
G73.5* Миопатия при эндокринных болезнях
G73.6* Миопатия при нарушениях обмена веществ
G73.7* Миопатия при других болезнях, классифицированных в других рубриках
ЦЕРЕБРАЛЬНЫЙ ПАРАЛИЧ И ДРУГИЕ
ПАРАЛИТИЧЕСКИЕ СИНДРОМЫ
(G80-G83)
G80 Детский церебральный паралич
Включено: болезнь Литтла
Исключено: наследственная спастическая параплегия (G11.4)
G80.0 Спастический церебральный паралич
G80.1 Спастическая диплегия
G80.2 Детская гемиплегия
G80.3 Дискинетический церебральный паралич
G80.4 Атаксический церебральный паралич
G80.8 Другой вид детского церебрального паралича
G80.9 Детский церебральный паралич неуточненный
G81 Гемиплегия
Примечание: для первичного кодирования эту рубрику следует использовать только тогда, когда о гемиплегии (полной) (неполной)
сообщается без дополнительного уточнения или утверждается, что
она установлена давно или существует длительно, но ее причина
не уточнена. Эту рубрику также применяют при кодировании по
множественным причинам для идентификации типов гемиплегии, вызванной любой причиной.
Исключено: врожденный и детский церебральный паралич (G80.-)
G81.0 Вялая гемиплегия
G81.1 Спастическая гемиплегия
G81.9 Гемиплегия неуточненная
G82 Параплегия и тетраплегия
Примечание: см. примечание к рубрике G81
Исключено: врожденный или детский церебральный паралич (G80.-)
G82.0 Вялая параплегия
G82.1 Спастическая параплегия
G82.2 Параплегия неуточненная
G82.3 Вялая тетраплегия
G82.4 Спастическая тетраплегия
G82.5 Тетраплегия неуточненная
G83 Другие паралитические синдромы
Примечание: см. примечание к рубрике G81
Включено: паралич (полный) (неполный), кроме указанного в рубриках G80-G82
G83.0 Диплегия верхних конечностей
G83.1 Моноплегия нижней конечности
G83.2 Моноплегия верхней конечности
G83.3 Моноплегия неуточненная
G83.4 Синдром конского хвоста
Исключено: спинальный мочевой пузырь БДУ (G95.8)
G83.8 Другие уточненные паралитические синдромы
G83.9 Паралитический синдром неуточненный
ДРУГИЕ НАРУШЕНИЯ НЕРВНОЙ СИСТЕМЫ
(G90-G99)
G90 Расстройства вегетативной [автономной] нервной системы
Исключено: расстройство вегетативной нервной системы, вызванное
алкоголем (G31.2)
G90.0 Идиопатическая периферическая вегетативная невропатия
G90.1 Семейная дизавтономия [Райли-Дея]
G90.2 Синдром Горнера
G90.3 Полисистемная дегенерация
Исключено: ортостатическая гипотензия БДУ (I95.1)90.8 Другие расстройства вегетативной [автономной] нервной сис-
темы
G90.9 Расстройство вегетативной [автономной] нервной системы неуточненное
G91 Гидроцефалия
Включено: приобретенная гидроцефалия
Исключено: гидроцефалия:
— врожденная (Q03.-)
— вызванная врожденным токсоплазмозом (P37.1)
G91.0 Сообщающаяся гидроцефалия
G91.1 Обструктивная гидроцефалия
G91.2 Гидроцефалия нормального давления
G91.3 Посттравматическая гидроцефалия неуточненная
G91.8 Другие виды гидроцефалии
G91.9 Гидроцефалия неуточненная
G92 Токсическая энцефалопатия
G93 Другие поражения головного мозга
G93.0 Церебральная киста
Исключено:
врожденная церебральная киста (Q04.6)
перивентрикулярная приобретенная киста новорожденного (P91.1)
G93.1 Аноксическое поражение головного мозга, не классифицированное в других рубриках
Исключено:
неонатальная аноксия (P21.9)
осложняющее:
— аборт, внематочную или молярную беременность (O00-O07,
O08.8)
— беременность, роды или родоразрешение (O29.2, O74.3,
O89.2)
— хирургическую и медицинскую помощь (T80-T88)
G93.2 Доброкачественная внутричерепная гипертензия
Исключено: гипертензивная энцефалопатия (I67.4)
G93.3 Синдром утомляемости после перенесенной вирусной болезни
G93.4 Энцефалопатия неуточненная
Исключено: энцефалопатия:
— алкогольная (G31.2)
— токсическая (G92)
G93.5 Сдавление головного мозга
Исключено:
травматическое сдавление головного мозга (S06.2)
— очаговое (S06.3)
G93.6 Отек мозга
Исключено: отек мозга:
— вследствие родовой травмы (P11.0)
— травматический (S06.1)
G93.7 Синдром Рейе
При необходимости идентифицировать внешний фактор исполь-
зуют дополнительный код внешних причин (класс XX).
G93.8 Другие уточненные поражения головного мозга
G93.9 Поражение головного мозга неуточненное
G94* Другие поражения головного мозга при болезнях, классифицированных в других рубриках
G94.0* Гидроцефалия при инфекционных и паразитарных болезнях,
классифицированных в других рубриках (A00-B99+)
G94.1* Гидроцефалия при опухолевых болезнях (C00-D48+)
G94.2* Гидроцефалия при других болезнях, классифицированных в
других рубриках
G94.8* Другие уточненные поражения головного мозга при болез-
нях, классифицированных в других рубриках
G95 Другие болезни спинного мозга
Исключено: миелит (G04.-)
G95.0 Сирингомиелия и сирингобульбия
G95.1 Сосудистые миелопатии
Исключено: спинномозговой флебит и тромбофлебит, кроме не-
пиогенного (G08)
G95.2 Сдавление спинного мозга неуточненное
G95.8 Другие уточненные болезни спинного мозга
Исключено:
нервно-мышечная дисфункция мочевого пузыря без упоминания
о поражении спинного мозга (N31.-)
неврогенный мочевой пузырь:
— БДУ (N31.9)
— связанный с синдромом конского хвоста (G83.4)
G95.9 Болезнь спинного мозга неуточненная
G96 Другие нарушения центральной нервной системы
G96.0 Истечение цереброспинальной жидкости [ликворея]
Исключено: при спинномозговой пункции (G97.0)
G96.1 Поражения оболочек головного мозга, не классифицированные
в других рубриках
G96.8 Другие уточненные поражения центральной нервной системы
G96.9 Поражение центральной нервной системы неуточненное
G97 Нарушения нервной системы после медицинских процедур, не классифицированные в других рубриках
G97.0 Истечение цереброспинальной жидкости при спинномозговой
пункции
G97.1 Другая реакция на спинномозговую пункцию
G97.2 Внутричерепная гипертензия после шунтирования желудочков
G97.8 Другие нарушения нервной системы после медицинских проце-
дур
G97.9 Расстройство нервной системы после медицинских процедур
неуточненное
G98 Другие нарушения нервной системы, не классифицированные в других
рубриках
G99* Другие поражения нервной системы при болезнях, классифицированных в других рубриках
G99.0* Вегетативная невропатия при эндокринных и метаболических
болезнях
G99.1* Другие нарушения вегетативной [автономной] нервной системы при прочих болезнях, классифицированных в других
рубриках
G99.2* Миелопатия при болезнях, классифицированных в других
рубриках
G99.8* Другие уточненные нарушения нервной системы при болезнях, классифицированных в других рубриках
И на английском
Chapter V
Mental and behavioural disorders
(F00-F99)
Organic, including symptomatic, mental disorders
(F00-F09)
This block comprises a range of mental disorders grouped together on the basis of their having in common a demonstrable etiology in cerebral disease, brain injury, or other insult leading to cerebral dysfunction. The dysfunction may be primary, as in diseases, injuries, and insults that affect the brain directly and selectively; or secondary, as in systemic diseases and disorders that attack the brain only as one of the multiple organs or systems of the body that are involved. Dementia (F00-F03) is a syndrome due to disease of the brain, usually of a chronic or progressive nature, in which there is disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not clouded. The impairments of cognitive function are commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behaviour, or motivation. This syndrome occurs in Alzheimer’s disease, in cerebrovascular disease, and in other conditions primarily or secondarily affecting the brain. |
||||||||
Use additional code, if desired, to identify the underlying disease. |
F00* |
Dementia in Alzheimer’s disease ( G30.-+ ) |
|||||||
Alzheimer’s disease is a primary degenerative cerebral disease of unknown etiology with characteristic neuropathological and neurochemical features. The disorder is usually insidious in onset and develops slowly but steadily over a period of several years. |
||||||||
F00.0* |
Dementia in Alzheimer’s disease with early onset ( G30.0+ ) |
|||||||
Dementia in Alzheimer’s disease with onset before the age of 65, with a relatively rapid deteriorating course and with marked multiple disorders of the higher cortical functions. |
||||||||
Alzheimer’s disease, type 2 |
||||||||
F00.1* |
Dementia in Alzheimer’s disease with late onset ( G30.1+ ) |
|||||||
Dementia in Alzheimer’s disease with onset after the age of 65, usually in the late 70s or thereafter, with a slow progression, and with memory impairment as the principal feature. |
||||||||
Alzheimer’s disease, type 1 |
||||||||
F00.2* |
Dementia in Alzheimer’s disease, atypical or mixed type ( G30.8+ ) |
|||||||
Atypical dementia, Alzheimer’s type |
||||||||
F00.9* |
Dementia in Alzheimer’s disease, unspecified ( G30.9+ ) |
F01 |
Vascular dementia |
|||||||
Vascular dementia is the result of infarction of the brain due to vascular disease, including hypertensive cerebrovascular disease. The infarcts are usually small but cumulative in their effect. Onset is usually in later life. |
||||||||
Includes: |
arteriosclerotic dementia |
|||||||
F01.0 |
Vascular dementia of acute onset |
|||||||
Usually develops rapidly after a succession of strokes from cerebrovascular thrombosis, embolism or haemorrhage. In rare cases, a single large infarction may be the cause. |
||||||||
F01.1 |
Multi-infarct dementia |
|||||||
Gradual in onset, following a number of transient ischaemic episodes which produce an accumulation of infarcts in the cerebral parenchyma. |
||||||||
Predominantly cortical dementia |
||||||||
F01.2 |
Subcortical vascular dementia |
|||||||
Includes cases with a history of hypertension and foci of ischaemic destruction in the deep white matter of the cerebral hemispheres. The cerebral cortex is usually preserved and this contrasts with the clinical picture which may closely resemble that of dementia in Alzheimer’s disease. |
||||||||
F01.3 |
Mixed cortical and subcortical vascular dementia |
|||||||
F01.8 |
Other vascular dementia |
|||||||
F01.9 |
Vascular dementia, unspecified |
F02* |
Dementia in other diseases classified elsewhere |
|||||||
Cases of dementia due, or presumed to be due, to causes other than Alzheimer’s disease or cerebrovascular disease. Onset may be at any time in life, though rarely in old age. |
||||||||
F02.0* |
Dementia in Pick’s disease ( G31.0+ ) |
|||||||
A progressive dementia, commencing in middle age, characterized by early, slowly progressing changes of character and social deterioration, followed by impairment of intellect, memory, and language functions, with apathy, euphoria and, occasionally, extrapyramidal phenomena. |
||||||||
F02.1* |
Dementia in Creutzfeldt-Jakob disease ( A81.0+ ) |
|||||||
A progressive dementia with extensive neurological signs, due to specific neuropathological changes that are presumed to be caused by a transmissible agent. Onset is usually in middle or later life, but may be at any adult age. The course is subacute, leading to death within one to two years. |
||||||||
F02.2* |
Dementia in Huntington’s disease ( G10+ ) |
|||||||
A dementia occurring as part of a widespread degeneration of the brain. The disorder is transmitted by a single autosomal dominant gene. Symptoms typically emerge in the third and fourth decade. Progression is slow, leading to death usually within 10 to 15 years. |
||||||||
Dementia in Huntington’s chorea |
||||||||
F02.3* |
Dementia in Parkinson’s disease ( G20+ ) |
|||||||
A dementia developing in the course of established Parkinson’s disease. No particular distinguishing clinical features have yet been demonstrated. |
||||||||
Dementia in: |
||||||||
F02.4* |
Dementia in human immunodeficiency virus [HIV] disease ( B22.0+ ) |
|||||||
Dementia developing in the course of HIV disease, in the absence of a concurrent illness or condition other than HIV infection that could explain the clinical features. |
||||||||
F02.8* |
Dementia in other specified diseases classified elsewhere |
|||||||
Dementia in: |
F03 |
Unspecified dementia |
|||||||
Presenile: |
||||||||
Excludes: |
senile dementia with delirium or acute confusional state ( F05.1 ) |
F04 |
Organic amnesic syndrome, not induced by alcohol and other psychoactive substances |
|||||||
A syndrome of prominent impairment of recent and remote memory while immediate recall is preserved, with reduced ability to learn new material and disorientation in time. Confabulation may be a marked feature, but perception and other cognitive functions, including the intellect, are usually intact. The prognosis depends on the course of the underlying lesion. |
||||||||
Korsakov’s psychosis or syndrome, nonalcoholic |
||||||||
Excludes: |
amnesia: |
F05 |
Delirium, not induced by alcohol and other psychoactive substances |
|||||||
An etiologically nonspecific organic cerebral syndrome characterized by concurrent disturbances of consciousness and attention, perception, thinking, memory, psychomotor behaviour, emotion, and the sleep-wake schedule. The duration is variable and the degree of severity ranges from mild to very severe. |
||||||||
Includes: |
acute or subacute: |
|||||||
Excludes: |
delirium tremens, alcohol-induced or unspecified ( F10.4 ) |
|||||||
F05.0 |
Delirium not superimposed on dementia, so described |
|||||||
F05.1 |
Delirium superimposed on dementia |
|||||||
Conditions meeting the above criteria but developing in the course of a dementia ( F00-F03 ) |
||||||||
F05.8 |
Other delirium |
|||||||
Delirium of mixed origin |
||||||||
F05.9 |
Delirium, unspecified |
F06 |
Other mental disorders due to brain damage and dysfunction and to physical disease |
|||||||
Includes miscellaneous conditions causally related to brain disorder due to primary cerebral disease, to systemic disease affecting the brain secondarily, to exogenous toxic substances or hormones, to endocrine disorders, or to other somatic illnesses. |
||||||||
Excludes: |
associated with: |
|||||||
F06.0 |
Organic hallucinosis |
|||||||
A disorder of persistent or recurrent hallucinations, usually visual or auditory, that occur in clear consciousness and may or may not be recognized by the subject as such. Delusional elaboration of the hallucinations may occur, but delusions do not dominate the clinical picture; insight may be preserved. |
||||||||
Organic hallucinatory state (nonalcoholic) |
||||||||
Excludes: |
||||||||
F06.1 |
Organic catatonic disorder |
|||||||
A disorder of diminished (stupor) or increased (excitement) psychomotor activity associated with catatonic symptoms. The extremes of psychomotor disturbance may alternate. |
||||||||
Excludes: |
catatonic schizophrenia ( F20.2 ) |
|||||||
F06.2 |
Organic delusional [schizophrenia-like] disorder |
|||||||
A disorder in which persistent or recurrent delusions dominate the clinical picture. The delusions may be accompanied by hallucinations. Some features suggestive of schizophrenia, such as bizarre hallucinations or thought disorder, may be present. |
||||||||
Paranoid and paranoid-hallucinatory organic states |
||||||||
Excludes: |
disorder: |
|||||||
F06.3 |
Organic mood [affective] disorders |
|||||||
Disorders characterized by a change in mood or affect, usually accompanied by a change in the overall level of activity, depressive, hypomanic, manic or bipolar (see F30-F38), but arising as a consequence of an organic disorder. |
||||||||
Excludes: |
mood disorders, nonorganic or unspecified ( F30-F39 ) |
|||||||
F06.4 |
Organic anxiety disorder |
|||||||
A disorder characterized by the essential descriptive features of a generalized anxiety disorder (F41.1), a panic disorder (F41.0), or a combination of both, but arising as a consequence of an organic disorder. |
||||||||
Excludes: |
anxiety disorders, nonorganic or unspecified ( F41.- ) |
|||||||
F06.5 |
Organic dissociative disorder |
|||||||
A disorder characterized by a partial or complete loss of the normal integration between memories of the past, awareness of identity and immediate sensations, and control of bodily movements (see F44.-), but arising as a consequence of an organic disorder. |
||||||||
Excludes: |
dissociative [conversion] disorders, nonorganic or unspecified ( F44.- ) |
|||||||
F06.6 |
Organic emotionally labile [asthenic] disorder |
|||||||
A disorder characterized by emotional incontinence or lability, fatigability, and a variety of unpleasant physical sensations (e.g. dizziness) and pains, but arising as a consequence of an organic disorder. |
||||||||
Excludes: |
somatoform disorders, nonorganic or unspecified ( F45.- ) |
|||||||
F06.7 |
Mild cognitive disorder |
|||||||
A disorder characterized by impairment of memory, learning difficulties, and reduced ability to concentrate on a task for more than brief periods. There is often a marked feeling of mental fatigue when mental tasks are attempted, and new learning is found to be subjectively difficult even when objectively successful. None of these symptoms is so severe that a diagnosis of either dementia (F00-F03) or delirium (F05.-) can be made. This diagnosis should be made only in association with a specified physical disorder, and should not be made in the presence of any of the mental or behavioural disorders classified to F10-F99. The disorder may precede, accompany, or follow a wide variety of infections and physical disorders, both cerebral and systemic, but direct evidence of cerebral involvement is not necessarily present. It can be differentiated from postencephalitic syndrome (F07.1) and postconcussional syndrome (F07.2) by its different etiology, more restricted range of generally milder symptoms, and usually shorter duration. |
||||||||
F06.8 |
Other specified mental disorders due to brain damage and dysfunction and to physical disease |
|||||||
Epileptic psychosis NOS |
||||||||
F06.9 |
Unspecified mental disorder due to brain damage and dysfunction and to physical disease |
|||||||
Organic: |
F07 |
Personality and behavioural disorders due to brain disease, damage and dysfunction |
|||||||
Alteration of personality and behaviour can be a residual or concomitant disorder of brain disease, damage or dysfunction. |
||||||||
F07.0 |
Organic personality disorder |
|||||||
A disorder characterized by a significant alteration of the habitual patterns of behaviour displayed by the subject premorbidly, involving the expression of emotions, needs and impulses. Impairment of cognitive and thought functions, and altered sexuality may also be part of the clinical picture. |
||||||||
Organic: |
||||||||
Excludes: |
enduring personality change after: |
|||||||
F07.1 |
Postencephalitic syndrome |
|||||||
Residual nonspecific and variable behavioural change following recovery from either viral or bacterial encephalitis. The principal difference between this disorder and the organic personality disorders is that it is reversible. |
||||||||
Excludes: |
organic personality disorder ( F07.0 ) |
|||||||
F07.2 |
Postconcussional syndrome |
|||||||
A syndrome that occurs following head trauma (usually sufficiently severe to result in loss of consciousness) and includes a number of disparate symptoms such as headache, dizziness, fatigue, irritability, difficulty in concentration and performing mental tasks, impairment of memory, insomnia, and reduced tolerance to stress, emotional excitement, or alcohol. |
||||||||
Postcontusional syndrome (encephalopathy) |
||||||||
F07.8 |
Other organic personality and behavioural disorders due to brain disease, damage and dysfunction |
|||||||
Right hemispheric organic affective disorder |
||||||||
F07.9 |
Unspecified organic personality and behavioural disorder due to brain disease, damage and dysfunction |
|||||||
Organic psychosyndrome |
F09 |
Unspecified organic or symptomatic mental disorder |
|||||||
Psychosis: |
||||||||
Excludes: |
psychosis NOS ( F29 ) |
Mental and behavioural disorders due to psychoactive substance use
(F10-F19)
This block contains a wide variety of disorders that differ in severity and clinical form but that are all attributable to the use of one or more psychoactive substances, which may or may not have been medically prescribed. The third character of the code identifies the substance involved, and the fourth character specifies the clinical state. The codes should be used, as required, for each substance specified, but it should be noted that not all fourth-character codes are applicable to all substances. Identification of the psychoactive substance should be based on as many sources of information as possible. These include self-report data, analysis of blood and other body fluids, characteristic physical and psychological symptoms, clinical signs and behaviour, and other evidence such as a drug being in the patient’s possession or reports from informed third parties. Many drug users take more than one type of psychoactive substance. The main diagnosis should be classified, whenever possible, according to the substance or class of substances that has caused or contributed most to the presenting clinical syndrome. Other diagnoses should be coded when other psychoactive substances have been taken in intoxicating amounts (common fourth character .0) or to the extent of causing harm (common fourth character .1), dependence (common fourth character .2) or other disorders (common fourth character .3-.9). Only in cases in which patterns of psychoactive substance-taking are chaotic and indiscriminate, or in which the contributions of different psychoactive substances are inextricably mixed, should the diagnosis of disorders resulting from multiple drug use (F19.-) be used. |
||||||||
Excludes: |
abuse of non-dependence-producing substances ( F55 ) |
|||||||
The following fourth-character subdivisions are for use with categories F10-F19: |
||||||||
.0 |
Acute intoxication |
|||||||
A condition that follows the administration of a psychoactive substance resulting in disturbances in level of consciousness, cognition, perception, affect or behaviour, or other psycho-physiological functions and responses. The disturbances are directly related to the acute pharmacological effects of the substance and resolve with time, with complete recovery, except where tissue damage or other complications have arisen. Complications may include trauma, inhalation of vomitus, delirium, coma, convulsions, and other medical complications. The nature of these complications depends on the pharmacological class of substance and mode of administration. |
||||||||
Acute drunkenness in alcoholism |
||||||||
.1 |
Harmful use |
|||||||
A pattern of psychoactive substance use that is causing damage to health. The damage may be physical (as in cases of hepatitis from the self-administration of injected psychoactive substances) or mental (e.g. episodes of depressive disorder secondary to heavy consumption of alcohol). |
||||||||
Psychoactive substance abuse |
||||||||
.2 |
Dependence syndrome |
|||||||
A cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state. The dependence syndrome may be present for a specific psychoactive substance (e.g. tobacco, alcohol, or diazepam), for a class of substances (e.g. opioid drugs), or for a wider range of pharmacologically different psychoactive substances. |
||||||||
Chronic alcoholism |
||||||||
.3 |
Withdrawal state |
|||||||
A group of symptoms of variable clustering and severity occurring on absolute or relative withdrawal of a psychoactive substance after persistent use of that substance. The onset and course of the withdrawal state are time-limited and are related to the type of psychoactive substance and dose being used immediately before cessation or reduction of use. The withdrawal state may be complicated by convulsions. |
||||||||
.4 |
Withdrawal state with delirium |
|||||||
A condition where the withdrawal state as defined in the common fourth character .3 is complicated by delirium as defined in F05.-. Convulsions may also occur. When organic factors are also considered to play a role in the etiology, the condition should be classified to F05.8. |
||||||||
Delirium tremens (alcohol-induced) |
||||||||
.5 |
Psychotic disorder |
|||||||
A cluster of psychotic phenomena that occur during or following psychoactive substance use but that are not explained on the basis of acute intoxication alone and do not form part of a withdrawal state. The disorder is characterized by hallucinations (typically auditory, but often in more than one sensory modality), perceptual distortions, delusions (often of a paranoid or persecutory nature), psychomotor disturbances (excitement or stupor), and an abnormal affect, which may range from intense fear to ecstasy. The sensorium is usually clear but some degree of clouding of consciousness, though not severe confusion, may be present. |
||||||||
Alcoholic: |
||||||||
Excludes: |
alcohol- or other psychoactive substance-induced residual and late-onset psychotic disorder ( F10-F19 with common fourth character .7) |
|||||||
.6 |
Amnesic syndrome |
|||||||
A syndrome associated with chronic prominent impairment of recent and remote memory. Immediate recall is usually preserved and recent memory is characteristically more disturbed than remote memory. Disturbances of time sense and ordering of events are usually evident, as are difficulties in learning new material. Confabulation may be marked but is not invariably present. Other cognitive functions are usually relatively well preserved and amnesic defects are out of proportion to other disturbances. |
||||||||
Amnestic disorder, alcohol- or drug-induced |
||||||||
Excludes: |
nonalcoholic Korsakov’s psychosis or syndrome ( F04 ) |
|||||||
.7 |
Residual and late-onset psychotic disorder |
|||||||
A disorder in which alcohol- or psychoactive substance-induced changes of cognition, affect, personality, or behaviour persist beyond the period during which a direct psychoactive substance-related effect might reasonably be assumed to be operating. Onset of the disorder should be directly related to the use of the psychoactive substance. Cases in which initial onset of the state occurs later than episode(s) of such substance use should be coded here only where clear and strong evidence is available to attribute the state to the residual effect of the psychoactive substance. Flashbacks may be distinguished from psychotic state partly by their episodic nature, frequently of very short duration, and by their duplication of previous alcohol- or other psychoactive substance-related experiences. |
||||||||
Alcoholic dementia NOS |
||||||||
Excludes: |
alcohol- or psychoactive substance-induced: |
|||||||
.8 |
Other mental and behavioural disorders |
|||||||
.9 |
Unspecified mental and behavioural disorder |
F10 |
Mental and behavioural disorders due to use of alcohol |
|||||||
F11 |
Mental and behavioural disorders due to use of opioids |
|||||||
F12 |
Mental and behavioural disorders due to use of cannabinoids |
|||||||
F13 |
Mental and behavioural disorders due to use of sedatives or hypnotics |
|||||||
F14 |
Mental and behavioural disorders due to use of cocaine |
|||||||
F15 |
Mental and behavioural disorders due to use of other stimulants, including caffeine |
|||||||
F16 |
Mental and behavioural disorders due to use of hallucinogens |
|||||||
F17 |
Mental and behavioural disorders due to use of tobacco |
|||||||
F18 |
Mental and behavioural disorders due to use of volatile solvents |
|||||||
F19 |
Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances |
|||||||
This category should be used when two or more psychoactive substances are known to be involved, but it is impossible to assess which substance is contributing most to the disorders. It should also be used when the exact identity of some or even all the psychoactive substances being used is uncertain or unknown, since many multiple drug users themselves often do not know the details of what they are taking. |
||||||||
Includes: |
misuse of drugs NOS |
Schizophrenia, schizotypal and delusional disorders
(F20-F29)
This block brings together schizophrenia, as the most important member of the group, schizotypal disorder, persistent delusional disorders, and a larger group of acute and transient psychotic disorders. Schizoaffective disorders have been retained here in spite of their controversial nature. |
F20 |
Schizophrenia |
|||||||
The schizophrenic disorders are characterized in general by fundamental and characteristic distortions of thinking and perception, and affects that are inappropriate or blunted. Clear consciousness and intellectual capacity are usually maintained although certain cognitive deficits may evolve in the course of time. The most important psychopathological phenomena include thought echo; thought insertion or withdrawal; thought broadcasting; delusional perception and delusions of control; influence or passivity; hallucinatory voices commenting or discussing the patient in the third person; thought disorders and negative symptoms. The course of schizophrenic disorders can be either continuous, or episodic with progressive or stable deficit, or there can be one or more episodes with complete or incomplete remission. The diagnosis of schizophrenia should not be made in the presence of extensive depressive or manic symptoms unless it is clear that schizophrenic symptoms antedate the affective disturbance. Nor should schizophrenia be diagnosed in the presence of overt brain disease or during states of drug intoxication or withdrawal. Similar disorders developing in the presence of epilepsy or other brain disease should be classified under F06.2, and those induced by psychoactive substances under F10-F19 with common fourth character .5. |
||||||||
Excludes: |
schizophrenia: |
|||||||
F20.0 |
Paranoid schizophrenia |
|||||||
Paranoid schizophrenia is dominated by relatively stable, often paranoid delusions, usually accompanied by hallucinations, particularly of the auditory variety, and perceptual disturbances. Disturbances of affect, volition and speech, and catatonic symptoms, are either absent or relatively inconspicuous. |
||||||||
Paraphrenic schizophrenia |
||||||||
Excludes: |
||||||||
F20.1 |
Hebephrenic schizophrenia |
|||||||
A form of schizophrenia in which affective changes are prominent, delusions and hallucinations fleeting and fragmentary, behaviour irresponsible and unpredictable, and mannerisms common. The mood is shallow and inappropriate, thought is disorganized, and speech is incoherent. There is a tendency to social isolation. Usually the prognosis is poor because of the rapid development of «negative» symptoms, particularly flattening of affect and loss of volition. Hebephrenia should normally be diagnosed only in adolescents or young adults. |
||||||||
Disorganized schizophrenia |
||||||||
F20.2 |
Catatonic schizophrenia |
|||||||
Catatonic schizophrenia is dominated by prominent psychomotor disturbances that may alternate between extremes such as hyperkinesis and stupor, or automatic obedience and negativism. Constrained attitudes and postures may be maintained for long periods. Episodes of violent excitement may be a striking feature of the condition. The catatonic phenomena may be combined with a dream-like (oneiroid) state with vivid scenic hallucinations. |
||||||||
Catatonic stupor |
||||||||
F20.3 |
Undifferentiated schizophrenia |
|||||||
Psychotic conditions meeting the general diagnostic criteria for schizophrenia but not conforming to any of the subtypes in F20.0-F20.2, or exhibiting the features of more than one of them without a clear predominance of a particular set of diagnostic characteristics. |
||||||||
Atypical schizophrenia |
||||||||
Excludes: |
acute schizophrenia-like psychotic disorder ( F23.2 ) |
|||||||
F20.4 |
Post-schizophrenic depression |
|||||||
A depressive episode, which may be prolonged, arising in the aftermath of a schizophrenic illness. Some schizophrenic symptoms, either «positive» or «negative», must still be present but they no longer dominate the clinical picture. These depressive states are associated with an increased risk of suicide. If the patient no longer has any schizophrenic symptoms, a depressive episode should be diagnosed (F32.-). If schizophrenic symptoms are still florid and prominent, the diagnosis should remain that of the appropriate schizophrenic subtype (F20.0-F20.3). |
||||||||
F20.5 |
Residual schizophrenia |
|||||||
A chronic stage in the development of a schizophrenic illness in which there has been a clear progression from an early stage to a later stage characterized by long- term, though not necessarily irreversible, «negative» symptoms, e.g. psychomotor slowing; underactivity; blunting of affect; passivity and lack of initiative; poverty of quantity or content of speech; poor nonverbal communication by facial expression, eye contact, voice modulation and posture; poor self-care and social performance. |
||||||||
Chronic undifferentiated schizophrenia |
||||||||
F20.6 |
Simple schizophrenia |
|||||||
A disorder in which there is an insidious but progressive development of oddities of conduct, inability to meet the demands of society, and decline in total performance. The characteristic negative features of residual schizophrenia (e.g. blunting of affect and loss of volition) develop without being preceded by any overt psychotic symptoms. |
||||||||
F20.8 |
Other schizophrenia |
|||||||
Cenesthopathic schizophrenia |
||||||||
Excludes: |
brief schizophreniform disorders ( F23.2 ) |
|||||||
F20.9 |
Schizophrenia, unspecified |
F21 |
Schizotypal disorder |
|||||||
A disorder characterized by eccentric behaviour and anomalies of thinking and affect which resemble those seen in schizophrenia, though no definite and characteristic schizophrenic anomalies occur at any stage. The symptoms may include a cold or inappropriate affect; anhedonia; odd or eccentric behaviour; a tendency to social withdrawal; paranoid or bizarre ideas not amounting to true delusions; obsessive ruminations; thought disorder and perceptual disturbances; occasional transient quasi-psychotic episodes with intense illusions, auditory or other hallucinations, and delusion-like ideas, usually occurring without external provocation. There is no definite onset and evolution and course are usually those of a personality disorder. |
||||||||
Latent schizophrenic reaction |
||||||||
Excludes: |
Asperger’s syndrome ( F84.5 ) |
F22 |
Persistent delusional disorders |
|||||||
Includes a variety of disorders in which long-standing delusions constitute the only, or the most conspicuous, clinical characteristic and which cannot be classified as organic, schizophrenic or affective. Delusional disorders that have lasted for less than a few months should be classified, at least temporarily, under F23.-. |
||||||||
F22.0 |
Delusional disorder |
|||||||
A disorder characterized by the development either of a single delusion or of a set of related delusions that are usually persistent and sometimes lifelong. The content of the delusion or delusions is very variable. Clear and persistent auditory hallucinations (voices), schizophrenic symptoms such as delusions of control and marked blunting of affect, and definite evidence of brain disease are all incompatible with this diagnosis. However, the presence of occasional or transitory auditory hallucinations, particularly in elderly patients, does not rule out this diagnosis, provided that they are not typically schizophrenic and form only a small part of the overall clinical picture. |
||||||||
Paranoia |
||||||||
Excludes: |
paranoid: |
|||||||
F22.8 |
Other persistent delusional disorders |
|||||||
Disorders in which the delusion or delusions are accompanied by persistent hallucinatory voices or by schizophrenic symptoms that do not justify a diagnosis of schizophrenia (F20.-). |
||||||||
Delusional dysmorphophobia |
||||||||
F22.9 |
Persistent delusional disorder, unspecified |
F23 |
Acute and transient psychotic disorders |
|||||||
A heterogeneous group of disorders characterized by the acute onset of psychotic symptoms such as delusions, hallucinations, and perceptual disturbances, and by the severe disruption of ordinary behaviour. Acute onset is defined as a crescendo development of a clearly abnormal clinical picture in about two weeks or less. For these disorders there is no evidence of organic causation. Perplexity and puzzlement are often present but disorientation for time, place and person is not persistent or severe enough to justify a diagnosis of organically caused delirium (F05.-). Complete recovery usually occurs within a few months, often within a few weeks or even days. If the disorder persists, a change in classification will be necessary. The disorder may or may not be associated with acute stress, defined as usually stressful events preceding the onset by one to two weeks. |
||||||||
F23.0 |
Acute polymorphic psychotic disorder without symptoms of schizophrenia |
|||||||
An acute psychotic disorder in which hallucinations, delusions or perceptual disturbances are obvious but markedly variable, changing from day to day or even from hour to hour. Emotional turmoil with intense transient feelings of happiness or ecstasy, or anxiety and irritability, is also frequently present. The polymorphism and instability are characteristic for the overall clinical picture and the psychotic features do not justify a diagnosis of schizophrenia (F20.-). These disorders often have an abrupt onset, developing rapidly within a few days, and they frequently show a rapid resolution of symptoms with no recurrence. If the symptoms persist the diagnosis should be changed to persistent delusional disorder (F22.-). |
||||||||
Bouffée délirante without symptoms of schizophrenia or unspecified |
||||||||
F23.1 |
Acute polymorphic psychotic disorder with symptoms of schizophrenia |
|||||||
An acute psychotic disorder in which the polymorphic and unstable clinical picture is present, as described in F23.0; despite this instability, however, some symptoms typical of schizophrenia are also in evidence for the majority of the time. If the schizophrenic symptoms persist the diagnosis should be changed to schizophrenia (F20.-). |
||||||||
Bouffée délirante with symptoms of schizophrenia |
||||||||
F23.2 |
Acute schizophrenia-like psychotic disorder |
|||||||
An acute psychotic disorder in which the psychotic symptoms are comparatively stable and justify a diagnosis of schizophrenia, but have lasted for less than about one month; the polymorphic unstable features, as described in F23.0, are absent. If the schizophrenic symptoms persist the diagnosis should be changed to schizophrenia (F20.-). |
||||||||
Acute (undifferentiated) schizophrenia |
||||||||
Excludes: |
organic delusional [schizophrenia-like] disorder ( F06.2 ) |
|||||||
F23.3 |
Other acute predominantly delusional psychotic disorders |
|||||||
Acute psychotic disorders in which comparatively stable delusions or hallucinations are the main clinical features, but do not justify a diagnosis of schizophrenia (F20.-). If the delusions persist the diagnosis should be changed to persistent delusional disorder (F22.-). |
||||||||
Paranoid reaction |
||||||||
F23.8 |
Other acute and transient psychotic disorders |
|||||||
Any other specified acute psychotic disorders for which there is no evidence of organic causation and which do not justify classification to F23.0-F23.3. |
||||||||
F23.9 |
Acute and transient psychotic disorder, unspecified |
|||||||
Brief reactive psychosis NOS |
F24 |
Induced delusional disorder |
|||||||
A delusional disorder shared by two or more people with close emotional links. Only one of the people suffers from a genuine psychotic disorder; the delusions are induced in the other(s) and usually disappear when the people are separated. |
||||||||
Folie à deux |
F25 |
Schizoaffective disorders |
|||||||
Episodic disorders in which both affective and schizophrenic symptoms are prominent but which do not justify a diagnosis of either schizophrenia or depressive or manic episodes. Other conditions in which affective symptoms are superimposed on a pre-existing schizophrenic illness, or co-exist or alternate with persistent delusional disorders of other kinds, are classified under F20-F29. Mood-incongruent psychotic symptoms in affective disorders do not justify a diagnosis of schizoaffective disorder. |
||||||||
F25.0 |
Schizoaffective disorder, manic type |
|||||||
A disorder in which both schizophrenic and manic symptoms are prominent so that the episode of illness does not justify a diagnosis of either schizophrenia or a manic episode. This category should be used for both a single episode and a recurrent disorder in which the majority of episodes are schizoaffective, manic type. |
||||||||
Schizoaffective psychosis, manic type |
||||||||
F25.1 |
Schizoaffective disorder, depressive type |
|||||||
A disorder in which both schizophrenic and depressive symptoms are prominent so that the episode of illness does not justify a diagnosis of either schizophrenia or a depressive episode. This category should be used for both a single episode and a recurrent disorder in which the majority of episodes are schizoaffective, depressive type. |
||||||||
Schizoaffective psychosis, depressive type |
||||||||
F25.2 |
Schizoaffective disorder, mixed type |
|||||||
Cyclic schizophrenia |
||||||||
F25.8 |
Other schizoaffective disorders |
|||||||
F25.9 |
Schizoaffective disorder, unspecified |
|||||||
Schizoaffective psychosis NOS |
F28 |
Other nonorganic psychotic disorders |
|||||||
Delusional or hallucinatory disorders that do not justify a diagnosis of schizophrenia (F20.-), persistent delusional disorders (F22.-), acute and transient psychotic disorders (F23.-), psychotic types of manic episode (F30.2), or severe depressive episode (F32.3). |
||||||||
Chronic hallucinatory psychosis |
F29 |
Unspecified nonorganic psychosis |
|||||||
Psychosis NOS |
||||||||
Excludes: |
mental disorder NOS ( F99 ) |
Mood [affective] disorders
(F30-F39)
This block contains disorders in which the fundamental disturbance is a change in affect or mood to depression (with or without associated anxiety) or to elation. The mood change is usually accompanied by a change in the overall level of activity; most of the other symptoms are either secondary to, or easily understood in the context of, the change in mood and activity. Most of these disorders tend to be recurrent and the onset of individual episodes can often be related to stressful events or situations. |
F30 |
Manic episode |
|||||||
All the subdivisions of this category should be used only for a single episode. Hypomanic or manic episodes in individuals who have had one or more previous affective episodes (depressive, hypomanic, manic, or mixed) should be coded as bipolar affective disorder (F31.-). |
||||||||
Includes: |
bipolar disorder, single manic episode |
|||||||
F30.0 |
Hypomania |
|||||||
A disorder characterized by a persistent mild elevation of mood, increased energy and activity, and usually marked feelings of well-being and both physical and mental efficiency. Increased sociability, talkativeness, over-familiarity, increased sexual energy, and a decreased need for sleep are often present but not to the extent that they lead to severe disruption of work or result in social rejection. Irritability, conceit, and boorish behaviour may take the place of the more usual euphoric sociability. The disturbances of mood and behaviour are not accompanied by hallucinations or delusions. |
||||||||
F30.1 |
Mania without psychotic symptoms |
|||||||
Mood is elevated out of keeping with the patient’s circumstances and may vary from carefree joviality to almost uncontrollable excitement. Elation is accompanied by increased energy, resulting in overactivity, pressure of speech, and a decreased need for sleep. Attention cannot be sustained, and there is often marked distractibility. Self-esteem is often inflated with grandiose ideas and overconfidence. Loss of normal social inhibitions may result in behaviour that is reckless, foolhardy, or inappropriate to the circumstances, and out of character. |
||||||||
F30.2 |
Mania with psychotic symptoms |
|||||||
In addition to the clinical picture described in F30.1, delusions (usually grandiose) or hallucinations (usually of voices speaking directly to the patient) are present, or the excitement, excessive motor activity, and flight of ideas are so extreme that the subject is incomprehensible or inaccessible to ordinary communication. |
||||||||
Mania with: |
||||||||
F30.8 |
Other manic episodes |
|||||||
F30.9 |
Manic episode, unspecified |
|||||||
Mania NOS |
F31 |
Bipolar affective disorder |
|||||||
A disorder characterized by two or more episodes in which the patient’s mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (hypomania or mania) and on others of a lowering of mood and decreased energy and activity (depression). Repeated episodes of hypomania or mania only are classified as bipolar. |
||||||||
Includes: |
manic-depressive: |
|||||||
Excludes: |
bipolar disorder, single manic episode ( F30.- ) |
|||||||
F31.0 |
Bipolar affective disorder, current episode hypomanic |
|||||||
The patient is currently hypomanic, and has had at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past. |
||||||||
F31.1 |
Bipolar affective disorder, current episode manic without psychotic symptoms |
|||||||
The patient is currently manic, without psychotic symptoms (as in F30.1), and has had at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past. |
||||||||
F31.2 |
Bipolar affective disorder, current episode manic with psychotic symptoms |
|||||||
The patient is currently manic, with psychotic symptoms (as in F30.2), and has had at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past. |
||||||||
F31.3 |
Bipolar affective disorder, current episode mild or moderate depression |
|||||||
The patient is currently depressed, as in a depressive episode of either mild or moderate severity (F32.0 or F32.1), and has had at least one authenticated hypomanic, manic, or mixed affective episode in the past. |
||||||||
F31.4 |
Bipolar affective disorder, current episode severe depression without psychotic symptoms |
|||||||
The patient is currently depressed, as in severe depressive episode without psychotic symptoms (F32.2), and has had at least one authenticated hypomanic, manic, or mixed affective episode in the past. |
||||||||
F31.5 |
Bipolar affective disorder, current episode severe depression with psychotic symptoms |
|||||||
The patient is currently depressed, as in severe depressive episode with psychotic symptoms (F32.3), and has had at least one authenticated hypomanic, manic, or mixed affective episode in the past. |
||||||||
F31.6 |
Bipolar affective disorder, current episode mixed |
|||||||
The patient has had at least one authenticated hypomanic, manic, depressive, or mixed affective episode in the past, and currently exhibits either a mixture or a rapid alteration of manic and depressive symptoms. |
||||||||
Excludes: |
single mixed affective episode ( F38.0 ) |
|||||||
F31.7 |
Bipolar affective disorder, currently in remission |
|||||||
The patient has had at least one authenticated hypomanic, manic, or mixed affective episode in the past, and at least one other affective episode (hypomanic, manic, depressive, or mixed) in addition, but is not currently suffering from any significant mood disturbance, and has not done so for several months. Periods of remission during prophylactic treatment should be coded here. |
||||||||
F31.8 |
Other bipolar affective disorders |
|||||||
Bipolar II disorder |
||||||||
F31.9 |
Bipolar affective disorder, unspecified |
F32 |
Depressive episode |
|||||||
In typical mild, moderate, or severe depressive episodes, the patient suffers from lowering of mood, reduction of energy, and decrease in activity. Capacity for enjoyment, interest, and concentration is reduced, and marked tiredness after even minimum effort is common. Sleep is usually disturbed and appetite diminished. Self-esteem and self-confidence are almost always reduced and, even in the mild form, some ideas of guilt or worthlessness are often present. The lowered mood varies little from day to day, is unresponsive to circumstances and may be accompanied by so-called «somatic» symptoms, such as loss of interest and pleasurable feelings, waking in the morning several hours before the usual time, depression worst in the morning, marked psychomotor retardation, agitation, loss of appetite, weight loss, and loss of libido. Depending upon the number and severity of the symptoms, a depressive episode may be specified as mild, moderate or severe. |
||||||||
Includes: |
single episodes of: |
|||||||
Excludes: |
adjustment disorder ( F43.2 ) |
|||||||
F32.0 |
Mild depressive episode |
|||||||
Two or three of the above symptoms are usually present. The patient is usually distressed by these but will probably be able to continue with most activities. |
||||||||
F32.1 |
Moderate depressive episode |
|||||||
Four or more of the above symptoms are usually present and the patient is likely to have great difficulty in continuing with ordinary activities. |
||||||||
F32.2 |
Severe depressive episode without psychotic symptoms |
|||||||
An episode of depression in which several of the above symptoms are marked and distressing, typically loss of self-esteem and ideas of worthlessness or guilt. Suicidal thoughts and acts are common and a number of «somatic» symptoms are usually present. |
||||||||
Agitated depression |
} |
single episode without psychotic symptoms |
||||||
F32.3 |
Severe depressive episode with psychotic symptoms |
|||||||
An episode of depression as described in F32.2, but with the presence of hallucinations, delusions, psychomotor retardation, or stupor so severe that ordinary social activities are impossible; there may be danger to life from suicide, dehydration, or starvation. The hallucinations and delusions may or may not be mood-congruent. |
||||||||
Single episodes of: |
||||||||
F32.8 |
Other depressive episodes |
|||||||
Atypical depression |
||||||||
F32.9 |
Depressive episode, unspecified |
|||||||
Depression NOS |
F33 |
Recurrent depressive disorder |
|||||||
A disorder characterized by repeated episodes of depression as described for depressive episode (F32.-), without any history of independent episodes of mood elevation and increased energy (mania). There may, however, be brief episodes of mild mood elevation and overactivity (hypomania) immediately after a depressive episode, sometimes precipitated by antidepressant treatment. The more severe forms of recurrent depressive disorder (F33.2 and F33.3) have much in common with earlier concepts such as manic-depressive depression, melancholia, vital depression and endogenous depression. The first episode may occur at any age from childhood to old age, the onset may be either acute or insidious, and the duration varies from a few weeks to many months. The risk that a patient with recurrent depressive disorder will have an episode of mania never disappears completely, however many depressive episodes have been experienced. If such an episode does occur, the diagnosis should be changed to bipolar affective disorder (F31.-). |
||||||||
Includes: |
recurrent episodes of: |
|||||||
Excludes: |
recurrent brief depressive episodes ( F38.1 ) |
|||||||
F33.0 |
Recurrent depressive disorder, current episode mild |
|||||||
A disorder characterized by repeated episodes of depression, the current episode being mild, as in F32.0, and without any history of mania. |
||||||||
F33.1 |
Recurrent depressive disorder, current episode moderate |
|||||||
A disorder characterized by repeated episodes of depression, the current episode being of moderate severity, as in F32.1, and without any history of mania. |
||||||||
F33.2 |
Recurrent depressive disorder, current episode severe without psychotic symptoms |
|||||||
A disorder characterized by repeated episodes of depression, the current episode being severe without psychotic symptoms, as in F32.2, and without any history of mania. |
||||||||
Endogenous depression without psychotic symptoms |
||||||||
F33.3 |
Recurrent depressive disorder, current episode severe with psychotic symptoms |
|||||||
A disorder characterized by repeated episodes of depression, the current episode being severe with psychotic symptoms, as in F32.3, and with no previous episodes of mania. |
||||||||
Endogenous depression with psychotic symptoms |
||||||||
F33.4 |
Recurrent depressive disorder, currently in remission |
|||||||
The patient has had two or more depressive episodes as described in F33.0-F33.3, in the past, but has been free from depressive symptoms for several months. |
||||||||
F33.8 |
Other recurrent depressive disorders |
|||||||
F33.9 |
Recurrent depressive disorder, unspecified |
|||||||
Monopolar depression NOS |
F34 |
Persistent mood [affective] disorders |
|||||||
Persistent and usually fluctuating disorders of mood in which the majority of the individual episodes are not sufficiently severe to warrant being described as hypomanic or mild depressive episodes. Because they last for many years, and sometimes for the greater part of the patient’s adult life, they involve considerable distress and disability. In some instances, recurrent or single manic or depressive episodes may become superimposed on a persistent affective disorder. |
||||||||
F34.0 |
Cyclothymia |
|||||||
A persistent instability of mood involving numerous periods of depression and mild elation, none of which is sufficiently severe or prolonged to justify a diagnosis of bipolar affective disorder (F31.-) or recurrent depressive disorder (F33.-). This disorder is frequently found in the relatives of patients with bipolar affective disorder. Some patients with cyclothymia eventually develop bipolar affective disorder. |
||||||||
Affective personality disorder |
||||||||
F34.1 |
Dysthymia |
|||||||
A chronic depression of mood, lasting at least several years, which is not sufficiently severe, or in which individual episodes are not sufficiently prolonged, to justify a diagnosis of severe, moderate, or mild recurrent depressive disorder (F33.-). |
||||||||
Depressive: |
||||||||
Excludes: |
anxiety depression (mild or not persistent) ( F41.2 ) |
|||||||
F34.8 |
Other persistent mood [affective] disorders |
|||||||
F34.9 |
Persistent mood [affective] disorder, unspecified |
F38 |
Other mood [affective] disorders |
|||||||
Any other mood disorders that do not justify classification to F30-F34, because they are not of sufficient severity or duration. |
||||||||
F38.0 |
Other single mood [affective] disorders |
|||||||
Mixed affective episode |
||||||||
F38.1 |
Other recurrent mood [affective] disorders |
|||||||
Recurrent brief depressive episodes |
||||||||
F38.8 |
Other specified mood [affective] disorders |
F39 |
Unspecified mood [affective] disorder |
|||||||
Affective psychosis NOS |
Neurotic, stress-related and somatoform disorders
(F40-F48)
Excludes: |
when associated with conduct disorder in F91.- ( F92.8 ) |
F40 |
Phobic anxiety disorders |
|||||||
A group of disorders in which anxiety is evoked only, or predominantly, in certain well-defined situations that are not currently dangerous. As a result these situations are characteristically avoided or endured with dread. The patient’s concern may be focused on individual symptoms like palpitations or feeling faint and is often associated with secondary fears of dying, losing control, or going mad. Contemplating entry to the phobic situation usually generates anticipatory anxiety. Phobic anxiety and depression often coexist. Whether two diagnoses, phobic anxiety and depressive episode, are needed, or only one, is determined by the time course of the two conditions and by therapeutic considerations at the time of consultation. |
||||||||
F40.0 |
Agoraphobia |
|||||||
A fairly well-defined cluster of phobias embracing fears of leaving home, entering shops, crowds and public places, or travelling alone in trains, buses or planes. Panic disorder is a frequent feature of both present and past episodes. Depressive and obsessional symptoms and social phobias are also commonly present as subsidiary features. Avoidance of the phobic situation is often prominent, and some agoraphobics experience little anxiety because they are able to avoid their phobic situations. |
||||||||
Agoraphobia without history of panic disorder |
||||||||
F40.1 |
Social phobias |
|||||||
Fear of scrutiny by other people leading to avoidance of social situations. More pervasive social phobias are usually associated with low self-esteem and fear of criticism. They may present as a complaint of blushing, hand tremor, nausea, or urgency of micturition, the patient sometimes being convinced that one of these secondary manifestations of their anxiety is the primary problem. Symptoms may progress to panic attacks. |
||||||||
Anthropophobia |
||||||||
F40.2 |
Specific (isolated) phobias |
|||||||
Phobias restricted to highly specific situations such as proximity to particular animals, heights, thunder, darkness, flying, closed spaces, urinating or defecating in public toilets, eating certain foods, dentistry, or the sight of blood or injury. Though the triggering situation is discrete, contact with it can evoke panic as in agoraphobia or social phobia. |
||||||||
Acrophobia |
||||||||
Excludes: |
dysmorphophobia (nondelusional) ( F45.2 ) |
|||||||
F40.8 |
Other phobic anxiety disorders |
|||||||
F40.9 |
Phobic anxiety disorder, unspecified |
|||||||
Phobia NOS |
F41 |
Other anxiety disorders |
|||||||
Disorders in which manifestation of anxiety is the major symptom and is not restricted to any particular environmental situation. Depressive and obsessional symptoms, and even some elements of phobic anxiety, may also be present, provided that they are clearly secondary or less severe. |
||||||||
F41.0 |
Panic disorder [episodic paroxysmal anxiety] |
|||||||
The essential feature is recurrent attacks of severe anxiety (panic), which are not restricted to any particular situation or set of circumstances and are therefore unpredictable. As with other anxiety disorders, the dominant symptoms include sudden onset of palpitations, chest pain, choking sensations, dizziness, and feelings of unreality (depersonalization or derealization). There is often also a secondary fear of dying, losing control, or going mad. Panic disorder should not be given as the main diagnosis if the patient has a depressive disorder at the time the attacks start; in these circumstances the panic attacks are probably secondary to depression. |
||||||||
Panic: |
||||||||
Excludes: |
panic disorder with agoraphobia ( F40.0 ) |
|||||||
F41.1 |
Generalized anxiety disorder |
|||||||
Anxiety that is generalized and persistent but not restricted to, or even strongly predominating in, any particular environmental circumstances (i.e. it is «free-floating»). The dominant symptoms are variable but include complaints of persistent nervousness, trembling, muscular tensions, sweating, lightheadedness, palpitations, dizziness, and epigastric discomfort. Fears that the patient or a relative will shortly become ill or have an accident are often expressed. |
||||||||
Anxiety: |
||||||||
Excludes: |
neurasthenia ( F48.0 ) |
|||||||
F41.2 |
Mixed anxiety and depressive disorder |
|||||||
This category should be used when symptoms of anxiety and depression are both present, but neither is clearly predominant, and neither type of symptom is present to the extent that justifies a diagnosis if considered separately. When both anxiety and depressive symptoms are present and severe enough to justify individual diagnoses, both diagnoses should be recorded and this category should not be used. |
||||||||
Anxiety depression (mild or not persistent) |
||||||||
F41.3 |
Other mixed anxiety disorders |
|||||||
Symptoms of anxiety mixed with features of other disorders in F42-F48. Neither type of symptom is severe enough to justify a diagnosis if considered separately. |
||||||||
F41.8 |
Other specified anxiety disorders |
|||||||
Anxiety hysteria |
||||||||
F41.9 |
Anxiety disorder, unspecified |
|||||||
Anxiety NOS |
F42 |
Obsessive-compulsive disorder |
|||||||
The essential feature is recurrent obsessional thoughts or compulsive acts. Obsessional thoughts are ideas, images, or impulses that enter the patient’s mind again and again in a stereotyped form. They are almost invariably distressing and the patient often tries, unsuccessfully, to resist them. They are, however, recognized as his or her own thoughts, even though they are involuntary and often repugnant. Compulsive acts or rituals are stereotyped behaviours that are repeated again and again. They are not inherently enjoyable, nor do they result in the completion of inherently useful tasks. Their function is to prevent some objectively unlikely event, often involving harm to or caused by the patient, which he or she fears might otherwise occur. Usually, this behaviour is recognized by the patient as pointless or ineffectual and repeated attempts are made to resist. Anxiety is almost invariably present. If compulsive acts are resisted the anxiety gets worse. |
||||||||
Includes: |
anankastic neurosis |
|||||||
Excludes: |
obsessive-compulsive personality (disorder) ( F60.5 ) |
|||||||
F42.0 |
Predominantly obsessional thoughts or ruminations |
|||||||
These may take the form of ideas, mental images, or impulses to act, which are nearly always distressing to the subject. Sometimes the ideas are an indecisive, endless consideration of alternatives, associated with an inability to make trivial but necessary decisions in day-to-day living. The relationship between obsessional ruminations and depression is particularly close and a diagnosis of obsessive-compulsive disorder should be preferred only if ruminations arise or persist in the absence of a depressive episode. |
||||||||
F42.1 |
Predominantly compulsive acts [obsessional rituals] |
|||||||
The majority of compulsive acts are concerned with cleaning (particularly handwashing), repeated checking to ensure that a potentially dangerous situation has not been allowed to develop, or orderliness and tidiness. Underlying the overt behaviour is a fear, usually of danger either to or caused by the patient, and the ritual is an ineffectual or symbolic attempt to avert that danger. |
||||||||
F42.2 |
Mixed obsessional thoughts and acts |
|||||||
F42.8 |
Other obsessive-compulsive disorders |
|||||||
F42.9 |
Obsessive-compulsive disorder, unspecified |
F43 |
Reaction to severe stress, and adjustment disorders |
|||||||
This category differs from others in that it includes disorders identifiable on the basis of not only symptoms and course but also the existence of one or other of two causative influences: an exceptionally stressful life event producing an acute stress reaction, or a significant life change leading to continued unpleasant circumstances that result in an adjustment disorder. Although less severe psychosocial stress («life events») may precipitate the onset or contribute to the presentation of a very wide range of disorders classified elsewhere in this chapter, its etiological importance is not always clear and in each case will be found to depend on individual, often idiosyncratic, vulnerability, i.e. the life events are neither necessary nor sufficient to explain the occurrence and form of the disorder. In contrast, the disorders brought together here are thought to arise always as a direct consequence of acute severe stress or continued trauma. The stressful events or the continuing unpleasant circumstances are the primary and overriding causal factor and the disorder would not have occurred without their impact. The disorders in this section can thus be regarded as maladaptive responses to severe or continued stress, in that they interfere with successful coping mechanisms and therefore lead to problems of social functioning. |
||||||||
F43.0 |
Acute stress reaction |
|||||||
A transient disorder that develops in an individual without any other apparent mental disorder in response to exceptional physical and mental stress and that usually subsides within hours or days. Individual vulnerability and coping capacity play a role in the occurrence and severity of acute stress reactions. The symptoms show a typically mixed and changing picture and include an initial state of «daze» with some constriction of the field of consciousness and narrowing of attention, inability to comprehend stimuli, and disorientation. This state may be followed either by further withdrawal from the surrounding situation (to the extent of a dissociative stupor — F44.2), or by agitation and over-activity (flight reaction or fugue). Autonomic signs of panic anxiety (tachycardia, sweating, flushing) are commonly present. The symptoms usually appear within minutes of the impact of the stressful stimulus or event, and disappear within two to three days (often within hours). Partial or complete amnesia (F44.0) for the episode may be present. If the symptoms persist, a change in diagnosis should be considered. |
||||||||
Acute: |
||||||||
F43.1 |
Post-traumatic stress disorder |
|||||||
Arises as a delayed or protracted response to a stressful event or situation (of either brief or long duration) of an exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone. Predisposing factors, such as personality traits (e.g. compulsive, asthenic) or previous history of neurotic illness, may lower the threshold for the development of the syndrome or aggravate its course, but they are neither necessary nor sufficient to explain its occurrence. Typical features include episodes of repeated reliving of the trauma in intrusive memories («flashbacks»), dreams or nightmares, occurring against the persisting background of a sense of «numbness» and emotional blunting, detachment from other people, unresponsiveness to surroundings, anhedonia, and avoidance of activities and situations reminiscent of the trauma. There is usually a state of autonomic hyperarousal with hypervigilance, an enhanced startle reaction, and insomnia. Anxiety and depression are commonly associated with the above symptoms and signs, and suicidal ideation is not infrequent. The onset follows the trauma with a latency period that may range from a few weeks to months. The course is fluctuating but recovery can be expected in the majority of cases. In a small proportion of cases the condition may follow a chronic course over many years, with eventual transition to an enduring personality change (F62.0). |
||||||||
Traumatic neurosis |
||||||||
F43.2 |
Adjustment disorders |
|||||||
States of subjective distress and emotional disturbance, usually interfering with social functioning and performance, arising in the period of adaptation to a significant life change or a stressful life event. The stressor may have affected the integrity of an individual’s social network (bereavement, separation experiences) or the wider system of social supports and values (migration, refugee status), or represented a major developmental transition or crisis (going to school, becoming a parent, failure to attain a cherished personal goal, retirement). Individual predisposition or vulnerability plays an important role in the risk of occurrence and the shaping of the manifestations of adjustment disorders, but it is nevertheless assumed that the condition would not have arisen without the stressor. The manifestations vary and include depressed mood, anxiety or worry (or mixture of these), a feeling of inability to cope, plan ahead, or continue in the present situation, as well as some degree of disability in 9the performance of daily routine. Conduct disorders may be an associated feature, particularly in adolescents. The predominant feature may be a brief or prolonged depressive reaction, or a disturbance of other emotions and conduct. |
||||||||
Culture shock |
||||||||
Excludes: |
separation anxiety disorder of childhood ( F93.0 ) |
|||||||
F43.8 |
Other reactions to severe stress |
|||||||
F43.9 |
Reaction to severe stress, unspecified |
F44 |
Dissociative [conversion] disorders |
|||||||
The common themes that are shared by dissociative or conversion disorders are a partial or complete loss of the normal integration between memories of the past, awareness of identity and immediate sensations, and control of bodily movements. All types of dissociative disorders tend to remit after a few weeks or months, particularly if their onset is associated with a traumatic life event. More chronic disorders, particularly paralyses and anaesthesias, may develop if the onset is associated with insoluble problems or interpersonal difficulties. These disorders have previously been classified as various types of «conversion hysteria». They are presumed to be psychogenic in origin, being associated closely in time with traumatic events, insoluble and intolerable problems, or disturbed relationships. The symptoms often represent the patient’s concept of how a physical illness would be manifest. Medical examination and investigation do not reveal the presence of any known physical or neurological disorder. In addition, there is evidence that the loss of function is an expression of emotional conflicts or needs. The symptoms may develop in close relationship to psychological stress, and often appear suddenly. Only disorders of physical functions normally under voluntary control and loss of sensations are included here. Disorders involving pain and other complex physical sensations mediated by the autonomic nervous system are classified under somatization disorder (F45.0). The possibility of the later appearance of serious physical or psychiatric disorders should always be kept in mind. |
||||||||
Includes: |
conversion: |
|||||||
Excludes: |
malingering [conscious simulation] ( Z76.5 ) |
|||||||
F44.0 |
Dissociative amnesia |
|||||||
The main feature is loss of memory, usually of important recent events, that is not due to organic mental disorder, and is too great to be explained by ordinary forgetfulness or fatigue. The amnesia is usually centred on traumatic events, such as accidents or unexpected bereavements, and is usually partial and selective. Complete and generalized amnesia is rare, and is usually part of a fugue (F44.1). If this is the case, the disorder should be classified as such. The diagnosis should not be made in the presence of organic brain disorders, intoxication, or excessive fatigue. |
||||||||
Excludes: |
alcohol- or other psychoactive substance-induced amnesic disorder ( F10-F19 with common fourth character .6) |
|||||||
F44.1 |
Dissociative fugue |
|||||||
Dissociative fugue has all the features of dissociative amnesia, plus purposeful travel beyond the usual everyday range. Although there is amnesia for the period of the fugue, the patient’s behaviour during this time may appear completely normal to independent observers. |
||||||||
Excludes: |
postictal fugue in epilepsy ( G40.- ) |
|||||||
F44.2 |
Dissociative stupor |
|||||||
Dissociative stupor is diagnosed on the basis of a profound diminution or absence of voluntary movement and normal responsiveness to external stimuli such as light, noise, and touch, but examination and investigation reveal no evidence of a physical cause. In addition, there is positive evidence of psychogenic causation in the form of recent stressful events or problems. |
||||||||
Excludes: |
organic catatonic disorder ( F06.1 ) |
|||||||
F44.3 |
Trance and possession disorders |
|||||||
Disorders in which there is a temporary loss of the sense of personal identity and full awareness of the surroundings. Include here only trance states that are involuntary or unwanted, occurring outside religious or culturally accepted situations. |
||||||||
Excludes: |
states associated with: |
|||||||
F44.4 |
Dissociative motor disorders |
|||||||
In the commonest varieties there is loss of ability to move the whole or a part of a limb or limbs. There may be close resemblance to almost any variety of ataxia, apraxia, akinesia, aphonia, dysarthria, dyskinesia, seizures, or paralysis. |
||||||||
Psychogenic: |
||||||||
F44.5 |
Dissociative convulsions |
|||||||
Dissociative convulsions may mimic epileptic seizures very closely in terms of movements, but tongue-biting, bruising due to falling, and incontinence of urine are rare, and consciousness is maintained or replaced by a state of stupor or trance. |
||||||||
F44.6 |
Dissociative anaesthesia and sensory loss |
|||||||
Anaesthetic areas of skin often have boundaries that make it clear that they are associated with the patient’s ideas about bodily functions, rather than medical knowledge. There may be differential loss between the sensory modalities which cannot be due to a neurological lesion. Sensory loss may be accompanied by complaints of paraesthesia. Loss of vision and hearing are rarely total in dissociative disorders. |
||||||||
Psychogenic deafness |
||||||||
F44.7 |
Mixed dissociative [conversion] disorders |
|||||||
Combination of disorders specified in F44.0-F44.6 |
||||||||
F44.8 |
Other dissociative [conversion] disorders |
|||||||
Ganser’s syndrome |
||||||||
F44.9 |
Dissociative [conversion] disorder, unspecified |
F45 |
Somatoform disorders |
|||||||
The main feature is repeated presentation of physical symptoms together with persistent requests for medical investigations, in spite of repeated negative findings and reassurances by doctors that the symptoms have no physical basis. If any physical disorders are present, they do not explain the nature and extent of the symptoms or the distress and preoccupation of the patient. |
||||||||
Excludes: |
dissociative disorders ( F44.- ) |
|||||||
F45.0 |
Somatization disorder |
|||||||
The main features are multiple, recurrent and frequently changing physical symptoms of at least two years’ duration. Most patients have a long and complicated history of contact with both primary and specialist medical care services, during which many negative investigations or fruitless exploratory operations may have been carried out. Symptoms may be referred to any part or system of the body. The course of the disorder is chronic and fluctuating, and is often associated with disruption of social, interpersonal, and family behaviour. Short-lived (less than two years) and less striking symptom patterns should be classified under undifferentiated somatoform disorder (F45.1). |
||||||||
Briquet’s disorder |
||||||||
Excludes: |
malingering [conscious simulation] ( Z76.5 ) |
|||||||
F45.1 |
Undifferentiated somatoform disorder |
|||||||
When somatoform complaints are multiple, varying and persistent, but the complete and typical clinical picture of somatization disorder is not fulfilled, the diagnosis of undifferentiated somatoform disorder should be considered. |
||||||||
Undifferentiated psychosomatic disorder |
||||||||
F45.2 |
Hypochondriacal disorder |
|||||||
The essential feature is a persistent preoccupation with the possibility of having one or more serious and progressive physical disorders. Patients manifest persistent somatic complaints or a persistent preoccupation with their physical appearance. Normal or commonplace sensations and appearances are often interpreted by patients as abnormal and distressing, and attention is usually focused upon only one or two organs or systems of the body. Marked depression and anxiety are often present, and may justify additional diagnoses. |
||||||||
Body dysmorphic disorder |
||||||||
Excludes: |
delusional dysmorphophobia ( F22.8 ) |
|||||||
F45.3 |
Somatoform autonomic dysfunction |
|||||||
Symptoms are presented by the patient as if they were due to a physical disorder of a system or organ that is largely or completely under autonomic innervation and control, i.e. the cardiovascular, gastrointestinal, respiratory and urogenital systems. The symptoms are usually of two types, neither of which indicates a physical disorder of the organ or system concerned. First, there are complaints based upon objective signs of autonomic arousal, such as palpitations, sweating, flushing, tremor, and expression of fear and distress about the possibility of a physical disorder. Second, there are subjective complaints of a nonspecific or changing nature such as fleeting aches and pains, sensations of burning, heaviness, tightness, and feelings of being bloated or distended, which are referred by the patient to a specific organ or system. |
||||||||
Cardiac neurosis |
||||||||
Excludes: |
psychological and behavioural factors associated with disorders or diseases classified elsewhere ( F54 ) |
|||||||
F45.4 |
Persistent somatoform pain disorder |
|||||||
The predominant complaint is of persistent, severe, and distressing pain, which cannot be explained fully by a physiological process or a physical disorder, and which occurs in association with emotional conflict or psychosocial problems that are sufficient to allow the conclusion that they are the main causative influences. The result is usually a marked increase in support and attention, either personal or medical. Pain presumed to be of psychogenic origin occurring during the course of depressive disorders or schizophrenia should not be included here. |
||||||||
Psychalgia |
||||||||
Excludes: |
backache NOS ( M54.9 ) |
|||||||
F45.8 |
Other somatoform disorders |
|||||||
Any other disorders of sensation, function and behaviour, not due to physical disorders, which are not mediated through the autonomic nervous system, which are limited to specific systems or parts of the body, and which are closely associated in time with stressful events or problems. |
||||||||
Psychogenic: |
||||||||
F45.9 |
Somatoform disorder, unspecified |
|||||||
Psychosomatic disorder NOS |
F48 |
Other neurotic disorders |
|||||||
F48.0 |
Neurasthenia |
|||||||
Considerable cultural variations occur in the presentation of this disorder, and two main types occur, with substantial overlap. In one type, the main feature is a complaint of increased fatigue after mental effort, often associated with some decrease in occupational performance or coping efficiency in daily tasks. The mental fatiguability is typically described as an unpleasant intrusion of distracting associations or recollections, difficulty in concentrating, and generally inefficient thinking. In the other type, the emphasis is on feelings of bodily or physical weakness and exhaustion after only minimal effort, accompanied by a feeling of muscular aches and pains and inability to relax. In both types a variety of other unpleasant physical feelings is common, such as dizziness, tension headaches, and feelings of general instability. Worry about decreasing mental and bodily well-being, irritability, anhedonia, and varying minor degrees of both depression and anxiety are all common. Sleep is often disturbed in its initial and middle phases but hypersomnia may also be prominent. |
||||||||
Fatigue syndrome |
||||||||
Use additional code, if desired, to identify previous physical illness. |
||||||||
Excludes: |
asthenia NOS ( R53 ) |
|||||||
F48.1 |
Depersonalization-derealization syndrome |
|||||||
A rare disorder in which the patient complains spontaneously that his or her mental activity, body, and surroundings are changed in their quality, so as to be unreal, remote, or automatized. Among the varied phenomena of the syndrome, patients complain most frequently of loss of emotions and feelings of estrangement or detachment from their thinking, their body, or the real world. In spite of the dramatic nature of the experience, the patient is aware of the unreality of the change. The sensorium is normal and the capacity for emotional expression intact. Depersonalization-derealization symptoms may occur as part of a diagnosable schizophrenic, depressive, phobic, or obsessive-compulsive disorder. In such cases the diagnosis should be that of the main disorder. |
||||||||
F48.8 |
Other specified neurotic disorders |
|||||||
Dhat syndrome |
||||||||
F48.9 |
Neurotic disorder, unspecified |
|||||||
Neurosis NOS |
Behavioural syndromes associated with physiological disturbances and physical factors
(F50-F59)
F50 |
Eating disorders |
|||||||
Excludes: |
anorexia NOS ( R63.0 ) |
|||||||
F50.0 |
Anorexia nervosa |
|||||||
A disorder characterized by deliberate weight loss, induced and sustained by the patient. It occurs most commonly in adolescent girls and young women, but adolescent boys and young men may also be affected, as may children approaching puberty and older women up to the menopause. The disorder is associated with a specific psychopathology whereby a dread of fatness and flabbiness of body contour persists as an intrusive overvalued idea, and the patients impose a low weight threshold on themselves. There is usually undernutrition of varying severity with secondary endocrine and metabolic changes and disturbances of bodily function. The symptoms include restricted dietary choice, excessive exercise, induced vomiting and purgation, and use of appetite suppressants and diuretics. |
||||||||
Excludes: |
||||||||
F50.1 |
Atypical anorexia nervosa |
|||||||
Disorders that fulfil some of the features of anorexia nervosa but in which the overall clinical picture does not justify that diagnosis. For instance, one of the key symptoms, such as amenorrhoea or marked dread of being fat, may be absent in the presence of marked weight loss and weight-reducing behaviour. This diagnosis should not be made in the presence of known physical disorders associated with weight loss. |
||||||||
F50.2 |
Bulimia nervosa |
|||||||
A syndrome characterized by repeated bouts of overeating and an excessive preoccupation with the control of body weight, leading to a pattern of overeating followed by vomiting or use of purgatives. This disorder shares many psychological features with anorexia nervosa, including an overconcern with body shape and weight. Repeated vomiting is likely to give rise to disturbances of body electrolytes and physical complications. There is often, but not always, a history of an earlier episode of anorexia nervosa, the interval ranging from a few months to several years. |
||||||||
Bulimia NOS |
||||||||
F50.3 |
Atypical bulimia nervosa |
|||||||
Disorders that fulfil some of the features of bulimia nervosa, but in which the overall clinical picture does not justify that diagnosis. For instance, there may be recurrent bouts of overeating and overuse of purgatives without significant weight change, or the typical overconcern about body shape and weight may be absent. |
||||||||
F50.4 |
Overeating associated with other psychological disturbances |
|||||||
Overeating due to stressful events, such as bereavement, accident, childbirth, etc. |
||||||||
Psychogenic overeating |
||||||||
Excludes: |
obesity ( E66.- ) |
|||||||
F50.5 |
Vomiting associated with other psychological disturbances |
|||||||
Repeated vomiting that occurs in dissociative disorders (F44.-) and hypochondriacal disorder (F45.2), and that is not solely due to conditions classified outside this chapter. This subcategory may also be used in addition to O21.- (excessive vomiting in pregnancy) when emotional factors are predominant in the causation of recurrent nausea and vomiting in pregnancy. |
||||||||
Psychogenic vomiting |
||||||||
Excludes: |
||||||||
F50.8 |
Other eating disorders |
|||||||
Pica in adults |
||||||||
Excludes: |
pica of infancy and childhood ( F98.3 ) |
|||||||
F50.9 |
Eating disorder, unspecified |
F51 |
Nonorganic sleep disorders |
|||||||
In many cases, a disturbance of sleep is one of the symptoms of another disorder, either mental or physical. Whether a sleep disorder in a given patient is an independent condition or simply one of the features of another disorder classified elsewhere, either in this chapter or in others, should be determined on the basis of its clinical presentation and course as well as on the therapeutic considerations and priorities at the time of the consultation. Generally, if the sleep disorder is one of the major complaints and is perceived as a condition in itself, the present code should be used along with other pertinent diagnoses describing the psychopathology and pathophysiology involved in a given case. This category includes only those sleep disorders in which emotional causes are considered to be a primary factor, and which are not due to identifiable physical disorders classified elsewhere. |
||||||||
Excludes: |
sleep disorders (organic) ( G47.- ) |
|||||||
F51.0 |
Nonorganic insomnia |
|||||||
A condition of unsatisfactory quantity and/or quality of sleep, which persists for a considerable period of time, including difficulty falling asleep, difficulty staying asleep, or early final wakening. Insomnia is a common symptom of many mental and physical disorders, and should be classified here in addition to the basic disorder only if it dominates the clinical picture. |
||||||||
Excludes: |
insomnia (organic) ( G47.0 ) |
|||||||
F51.1 |
Nonorganic hypersomnia |
|||||||
Hypersomnia is defined as a condition of either excessive daytime sleepiness and sleep attacks (not accounted for by an inadequate amount of sleep) or prolonged transition to the fully aroused state upon awakening. In the absence of an organic factor for the occurrence of hypersomnia, this condition is usually associated with mental disorders. |
||||||||
Excludes: |
||||||||
F51.2 |
Nonorganic disorder of the sleep-wake schedule |
|||||||
A lack of synchrony between the sleep-wake schedule and the desired sleep-wake schedule for the individual’s environment, resulting in a complaint of either insomnia or hypersomnia. |
||||||||
Psychogenic inversion of: |
||||||||
· circadian |
} |
rhythm |
||||||
Excludes: |
disorders of the sleep-wake schedule (organic) ( G47.2 ) |
|||||||
F51.3 |
Sleepwalking [somnambulism] |
|||||||
A state of altered consciousness in which phenomena of sleep and wakefulness are combined. During a sleepwalking episode the individual arises from bed, usually during the first third of nocturnal sleep, and walks about, exhibiting low levels of awareness, reactivity, and motor skill. Upon awakening, there is usually no recall of the event. |
||||||||
F51.4 |
Sleep terrors [night terrors] |
|||||||
Nocturnal episodes of extreme terror and panic associated with intense vocalization, motility, and high levels of autonomic discharge. The individual sits up or gets up, usually during the first third of nocturnal sleep, with a panicky scream. Quite often he or she rushes to the door as if trying to escape, although very seldom leaves the room. Recall of the event, if any, is very limited (usually to one or two fragmentary mental images). |
||||||||
F51.5 |
Nightmares |
|||||||
Dream experiences loaded with anxiety or fear. There is very detailed recall of the dream content. The dream experience is very vivid and usually includes themes involving threats to survival, security, or self-esteem. Quite often there is a recurrence of the same or similar frightening nightmare themes. During a typical episode there is a degree of autonomic discharge but no appreciable vocalization or body motility. Upon awakening the individual rapidly becomes alert and oriented. |
||||||||
Dream anxiety disorder |
||||||||
F51.8 |
Other nonorganic sleep disorders |
|||||||
F51.9 |
Nonorganic sleep disorder, unspecified |
|||||||
Emotional sleep disorder NOS |
F52 |
Sexual dysfunction, not caused by organic disorder or disease |
|||||||
Sexual dysfunction covers the various ways in which an individual is unable to participate in a sexual relationship as he or she would wish. Sexual response is a psychosomatic process and both psychological and somatic processes are usually involved in the causation of sexual dysfunction. |
||||||||
Excludes: |
Dhat syndrome ( F48.8 ) |
|||||||
F52.0 |
Lack or loss of sexual desire |
|||||||
Loss of sexual desire is the principal problem and is not secondary to other sexual difficulties, such as erectile failure or dyspareunia. |
||||||||
Frigidity |
||||||||
F52.1 |
Sexual aversion and lack of sexual enjoyment |
|||||||
Either the prospect of sexual interaction produces sufficient fear or anxiety that sexual activity is avoided (sexual aversion) or sexual responses occur normally and orgasm is experienced but there is a lack of appropriate pleasure (lack of sexual enjoyment). |
||||||||
Anhedonia (sexual) |
||||||||
F52.2 |
Failure of genital response |
|||||||
The principal problem in men is erectile dysfunction (difficulty in developing or maintaining an erection suitable for satisfactory intercourse). In women, the principal problem is vaginal dryness or failure of lubrication. |
||||||||
Female sexual arousal disorder |
||||||||
Excludes: |
impotence of organic origin ( N48.4 ) |
|||||||
F52.3 |
Orgasmic dysfunction |
|||||||
Orgasm either does not occur or is markedly delayed. |
||||||||
Inhibited orgasm (male)(female) |
||||||||
F52.4 |
Premature ejaculation |
|||||||
The inability to control ejaculation sufficiently for both partners to enjoy sexual interaction. |
||||||||
F52.5 |
Nonorganic vaginismus |
|||||||
Spasm of the pelvic floor muscles that surround the vagina, causing occlusion of the vaginal opening. Penile entry is either impossible or painful. |
||||||||
Psychogenic vaginismus |
||||||||
Excludes: |
vaginismus (organic) ( N94.2 ) |
|||||||
F52.6 |
Nonorganic dyspareunia |
|||||||
Dyspareunia (or pain during sexual intercourse) occurs in both women and men. It can often be attributed to local pathology and should then properly be categorized under the pathological condition. This category is to be used only if there is no primary nonorganic sexual dysfunction (e.g. vaginismus or vaginal dryness). |
||||||||
Psychogenic dyspareunia |
||||||||
Excludes: |
dyspareunia (organic) ( N94.1 ) |
|||||||
F52.7 |
Excessive sexual drive |
|||||||
Nymphomania |
||||||||
F52.8 |
Other sexual dysfunction, not caused by organic disorder or disease |
|||||||
F52.9 |
Unspecified sexual dysfunction, not caused by organic disorder or disease |
F53 |
Mental and behavioural disorders associated with the puerperium, not elsewhere classified |
|||||||
This category includes only mental disorders associated with the puerperium (commencing within six weeks of delivery) that do not meet the criteria for disorders classified elsewhere in this chapter, either because insufficient information is available, or because it is considered that special additional clinical features are present that make their classification elsewhere inappropriate. |
||||||||
F53.0 |
Mild mental and behavioural disorders associated with the puerperium, not elsewhere classified |
|||||||
Depression: |
||||||||
F53.1 |
Severe mental and behavioural disorders associated with the puerperium, not elsewhere classified |
|||||||
Puerperal psychosis NOS |
||||||||
F53.8 |
Other mental and behavioural disorders associated with the puerperium, not elsewhere classified |
|||||||
F53.9 |
Puerperal mental disorder, unspecified |
F54 |
Psychological and behavioural factors associated with disorders or diseases classified elsewhere |
|||||||
This category should be used to record the presence of psychological or behavioural influences thought to have played a major part in the etiology of physical disorders which can be classified to other chapters. Any resulting mental disturbances are usually mild, and often prolonged (such as worry, emotional conflict, apprehension) and do not of themselves justify the use of any of the categories in this chapter. |
||||||||
Psychological factors affecting physical conditions |
||||||||
Use additional code, if desired, to identify the associated physical disorder. |
||||||||
Excludes: |
tension-type headache ( G44.2 ) |
F55 |
Abuse of non-dependence-producing substances |
|||||||
A wide variety of medicaments and folk remedies may be involved, but the particularly important groups are: (a) psychotropic drugs that do not produce dependence, such as antidepressants, (b) laxatives, and (c) analgesics that may be purchased without medical prescription, such as aspirin and paracetamol. Persistent use of these substances often involves unnecessary contacts with medical professionals or supporting staff, and is sometimes accompanied by harmful physical effects of the substances. Attempts to dissuade or forbid the use of the substance are often met with resistance; for laxatives and analgesics this may be in spite of warnings about (or even the development of) physical harm such as renal dysfunction or electrolyte disturbances. Although it is usually clear that the patient has a strong motivation to take the substance, dependence or withdrawal symptoms do not develop as in the case of the psychoactive substances specified in F10-F19. |
||||||||
Abuse of: |
||||||||
Excludes: |
abuse of psychoactive substances ( F10-F19 ) |
F59 |
Unspecified behavioural syndromes associated with physiological disturbances and physical factors |
|||||||
Psychogenic physiological dysfunction NOS |
Disorders of adult personality and behaviour
(F60-F69)
This block includes a variety of conditions and behaviour patterns of clinical significance which tend to be persistent and appear to be the expression of the individual’s characteristic lifestyle and mode of relating to himself or herself and others. Some of these conditions and patterns of behaviour emerge early in the course of individual development, as a result of both constitutional factors and social experience, while others are acquired later in life. Specific personality disorders (F60.-), mixed and other personality disorders (F61.-), and enduring personality changes (F62.-) are deeply ingrained and enduring behaviour patterns, manifesting as inflexible responses to a broad range of personal and social situations. They represent extreme or significant deviations from the way in which the average individual in a given culture perceives, thinks, feels and, particularly, relates to others. Such behaviour patterns tend to be stable and to encompass multiple domains of behaviour and psychological functioning. They are frequently, but not always, associated with various degrees of subjective distress and problems of social performance. |
F60 |
Specific personality disorders |
|||||||
These are severe disturbances in the personality and behavioural tendencies of the individual; not directly resulting from disease, damage, or other insult to the brain, or from another psychiatric disorder; usually involving several areas of the personality; nearly always associated with considerable personal distress and social disruption; and usually manifest since childhood or adolescence and continuing throughout adulthood. |
||||||||
F60.0 |
Paranoid personality disorder |
|||||||
Personality disorder characterized by excessive sensitivity to setbacks, unforgiveness of insults; suspiciousness and a tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous; recurrent suspicions, without justification, regarding the sexual fidelity of the spouse or sexual partner; and a combative and tenacious sense of personal rights. There may be excessive self-importance, and there is often excessive self-reference. |
||||||||
Personality (disorder): |
||||||||
Excludes: |
paranoia ( F22.0 ) |
|||||||
F60.1 |
Schizoid personality disorder |
|||||||
Personality disorder characterized by withdrawal from affectional, social and other contacts with preference for fantasy, solitary activities, and introspection. There is a limited capacity to express feelings and to experience pleasure. |
||||||||
Excludes: |
Asperger’s syndrome ( F84.5 ) |
|||||||
F60.2 |
Dissocial personality disorder |
|||||||
Personality disorder characterized by disregard for social obligations, and callous unconcern for the feelings of others. There is gross disparity between behaviour and the prevailing social norms. Behaviour is not readily modifiable by adverse experience, including punishment. There is a low tolerance to frustration and a low threshold for discharge of aggression, including violence; there is a tendency to blame others, or to offer plausible rationalizations for the behaviour bringing the patient into conflict with society. |
||||||||
Personality (disorder): |
||||||||
Excludes: |
conduct disorders ( F91.- ) |
|||||||
F60.3 |
Emotionally unstable personality disorder |
|||||||
Personality disorder characterized by a definite tendency to act impulsively and without consideration of the consequences; the mood is unpredictable and capricious. There is a liability to outbursts of emotion and an incapacity to control the behavioural explosions. There is a tendency to quarrelsome behaviour and to conflicts with others, especially when impulsive acts are thwarted or censored. Two types may be distinguished: the impulsive type, characterized predominantly by emotional instability and lack of impulse control, and the borderline type, characterized in addition by disturbances in self-image, aims, and internal preferences, by chronic feelings of emptiness, by intense and unstable interpersonal relationships, and by a tendency to self-destructive behaviour, including suicide gestures and attempts. |
||||||||
Personality (disorder): |
||||||||
Excludes: |
dissocial personality disorder ( F60.2 ) |
|||||||
F60.4 |
Histrionic personality disorder |
|||||||
Personality disorder characterized by shallow and labile affectivity, self-dramatization, theatricality, exaggerated expression of emotions, suggestibility, egocentricity, self-indulgence, lack of consideration for others, easily hurt feelings, and continuous seeking for appreciation, excitement and attention. |
||||||||
Personality (disorder): |
||||||||
F60.5 |
Anankastic personality disorder |
|||||||
Personality disorder characterized by feelings of doubt, perfectionism, excessive conscientiousness, checking and preoccupation with details, stubbornness, caution, and rigidity. There may be insistent and unwelcome thoughts or impulses that do not attain the severity of an obsessive-compulsive disorder. |
||||||||
Personality (disorder): |
||||||||
Excludes: |
obsessive-compulsive disorder ( F42.- ) |
|||||||
F60.6 |
Anxious [avoidant] personality disorder |
|||||||
Personality disorder characterized by feelings of tension and apprehension, insecurity and inferiority. There is a continuous yearning to be liked and accepted, a hypersensitivity to rejection and criticism with restricted personal attachments, and a tendency to avoid certain activities by habitual exaggeration of the potential dangers or risks in everyday situations. |
||||||||
F60.7 |
Dependent personality disorder |
|||||||
Personality disorder characterized by pervasive passive reliance on other people to make one’s major and minor life decisions, great fear of abandonment, feelings of helplessness and incompetence, passive compliance with the wishes of elders and others, and a weak response to the demands of daily life. Lack of vigour may show itself in the intellectual or emotional spheres; there is often a tendency to transfer responsibility to others. |
||||||||
Personality (disorder): |
||||||||
F60.8 |
Other specific personality disorders |
|||||||
Personality (disorder): |
||||||||
F60.9 |
Personality disorder, unspecified |
|||||||
Character neurosis NOS |
F61 |
Mixed and other personality disorders |
|||||||
This category is intended for personality disorders that are often troublesome but do not demonstrate the specific pattern of symptoms that characterize the disorders described in F60.-. As a result they are often more difficult to diagnose than the disorders in F60.-. Examples include:
|
||||||||
Excludes: |
accentuated personality traits ( Z73.1 ) |
F62 |
Enduring personality changes, not attributable to brain damage and disease |
|||||||
Disorders of adult personality and behaviour that have developed in persons with no previous personality disorder following exposure to catastrophic or excessive prolonged stress, or following a severe psychiatric illness. These diagnoses should be made only when there is evidence of a definite and enduring change in a person’s pattern of perceiving, relating to, or thinking about the environment and himself or herself. The personality change should be significant and be associated with inflexible and maladaptive behaviour not present before the pathogenic experience. The change should not be a direct manifestation of another mental disorder or a residual symptom of any antecedent mental disorder. |
||||||||
Excludes: |
personality and behavioural disorder due to brain disease, damage and dysfunction ( F07.- ) |
|||||||
F62.0 |
Enduring personality change after catastrophic experience |
|||||||
Enduring personality change, present for at least two years, following exposure to catastrophic stress. The stress must be so extreme that it is not necessary to consider personal vulnerability in order to explain its profound effect on the personality. The disorder is characterized by a hostile or distrustful attitude toward the world, social withdrawal, feelings of emptiness or hopelessness, a chronic feeling of «being on edge» as if constantly threatened, and estrangement. Post-traumatic stress disorder (F43.1) may precede this type of personality change. |
||||||||
Personality change after: |
||||||||
Excludes: |
post-traumatic stress disorder ( F43.1 ) |
|||||||
F62.1 |
Enduring personality change after psychiatric illness |
|||||||
Personality change, persisting for at least two years, attributable to the traumatic experience of suffering from a severe psychiatric illness. The change cannot be explained by a previous personality disorder and should be differentiated from residual schizophrenia and other states of incomplete recovery from an antecedent mental disorder. This disorder is characterized by an excessive dependence on and a demanding attitude towards others; conviction of being changed or stigmatized by the illness, leading to an inability to form and maintain close and confiding personal relationships and to social iso-lation; passivity, reduced interests, and diminished involvement in leisure activities; persistent complaints of being ill, which may be associated with hypochondriacal claims and illness behaviour; dysphoric or labile mood, not due to the presence of a current mental disorder or antecedent mental disorder with residual affective symptoms; and longstanding problems in social and occupational functioning. |
||||||||
F62.8 |
Other enduring personality changes |
|||||||
Chronic pain personality syndrome |
||||||||
F62.9 |
Enduring personality change, unspecified |
F63 |
Habit and impulse disorders |
|||||||
This category includes certain disorders of behaviour that are not classifiable under other categories. They are characterized by repeated acts that have no clear rational motivation, cannot be controlled, and generally harm the patient’s own interests and those of other people. The patient reports that the behaviour is associated with impulses to action. The cause of these disorders is not understood and they are grouped together because of broad descriptive similarities, not because they are known to share any other important features. |
||||||||
Excludes: |
habitual excessive use of alcohol or psychoactive substances ( F10-F19 ) |
|||||||
F63.0 |
Pathological gambling |
|||||||
The disorder consists of frequent, repeated episodes of gambling that dominate the patient’s life to the detriment of social, occupational, material, and family values and commitments. |
||||||||
Compulsive gambling |
||||||||
Excludes: |
excessive gambling by manic patients ( F30.- ) |
|||||||
F63.1 |
Pathological fire-setting [pyromania] |
|||||||
Disorder characterized by multiple acts of, or attempts at, setting fire to property or other objects, without apparent motive, and by a persistent preoccupation with subjects related to fire and burning. This behaviour is often associated with feelings of increasing tension before the act, and intense excitement immediately afterwards. |
||||||||
Excludes: |
fire-setting (by)(in): |
|||||||
F63.2 |
Pathological stealing [kleptomania] |
|||||||
Disorder characterized by repeated failure to resist impulses to steal objects that are not acquired for personal use or monetary gain. The objects may instead be discarded, given away, or hoarded. This behaviour is usually accompanied by an increasing sense of tension before, and a sense of gratification during and immediately after, the act. |
||||||||
Excludes: |
depressive disorder with stealing ( F31-F33 ) |
|||||||
F63.3 |
Trichotillomania |
|||||||
A disorder characterized by noticeable hair-loss due to a recurrent failure to resist impulses to pull out hairs. The hair-pulling is usually preceded by mounting tension and is followed by a sense of relief or gratification. This diagnosis should not be made if there is a pre-existing inflammation of the skin, or if the hair-pulling is in response to a delusion or a hallucination. |
||||||||
Excludes: |
stereotyped movement disorder with hair-plucking ( F98.4 ) |
|||||||
F63.8 |
Other habit and impulse disorders |
|||||||
Other kinds of persistently repeated maladaptive behaviour that are not secondary to a recognized psychiatric syndrome, and in which it appears that the patient is repeatedly failing to resist impulses to carry out the behaviour. There is a prodromal period of tension with a feeling of release at the time of the act. |
||||||||
Intermittent explosive disorder |
||||||||
F63.9 |
Habit and impulse disorder, unspecified |
F64 |
Gender identity disorders |
|||||||
F64.0 |
Transsexualism |
|||||||
A desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one’s anatomic sex, and a wish to have surgery and hormonal treatment to make one’s body as congruent as possible with one’s preferred sex. |
||||||||
F64.1 |
Dual-role transvestism |
|||||||
The wearing of clothes of the opposite sex for part of the individual’s existence in order to enjoy the temporary experience of membership of the opposite sex, but without any desire for a more permanent sex change or associated surgical reassignment, and without sexual excitement accompanying the cross-dressing. |
||||||||
Gender identity disorder of adolescence or adulthood, nontranssexual type |
||||||||
Excludes: |
fetishistic transvestism ( F65.1 ) |
|||||||
F64.2 |
Gender identity disorder of childhood |
|||||||
A disorder, usually first manifest during early childhood (and always well before puberty), characterized by a persistent and intense distress about assigned sex, together with a desire to be (or insistence that one is) of the other sex. There is a persistent preoccupation with the dress and activities of the opposite sex and repudiation of the individual’s own sex. The diagnosis requires a profound disturbance of the normal gender identity; mere tomboyishness in girls or girlish behaviour in boys is not sufficient. Gender identity disorders in individuals who have reached or are entering puberty should not be classified here but in F66.-. |
||||||||
Excludes: |
egodystonic sexual orientation ( F66.1 ) |
|||||||
F64.8 |
Other gender identity disorders |
|||||||
F64.9 |
Gender identity disorder, unspecified |
|||||||
Gender-role disorder NOS |
F65 |
Disorders of sexual preference |
|||||||
Includes: |
paraphilias |
|||||||
F65.0 |
Fetishism |
|||||||
Reliance on some non-living object as a stimulus for sexual arousal and sexual gratification. Many fetishes are extensions of the human body, such as articles of clothing or footwear. Other common examples are characterized by some particular texture such as rubber, plastic or leather. Fetish objects vary in their importance to the individual. In some cases they simply serve to enhance sexual excitement achieved in ordinary ways (e.g. having the partner wear a particular garment). |
||||||||
F65.1 |
Fetishistic transvestism |
|||||||
The wearing of clothes of the opposite sex principally to obtain sexual excitement and to create the appearance of a person of the opposite sex. Fetishistic transvestism is distinguished from transsexual transvestism by its clear association with sexual arousal and the strong desire to remove the clothing once orgasm occurs and sexual arousal declines. It can occur as an earlier phase in the development of transsexualism. |
||||||||
Transvestic fetishism |
||||||||
F65.2 |
Exhibitionism |
|||||||
A recurrent or persistent tendency to expose the genitalia to strangers (usually of the opposite sex) or to people in public places, without inviting or intending closer contact. There is usually, but not invariably, sexual excitement at the time of the exposure and the act is commonly followed by masturbation. |
||||||||
F65.3 |
Voyeurism |
|||||||
A recurrent or persistent tendency to look at people engaging in sexual or intimate behaviour such as undressing. This is carried out without the observed people being aware, and usually leads to sexual excitement and masturbation. |
||||||||
F65.4 |
Paedophilia |
|||||||
A sexual preference for children, boys or girls or both, usually of prepubertal or early pubertal age. |
||||||||
F65.5 |
Sadomasochism |
|||||||
A preference for sexual activity which involves the infliction of pain or humiliation, or bondage. If the subject prefers to be the recipient of such stimulation this is called masochism; if the provider, sadism. Often an individual obtains sexual excitement from both sadistic and masochistic activities. |
||||||||
Masochism |
||||||||
F65.6 |
Multiple disorders of sexual preference |
|||||||
Sometimes more than one abnormal sexual preference occurs in one person and there is none of first rank. The most common combination is fetishism, transvestism and sadomasochism. |
||||||||
F65.8 |
Other disorders of sexual preference |
|||||||
A variety of other patterns of sexual preference and activity, including making obscene telephone calls, rubbing up against people for sexual stimulation in crowded public places, sexual activity with animals, and use of strangulation or anoxia for intensifying sexual excitement. |
||||||||
Frotteurism |
||||||||
F65.9 |
Disorder of sexual preference, unspecified |
|||||||
Sexual deviation NOS |
F66 |
Psychological and behavioural disorders associated with sexual development and orientation |
|||||||
Note: |
Sexual orientation by itself is not to be regarded as a disorder. |
|||||||
F66.0 |
Sexual maturation disorder |
|||||||
The patient suffers from uncertainty about his or her gender identity or sexual orientation, which causes anxiety or depression. Most commonly this occurs in adolescents who are not certain whether they are homosexual, heterosexual or bisexual in orientation, or in individuals who, after a period of apparently stable sexual orientation (often within a longstanding relationship), find that their sexual orientation is changing. |
||||||||
F66.1 |
Egodystonic sexual orientation |
|||||||
The gender identity or sexual preference (heterosexual, homosexual, bisexual, or prepubertal) is not in doubt, but the individual wishes it were different because of associated psychological and behavioural disorders, and may seek treatment in order to change it. |
||||||||
F66.2 |
Sexual relationship disorder |
|||||||
The gender identity or sexual orientation (heterosexual, homosexual, or bisexual) is responsible for difficulties in forming or maintaining a relationship with a sexual partner. |
||||||||
F66.8 |
Other psychosexual development disorders |
|||||||
F66.9 |
Psychosexual development disorder, unspecified |
F68 |
Other disorders of adult personality and behaviour |
|||||||
F68.0 |
Elaboration of physical symptoms for psychological reasons |
|||||||
Physical symptoms compatible with and originally due to a confirmed physical disorder, disease or disability become exaggerated or prolonged due to the psychological state of the patient. The patient is commonly distressed by this pain or disability, and is often preoccupied with worries, which may be justified, of the possibility of prolonged or progressive disability or pain. |
||||||||
Compensation neurosis |
||||||||
F68.1 |
Intentional production or feigning of symptoms or disabilities, either physical or psychological [factitious disorder] |
|||||||
The patient feigns symptoms repeatedly for no obvious reason and may even inflict self-harm in order to produce symptoms or signs. The motivation is obscure and presumably internal with the aim of adopting the sick role. The disorder is often combined with marked disorders of personality and relationships. |
||||||||
Hospital hopper syndrome |
||||||||
Excludes: |
factitial dermatitis ( L98.1 ) |
|||||||
F68.8 |
Other specified disorders of adult personality and behaviour |
|||||||
Character disorder NOS |
F69 |
Unspecified disorder of adult personality and behaviour |
Mental retardation
(F70-F79)
A condition of arrested or incomplete development of the mind, which is especially characterized by impairment of skills manifested during the developmental period, skills which contribute to the overall level of intelligence, i.e. cognitive, language, motor, and social abilities. Retardation can occur with or without any other mental or physical condition. Degrees of mental retardation are conventionally estimated by standardized intelligence tests. These can be supplemented by scales assessing social adaptation in a given environment. These measures provide an approximate indication of the degree of mental retardation. The diagnosis will also depend on the overall assessment of intellectual functioning by a skilled diagnostician. Intellectual abilities and social adaptation may change over time, and, however poor, may improve as a result of training and rehabilitation. Diagnosis should be based on the current levels of functioning. |
||||||||
The following fourth-character subdivisions are for use with categories F70-F79 to identify the extent of impairment of behaviour: |
||||||||
.0 |
With the statement of no, or minimal, impairment of behaviour |
|||||||
.1 |
Significant impairment of behaviour requiring attention or treatment |
|||||||
.8 |
Other impairments of behaviour |
|||||||
.9 |
Without mention of impairment of behaviour |
Use additional code, if desired, to identify associated conditions such as autism, other developmental disorders, epilepsy, conduct disorders, or severe physical handicap.
F70 |
Mild mental retardation |
|||||||
Approximate IQ range of 50 to 69 (in adults, mental age from 9 to under 12 years). Likely to result in some learning difficulties in school. Many adults will be able to work and maintain good social relationships and contribute to society. |
||||||||
Includes: |
feeble-mindedness |
F71 |
Moderate mental retardation |
|||||||
Approximate IQ range of 35 to 49 (in adults, mental age from 6 to under 9 years). Likely to result in marked developmental delays in childhood but most can learn to develop some degree of independence in self-care and acquire adequate communication and academic skills. Adults will need varying degrees of support to live and work in the community. |
||||||||
Includes: |
moderate mental subnormality |
F72 |
Severe mental retardation |
|||||||
Approximate IQ range of 20 to 34 (in adults, mental age from 3 to under 6 years). Likely to result in continuous need of support. |
||||||||
Includes: |
severe mental subnormality |
F73 |
Profound mental retardation |
|||||||
IQ under 20 (in adults, mental age below 3 years). Results in severe limitation in self-care, continence, communication and mobility. |
||||||||
Includes: |
profound mental subnormality |
F78 |
Other mental retardation |
|||||||
F79 |
Unspecified mental retardation |
|||||||
Includes: |
mental: |
Disorders of psychological development
(F80-F89)
The disorders included in this block have in common: (a) onset invariably during infancy or childhood; (b) impairment or delay in development of functions that are strongly related to biological maturation of the central nervous system; and (c) a steady course without remissions and relapses. In most cases, the functions affected include language, visuo-spatial skills, and motor coordination. Usually, the delay or impairment has been present from as early as it could be detected reliably and will diminish progressively as the child grows older, although milder deficits often remain in adult life. |
F80 |
Specific developmental disorders of speech and language |
|||||||
Disorders in which normal patterns of language acquisition are disturbed from the early stages of development. The conditions are not directly attributable to neurological or speech mechanism abnormalities, sensory impairments, mental retardation, or environmental factors. Specific developmental disorders of speech and language are often followed by associated problems, such as difficulties in reading and spelling, abnormalities in interpersonal relationships, and emotional and behavioural disorders. |
||||||||
F80.0 |
Specific speech articulation disorder |
|||||||
A specific developmental disorder in which the child’s use of speech sounds is below the appropriate level for its mental age, but in which there is a normal level of language skills. |
||||||||
Developmental: |
||||||||
Excludes: |
speech articulation impairment (due to): |
|||||||
F80.1 |
Expressive language disorder |
|||||||
A specific developmental disorder in which the child’s ability to use expressive spoken language is markedly below the appropriate level for its mental age, but in which language comprehension is within normal limits. There may or may not be abnormalities in articulation. |
||||||||
Developmental dysphasia or aphasia, expressive type |
||||||||
Excludes: |
acquired aphasia with epilepsy [Landau-Kleffner] ( F80.3 ) |
|||||||
F80.2 |
Receptive language disorder |
|||||||
A specific developmental disorder in which the child’s understanding of language is below the appropriate level for its mental age. In virtually all cases expressive language will also be markedly affected and abnormalities in word-sound production are common. |
||||||||
Congenital auditory imperception |
||||||||
Excludes: |
acquired aphasia with epilepsy [Landau-Kleffner] ( F80.3 ) |
|||||||
F80.3 |
Acquired aphasia with epilepsy [Landau-Kleffner] |
|||||||
A disorder in which the child, having previously made normal progress in language development, loses both receptive and expressive language skills but retains general intelligence; the onset of the disorder is accompanied by paroxysmal abnormalities on the EEG, and in the majority of cases also by epileptic seizures. Usually the onset is between the ages of three and seven years, with skills being lost over days or weeks. The temporal association between the onset of seizures and loss of language is variable, with one preceding the other (either way round) by a few months to two years. An inflammatory encephalitic process has been suggested as a possible cause of this disorder. About two-thirds of patients are left with a more or less severe receptive language deficit. |
||||||||
Excludes: |
aphasia (due to): |
|||||||
F80.8 |
Other developmental disorders of speech and language |
|||||||
Lisping |
||||||||
F80.9 |
Developmental disorder of speech and language, unspecified |
|||||||
Language disorder NOS |
F81 |
Specific developmental disorders of scholastic skills |
|||||||
Disorders in which the normal patterns of skill acquisition are disturbed from the early stages of development. This is not simply a consequence of a lack of opportunity to learn, it is not solely a result of mental retardation, and it is not due to any form of acquired brain trauma or disease. |
||||||||
F81.0 |
Specific reading disorder |
|||||||
The main feature is a specific and significant impairment in the development of reading skills that is not solely accounted for by mental age, visual acuity problems, or inadequate schooling. Reading comprehension skill, reading word recognition, oral reading skill, and performance of tasks requiring reading may all be affected. Spelling difficulties are frequently associated with specific reading disorder and often remain into adolescence even after some progress in reading has been made. Specific developmental disorders of reading are commonly preceded by a history of disorders in speech or language development. Associated emotional and behavioural disturbances are common during the school age period. |
||||||||
«Backward reading» |
||||||||
Excludes: |
alexia NOS ( R48.0 ) |
|||||||
F81.1 |
Specific spelling disorder |
|||||||
The main feature is a specific and significant impairment in the development of spelling skills in the absence of a history of specific reading disorder, which is not solely accounted for by low mental age, visual acuity problems, or inadequate schooling. The ability to spell orally and to write out words correctly are both affected. |
||||||||
Specific spelling retardation (without reading disorder) |
||||||||
Excludes: |
agraphia NOS ( R48.8 ) |
|||||||
F81.2 |
Specific disorder of arithmetical skills |
|||||||
Involves a specific impairment in arithmetical skills that is not solely explicable on the basis of general mental retardation or of inadequate schooling. The deficit concerns mastery of basic computational skills of addition, subtraction, multiplication, and division rather than of the more abstract mathematical skills involved in algebra, trigonometry, geometry, or calculus. |
||||||||
Developmental: |
||||||||
Excludes: |
acalculia NOS ( R48.8 ) |
|||||||
F81.3 |
Mixed disorder of scholastic skills |
|||||||
An ill-defined residual category of disorders in which both arithmetical and reading or spelling skills are significantly impaired, but in which the disorder is not solely explicable in terms of general mental retardation or of inadequate schooling. It should be used for disorders meeting the criteria for both F81.2 and either F81.0 or F81.1. |
||||||||
Excludes: |
specific: |
|||||||
F81.8 |
Other developmental disorders of scholastic skills |
|||||||
Developmental expressive writing disorder |
||||||||
F81.9 |
Developmental disorder of scholastic skills, unspecified |
|||||||
Knowledge acquisition disability NOS |
F82 |
Specific developmental disorder of motor function |
|||||||
A disorder in which the main feature is a serious impairment in the development of motor coordination that is not solely explicable in terms of general intellectual retardation or of any specific congenital or acquired neurological disorder. Nevertheless, in most cases a careful clinical examination shows marked neurodevelopmental immaturities such as choreiform movements of unsupported limbs or mirror movements and other associated motor features, as well as signs of impaired fine and gross motor coordination. |
||||||||
Clumsy child syndrome |
||||||||
Excludes: |
abnormalities of gait and mobility ( R26.- ) |
F83 |
Mixed specific developmental disorders |
|||||||
A residual category for disorders in which there is some admixture of specific developmental disorders of speech and language, of scholastic skills, and of motor function, but in which none predominates sufficiently to constitute the prime diagnosis. This mixed category should be used only when there is a major overlap between each of these specific developmental disorders. The disorders are usually, but not always, associated with some degree of general impairment of cognitive functions. Thus, the category should be used when there are dysfunctions meeting the criteria for two or more of F80.-, F81.- and F82. |
F84 |
Pervasive developmental disorders |
|||||||
A group of disorders characterized by qualitative abnormalities in reciprocal social interactions and in patterns of communication, and by a restricted, stereotyped, repetitive repertoire of interests and activities. These qualitative abnormalities are a pervasive feature of the individual’s functioning in all situations. |
||||||||
Use additional code, if desired, to identify any associated medical condition and mental retardation. |
||||||||
F84.0 |
Childhood autism |
|||||||
A type of pervasive developmental disorder that is defined by: (a) the presence of abnormal or impaired development that is manifest before the age of three years, and (b) the characteristic type of abnormal functioning in all the three areas of psychopathology: reciprocal social interaction, communication, and restricted, stereotyped, repetitive behaviour. In addition to these specific diagnostic features, a range of other nonspecific problems are common, such as phobias, sleeping and eating disturbances, temper tantrums, and (self-directed) aggression. |
||||||||
Autistic disorder |
||||||||
Excludes: |
autistic psychopathy ( F84.5 ) |
|||||||
F84.1 |
Atypical autism |
|||||||
A type of pervasive developmental disorder that differs from childhood autism either in age of onset or in failing to fulfil all three sets of diagnostic criteria. This subcategory should be used when there is abnormal and impaired development that is present only after age three years, and a lack of sufficient demonstrable abnormalities in one or two of the three areas of psychopathology required for the diagnosis of autism (namely, reciprocal social interactions, communication, and restricted, stereotyped, repetitive behaviour) in spite of characteristic abnormalities in the other area(s). Atypical autism arises most often in profoundly retarded individuals and in individuals with a severe specific developmental disorder of receptive language. |
||||||||
Atypical childhood psychosis |
||||||||
Use additional code (F70-F79), if desired, to identify mental retardation. |
||||||||
F84.2 |
Rett’s syndrome |
|||||||
A condition, so far found only in girls, in which apparently normal early development is followed by partial or complete loss of speech and of skills in locomotion and use of hands, together with deceleration in head growth, usually with an onset between seven and 24 months of age. Loss of purposive hand movements, hand-wringing stereotypies, and hyperventilation are characteristic. Social and play development are arrested but social interest tends to be maintained. Trunk ataxia and apraxia start to develop by age four years and choreoathetoid movements frequently follow. Severe mental retardation almost invariably results. |
||||||||
F84.3 |
Other childhood disintegrative disorder |
|||||||
A type of pervasive developmental disorder that is defined by a period of entirely normal development before the onset of the disorder, followed by a definite loss of previously acquired skills in several areas of development over the course of a few months. Typically, this is accompanied by a general loss of interest in the environment, by stereotyped, repetitive motor mannerisms, and by autistic-like abnormalities in social interaction and communication. In some cases the disorder can be shown to be due to some associated encephalopathy but the diagnosis should be made on the behavioural features. |
||||||||
Dementia infantilis |
||||||||
Use additional code, if desired, to identify any associated neurological condition. |
||||||||
Excludes: |
Rett’s syndrome ( F84.2 ) |
|||||||
F84.4 |
Overactive disorder associated with mental retardation and stereotyped movements |
|||||||
An ill-defined disorder of uncertain nosological validity. The category is designed to include a group of children with severe mental retardation (IQ below 35) who show major problems in hyperactivity and in attention, as well as stereotyped behaviours. They tend not to benefit from stimulant drugs (unlike those with an IQ in the normal range) and may exhibit a severe dysphoric reaction (sometimes with psychomotor retardation) when given stimulants. In adolescence, the overactivity tends to be replaced by underactivity (a pattern that is not usual in hyperkinetic children with normal intelligence). This syndrome is also often associated with a variety of developmental delays, either specific or global. The extent to which the behavioural pattern is a function of low IQ or of organic brain damage is not known. |
||||||||
F84.5 |
Asperger’s syndrome |
|||||||
A disorder of uncertain nosological validity, characterized by the same type of qualitative abnormalities of reciprocal social interaction that typify autism, together with a restricted, stereotyped, repetitive repertoire of interests and activities. It differs from autism primarily in the fact that there is no general delay or retardation in language or in cognitive development. This disorder is often associated with marked clumsiness. There is a strong tendency for the abnormalities to persist into adolescence and adult life. Psychotic episodes occasionally occur in early adult life. |
||||||||
Autistic psychopathy |
||||||||
F84.8 |
Other pervasive developmental disorders |
|||||||
F84.9 |
Pervasive developmental disorder, unspecified |
F88 |
Other disorders of psychological development |
|||||||
Developmental agnosia |
F89 |
Unspecified disorder of psychological development |
|||||||
Developmental disorder NOS |
Behavioural and emotional disorders with onset usually occurring in childhood and adolescence
(F90-F98)
F90 |
Hyperkinetic disorders |
|||||||
A group of disorders characterized by an early onset (usually in the first five years of life), lack of persistence in activities that require cognitive involvement, and a tendency to move from one activity to another without completing any one, together with disorganized, ill-regulated, and excessive activity. Several other abnormalities may be associated. Hyperkinetic children are often reckless and impulsive, prone to accidents, and find themselves in disciplinary trouble because of unthinking breaches of rules rather than deliberate defiance. Their relationships with adults are often socially disinhibited, with a lack of normal caution and reserve. They are unpopular with other children and may become isolated. Impairment of cognitive functions is common, and specific delays in motor and language development are disproportionately frequent. Secondary complications include dissocial behaviour and low self-esteem. |
||||||||
Excludes: |
anxiety disorders ( F41.- ) |
|||||||
F90.0 |
Disturbance of activity and attention |
|||||||
Attention deficit: |
||||||||
Excludes: |
hyperkinetic disorder associated with conduct disorder ( F90.1 ) |
|||||||
F90.1 |
Hyperkinetic conduct disorder |
|||||||
Hyperkinetic disorder associated with conduct disorder |
||||||||
F90.8 |
Other hyperkinetic disorders |
|||||||
F90.9 |
Hyperkinetic disorder, unspecified |
|||||||
Hyperkinetic reaction of childhood or adolescence NOS |
F91 |
Conduct disorders |
|||||||
Disorders characterized by a repetitive and persistent pattern of dissocial, aggressive, or defiant conduct. Such behaviour should amount to major violations of age-appropriate social expectations; it should therefore be more severe than ordinary childish mischief or adolescent rebelliousness and should imply an enduring pattern of behaviour (six months or longer). Features of conduct disorder can also be symptomatic of other psychiatric conditions, in which case the underlying diagnosis should be preferred. Examples of the behaviours on which the diagnosis is based include excessive levels of fighting or bullying, cruelty to other people or animals, severe destructiveness to property, fire-setting, stealing, repeated lying, truancy from school and running away from home, unusually frequent and severe temper tantrums, and disobedience. Any one of these behaviours, if marked, is sufficient for the diagnosis, but isolated dissocial acts are not. |
||||||||
Excludes: |
mood [affective] ( F30-F39 ) |
|||||||
F91.0 |
Conduct disorder confined to the family context |
|||||||
Conduct disorder involving dissocial or aggressive behaviour (and not merely oppositional, defiant, disruptive behaviour), in which the abnormal behaviour is entirely, or almost entirely, confined to the home and to interactions with members of the nuclear family or immediate household. The disorder requires that the overall criteria for F91.- be met; even severely disturbed parent-child relationships are not of themselves sufficient for diagnosis. |
||||||||
F91.1 |
Unsocialized conduct disorder |
|||||||
Disorder characterized by the combination of persistent dissocial or aggressive behaviour (meeting the overall criteria for F91.- and not merely comprising oppositional, defiant, disruptive behaviour) with significant pervasive abnormalities in the individual’s relationships with other children. |
||||||||
Conduct disorder, solitary aggressive type |
||||||||
F91.2 |
Socialized conduct disorder |
|||||||
Disorder involving persistent dissocial or aggressive behaviour (meeting the overall criteria for F91.- and not merely comprising oppositional, defiant, disruptive behaviour) occurring in individuals who are generally well integrated into their peer group. |
||||||||
Conduct disorder, group type |
||||||||
F91.3 |
Oppositional defiant disorder |
|||||||
Conduct disorder, usually occurring in younger children, primarily characterized by markedly defiant, disobedient, disruptive behaviour that does not include delinquent acts or the more extreme forms of aggressive or dissocial behaviour. The disorder requires that the overall criteria for F91.- be met; even severely mischievous or naughty behaviour is not in itself sufficient for diagnosis. Caution should be employed before using this category, especially with older children, because clinically significant conduct disorder will usually be accompanied by dissocial or aggressive behaviour that goes beyond mere defiance, disobedience, or disruptiveness. |
||||||||
F91.8 |
Other conduct disorders |
|||||||
F91.9 |
Conduct disorder, unspecified |
|||||||
Childhood: |
F92 |
Mixed disorders of conduct and emotions |
|||||||
A group of disorders characterized by the combination of persistently aggressive, dissocial or defiant behaviour with overt and marked symptoms of depression, anxiety or other emotional upsets. The criteria for both conduct disorders of childhood (F9l.-) and emotional disorders of childhood (F93.-) or an adult-type neurotic diagnosis (F40-F48) or a mood disorder (F30-F39) must be met. |
||||||||
F92.0 |
Depressive conduct disorder |
|||||||
This category requires the combination of conduct disorder (F91.-) with persistent and marked depression of mood (F32.-), as demonstrated by symptoms such as excessive misery, loss of interest and pleasure in usual activities, self-blame, and hopelessness; disturbances of sleep or appetite may also be present. |
||||||||
Conduct disorder in F91.- associated with depressive disorder in F32.- |
||||||||
F92.8 |
Other mixed disorders of conduct and emotions |
|||||||
This category requires the combination of conduct disorder (F91.-) with persistent and marked emotional symptoms such as anxiety, obsessions or compulsions, depersonalization or derealization, phobias, or hypochondriasis. |
||||||||
Conduct disorder in F91.- associated with: |
||||||||
F92.9 |
Mixed disorder of conduct and emotions, unspecified |
F93 |
Emotional disorders with onset specific to childhood |
|||||||
Mainly exaggerations of normal developmental trends rather than phenomena that are qualitatively abnormal in themselves. Developmental appropriateness is used as the key diagnostic feature in defining the difference between these emotional disorders, with onset specific to childhood, and the neurotic disorders (F40-F48). |
||||||||
Excludes: |
when associated with conduct disorder ( F92.- ) |
|||||||
F93.0 |
Separation anxiety disorder of childhood |
|||||||
Should be diagnosed when fear of separation constitutes the focus of the anxiety and when such anxiety first arose during the early years of childhood. It is differentiated from normal separation anxiety when it is of a degree (severity) that is statistically unusual (including an abnormal persistence beyond the usual age period), and when it is associated with significant problems in social functioning. |
||||||||
Excludes: |
mood [affective] disorders ( F30-F39 ) |
|||||||
F93.1 |
Phobic anxiety disorder of childhood |
|||||||
Fears in childhood that show a marked developmental phase specificity and arise (to some extent) in a majority of children, but that are abnormal in degree. Other fears that arise in childhood but that are not a normal part of psychosocial development (for example agoraphobia) should be coded under the appropriate category in section F40-F48. |
||||||||
Excludes: |
generalized anxiety disorder ( F41.1 ) |
|||||||
F93.2 |
Social anxiety disorder of childhood |
|||||||
In this disorder there is a wariness of strangers and social apprehension or anxiety when encountering new, strange, or socially threatening situations. This category should be used only where such fears arise during the early years, and are both unusual in degree and accompanied by problems in social functioning. |
||||||||
Avoidant disorder of childhood or adolescence |
||||||||
F93.3 |
Sibling rivalry disorder |
|||||||
Some degree of emotional disturbance usually following the birth of an immediately younger sibling is shown by a majority of young children. A sibling rivalry disorder should be diagnosed only if the degree or persistence of the disturbance is both statistically unusual and associated with abnormalities of social interaction. |
||||||||
Sibling jealousy |
||||||||
F93.8 |
Other childhood emotional disorders |
|||||||
Identity disorder |
||||||||
Excludes: |
gender identity disorder of childhood ( F64.2 ) |
|||||||
F93.9 |
Childhood emotional disorder, unspecified |
F94 |
Disorders of social functioning with onset specific to childhood and adolescence |
|||||||
A somewhat heterogeneous group of disorders that have in common abnormalities in social functioning which begin during the developmental period, but which (unlike the pervasive developmental disorders) are not primarily characterized by an apparently constitutional social incapacity or deficit that pervades all areas of functioning. In many instances, serious environmental distortions or privations probably play a crucial role in etiology. |
||||||||
F94.0 |
Elective mutism |
|||||||
Characterized by a marked, emotionally determined selectivity in speaking, such that the child demonstrates a language competence in some situations but fails to speak in other (definable) situations. The disorder is usually associated with marked personality features involving social anxiety, withdrawal, sensitivity, or resistance. |
||||||||
Selective mutism |
||||||||
Excludes: |
pervasive developmental disorders ( F84.- ) |
|||||||
F94.1 |
Reactive attachment disorder of childhood |
|||||||
Starts in the first five years of life and is characterized by persistent abnormalities in the child’s pattern of social relationships that are associated with emotional disturbance and are reactive to changes in environmental circumstances (e.g. fearfulness and hypervigilance, poor social interaction with peers, aggression towards self and others, misery, and growth failure in some cases). The syndrome probably occurs as a direct result of severe parental neglect, abuse, or serious mishandling. |
||||||||
Use additional code, if desired, to identify any associated failure to thrive or growth retardation. |
||||||||
Excludes: |
Asperger’s syndrome ( F84.5 ) |
|||||||
F94.2 |
Disinhibited attachment disorder of childhood |
|||||||
A particular pattern of abnormal social functioning that arises during the first five years of life and that tends to persist despite marked changes in environmental circumstances, e.g. diffuse, nonselectively focused attachment behaviour, attention-seeking and indiscriminately friendly behaviour, poorly modulated peer interactions; depending on circumstances there may also be associated emotional or behavioural disturbance. |
||||||||
Affectionless psychopathy |
||||||||
Excludes: |
Asperger’s syndrome ( F84.5 ) |
|||||||
F94.8 |
Other childhood disorders of social functioning |
|||||||
F94.9 |
Childhood disorder of social functioning, unspecified |
F95 |
Tic disorders |
|||||||
Syndromes in which the predominant manifestation is some form of tic. A tic is an involuntary, rapid, recurrent, nonrhythmic motor movement (usually involving circumscribed muscle groups) or vocal production that is of sudden onset and that serves no apparent purpose. Tics tend to be experienced as irresistible but usually they can be suppressed for varying periods of time, are exacerbated by stress, and disappear during sleep. Common simple motor tics include only eye-blinking, neck-jerking, shoulder- shrugging, and facial grimacing. Common simple vocal tics include throat-clearing, barking, sniffing, and hissing. Common complex tics include hitting oneself, jumping, and hopping. Common complex vocal tics include the repetition of particular words, and sometimes the use of socially unacceptable (often obscene) words (coprolalia), and the repetition of one’s own sounds or words (palilalia). |
||||||||
F95.0 |
Transient tic disorder |
|||||||
Meets the general criteria for a tic disorder but the tics do not persist longer than 12 months. The tics usually take the form of eye-blinking, facial grimacing, or head-jerking. |
||||||||
F95.1 |
Chronic motor or vocal tic disorder |
|||||||
Meets the general criteria for a tic disorder, in which there are motor or vocal tics (but not both), that may be either single or multiple (but usually multiple), and last for more than a year. |
||||||||
F95.2 |
Combined vocal and multiple motor tic disorder [de la Tourette] |
|||||||
A form of tic disorder in which there are, or have been, multiple motor tics and one or more vocal tics, although these need not have occurred concurrently. The disorder usually worsens during adolescence and tends to persist into adult life. The vocal tics are often multiple with explosive repetitive vocalizations, throat-clearing, and grunting, and there may be the use of obscene words or phrases. Sometimes there is associated gestural echopraxia which may also be of an obscene nature (copropraxia). |
||||||||
F95.8 |
Other tic disorders |
|||||||
F95.9 |
Tic disorder, unspecified |
|||||||
Tic NOS |
F98 |
Other behavioural and emotional disorders with onset usually occurring in childhood and adolescence |
|||||||
A heterogeneous group of disorders that share the characteristic of an onset in childhood but otherwise differ in many respects. Some of the conditions represent well-defined syndromes but others are no more than symptom complexes that need inclusion because of their frequency and association with psychosocial problems, and because they cannot be incorporated into other syndromes. |
||||||||
Excludes: |
breath-holding spells ( R06.8 ) |
|||||||
F98.0 |
Nonorganic enuresis |
|||||||
A disorder characterized by involuntary voiding of urine, by day and by night, which is abnormal in relation to the individual’s mental age, and which is not a consequence of a lack of bladder control due to any neurological disorder, to epileptic attacks, or to any structural abnormality of the urinary tract. The enuresis may have been present from birth or it may have arisen following a period of acquired bladder control. The enuresis may or may not be associated with a more widespread emotional or behavioural disorder. |
||||||||
Enuresis (primary)(secondary) of nonorganic origin |
||||||||
Excludes: |
enuresis NOS ( R32 ) |
|||||||
F98.1 |
Nonorganic encopresis |
|||||||
Repeated, voluntary or involuntary passage of faeces, usually of normal or near-normal consistency, in places not appropriate for that purpose in the individual’s own sociocultural setting. The condition may represent an abnormal continuation of normal infantile incontinence, it may involve a loss of continence following the acquisition of bowel control, or it may involve the deliberate deposition of faeces in inappropriate places in spite of normal physiological bowel control. The condition may occur as a monosymptomatic disorder, or it may form part of a wider disorder, especially an emotional disorder (F93.-) or a conduct disorder (F91.-). |
||||||||
Functional encopresis |
||||||||
Use additional code, if desired, to identify the cause of any coexisting constipation. |
||||||||
Excludes: |
encopresis NOS ( R15 ) |
|||||||
F98.2 |
Feeding disorder of infancy and childhood |
|||||||
A feeding disorder of varying manifestations usually specific to infancy and early childhood. It generally involves food refusal and extreme faddiness in the presence of an adequate food supply, a reasonably competent caregiver, and the absence of organic disease. There may or may not be associated rumination (repeated regurgitation without nausea or gastrointestinal illness). |
||||||||
Rumination disorder of infancy |
||||||||
Excludes: |
anorexia nervosa and other eating disorders ( F50.- ) |
|||||||
F98.3 |
Pica of infancy and childhood |
|||||||
Persistent eating of non-nutritive substances (such as soil, paint chippings, etc.). It may occur as one of many symptoms that are part of a more widespread psychiatric disorder (such as autism), or as a relatively isolated psychopathological behaviour; only the latter is classified here. The phenomenon is most common in mentally retarded children and, if mental retardation is also present, F70-F79 should be selected as the main diagnosis. |
||||||||
F98.4 |
Stereotyped movement disorders |
|||||||
Voluntary, repetitive, stereotyped, nonfunctional (and often rhythmic) movements that do not form part of any recognized psychiatric or neurological condition. When such movements occur as symptoms of some other disorder, only the overall disorder should be recorded. The movements that are of a non self-injurious variety include: body-rocking, head-rocking, hair-plucking, hair-twisting, finger-flicking mannerisms, and hand-flapping. Stereotyped self-injurious behaviour includes repetitive head-banging, face-slapping, eye-poking, and biting of hands, lips or other body parts. All the stereotyped movement disorders occur most frequently in association with mental retardation (when this is the case, both should be recorded). If eye-poking occurs in a child with visual impairment, both should be coded: eye-poking under this category and the visual condition under the appropriate somatic disorder code. |
||||||||
Stereotype/habit disorder |
||||||||
Excludes: |
abnormal involuntary movements ( R25.- ) |
|||||||
F98.5 |
Stuttering [stammering] |
|||||||
Speech that is characterized by frequent repetition or prolongation of sounds or syllables or words, or by frequent hesitations or pauses that disrupt the rhythmic flow of speech. It should be classified as a disorder only if its severity is such as to markedly disturb the fluency of speech. |
||||||||
Excludes: |
||||||||
F98.6 |
Cluttering |
|||||||
A rapid rate of speech with breakdown in fluency, but no repetitions or hesitations, of a severity to give rise to diminished speech intelligibility. Speech is erratic and dysrhythmic, with rapid jerky spurts that usually involve faulty phrasing patterns. |
||||||||
Excludes: |
||||||||
F98.8 |
Other specified behavioural and emotional disorders with onset usually occurring in childhood and adolescence |
|||||||
Attention deficit disorder without hyperactivity |
||||||||
F98.9 |
Unspecified behavioural and emotional disorders with onset usually occurring in childhood and adolescence |
Unspecified mental disorder
(F99)
F99 |
Mental disorder, not otherwise specified |
|||||||
Mental illness NOS |
||||||||
Excludes: |
organic mental disorder NOS ( F06.9 ) |
Комментарии: