175Chapter 7

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A Brief Version of DSM-5

176TABLE 7–1. Abbreviated DSM-5 criteria for common diagnoses

Diagnosis	Criteria/time	Symptoms
Neurodevelopmental disorders
Attention-deficit/hyperactivity disorder	≥6 for ≥6 months OR	Inattention: makes careless mistakes; cannot sustain attention; does not seem to listen; often does not follow through; struggles to organize tasks; dislikes mental effort; loses objects necessary for tasks; distractible; forgetful
	≥6 for ≥6 months	Hyperactivity/impulsivity: fidgets; leaves seat; runs or climbs; unable to remain quiet; on the go as if driven by a motor; talks excessively; blurts out answers; cannot wait turn; interrupts or intrudes without thinking
Intellectual disability	Both beginning in early childhood	Deficits in intellectual functions confirmed by standardized intelligence testing; deficits in adaptive functioning
Autism spectrum disorder	All 3 beginning in early childhood AND	Deficits in social-emotional reciprocity; deficits in nonverbal communicative behaviors; deficits in developing and maintaining relationships
	≥2	Stereotyped or repetitive speech, motor movements, or use of objects; excessive adherence to routines or excessive resistance to change; restricted interests of abnormal intensity or focus; hyperreactivity or hyporeactivity to sensory input
177Specific learning disorder	≥1 for ≥6 months beginning during childhood DESPITE interventions to reduce difficulties	Inaccurate word reading; impaired reading comprehension; spelling difficulties; difficulties with written expression; difficulties with numbers; difficulties with mathematical reasoning
Schizophrenia spectrum and other psychotic disorders
Schizophrenia	≥2 for ≥1 month AND	Delusions; hallucinations; disorganized speech; grossly disorganized or catatonic behavior; negative symptoms (at least one symptom must be delusions, hallucinations, or disorganized speech)
	≥6 months	Continuous signs of disturbance
Schizoaffective disorder	≥50% of the time AND	All criteria for schizophrenia
	≥2 weeks	Also experiences major depressive or manic episodes
		Delusions or hallucinations without depressive or manic episodes
178Bipolar and related disorders
Bipolar I disorder	Both for ≥1 week (or any duration if hospitalized) AND	Persistently elevated or irritable mood; persistently increased energy or activity
	≥3	Mania: inflated self-esteem or grandiosity; decreased need for sleep; pressured speech; racing thoughts; distractibility; risky behavior
Bipolar II disorder	≥3 for ≥4 days	Hypomania: inflated self-esteem or grandiosity; decreased need for sleep; pressured speech; racing thoughts; distractibility; increased goaldirected activity; risky behavior without psychosis or hospitalization
Depressive disorders
Disruptive mood dysregulation disorder	≥3 outbursts per week for ≥12 months	Severe recurrent temper outbursts manifested verbally and/or behaviorally that are out of proportion to the situation and inconsistent with developmental level (diagnosis cannot be made in children younger than 6 years)
		Mood between outbursts is persistently irritable or angry
179Major depressive disorder	≥1 for ≥2 weeks AND	Depressed mood; loss of interest in activities or pleasure (anhedonia)
	≥4 for ≥2 weeks	Weight loss or decreased appetite; insomnia or hypersomnia; agitation or retardation; fatigue or loss of energy; excessive guilt; decreased ability to concentrate; thoughts of death or suicide
Anxiety disorders
Separation anxiety disorder	≥3 for ≥4 weeks	Excessive distress with separation from home or caregivers; persistent worry about harm to caregivers; excessive worry about untoward event separating from caregiver; excessive reluctance to be alone; persistent reluctance to sleep away from home; repetitive nightmares about separation; repeated physical symptoms when separating
Panic disorder	≥4 AND	Palpitations; sweating; trembling; shortness of breath; choking; chest pain; nausea; dizziness; chills; paresthesias; derealization; fear of insanity; fear of death
	≥1 month	Persistent concern or worry about attacks; significant behavior change related to attacks
180Generalized anxiety disorder	≥3 for ≥6 months	Restlessness; easy fatigability; difficulty concentrating; irritability; muscle tension; sleep disturbance; avoidance of situations
Obsessive-compulsive and related disorders
Obsessive-compulsive disorder	≥1 hour/day	Obsessions: recurrent and intrusive thoughts, urges, images that a person attempts to ignore or suppress through compulsive acts AND/OR
		Compulsions: repetitive behaviors or mental acts to reduce distress
Trauma- and stressor-related disorders
Reactive attachment disorder	Both beginning before 5 years old	Experience of extreme insufficient care
		Consistent pattern of emotionally withdrawn behavior toward caregivers; persistent social and emotional disturbance
181Posttraumatic stress disorder (6 years or younger)	≥1 for ≥1 month AND	Intrusive experiences: distressing memories; dreams; flashbacks; reminder exposure distress; physiological reactions
	≥2 for ≥1 month AND	Arousal: irritability and angry outbursts; hypervigilance; exaggerated startle; impaired concentration; sleep disturbance
	≥1 for ≥1 month OR	Avoidance of: internal reminders; external reminders
	≥2 for ≥1 month	Negative cognitions: negative emotional states; diminished interest in significant activities; socially withdrawn; reduced expression of positive emotions
182Posttraumatic stress disorder (older than 6 years)	≥1 for ≥1 month AND	Intrusive experiences: distressing memories; dreams; flashbacks; reminder exposure distress; physiological reactions
	≥1 for ≥1 month AND	Avoidance of: internal reminders; external reminders
	≥2 for ≥1 month AND	Negative cognitions: impaired memories; negative self-image; blame; negative emotional states; decreased participation; detachment; inability to experience pleasure
	≥2 for ≥1 month	Arousal: irritability and angry outbursts; recklessness; hypervigilance; exaggerated startle; impaired concentration; sleep disturbance
183Feeding and eating disorders
Pica	≥1 month	Persistent consumption of nonnutritive, nonfood substances that is inconsistent with developmental stage and cultural practices
Anorexia nervosa	All 3	Persistent energy intake restriction; intense fear of gaining weight or persistent behavior that interferes with weight gain; disturbance in self-perceived body shape or weight
Bulimia nervosa	Both at least weekly for ≥3 months	Recurrent episodes of binge eating; self-evaluation unduly influenced by body shape and weight
		Recurrent inappropriate compensatory behaviors to prevent weight gain
Elimination disorders
Enuresis (≥5 years)	≥2 times weekly for ≥3 months	Repeated passage of urine into bed or clothes not attributable to a substance or another medical condition
Encopresis (≥4 years)	≥1 monthly for ≥3 months	Repeated passage of feces into inappropriate places not attributable to a substance or another medical condition
184Disruptive, impulse-control, and conduct disorders
Oppositional defiant disorder	≥4 for ≥6 months; if younger than 5 years, symptoms on most days; if older than 5 years, symptoms at least weekly	Often loses temper; often touchy or easily annoyed; often angry and resentful; often argues with adults; often defies rules or authority figures; often annoys others; often blames others; spiteful or vindictive
Intermittent explosive disorder	≥1 in a person ≥6 years	Recurrent, impulsive (or anger-based) verbal outbursts ≥2 times weekly for ≥3 months; ≥3 impulsive (or anger-based) behavioral outbursts resulting in property damage or injury to animals or persons in a 12-month period 185
Conduct disorder	≥3 in the past 12 months AND ≥1 in the past 6 months	Often bullies or threatens others; often initiates physical fights; uses a weapon; physically cruel to people; physically cruel to animals; stealing while confronting a victim; forcing someone into sexual activity; deliberately sets fire to cause damage; deliberately destroys property; breaks into someone else’s dwelling or car; frequently lies to obtain favors or avoid obligations; steals items of nontrivial value; stays out at night without permission; runs away from home overnight; often truant from school

Source. American Psychiatric Association 2013.186