Category: Psychiatry

Body Dysmorphic Disorder

Body Dysmorphic Disorder

Psychiatry

Body Dysmorphic Disorder

Diagnostic Criteria

  1. Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.
  2. At some point during the course of the disorder, the individual has performed repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking, reassurance seeking) or mental acts (e.g., comparing his or her appearance with that of others) in response to the appearance concerns.
  3. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  4. The appearance preoccupation is not better explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder.

Specify if:

With Muscle dysmorphia: The individual is preoccupied with the idea that his or her body build is too small or insufficiently muscular. This specifier is used even if the individual is preoccupied with other body areas, which is often the case.

Specify if:

Indicate degree of insight regarding body dysmorphic beliefs (e.g. “I look ugly or deformed”)

With good of fair insight: The individual recognizes that the body dysmorphic disorder beliefs are definitely or probably not true or that they may or may not be true)

With poor insight: The individual thinks that the body dysmorphic disorder beliefs are probably true.

With absent insight /delusional beliefs: The individual is completely convinced that the body dysmorphic disorder beliefs are true.

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Hoarding Disorder

Hoarding Disorder

Psychiatry

Hoarding Disorder

Diagnostic Criteria

  1. Persistent difficulty discarding or parting with possessions, regardless of their actual value.
  2. This difficulty is due to a perceived need to save the items and to distress associated with discarding them.
  3. The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (e.g., family members, cleaners, authorities).
  4. The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment for self and others).
  5. The hoarding is not attributable to another medical condition (e.g., brain injury, cerebrovascular disease, Prader-Willi syndrome).
  6. The hoarding is not better explained by the symptoms of another mental disorder (e.g., obsessions in obsessive-compulsive disorder, decreased energy in major depressive disorder, delusions in schizophrenia or another psychotic disorder, cognitive deficits in major neurocognitive disorder, restricted interests in autism spectrum disorder).

Specify if:

With excessive acquisition: If difficulty discarding possessions is accompanied by excessive acquisition of items that are not needed or for which there is no available space.

Specify if:

With good or fair insight: the individual recognizes that the hoarding related beliefs and behaviours (pertaining to difficulty in discarding items, clutter or excessive acquisition) are problematic.

With poor insight: The individual is mostly convinced that hoarding related beliefs and behaviours

(Pertaining to difficulty in discarding items, clutter or excessive acquisition) are not problematic despite evidence to the contrary.

With absent insight or delusional beliefs: The individual is completely convinced that hoarding related beliefs and behaviours (pertaining to difficulty in discarding items, clutter or excessive acquisition) are not problematic despite evidence to the contrary.

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Trichotillomania (Hair-Pulling Disorder)

Trichotillomania (Hair-Pulling Disorder)

Psychiatry

Trichotillomania (Hair-Pulling Disorder)

Diagnostic Criteria

  1. Recurrent pulling out of one’s hair, resulting in hair loss.
  2. Repeated attempts to decrease or stop hair pulling.
  3. The hair pulling causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  4. The hair pulling or hair loss is not attributable to another medical condition (e.g., a dermatological condition).
  5. The hair pulling is not better explained by the symptoms of another mental disorder (e.g., attempts to improve a perceived defect or flaw in appearance in body dimorphic disorder).

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Excoriation (Skin-Picking) Disorder

Excoriation (Skin-Picking) Disorder

Psychiatry

Excoriation (Skin-Picking) Disorder

Diagnostic Criteria

  1. Recurrent skin picking resulting in skin lesions.
  2. Repeated attempts to decrease or stop skin picking.
  3. The skin picking causes clinically significant distress or impairment is social, occupational, or other important areas of functioning.
  4. The skin picking is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., scabies).
  5. The skin picking is not better explained by symptoms of another mental disorder (e.g., delusions or tactile hallucinations in a psychotic disorder, attempts to improve a perceived defect or flaw in appearance in body dimorphic disorder, stereotypes in stereotypic movement disorder, or intention to harm oneself in no suicidal self-injury).

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Specific Phobia

Specific Phobia

Psychiatry

Specific Phobia

Diagnostic Criteria

A) Marked fear or anxiety about a specific object or situation (e.g., flying, heights, and animals, receiving an injection, seeing blood).

Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, or clinging.

B) The phobic object or situation almost always provokes immediate fear or anxiety.

C) The phobic object or situation is actively avoided or endured with intense fear or anxiety.

D) The fear or anxiety is out of proportion to the actual danger posed by the specific object or situation and to the sociocultural context.

E) The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.

F) The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

G) The disturbance is not better explained by the symptoms of another mental disorder, including fear, anxiety, and avoidance of situations associated with panic-like symptoms or other incapacitating symptoms (as in agoraphobia); objects or situations related to obsessions (as in obsessive-compulsive disorder); reminders of traumatic events (as in separation anxiety disorder); or social situations (as is social anxiety disorder).

Specify if:

Code based on the phobic stimulus: Like animal (e.g. Spiders, insects, dogs)

Natural environment (e.g. Heights, storm, water)

Blood-injection-injury (e.g. Needles, invasive medical procedures)

Situational (e.g. Aeroplanes, elevators, enclosed spaces)

Other. (E.g. Situations that may lead to choking or vomiting, in children such as loud sounds or costume characters)

Coding note: When more than one phobic stimulus is present, code all ICD-10-CM codes that apply (e.g., fear of snakes and flying, F40.218 specific phobia, animal, and specific phobia, situational).

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Social Anxiety Disorder (Social Phobia)

Social Anxiety Disorder (Social Phobia)

Psychiatry

Social Anxiety Disorder (Social Phobia)

Diagnostic Criteria

A) Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others. Examples include social interactions (e.g., having a conversation, meeting unfamiliar people), being observed (e.g., eating or drinking), and performing in front of others (e.g., giving a speech).

Note: In children, the anxiety must occur in peer setting and not just during interactions with adults.

B) The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated (i.e., will be humiliating or embarrassing; will lead to rejection or offend others).

C) The social situations almost always provoke fear or anxiety.

Note: In children, the fear or anxiety may be expressed by crying, tantrums, freezing, clinging, shrinking, or failing to speak in social situations.

D) The social situations are avoided or endured with intense fear or anxiety.

E) The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context.

F) The fear, anxiety, or avoidance is persistent, typically lasting for 6 months or more.

G) The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

H) The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

I) The fear, anxiety, or avoidance is not better explained disorder, or autism spectrum disorder.

J) If another medical condition (e.g., Parkinson’s disease, obesity, disfigurement from burns or injury) is present, the fear, anxiety, or avoidance is clearly unrelated or is excessive.

Specify if:

Performance only: If the fear is restricted to speaking or performing in public.

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