1、DIAGNOSTIC AND STATISTICALMANUAL OF MENTAL DISORDERSFIFTH EDITIONDSM-5TMAmerican Psychiatric AssociationOfficers 2012-2013 President Dilip V.Jeste,M.D.President-Elect Jeffrey A.Lieberman,M.D.Treasurer David Fassler,M.D.Secretary Rcxser Peele,M.D.Assembly Speaker R.Scott Benson,M.D.Speaker-Elect M el
2、inda L.Young,M.D.Board of Trustees Jeffrey Akaka,M.D.Carol A.Bernstein,M.D.BrL Crowley,M.D.Anita S.Everett,M.D.Jeffrey Geller,M.D.,M.P.H.M c David Graff,M.D.J e&A.Gi eneVM.D.Judith F.Kashtan,M.D.Molly K.McVoy,M.D.James E.N ininger,M.D.John M.Oldham,M.D.Alan F.Schatzberg,M.D.A lik s.W idge,M.D.,Ph.D.
3、Erik R.Vanderlip,M.D.,Member-in-Training Trustee-ElectDIAGNOSTIC AND STATISTICALMANUAL OF MENTAL DISORDERS7FIFTH EDITIONDSM-5TMNew School Library/44AmcriccinOsvchiatricADiviono(AmCTMlVhijtiKAModnW ashington,DC London,EnglandCopyright 2013 American Psychiatric AssociationDSM and DSM-5 are trademarks
4、of the American Psychiatric Association.Use of these terms is prohibited without permission of the American Psychiatric Association.ALL RIGHTS RESERVED.Unless authorized in writing by the APA,no part of this book may be reproduced or used in a manner inconsistent with the APAs copyright.This prohibi
5、tion apphes to unauthorized uses or reproductions in any form,including electronic applications.Correspondence regarding copyright permissions should be directed to DSM Permissions,American Psychiatric Publishing,1000 Wilson Boulevard,Suite 1825,Arlington,VA 222093901.Manufactured in the United Stat
6、es of America on acid-free paper.ISBN 978-0-89042-554-1(Hardcover)ISBN 978-0-89042-555-8(Paperback)American Psychiatric Association 1000 Wilson Boulevard Arlington,VA 22209-3901 www.psych.orgThe correct citation for this book is American Psychiatric Association:Diagnostic and Statistical Manual of M
7、ental Disorders,Fifth Edition.Arlington,VA,American Psychiatric Association,2013.Library of Congress Cataloging-in-Publication DataDiagnostic and statistical manual of mental disorders:DSM-5.5th ed.p.;cm.DSM-5DSM-VIncludes index.ISBN 978-0-89042-554-1(hardcover:alk.paper)ISBN 978-0-89042-555-8(pbk.:
8、alk.paper)I.American Psychiatric Association.II.American Psychiatric Association.DSM-5 Task Force,m.Title:DSM-5.IV.Title:DSM-V.DNLM:1.Diagnostic and statistical manual of mental disorders.5th ed.2.Mental Disorders classification.3.Mental Disordersdiagnosis.WM 15RC455.2.C4 616.8975dc232013011061Briti
9、sh Library Cataloguing in Publication Data nA CIP record is available from the British Library.Text DesignTammy J.CordovaManufacturingEdwards Brothers Malloy cHContentsDSM-5 Classification.xiiiPreface.xliSection IDSM-5 BasicsIntroduction.5Use of the M anual.19Cautionary Statement for Forensic Use of
10、 DSM-5.25Section IIDiagnostic Criteria and CodesNeurodevelopmental Disorders.31Schizophrenia Spectrum and Other Psychotic Disorders.87Bipolar and Related Disorders.123Depressive Disorders.155Anxiety Disorders.189Obsessive-Compulsive and Related Disorders.235Trauma-and Stressor-Related Disorders.265D
11、issociative Disorders.291Somatic Symptom and Related Disorders.309Feeding and Eating Disorders.329Elimination Disorders.355Sleep-Wake Disorders.361Sexual Dysfunctions.423Gender Dysphoria.451Disruptive,Impulse-Control,and Conduct Disorders.461Substance-Related and Addictive Disorders.481Neurocognitiv
12、e Disorders.591Personality Disorders.645Paraphilic Disorders.685Other Mental Disorders.707Medication-Induced Movement Disorders and Other Adverse Effects of M edication.709Other Conditions That May Be a Focus of Clinical Attention.715Section IIIEmerging Measures and ModelsAssessment Measures.733Cult
13、ural Formulation.749Alternative DSM-5 Model for Personality Disorders.761Conditions for Further Study.783AppendixHighlights of Changes From DSM-IV to DSM-5.809Glossary of Technical Term s.817Glossary of Cultural Concepts of Distress.833Alphabetical Listing of DSM-5 Diagnoses and Codes(ICD-9-CM and I
14、CD-10-CM).839Numerical Listing of DSM-5 Diagnoses and Codes(ICD-9-CM).863Numerical Listing of DSM-5 Diagnoses and Codes(ICD-10-CM).877DSM-5 Advisors and Other Contributors.897Index.917DSM-5 Task ForceDavid J.Kupfer,M.D.Task Force ChairDarrel A.Regier,M.D.,M.P.H.Task Force Vice-ChairWilliam E.Narrow,
15、M.D.,Research DirectorDan G.Blazer,M.D.,Ph.D.,M.P.H.Jack D.Burke Jr.,M.D.,M.P.H.William T.Carpenter Jr.,M.D.F.Xavier Castellanos,M.D.Wilson M.Compton,M.D.,M.P.E.Joel E.Dimsdale,M.D.Javier I.Escobar,M.D.,M.Sc.Jan A.Fawcett,M.D.Bridget F.Grant,Ph.D.,Ph.D.(2009-)Steven E.Hyman,M.D.(2007-2012)Dilip V.Je
16、ste,M.D.(2007-2011)Helena C.Kraemer,Ph.D.Daniel T.Mamah,M.D.,M.P.E.James P.McNulty,A.B.,Sc.B.Howard B.Moss,M.D.(2007-2009)Susan K.Schultz,M.D.,Text Editor Emily A.Kuhl,Ph.D.,APA Text EditorCharles P.OBrien,M.D.,Ph.D.Roger Peele,M.D.Katharine A.Phillips,M.D.Daniel S.Pine,M.D.Charles F.Reynolds III,M.
17、D.Maritza Rubio-Stipec,Sc.D.David Shaffer,M.D.Andrew E.Skodol II,M.D.Susan E.Swedo,M.D.B.Timothy Walsh,M.D.Philip Wang,M.D.,Dr.P.H.(2007-2012)William M.Womack,M.D.Kimberly A.Yonkers,M.D.Kenneth J.Zucker,Ph.D.Norman Sartorius,M.D.,Ph.D.,ConsultantAPA Division of Research Staff on DSIVI-5Darrel A.Regi
18、er,M.D.,M.P.H.,Director,Division of Research William E.Narrow,M.D.,M.P.H.,Associate Director Emily A.Kuhl,Ph.D.,Senior Science Writer;Staff Text Editor Diana E.Clarke,Ph.D.,M.Sc.,Research StatisticianLisa H.Greiner,M.S.S.A.,DSM-5 Field Trials Project Manager Eve K.Moscicki,Sc.D.,M.P.H.,Director,Prac
19、tice Research Network S.Janet Kuramoto,Ph.D.M.H.S.,Senior Scientific Research Associate,Practice Research NetworkAmy Porfiri,M.B.A.Director of Finance and AdministrationJennifer J.Shupinka,Assistant Director,DSM Operations Seung-Hee Hong,DSM Senior Research AssociateAnne R.Hiller,DSM Research Associ
20、ate Alison S.Beale,DSM Research Associate Spencer R.Case,DSM Research AssociateJoyce C.West,Ph.D.,M.P.P.,Health Policy Research Director,Practice Research Network Farifteh F.Duffy,Ph.D.,Quality Care Research Director,Practice Research Network Lisa M.Countis,Field Operations Manager,Practice Research
21、 NetworkChristopher M.Reynolds,Executive AssistantAPA Office of the IVIedlcal DirectorJames H.S c u lly Jr.,M.D.Medical Director and CEOEditorial and Coding ConsultantsMichael B.First,M.D.Maria N.Ward,M.Ed.,RHIT,CCS-PDSM-5 Work GroupsADHD and Disruptive Behavior DisordersDavid Shaffer,M.D.ChairF.Xav
22、ier Castellanos,M.D.Co-ChairPaul J.Frick,Ph.D.,Text Coordinator Luis Augusto Rohde,M.D.,Sc.D.Glorisa Canino,Ph.D.Rosemary Tannock,Ph.D.Terrie E.Moffitt,Ph.D.Eric A.Taylor,M.B.Joel T.Nigg,Ph.D.Richard Todd,Ph.D.,M.D.(d.2008)Anxiety,Obsessive-Compulsive Spectrum,Posttraumatic,and Dissociative Disorder
23、sK atharine A.Phillips,M.D.ChairMichelle G.Craske,Ph.D.,Text Scott L.Rauch,M.D.Coordinator H.Blair Simpson,M.D.,Ph.D.J.Gavin Andrews,M.D.David Spiegel,M.D.Susan M.Bgels,Ph.D.Dan J.Stein,M.D.,Ph.D.Matthew J.Friedman,M.D.,Ph.D.Murray B.Stein,M.D.Eric Hollander,M.D.(2007-2009)Robert J.Ursano,M.D.Robert
24、o Lewis-Fernandez,M.D.,M.T.S.Hans-Ulrich Wittchen,Ph.D.Robert S.Pynoos,M.D.,M.P.H.Childhood and Adolescent DisordersDaniel S.Pine,M.D.ChairRonald E.Dahl,M.D.James F.Leckman,M.D.E.Jane Costello,Ph.D.(2007-2009)Ellen Leibenluft,M.D.Regina Smith James,M.D.Judith H.L.Rapoport,M.D.Rachel G.Klein,Ph.D.Cha
25、rles H.Zeanah,M.D.Eating DisordersB.Timothy W alsh,M.D.ChairStephen A.Wonderlich,Ph.D.,Richard E.Kreipe,M.D.Text Coordinator Marsha D.Marcus,Ph.D.Evelyn Attia,M.D.James E.Mitchell,M.D.Anne E.Becker,M.D.,Ph.D.,Sc.M.Ruth H.Striegel-Moore,Ph.D.Rachel Bryant-Waugh,M.D.G.Terence Wilson,Ph.D.Hans W.Hoek,M
26、.D.,Ph.D.Barbara E.Wolfe,Ph.D.A.P.R.N.Mood DisordersJa n a.F a w ce tt,M.D.ChairEllen Frank,Ph.D.,Text Coordinator Jules Angst,M.D.(2007-2008)William H.Coryell,M.D.Lori L.Davis,M.D.Raymond J.DePaulo,M.D.Sir David Goldberg,M.D.James S.Jackson,Ph.D.Kenneth S.Kendler,M.D.,Ph.D.(2007-2010)Mario Maj,M.D.
27、,Ph.D.Husseini K.Manji,M.D.(2007-2008)Michael R.Phillips,M.D.Trisha Suppes,M.D.,Ph.D.Carlos A.Zarate,M.D.Neurocognitive DisordersDilip V.Jeste,M.D.(2007-2011)Chair EmeritusDan G.Blazer,M.D.,Ph.D.,M.P.H.ChairR o n a ld C.P etersen,M.D.,Ph.D.Co-ChairMary Ganguli,M.D.,M.P.H.,Text Coordinator Deborah Bl
28、acker,M.D.,Sc.D.Warachal Faison,M.D.(2007-2008)Igor Grant,M.D.Eric J.Lenze,M.D.Jane S.Paulsen,Ph.D.Perminder S.Sachdev,M.D.,Ph.D.Neurodevelopmental DisordersSusan E.Swedo,M.D.ChairGillian Baird,M.A.,M.B.,B.Chir.,Text Coordinator Edwin H.Cook Jr.,M.D.Francesca G.Happ,Ph.D.James C.Harris,M.D.Walter E.
29、Kaufmann,M.D.Bryan H.King,M.D.Catherine E.Lord,Ph.D.Joseph Piven,M.D.Sally J.Rogers,Ph.D.Sarah J.Spence,M.D.,Ph.D.Fred Volkmar,M.D.(2007-2009)Amy M.Wetherby,Ph.D.Harry H.Wright,M.D.Personality and Personality DisordersAndrew E.Skodol,M.D.ChairJohn M.Oldham,M.D.Co-ChairRobert F.Krueger,Ph.D.,Text Coo
30、rdinator Renato D.Alarcon,M.D.,M.P.H.Carl C.Bell,M.D.Donna S.Bender,Ph.D.Lee Anna Clark,Ph.D.W.John Livesley,M.D.,Ph.D.(2007-2012)Leslie C.Morey,Ph.D.Larry J.Siever,M.D.Roel Verheul,Ph.D.(2008-2012)The members of the Personality and Personality Disorders W ork Group are responsible for the alternati
31、ve DSM-5 model for personality disorders that is included in Section III.The Section II personality disorders criteria and text(with updating of the text)are retained from DSM-IV-TR.Psychotic DisordersW illiam T.Carpenter Jr.,M.D.ChairDeanna M.Barch,Ph.D.,Text Dolores Malaspina,M.D.,M.S.P.H.Coordina
32、tor Michael J.Owen,M.D.,Ph.D.Juan R.Bustillo,M.D.Susan K.Schultz,M.D.Wolfgang Gaebel,M.D.Rajiv Tandon,M.D.Raquel E.Gur,M.D.,Ph.D.Ming T.Tsuang,M.D.,Ph.D.Stephan H.Heckers,M.D.Jim van Os,M.D.Sexual and Gender Identity DisordersKenneth J.Zucker,Ph.D.ChairLori Brotto,Ph.D.,Text Coordinator Martin P.Kaf
33、ka,M.D.Irving M.Binik,Ph.D.Richard B.Krueger,M.D.Ray M.Blanchard,Ph.D.Niklas Langstrm,M.D.,Ph.D.Peggy T.Cohen-Kettenis,Ph.D.Heino F.L.Meyer-Bahlburg,Dr.rer.nat.Jack Drescher,M.D.Friedemann Pffflin,M.D.Cynthia A.Graham,Ph.D.Robert Taylor Segraves,M.D.,Ph.D.Sleep-Wake DisordersC harles F.Reynolds III,
34、M.D.ChairRuth M.OHara,Ph.D.,Text Coordinator Kathy P.Parker,Ph.D.,R.N.Charles M.Morin,Ph.D.Susan Redline,M.D.,M.P.H.Allan I.Pack,Ph.D.Dieter Riemann,Ph.D.Somatic Symptom DisordersJoel E.Dimsdale,M.D.ChairJames L.Levenson,M.D.,Text Michael R.Irwin,M.D.Coordinator Francis J.Keefe,Ph.D.(2007-2011)Arthu
35、r J.Barsky III,M.D.Sing Lee,M.D.Francis Creed,M.D.Michael Sharpe,M.D.Nancy Frasure-Smith,Ph.D.(2007-2011)Lawson R.Wulsin,M.D.Substance-Related DisordersC harles P.OBrien,M.D.,Ph.D.ChairThomas J.Crowley,M.D.Co-ChairWilson M.Compton,M.D.,M.P.E.,Thomas R.Kosten,M.D.(2007-2008)Text Coordinator Walter Li
36、ng,M.D.Marc Auriacombe,M.D.Spero M.Manson,Ph.D.(2007-2008)Guilherme L.G.Borges,M.D.,Dr.Sc.A.Thomas McLellan,Ph.D.(2007-2008)Kathleen K.Bucholz,Ph.D.Nancy M.Petry,Ph.D.Alan J.Budney,Ph.D.Marc A.Schuckit,M.D.Bridget F.Grant,Ph.D.,Ph.D.Wim van den Brink,M.D.,Ph.D.Deborah S.Hasin,Ph.D.(2007-2008)DSM-5 S
37、tudy GroupsDiagnostic Spectra and DSM/ICD HarmonizationSteven E.H yman,M.D.Chair(2007-2012)William T.Carpenter Jr.,M.D.William E.Narrow,M.D.,M.P.H.Wilson M.Compton,M.D.,M.P.E.Charles P.OBrien,M.D.,Ph.D.Jan A.Fawcett,M.D.John M.Oldham,M.D.Helena C.Kraemer,Ph.D.Katharine A.Phillips,M.D.David J.Kupfer,
38、M.D.Darrel A.Regier,M.D.,M.P.H.Lifespan Developmental ApproachesEric J.Lenze,M.D.ChairSusan K.Schultz,M.D.Chair EmeritusDaniel S.Pine,M.D.Chair EmeritusDan G.Blazer,M.D.,Ph.D.,M.P.H.F.Xavier Castellanos,M.D.Wilson M.Compton,M.D.,M.P.E.Daniel T.Mamah,M.D.,M.P.E.Andrew E.Skodol II,M.D.Susan E.Swedo,M.
39、D.Gender and Cross-Cultural IssuesKimberly A.Yonkers,M.D.ChairRoberto Lewis-Fernndez,M.D.,M.T.S.Co-Chair,Cross-Cultural IssuesRenato D.Alarcon,M.D.,M.P.H.Diana E.Clarke,Ph.D.,M.Sc.Javier I.Escobar,M.D.,M.Sc.Ellen Frank,Ph.D.James S.Jackson,Ph.D.Spiro M.Manson,Ph.D.(2007-2008)James P.McNulty,A.B.,Sc.
40、B.Leslie C.Morey,Ph.D.William E.Narrow,M.D.,M.P.H.Roger Peele,M.D.Philip Wang,M.D.,Dr.P.H.(2007-2012)William M.Womack,M.D.Kermeth J.Zucker,Ph.D.Psychiatric/General Medical InterfaceLawson R.W ulsin,M.D.ChairRonald E.Dahl,M.D.Joel E.Dimsdale,M.D.Javier I.Escobar,M.D.,M.Sc.Dilip V.Jeste,M.D.(2007-2011
41、)Walter E.Kaufmann,M.D.Richard E.Kreipe,M.D.Ronald C.Petersen,Ph.D.,M.D.Charles F.Reynolds III,M.D.Robert Taylor Segraves,M.D.,Ph.D.B.Timothy Walsh,M.D.Impairment and DisabilityJan e S.P au lsen,Ph.D.ChairJ.Gavin Andrews,M.D.Glorisa Canino,Ph.D.Lee Anna Clark,Ph.D.Diana E.Clarke,Ph.D.,M.Sc.Michelle
42、G.Craske,Ph.D.Hans W.Hoek,M.D.,Ph.D.Helena C.Kraemer,Ph.D.William E.Narrow,M.D.,M.P.H.David Shaffer,M.D.Diagnostic Assessment InstrumentsJack D.Burke Jr.,M.D.,M.P.H.ChairLee Anna Clark,Ph.D.Diana E.Clarke,Ph.D.,M.Sc.Bridget F.Grant,Ph.D.,Ph.D.Helena C.Kraemer,Ph.D.William E.Narrow,M.D.,M.P.H.David S
43、haffer,M.D.DSM-5 Research GroupW illiam E.N arrow,M.D.,M.P.H.ChairJack D.Burke Jr.,M.D.,M.P.H.Diana E.Clarke,Ph.D.,M.Sc.Helena C.Kraemer,Ph.D.David J.Kupfer,M.D.Darrel A.Regier,M.D.,M.P.H.David Shaffer,M.D.Course Specifiers and GlossaryW olfgang Gaebel,M.D.ChairEllen Frank,Ph.D.Charles P.OBrien,M.D.
44、,Ph.D.Norman Sartorius,M.D.,Ph.D.,Consultant Susan K.Schultz,M.D.Dan J.Stein,M.D.,Ph.D.Eric A.Taylor,M.B.David J.Kupfer,M.D.Darrel A.Regier,M.D.,M.P.H.Before each disorder name,ICD-9-CM codes are provided,followed by ICD-IO-CM codes in parentheses.Blank lines indicate that either the ICD-9-CM or the
45、 ICD-IO-CM code is not applicable.For some disorders,the code can be indicated only according to the subtype or specifier.ICD-9-CM codes are to be used for coding purposes in the United States through September 30,2014.ICD-IO-CM codes are to be used starting October 1,2014.Following chapter titles a
46、nd disorder names,page numbers for the corresponding text or criteria are included in parentheses.Note for all mental disorders due to another medical condition:Indicate the name of the other medical condition in the name of the mental disorder due to the medical condition.The code and name for the
47、other medical condition should be listed first immediately before the mental disorder due to the medical condition.Neurodevelopm ental Disorders(31)Intellectual Disabilities(33)319(_._)Intellectual Disability(Intellectual Developmental Disorder)(33)Specify current severity;(F70)Mild(F71)Moderate(F72
48、)Severe(F73)Profound315.8(F88)Global Developmental Delay(41)319(F79)Unspecified Intellectual Disability(Intellectual DevelopmentalDisorder)(41)Communication Disorders(41)315.39(F80.9)Language Disorder(42)315.39(F80.0)Speech Sound Disorder(44)315.35(F80.81)Childhood-Onset Fluency Disorder(Stuttering)
49、(45)Note:Later-onset cases are diagnosed as 307.0(F98.5)adult-onset fluency disorder.315.39(F80.89)Social(Pragmatic)Communication Disorder(47)307.9(F80.9)Unspecified Communication Disorder(49)Autism Spectrum Disorder(50)299.00(F84.0)Autism Spectrum Disorder(50)Specify if:Associated with a known medi
50、cal or genetic condition or environmental factor;Associated with another neurodevelopmental,mental,or behavioral disorder Specify current severity for Criterion A and Criterion B:Requiring very substantial support.Requiring substantial support.Requiring support Specify if:With or without accompanyin