DSM5 Diagnostic Manual.docx

DSM5 Diagnostic Manual.docx

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DSM5DiagnosticManual

***DSM-5DISORDERS:

ESSENTIALFEATURES***

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

GENERALINCLUSIONCRITERIA（mostorallpresent）:

∙deviancefromsocialnorms

∙distress

∙dysfunction

∙danger

GENERALEXCLUSIONCRITERIA:

∙normalresponsetoanevent

∙normalbehaviourwithinethnicorsubculturalcontext

∙normalbehaviourforastageoflife

∙behaviorreflectingindividual/societalconflict

∙identifiablebiologicalcause（unlessspecifiedindiagnosticcriteriaforaparticulardisorder）

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

ANXIETYDISORDERS

∙PANICDISORDER惊恐性障碍，恐慌症

:

∙recurrentpanicattacks恐慌症

[Intensefear,startingsuddenlyandreachingpeakwithin10minutes;atleastfourofthefollowing:

chestpain,chills,toohot,choking,gasping,rapidorirregularheartbeat,tinglingornumbness,heavyperspiration,nausea恶心,作呕,晕船,dizziness,tremor震颤；战栗，发抖；惊恐；颤音；震动，地震。

]

∙intensefearofrecurrence,and/or

∙avoidanceofactionsorplacesassociatedwithpriorattacks

∙durationatleast1month

AGORAPHOBIA:

旷野恐怖；[心理]广场恐怖症；陌生环境恐怖症

∙intensefearwheninsituationsfromwhichrapidescapeisimpossible,and/orrapidhelpisunavailable

∙effortstoavoidsuchsituations

∙durationatleast6months

SOCIALANXIETYDISORDER:

∙intensefearwhenotherscouldcloselyobservetheperson

∙effortstoavoidsuchsituations

∙durationatleast6months

SPECIFICPHOBIA:

∙specificobjectorsituationhabituallytriggersanxietyoutofproportiontoanyobjectivethreat

∙objectisavoided,orenduredwithgreatdistress

∙durationatleast6months

∙notAgoraphobiaorSocialAnxietyDisorder

GENERALIZEDANXIETYDISORDER:

∙excessiveworryingaboutmultipleareasoflife

∙leadstoarangeofphysicalandmentalcomplaints（eg.tension,restlessness,tired,irritable,insomnia,poorconcentration）

∙mostdaysforatleast6months

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

OBSESSIVE-COMPULSIVEANDRELATEDDISORDERS

OBSESSIVE-COMPULSIVEDISORDER:

∙obsessions（recurringinvasiveideasorimagesthatproduceanxiety）and/or

∙compulsions（physicalormentalactionsaimedatreducingtheobsession-causedanxiety）

∙symptomsconsumesomuchtimethattheyinterferewithdailylife

HOARDINGDISORDER:

囤积症*强迫性囤积”，一个人格障碍，迫使人去积聚。

∙strongurgetoaccumulatestuff

∙intensedistresswhentryingtodiscardanything,evenseeminglyvaluelessthings

∙clutterinterfereswithlivingspaces

∙persistentduration

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

MOODDISORDERS

MAJORDEPRESSIVEDISORDER:

∙presenceofatleastfiveofthefollowing:

∙-depressedmood

∙-anhedonia【精神分析学】（精神病患者常有的）快感缺乏

∙-lossofappetiteandweight

∙-insomniaorhypersomnia嗜睡，[医]睡眠过度

∙-fatigue

∙*psychomotorretardation精神运动性阻滞

∙

∙-agitation

∙-lowself-esteemorguilt

∙-concentrationdecline

∙-suicidalideas

∙oneofthefiveabovemustbeeitherdepressedmoodoranhedonia

∙durationatleast2weeks,mostoftheday

∙[theabovepointsdefineamajordepressiveepisode]

∙[canbediagnosedduringbereavement]

∙[‘melancholicfeatures’referstomostsevereMDD]忧郁的特性

∙[‘rapidcycling’refersto4+episodesperyear]

--An·he·do·nia

:

Apsychologicalconditioncharacterizedbyinabilitytoexperiencepleasureinnormallypleasurableacts

BIPOLARIDISORDER:

∙changeinmood–euphoria精神欢快and/orirritability

∙ifeuphoria,atleastthreeofthefollowing/ifirritability,atleastfourofthefollowing:

heightenedself-esteem;decreasedsleep;heightenedactivity;impairedjudgment;rapidorpressuredspeech;flightofideas;distractibility

∙increaseinenergyoractivitylevel

∙durationatleast1week

∙*[theabovepointsdefineamanicepisode]躁狂发作

∙[mostpeoplewithBipolarIexperiencemajordepressiveepisodes,buttheiroccurrenceisnotrequiredforthediagnosisofBipolarI]

∙[‘rapidcycling’refersto4+episodesperyear]

BIPOLARIIDISORDER:

∙sameasBipolarI,exceptforthefollowing:

∙aclearchangefromtheperson’sbaselinemoodandbehaviour,tothepointwhereitisnoticeablebyothers,butwithoutsignificantfunctionalimpairmentorpsychoticfeatures

∙durationatleast4days

∙[theabovepointsdefineahypomanicepisode]轻躁狂发作

∙occurrenceofamajordepressiveepisode

∙[ifapersonwithadiagnosisofMajorDepressiveDisorderhasahypomanicepisode,thediagnosisischangedtoBipolarII）

∙[ifapersonwithadiagnosisofBipolarIIhasamanicepisode,thediagnosisischangedtoBipolarI]

∙[‘rapidcycling’refersto4+episodesperyear]

PERSISTENTDEPRESSIVEDISORDER:

持续的抑郁症

∙mostorallofthesymptomsofMajorDepressiveDisorderarepresent,mostofthetime,foratleast2years（withnosymptom-freeperiodlongerthan2months）foradults/foratleast1yearforchildren

∙[ifallcriteriaforMDDarenotmet,itiscalledDysthymiaorDysthymicDisorder]

Dysthymic-境恶劣障碍.重性抑郁症和心境恶劣障碍的神经心理

CYCLOTHYMICDISORDER:

∙recurrentepisodesofelationordepressionthatdonotmeetthecriteriaformajordepressiveepisode,maniaorhypomania

∙symptomsarepresent,mostofthetime,foratleast2years（withnosymptom-freeperiodlongerthan2months）foradults/foratleast1yearforchildrenoradolescents

如果在抑郁过程中间或出现兴奋、情绪高涨等轻度躁狂状态则称为 循环性情绪障碍 （cyclothymicdisorder ），其严重程度低于重性抑郁障碍和双相障碍（如下述）。

~~~~~~~~~~~~~~~~~~~~~~~~~~~~

SOMATICSYMPTOMANDRELATEDDISORDERS

ILLNESSANXIETYDISORDER:

∙extremeanxietyaboutthepossibilityofseriousphysicalillness,intheabsenceofserioussomaticsymptoms;oranxietythatisexaggeratedinthepresenceofsomaticsymptoms

∙durationatleast6months

∙[alsocalledHypochondriasis]

SOMATICSYMPTOMDISORDER:

∙extremeanxiety,persistentthoughtsorseekingofmedicalcareinresponsetoatleastonesubjectivesomaticsymptomintheabsenceofanidentifiablephysicalcause

∙symptomsarenotconsciouslyfeigned

∙durationatleast6months

∙[ifmultiplesymptoms,‘somatizationpattern’]

∙[ifmainlypain,‘predominantpainpattern’]

CONVERSIONDISORDER:

∙atleastonesymptomofdisturbedsensoryorvoluntarymotorfunctionintheabsenceofanidentifiablephysicalcause

∙symptomsarenotconsciouslyfeigned

FACTITIOUSDISORDER:

∙consciousfeigningofsomaticsymptoms

∙motivationistoaccesstheattentionandsympathygiventosomeoneintheroleofasickperson（ortheroleofacare-giver）

∙[ifself-harmingbehaviourisusedtoproducesymptoms,itisdesignated‘MunchausenSyndrome’]

∙[ifanotherpersonisharmedtoproducesymptoms,itisdesignated‘MunchausenSyndromebyProxy’]

MALINGERING（notaDSMpsychologicaldisorder!

）:

∙consciousfeigningofsomaticsymptoms

∙motivationistoaccessarewardotherthanthosetypicallyarisingfromtheroleofasickpersonorcare-giver

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

EATINGDISORDERS

ANOREXIANERVOSA:

∙deliberaterestrictionofnourishment,leadingtosignificantlylowbodyweight（eg.BMI<18.5）

∙intensefearofweightgain

∙disturbedbodyimage,minimizingordenialofproblem,oroveremphasisofbodyshapeorweightinself-esteem

∙[binge/purgingtype]

∙[restrictingtype=withoutbinge/purgecycles]

BULIMIANERVOSA:

∙recurrentepisodesofbingeeating

∙recurrentinappropriatecompensatoryactions

∙bingeandcompensatorybehavioursaveragingatleastonceaweekfor3months

∙overemphasisofbodyshapeandweightinself-esteem

∙notwithsignificantlylowbodyweight

BINGEEATINGDISORDER:

∙recurrentepisodesofbingeeating,withoutcompensatorybehaviour,averagingonceaweekfor3months

∙atleast3of:

rapideating;eatinglargeamountswithouthunger;eatinguntilfeelingstuffed;eatingalonefromembarrassment;intenseguiltordisgustafterbinge

~~~~~~~~~~~~~~~~~~~~~~~~~~~

TRAUMA-RELATEDDISORDERS

ACUTESTRESSDISORDER:

∙exposuretoahorrificevent,eitherdirectlyorviaemotionalattachmenttosomeone

∙repeated,intrusivere-experiencing

∙avoidanceofmemorycuesfortheevent

∙hyperarousal

∙dissociativeexperiences

∙durationfrom3daysto1monthaftertheevent

POST-TRAUMATICSTRESSDISORDER:

∙exposuretoahorrificevent,eitherdirectlyorviaemotionalattachmenttosomeone

∙repeated,intrusivere-experiencing

∙avoidanceofmemorycuesfortheevent

∙hyperarousal

∙atleasttwoof:

negativemood,negativethoughts,anhedoniaordissociativesymptoms

∙durationatleast1month

∙[‘delayedexpression’ifcriteriafordiagnosisnotreacheduntil6monthsafterevent]

~~~~~~~~~~~~~~~~~~~~~~~~~~~

PSYCHOTICDISORDERS

SCHIZOPHRENIA:

∙atleasttwoofthefollowing:

∙-delusions

∙-hallucinations

∙-disorganizedspeech

∙-disorganizedbehaviour

∙-negativesymptoms

∙atleastoneoftheabovemustbedelusions,hallucinationsordisorganizedspeech

∙lackofinsightintosymptoms

∙durationofabove,atleast1month;durationofdisturbance,includingprodrome,atleast6months

SCHIZOPHRENIFORMDISORDER:

∙symptomcriteriaforSchizophreniaaremet

∙durationfrom1to6months

∙[ifsymptomspersistpast6months,diagnosischangestoSchizophrenia]

BRIEFPSYCHOTICDISORDER:

∙atleastoneofthefollowing:

∙-delusions

∙-hallucinations

∙-disorganizedspeech

∙durationfrom1dayto1month

∙[iftwopsychoticsymptomsarepresentanddurationexceeds1month,diagnosischangestoSchizophreniformDisorder]

DELUSIONALDISORDER:

∙persistentdelusionsintheabsenceofanyotherpersistentpsychoticsymptoms

∙behaviourisaffectedonlyinareasdirectlyrelatedtothedelusionalcontent

∙durationatleast1month

SCHIZOAFFECTIVEDISORDER:

∙symptomcriteriaforSchizophreniaaremetforatleast2weeks,duringwhichtimesignificantmoodsymptomsareabsent

∙manicormajordepressiveepisodeforatleas