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DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS FIFTH EDITION Psychiatric Association Officers PRESIDENT DILIP V
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J ESTE M D PRESIDENT JEFFREY A
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L IEBERMAN M D TREASURER DAVID FASSLER M D SECRETARY ROGER PEELE M D Assembly SPEAKER R
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S COTT BENSON M D SPEAKER MELINDA L
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Y OUNG M D Board of Trustees JEFFREY AKAKA M D CAROL A
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B ERNSTEIN M D BRIAN CROWLEY M D ANITA S
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E VERETT M D JEFFREY GELLER M D M P H MARC DAVID GRAFF M D JAMES A
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N ININGER M D JOHN M
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V ANDERLIP M D MEMBER TRUSTEE DC London EnglandDIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS FIFTH EDITION 2013 American Psychiatric Association DSM and are trademarks of the American Psychiatric Association
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Use of these terms is prohibited without perm ission of the American Psychiatric Association ALL RIGHTS RESERVED
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Unless auth orized in writing by the APA no part of this book may be reproduced or used in a manner inconsistent with the copyright
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This prohibition applies 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 Wilso n Boulevard Suite 1825 Arlington VA 3901 Manufactured in the United States of America on paper ISBN 2nd printing June 2013 ISBN 2nd prin ting June 2013 American Psychiatric Association 1000 Wilson Boulevard Arlington VA www psych org The correct citation for this book is American Psychiatric Diagnostic and cal Manual of Mental Disorders Fifth Edition
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Arlington VA American Psychiatric tion 2013 Library of Congress Data Diagnostic and statistical manual of mental disorders 5th ed p cm Includes index ISBN alk ISBN alk I
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American Psychiatric Association
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II
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American Psychiatric Association
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Task Force III
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IV
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1
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Diagnostic and statistical manual of mental disorders 5th ed 2
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Mental classification 3
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Mental
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WM RC455 2 C4 616 2013011061 British Library Cataloguing in Publication Data A CIP record is available from the British Library Text J
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Cordova R
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DonnelleyContents Classification xiii Preface xli
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Section I Basics Introduction 5 Use of the Manual 19 Cautionary Statement for Forensic Us e of 25
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Section II Diagnostic Criteria and Codes Neurodevelopmental Disorders 31 Schizophrenia Spectrum and Other Psychotic Disorders 87 Bipolar and Related Disorders 123 Depressive Disorders 155 Anxiety Disorders 189 and Re lated Disorders 235 and Disorders 265 Dissociative Disorders 291 Somatic Symptom and Related Disorders 309 Feeding and Eating Disorders 329 Elimination Disorders 355 Disorders 361 Sexual Dysfunctions 423 Gender Dysphoria 451Disruptive and Con duct Disorders 461 and Addictive Disord ers 481 Neurocognitive Disorders 591 Personality Disorders 645 Paraphilic Disorders 685 Other Mental Disorders 707 Movement Disorders and Other Adverse Effects of Medication 709 Other Conditions That May Be a Fo cus of Clinical Attention 715
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Section III Emerging Measures and Models Assessment Measures 733 Cultural Formulation 749 Alternative Model for Personality Disorder s 761 Conditions for Further Study 783
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Appendix Highlights of Ch anges From to 809 Glossary of Technical Terms 817 Glossary of Cultural Concepts of Dist ress 833 Alphabetical Listing of Diagno ses and Codes and 839 Numerical Listing of DS Diagnoses and Codes 863 Numerical Listing of DS Diagnoses and Codes 877 Advisors and Other Contributors 897 Index Task Force DAVID J
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K UPFER M D Task Force Chair DARREL A
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R EGIER M D M P H Task Force William E
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Narrow M D M P H Research DirectorSusan K
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Schultz M D Text Editor Emily A
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Kuhl Ph D APA Text Editor Dan G
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Escobar M D M Sc Jan A
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Fawcett M D Bridget F
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Grant Ph D Ph D Steven E
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Hyman M D Dilip V
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Jeste M D Helena C
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Kraemer Ph D Daniel T
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Mamah M D M P E James P
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McNulty A B Sc B Howard B
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Moss M D P
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M D Ph D Roger Peele M D Katharine A
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Phillips M D Daniel S
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Pine M D Charles F
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Reynolds III M D Maritza Sc D David Shaffer M D Andrew E
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Skodol II M D Susan E
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Swedo M D B
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Timothy Walsh M D Philip Wang M D Dr P H William M
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Womack M D Kimberly A
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Yonkers M D Kenneth J
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Zucker Ph D Norman Sartorius M D Ph D Consultant APA Division of Research Staff on Darrel A
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Regier M D M P H Director Division of Research William E
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Narrow M D M P H Associate Director Emily A
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Kuhl Ph D Senior Science Staff Text Editor Diana E
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Clarke Ph D M Sc Research Statistician Lisa H
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Greiner M S S A Field Trials Project Manager Eve K
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Moscicki Sc D M P H Director Practice Research Network S
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Janet Kuramoto Ph D
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M H S Senior Scientific Research Associate Practice Research Network Amy Porfiri M B A Director of Finance and AdministrationJennifer J
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Shupinka Assistant Director DSM Operations Hong DSM Senior Research Associate Anne R
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Hiller DSM Research Associate Alison S
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Beale DSM Research Associate Spencer R
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Case DSM Research Associate Joyce C
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West Ph D M P P Health Policy Research Director Practice Research Network Farifteh F
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Duffy Ph D Quality Care Research Director Practice Research Network Lisa M
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Countis Field Operations Manager Practice Research Network Christopher M
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Reynolds Executive Assistant APA Office of the Medical Director JAMES H
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S CULLY JR M D Medical Director and CEOEditorial and Coding Consultants Michael B
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First M D
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Maria N
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Ward M Ed RHIT Work Groups ADHD and Disruptive Behavior Disorders DAVID SHAFFER M D Chair F
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X AVIER CASTELLANOS M D Paul J
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Frick Ph D Text Coordinator Glorisa Canino Ph D Terrie E
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Moffitt Ph D Joel T
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Nigg Ph D
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Luis Augusto Rohde M D Sc D Rosemary Tannock Ph D Eric A
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Taylor M B Richard Todd Ph D M D Anxiety Spectrum Posttraumatic and Dissociative Disorders KATHARINE A
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P HILLIPS M D Chair Michelle G
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Craske Ph D Text Coordinator J
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Gavin Andrews M D Susan M
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Ph D Matthew J
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94
Friedman M D Ph D Eric Hollander M D Roberto M D M T S Robert S
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95
Pynoos M D M P H Scott L
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96
Rauch M D H
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97
Blair Simpson M D Ph D David Spiegel M D Dan J
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98
Stein M D Ph D Murray B
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99