Diagnostic and Statistical Manual of Mental Disorders - DSM-III-R.

Diagnostic and Statistical Manual of Mental Disorders - DSM-III-R.

Association American Psychiatric & Staff American Psychiatric Association & DSM-III. American Psychiatric Association. Work Group to Revise

(THIRD EDITION - REVISED)

DSM-III-R

AMERICAN

Published by the

American Psychiatric Association

Washington, DC

1987

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Copyright © 1987 The American Psychiatric Association

Manufactured in the U.S.A.

Available outside North America from the Press Syndicate of the University of Cambridge, the Pitt Building, Trumpington Street, Cambridge, CB2 1 RP.

ISBN 0-521-34509-X (casebound); 0-521-36755-6 (soft cover).

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 APA's copyright. This prohibition applies to unauthorized uses or reproductions in any form, including computer programs.

Correspondence regarding copyright permissions should be directed to the Division of Publications and Marketing, American Psychiatric Association, 1400 K Street, N.W., Washington, DC

20005.

The correct citation for this book is:

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Washington, DC, American Psychiatric Association, 1987.

Library of Congress Cataloging-in-Publication Data

Diagnostic and statistical manual of mental disorders.

Prepared by the Work Group to Revise DSM-III of the American Psychiatric Association.

Includes index.

1. Mental illness-Classification. 2. Mental illness-Diagnosis. I. American Psychiatric Association. II. American Psychiatric Association. Work Group to Revise DSM-III.

IDNLM: 1. Mental Disorders-classification. 2. Psychiatry-nomenclature. WM 15 D536] RC455.2.C4D54

1987 616.89 075 87-1458

ISBN 0-89042-018-1

ISBN 0-89042-019-X (soft)

First printing, 75,000, May 1987

Second printing, 80,000, June 1987

Contents

Introduction

Cautionary Statement

CHAPTER 1 DSM-III-R Classification: Axes I and ll Categories and Codes

CHAPTER 2 Use of This Manual

CHAPTER 3

The Diagnostic Categories: Text and Criteria

Disorders Usually First Evident in Infancy, Childhood, or Adolescence

Organic Mental Syndromes and Disorders

Psychoactive Substance Use Disorders

Schizophrenia

Delusional Disorder

Psychotic Disorders Not Elsewhere Classified

Mood Disorders

Anxiety Disorders

Somatoform Disorders

Dissociative Disorders

Sexual Disorders

Sleep Disorders

Factitious Disorders

Impulse Control Disorders Not Elsewhere Classified

Adjustment Disorder

Psychological Factors Affecting Physical Condition

Personality Disorders

V Codes for Conditions Not Attributable to a Mental Disorder

That are a Focus of Attention or Treatment

Additional Codes

Appendix A Proposed Diagnostic Categories Needing Further Study

Appendix B Decision Trees for Differential Diagnosis

Appendix C Glossary of Technical Terms

Appendix D Annotated Comparative Listing of DSM-III and DSM-III-P

Appendix E

Historical Review, ICD-9 Glossary and Classification, and ICD-9-CM Classification

Appendix F DSM-III-R Field Trial Participants

Appendix G Alphabetic Listing of DSM-III-R Diagnoses and Codes

Appendix H Numeric Listing of DSM-III-R Diagnoses and Codes

Symptom Index:

Index of Selected Symptoms Included in the Diagnostic Criteria

Diagnostic Index:

Index of DSM-III-R Diagnoses and

Selected Diagnostic Terms

Page

XV

xxiX

ACKNOWLEDGMENTS

This manual was prepared with the help of many people. Special thanks are given to the members of the Work Group to Revise DSM-III, the various Advisory Committees and the members of the Ad Hoc Committee to Review DSM-III of the Board of Trustees and Assembly of District Branches. In addition, the work of the participants in the field trials of certain DSM-III-R categories, who are listed in Appendix F, is gratefully appreci-ated.

A final word of thanks must be given to the many other participants in this effort who have not received formal recognition, but who provided critiques and suggestions that were helpful in the preparation of DSM-III-R.

Robert L. Spitzer, M.D.

Chair, Work Group to Revise DSM-III

Janet B. W. Williams, D.S. W.

Text Editor

Robert L. Spitzer, M.D.

Chair

Janet B. W. Williams, D.S. W.

Text Editor

Dennis Cantwell, M.D.

Allen J. Frances, M.D.

Kenneth S. Kendler, M.D.

Gerald L. Klerman, M.D.

David Kupfer, M.D.

WORK GROUP TO REVISE DSM-III

Roger Peele, M.D.

Judith L. Rapoport, M.D.

Darrel A. Regier, M.D., M.P.H.

Bruce Rounsaville, M.D.

George Vaillant, M.D.

Lyman C. Wynne, M.D., Ph.D.

Staff Liaisons

Harold A. Pincus, M.D.

Steven S. Sharfstein, M.D.

AD HOC COMMITTEE TO REVIEW DSM-III-R OF THE BOARD OF TRUSTEES AND ASSEMBLY OF DISTRICT BRANCHES

Robert O. Pasnau, M.D.

Elissa Benedek, M.D.

(Chair: September 1985-May 1986)

Richard M. Finn, M.D.

Paul J. Fink, M.D.

Cynthia Rose, M.D.

(Chair: May 1986-

Lindbergh S. Sata, M.D.

Chester W. Schmidt, M.D.

Roger Peele, M.D. (Vice-chair)

William L. Webb, Jr., M.D.

ADVISORY COMMITTEES ON DIAGNOSTIC CATEGORIES

DISORDERS USUALLY FIRST EVIDENT IN INFANCY, CHILDHOOD, OR ADOLESCENCE

Thomas Achenbach, Ph.D.

Dennis Cantwell, M.D.

Donald Cohen, M.D.

Anthony Costello, M.D.

Rachel G. Klein, Ph.D.

Joaquim Puig-Antich, M.D.

Judith L. Rapoport, M.D.

David Shaffer, M.D.

Robert L. Spitzer, M.D.

Janet B. W. Williams, D.S. W.

Subcommittee on Mental Retardation

Dennis Cantwell, M.D.

Donald Cohen, M.D.

Herbert Grossman, M.D.

Robert L. Spitzer, M.D.

Ludwik Szymanski, M.D.

Janet B. W. Williams, D.S. W.

Sara Sparrow, Ph.D.

Subcommittee on Pervasive Developmental Disorders

Sheila Cantor, M.D.

Sally Provence, M.D.

Dennis Cantwell, M.D.

Judith L. Rapoport, M.D.

Donald Cohen, M.D.

Judith Rumsey, Ph.D.

Howard Demo, M.D.

Michael Rutter, M.D.

Martha Denckla, M.D.

Eric Schopler, Ph.D.

Robert N. Emde, M.D.

Robert L. Spitzer, M.D.

Deborah Fein, Ph.D.

A. Hussain Tuma, Ph.D.

Stanley Greenspan, M.D.

Fred Volkmar, M.D.

Rachel G. Klein, Ph.D.

Lynn Waterhouse, Ph.D.

Jack M. Levine, M.D.

Janet B. W. Williams, D.S.W.

Klaus Minde, M.D.

Lorna Wing, M.D.

Robert A. Nover, M.D.