DSM-5分类

精神疾病诊断与统计手册第5版目录美国精神病学会编，邓明昱博士译 精神疾病诊断与统计手册第5版（DSM-5）已于2013年5月18日由美国精神病协会(APA)在美国正式出版，此本书的特点在于对某些精神疾病提高其“诊断特异性”标准(也就是诊断准严格要求排除真正没有精神疾病的人)且降低其“诊断敏感性”(亦即某些可能有精神疾患前驱症状不再被确诊为“疾患”)。除此之外，DSM-5尝试使用光谱系统(Spectrum)，疾患将不再只是“类别分类”。Preface前言Section I: DSM-5 BasicsIntroductionUse of the ManualCautionary Statement for Forensic Use of DSM-5第一节：DSM-5基础介绍手册的使用法医使用DSM-5的警示声明Section II: Diagnostic Criteria and CodesNeurodevelopmental DisordersIntellectual DisabilitiesIntellectual Disability (Intellectual Developmental Disorder)Global Developmental DelayUnspecified Intellectual Disability (Intellectual Developmental Disorder)Communication DisordersLanguage DisorderSpeech Sound Disorder (previously Phonological Disorder)Childhood-Onset Fluency Disorder (Stuttering)Social (Pragmatic) Communication DisorderUnspecified Communication DisorderAutism Spectrum DisorderAutism Spectrum DisorderAttention-Deficit/Hyperactivity DisorderAttention-Deficit/Hyperactivity DisorderOther Specified Attention-Deficit/Hyperactivity DisorderUnspecified Attention-Deficit/Hyperactivity DisorderSpecific Learning DisorderSpecific Learning DisorderMotor DisordersDevelopmental Coordination Disorder Stereotypic Movement DisorderTic DisordersTourettes DisorderPersistent (Chronic) Motor or Vocal Tic DisorderProvisional Tic DisorderOther Specified Tic DisorderUnspecified Tic DisorderOther Neurodevelopmental DisordersOther Specified Neurodevelopmental DisorderUnspecified Neurodevelopmental DisorderSchizophrenia Spectrum and Other Psychotic DisordersSchizotypal (Personality) DisorderDelusional DisorderBrief Psychotic DisorderSchizophreniform DisorderSchizophreniaSchizoaffective DisorderSubstance/Medication-Induced Psychotic DisorderPsychotic Disorder Due to Another Medical ConditionCatatoniaCatatonia Associated With Another Mental Disorder (Catatonia Specifier) Catatonic Disorder Due to Another Medical ConditionUnspecified Catatonia Other Specified Schizophrenia Spectrum and Other Psychotic DisorderUnspecified Schizophrenia Spectrum and Other Psychotic DisorderBipolar and Related DisordersBipolar I DisorderBipolar II DisorderCyclothymic DisorderSubstance/Medication-Induced Bipolar and Related DisorderBipolar and Related Disorder Due to Another Medical ConditionOther Specified Bipolar and Related DisorderUnspecified Bipolar and Related DisorderDepressive DisordersDisruptive Mood Dysregulation DisorderMajor Depressive Disorder, Single and Recurrent EpisodesPersistent Depressive Disorder (Dysthymia)Premenstrual Dysphoric DisorderSubstance/Medication-Induced Depressive DisorderDepressive Disorder Due to Another Medical ConditionOther Specified Depressive DisorderUnspecified Depressive DisorderAnxiety DisordersSeparation Anxiety DisorderSelective MutismSpecific PhobiaSocial Anxiety Disorder (Social Phobia)Panic DisorderPanic Attack (Specifier)AgoraphobiaGeneralized Anxiety DisorderSubstance/Medication-Induced Anxiety DisorderAnxiety Disorder Due to Another Medical ConditionOther Specified Anxiety DisorderUnspecified Anxiety DisorderObsessive-Compulsive and Related DisordersObsessive-Compulsive DisorderBody Dysmorphic DisorderHoarding DisorderTrichotillomania (Hair-Pulling Disorder)Excoriation (Skin-Picking) DisorderSubstance/Medication-Induced Obsessive-Compulsive and Related DisorderObsessive-Compulsive and Related Disorder Due to Another Medical ConditionOther Specified Obsessive-Compulsive and Related DisorderUnspecified Obsessive-Compulsive and Related Disorder Trauma- and Stressor-Related DisordersReactive Attachment DisorderDisinhibited Social Engagement DisorderPosttraumatic Stress DisorderAcute Stress DisorderAdjustment DisordersOther Specified Trauma- and Stressor-Related DisorderUnspecified Trauma- and Stressor-Related DisorderDissociative DisordersDissociative Identity DisorderDissociative AmnesiaDepersonalization/Derealization DisorderOther Specified Dissociative DisorderUnspecified Dissociative Disorder Somatic Symptom and Related DisordersSomatic Symptom DisorderIllness Anxiety DisorderConversion Disorder (Functional Neurological Symptom Disorder)Psychological Factors Affecting Other Medical ConditionsFactitious DisorderOther Specified Somatic Symptom and Related DisorderUnspecified Somatic Symptom and Related DisorderFeeding and Eating DisordersPica Rumination DisorderAvoidant/Restrictive Food Intake DisorderAnorexia NervosaBulimia NervosaBinge-Eating DisorderOther Specified Feeding or Eating DisorderUnspecified Feeding or Eating DisorderElimination DisordersEnuresisEncopresisOther Specified Elimination DisorderUnspecified Elimination DisorderSleep-Wake DisordersInsomnia DisorderHypersomnolence DisorderNarcolepsy Breathing-Related Sleep DisordersObstructive Sleep Apnea HypopneaCentral Sleep ApneaSleep-Related HypoventilationCircadian Rhythm Sleep-Wake DisordersParasomniasNonRapid Eye Movement Sleep Arousal Disorders Sleepwalking Sleep TerrorsNightmare DisorderRapid Eye Movement Sleep Behavior DisorderRestless Legs SyndromeSubstance/Medication-Induced Sleep DisorderOther Specified Insomnia DisorderUnspecified Insomnia DisorderOther Specified Hypersomnolence DisorderUnspecified Hypersomnolence DisorderOther Specified Sleep-Wake DisorderUnspecified Sleep-Wake DisorderSexual DysfunctionsDelayed EjaculationErectile DisorderFemale Orgasmic DisorderFemale Sexual Interest/Arousal DisorderGenito-PelvicPain/Penetration DisorderMale Hypoactive Sexual Desire DisorderPremature (Early) EjaculationSubstance/Medication-Induced Sexual DysfunctionOther Specified Sexual DysfunctionUnspecified Sexual DysfunctionGender DysphoriaGender DysphoriaOther Specified Gender DysphoriaUnspecified Gender DysphoriaDisruptive, Impulse-Control, and Conduct DisordersOppositional Defiant DisorderIntermittent Explosive DisorderConduct DisorderAntisocial Personality DisorderPyromaniaKleptomaniaOther Specified Disruptive, Impulse-Control, and Conduct Disorder Unspecified Disruptive, Impulse-Control, and Conduct DisorderSubstance-Related and Addictive DisordersSubstance-Related Disorders Substance Use Disorders Substance-Induced Disorders Substance Intoxication and Withdrawal Substance/Medication-Induced Mental Disorders Alcohol-Related Disorders Alcohol Use Disorder Alcohol Intoxication Alcohol Withdrawal Other Alcohol-Induced Disorders Unspecified Alcohol-Related Disorder Caffeine-Related Disorders Caffeine Intoxication Caffeine Withdrawal Other Caffeine-Induced Disorders Unspecified Caffeine-Related Disorder Cannabis-Related Disorders Cannabis Use Disorder Cannabis Intoxication Cannabis Withdrawal Other Cannabis-Induced DisordersUnspecified Cannabis-Related Disorder Hallucinogen-Related Disorders Phencyclidine Use Disorder Other Hallucinogen Use Disorder Phencyclidine Intoxication Other Hallucinogen Intoxication Hallucinogen Persisting Perception Disorder Other Phencyclidine-Induced Disorders Other Hallucinogen-Induced Disorders Unspecified Phencyclidine-Related Disorder Unspecified Hallucinogen-Related Disorder Inhalant-Related Disorders Inhalant Use Disorder Inhalant Intoxication Other Inhalant-Induced Disorders Unspecified Inhalant-Related Disorder Opioid-Related Disorders Opioid Use Disorder Opioid Intoxication Opioid Withdrawal Other Opioid-Induced Disorders Unspecified Opioid-Related Disorder Sedative-, Hypnotic-, or Anxiolytic-Related DisordersSedative, Hypnotic, or Anxiolytic Use Disorder Sedative, Hypnotic, or Anxiolytic Intoxication Sedative, Hypnotic, or Anxiolytic Withdrawal Other Sedative-, Hypnotic-, or Anxiolytic-Induced Disorders Unspecified Sedative-, Hypnotic-, or Anxiolytic -Related Disorder Stimulant-Related Disorders Stimulant Use Disorder Stimulant Intoxication Stimulant Withdrawal Other Stimulant-Induced Disorders Unspecified Stimulant-Related Disorder Tobacco-Related Disorders Tobacco Use Disorder Tobacco Withdrawal Other Tobacco-Induced Disorders Unspecified Tobacco-Related Disorder Other (or Unknown) SubstanceRelated Disorders Other (or Unknown) Substance Use Disorder Other (or Unknown) Substance Intoxication Other (or Unknown) Substance Withdrawal Other (or Unknown) SubstanceInduced Disorders Unspecified Other (or Unknown) SubstanceRelated DisorderNon-Substance-Related DisordersGambling DisorderNeurocognitive DisordersDeliriumOther Specified DeliriumUnspecified DeliriumMajor and Mild Neurocognitive DisordersMajor Neurocognitive DisorderMild Neurocognitive DisorderMajor or Mild Neurocognitive Disorder Due to Alzheimers DiseaseMajor or Mild Frontotemporal Neurocognitive DisorderMajor or Mild Neurocognitive Disorder WithLewy BodiesMajor or Mild Vascular Neurocognitive DisorderMajor or Mild Neurocognitive Disorder Due to Traumatic Brain InjurySubstance/Medication-Induced Major or Mild Neurocognitive DisorderMajor or Mild Neurocognitive Disorder Due to HIV InfectionMajor or Mild Neurocognitive Disorder Due to Prion DiseaseMajor or Mild Neurocognitive Disorder Due to Parkinsons DiseaseMajor or Mild Neurocognitive Disorder Due to Huntingtons DiseaseMajor or Mild Neurocognitive Disorder Due to Another Medical ConditionMajor or Mild Neurocognitive Disorder Due to Multiple EtiologiesUnspecified Neurocognitive DisorderPersonality DisordersGeneral Personality DisorderCluster APersonality DisordersParanoid Personality DisorderSchizoid Personality DisorderSchizotypal Personality DisorderCluster B Personality DisordersAntisocial Personality DisorderBorderline Personality DisorderHistrionic Personality DisorderNarcissistic Personality DisorderCluster C Personality DisordersAvoidant Personality DisorderDependent Personality DisorderObsessive-Compulsive Personality DisorderOther Personality DisordersPersonality Change Due to Another Medical ConditionOther Specified Personality DisorderUnspecified Personality DisorderParaphilic DisordersVoyeuristic DisorderExhibitionistic DisorderFrotteuristic DisorderSexual Masochism DisorderSexual Sadism DisorderPedophilic DisorderFetishistic DisorderTransvestic DisorderOther Specified Paraphilic DisorderUnspecified Paraphilic DisorderOther Mental DisordersOther Specified Mental Disorder Due to Another Medical ConditionUnspecified Mental Disorder Due to Another Medical ConditionOther Specified Mental DisorderUnspecified Mental Disorder Medication-Induced Movement Disorders and Other Adverse Effects of MedicationOther Conditions That May Be a Focus of Clinical Attention第二节：基本要素：诊断标准和代码神经发育障碍（一）智力发展障碍智力残疾（智力发育障碍）整体发展迟缓未说明智力发展障碍交流性障碍语言性障碍谈话性语音障碍（以前的口吃障碍）儿童期发病的流畅性障碍（口吃）社会（应用）交流性障碍未特定的交流性障碍自闭症谱系障碍自闭症谱系障碍注意缺陷/多动障碍注意缺陷/多动障碍其他特定的注意缺陷/多动障碍未特定的注意缺陷/多动障碍特殊学习障碍特殊学习障碍运动障碍发展性协调障碍刻板性运动障碍抽动障碍面肌和声带抽动障碍持久（慢性）运动或发声抽动障碍一过性抽动障碍其他特定的抽动障碍未特定的抽动障碍其他神经发育障碍其他特定的神经发育障碍未特定的神经发育障碍精神分裂症谱系和其他精神病性障碍(二)分裂型（人格）障碍妄想性障碍短暂的精神病性障碍分裂样障碍精神分裂症情感性分裂障碍物质/药物引起精神障碍由于其他医疗条件所致的精神障碍紧张症紧张症并其他精神障碍（紧张症详细说明）由于其他医疗条件所致的紧张性障碍未特定的紧张症其他特定的精神分裂症谱系和其他精神病性障碍未特定的精神分裂症谱系和其他精神病性障碍双相及相关障碍（三）第一型双相障碍第二型双相障碍环性情感性障碍物质/药物引起的双相及相关障碍由于其他医疗条件所致的双相及相关障碍其他特定的双相及相关障碍未特定的双相及相关障碍抑郁障碍（四）破坏性情绪失调障碍重度抑郁障碍，单次和反复发作持久性抑郁障碍（心境）经前苦恼障碍物质/药物引起的抑郁障碍由于其他医疗条件所致的抑郁障碍其他特定的抑郁障碍未特定的抑郁障碍焦虑障碍（五）分离性焦虑障碍选择性缄默症特定的恐怖症社交焦虑障碍（社交恐怖症）恐慌障碍惊恐发作（详细说明）广场恐怖症广泛性焦虑障碍物质/药物诱发的焦虑障碍由于其他医疗条件所致的焦虑障碍其他特定的焦虑障碍未特定的焦虑障碍强迫及相关障碍（六）强迫性障碍躯体变形障碍囤积障碍拔毛症（拔头发障碍）剥皮（皮肤采摘）障碍物质/药物引起的强迫及相关障碍由于其他医疗条件所致的强迫及相关障碍其他特定的强迫和相关障碍未特定的强迫和相关障碍创伤和应激相关的障碍（七）反应性依恋障碍去抑制性社会参与障碍创伤后应激障碍急性应激障碍适应障碍其他特定的创伤和应激相关障碍未特定的创伤和应激相关障碍分离性障碍（八）分离性身份障碍分离性遗忘症人格解体/失实障碍其他特定的分离性障碍未特定的分离性障碍躯体症状及相关障碍（九）躯体性症状障碍疾患焦虑障碍转换性障碍（功能神经性症状障碍）心理因素影响的其他医学状况人为障碍其他特定的躯体症状和相关的障碍未特定的躯体症状和相关的障碍喂食与饮食障碍（十）异食症反刍障碍回避/限制食物摄入量障碍神经性厌食症暴食症暴饮暴食障碍其他特定的喂食和饮食失调症未特定的喂食和饮食失调症排泄障碍（十一）夜尿大便失禁其他特定的排泄障碍未特定的排泄障碍睡眠-觉醒障(十二)失眠障碍嗜睡障碍发作性嗜睡症与呼吸相关的睡眠障碍阻塞性睡眠呼吸暂停低通气症中央性睡眠呼吸暂停症睡眠相关的通气不足昼夜节律睡眠觉醒障碍异睡症非快速眼动睡眠觉醒障碍 梦游症 夜惊症梦魇障碍快速眼动睡眠行为障碍多动腿综合征物质/药物诱导睡眠的障碍其他特定的失眠障碍未特定的失眠障碍其他特定嗜睡障碍未特定的嗜睡障碍其他特定的睡眠-觉醒障碍未特定的睡眠-觉醒障碍性功能障碍（十三）延迟射精勃起功能障碍女性性高潮障碍女性性趣/性欲障碍生殖器-盆腔的疼痛/侵入障碍男性性欲减退障碍早泄物质/药物引起的性功能障碍其他特定的性功能障碍未特定的性功能障碍性别苦恼症（十四）性別苦恼症其他特定的性别苦恼症未特定的性別苦恼症破坏性的，冲动控制和行为障碍（十五）对立违抗性障碍间歇性爆发性障碍品行障碍反社会人格障碍纵火症盗窃症其他特定的破坏性，冲动控制和行为障碍未特定的破坏性，冲动控制和行为障碍物质相关和成瘾性障碍（十六）物质相关性障碍使用物质所致的障碍物质诱发性障碍物质中毒和戒断物质/药物诱发的心理障碍酒精相关障碍饮酒障碍酒精中毒酒精戒断其他酒精诱发的障碍未特定的酒精相关障碍咖啡因相关障碍咖啡因中毒咖啡因戒断其他咖啡因诱发的障碍未特定的咖啡因相关障碍大麻相关障碍吸食大麻障碍大麻中毒大麻戒断其他大麻诱发的障碍未特定的大麻相关障碍致幻剂相关障碍使用苯环己哌啶所致的障碍使用其他致幻剂所致的障碍苯环己哌啶中毒其他致幻剂中毒致幻剂引起的持久性知觉障碍其他苯环己哌啶诱发的障碍其他致幻剂诱发的障碍未特定的苯环己哌啶相关障碍未特定的致幻剂相关障碍吸入性药物相关障碍使用吸入性药物所致的障碍吸入性药物中毒其他吸入性药物诱发的障碍未特定的吸入性药物相关障碍阿片类物质相关障碍使用阿片类物质所致的障碍阿片类物质中毒阿片类物质戒断其他阿片类物质诱发的障碍未特定的阿片类物质相关障碍镇静、催眠、或抗焦虑药物相关障碍使用镇静、催眠、或抗焦虑药物所致障碍镇静、催眠、或抗焦虑药物中毒镇静、催眠、或抗焦虑药物戒断其他镇静、催眠、或抗焦虑药物诱发的障碍未特定的镇静、催眠、或抗焦虑药物相关障碍兴奋剂相关障碍使用兴奋剂所致的障碍兴奋剂中毒兴奋剂戒断其他兴奋剂诱发的障碍未特定的兴奋剂相关障碍烟草相关障碍使用烟草所致的障碍烟草戒断其他烟草诱发的障碍未特定的烟草相关障碍其他（或未知）的物质相关障碍使用其他（或未知）物质所致的障碍其他（或未知）的物质中毒其他（或未知）的物质戒断其他（或未知）的物质诱发的障碍未特定的其他（或未知）的物质相关障碍非物质的相关障碍赌博障碍神经认知障碍（十七）谵妄其他特定的谵妄未特定的谵妄重度和轻度的神经认知障碍重度的神经认知障碍轻度的神经认知障碍由于阿尔茨海默氏病导致的重度或轻度的神经认知障碍重度或轻度的额颞叶神经认知障碍重度或轻度的路易氏体型神经认知障碍重度或轻度血管性神经认知障碍由于脑损伤导致的重度或轻度的神经认知障碍物质/药物诱发的重度或轻度神经认知障碍由于艾滋病毒HIV感染导致的重度或轻度神经认知障碍由于朊病毒病导致的重度或轻度神经认知障碍由于帕金森氏病导致的重度或轻度神经认知障碍由于亨廷顿氏病导致的重度或轻度神经认知障碍由于其他医疗条件导致的重度或轻度神经认知障碍由于多种病因导致的重度或轻度神经认知障碍未特定的神经认知障碍人格障碍（十八）一般的人格障碍人格障碍A群偏执型人格障碍分裂样人格障碍分裂型人格障碍人格障碍B群反社会型人格障碍边缘型人格障碍表演型人格障碍自恋型人格障碍人格障碍C群回避型人格障碍依赖型人格障碍强迫性人格障碍其他人格障碍由于其他医疗条件所致的人格障碍其他特定人格障碍未特定的人格障碍性偏好异常症（十九）窥淫障碍露阴障碍摩擦障碍性受虐障碍性施虐障碍恋童障碍恋物障碍异性装扮障碍其他指定的性偏好异常症未指定的性偏好异常症其他心理障碍（二十）由其他医疗条件所致的其他特定的心理障碍由其他医疗条件所致的未特定的心理障碍其他特定的心理障碍未特定的心理障碍药物诱发的运动障碍及其它药物的不良反应其他情况，可能成为临床关注的焦点Section III: Emerging Measures and ModelsAssessment MeasuresCross-Cutting Symptom Measures DSM-5 Self-Rated Level 1 Cross-Cutting Symptom MeasureAdult Parent/Guardian-Rated DSM-5 Level 1 Cross- Cutting Symptom MeasureChild Age 617Clinician-Rated Dimensions of Psychosis Symptom SeverityWorld Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0)Cultural FormulationCultural Formulation Interview (CFI)Cultural Formulation Interview (CFI)Informant VersionAlternative DSM-5 Model for Personality DisordersConditions for Further StudyAttenuated Psychosis SyndromeDepressive Episodes With Short-Duration HypomaniaPersistent Complex Bereavement Disorder Caffeine Use DisorderInternet Gaming DisorderNeurobehavioral Disorder Associated With Prenatal Alcohol ExposureSuicidal Behavior DisorderNonsuicidal Self-Injury第三节新兴的测量方法与模式评估测量横截面测量DSM-5自测水平1，横截面测量成人父母/监护人测查DSM-5水平1，横截面测量6-17岁儿童临床医生测查精神病症状的严重程度世界卫生组织的残疾评估表2.0文化构想文化构想晤谈文化构想晤谈被调查者版本DSM-5关于人格障碍的替代模式进一步研究的疾患弱型精神病综合征抑郁发作并短时轻躁狂持久复杂的居丧障碍咖啡因导致的障碍网络游戏障碍与神经行为障碍相关的胎儿酒精综合征自杀行为障碍非自杀性自我伤害Appendix附录