Mental, behavioural or neurodevelopmental disorders
This chapter has 161 four-character categories.
Code range starts with 6A00
Mental, behavioural and neurodevelopmental disorders are syndromes characterized by clinically significant disturbance in an individual's cognition, emotional regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes that underlie mental and behavioural functioning. These disturbances are usually associated with distress or impairment in personal, family, social, educational, occupational, or other important areas of functioning.
Exclusions: Acute stress reaction (QE84)
Uncomplicated bereavement (QE62)
Coded Elsewhere: Sleep-wake disorders (7A00-7B2Z)
Sexual dysfunctions (HA00-HA0Z)
Gender incongruence (HA60-HA6Z)
This chapter contains the following top level blocks:
• Neurodevelopmental disorders
• Schizophrenia or other primary psychotic disorders
• Catatonia
• Mood disorders
• Anxiety or fear-related disorders
• Obsessive-compulsive or related disorders
• Disorders specifically associated with stress
• Dissociative disorders
• Feeding or eating disorders
• Elimination disorders
• Disorders of bodily distress or bodily experience
• Disorders due to substance use or addictive behaviours
• Impulse control disorders
• Disruptive behaviour or dissocial disorders
• Personality disorders and related traits
• Paraphilic disorders
• Factitious disorders
• Neurocognitive disorders
• Mental or behavioural disorders associated with pregnancy, childbirth and the puerperium
• Secondary mental or behavioural syndromes associated with disorders or diseases classified elsewhere
Neurodevelopmental disorders (BlockL1‑6A0)
Neurodevelopmental disorders are behavioural and cognitive disorders that arise during the developmental period that involve significant difficulties in the acquisition and execution of specific intellectual, motor, or social functions. Although behavioural and cognitive deficits are present in many mental and behavioural disorders that can arise during the developmental period (e.g., Schizophrenia, Bipolar disorder), only disorders whose core features are neurodevelopmental are included in this grouping. The presumptive etiology for neurodevelopmental disorders is complex, and in many individual cases is unknown.
Coded Elsewhere: Primary tics or tic disorders (8A05.0)
Secondary neurodevelopmental syndrome (6E60)
6A00 Disorders of intellectual development
Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterized by significantly below average intellectual functioning and adaptive behavior that are approximately two or more standard deviations below the mean (approximately less than the 2.3rd percentile), based on appropriately normed, individually administered standardized tests. Where appropriately normed and standardized tests are not available, diagnosis of disorders of intellectual development requires greater reliance on clinical judgment based on appropriate assessment of comparable behavioural indicators.
Note: Use additional code, if desired, to identify any known aetiology.
6A00.0 Disorder of intellectual development, mild
A mild disorder of intellectual development is a condition originating during the developmental period characterized by significantly below average intellectual functioning and adaptive behaviour that are approximately two to three standard deviations below the mean (approximately 0.1 – 2.3 percentile), based on appropriately normed, individually administered standardized tests or by comparable behavioural indicators when standardized testing is unavailable. Affected persons often exhibit difficulties in the acquisition and comprehension of complex language concepts and academic skills. Most master basic self-care, domestic, and practical activities. Persons affected by a mild disorder of intellectual development can generally achieve relatively independent living and employment as adults but may require appropriate support.
6A00.1 Disorder of intellectual development, moderate
A moderate disorder of intellectual development is a condition originating during the developmental period characterized by significantly below average intellectual functioning and adaptive behaviour that are approximately three to four standard deviations below the mean (approximately 0.003 – 0.1 percentile), based on appropriately normed, individually administered standardized tests or by comparable behavioural indicators when standardized testing is unavailable. Language and capacity for acquisition of academic skills of persons affected by a moderate disorder of intellectual development vary but are generally limited to basic skills. Some may master basic self-care, domestic, and practical activities. Most affected persons require considerable and consistent support in order to achieve independent living and employment as adults.
6A00.2 Disorder of intellectual development, severe
A severe disorder of intellectual development is a condition originating during the developmental period characterized by significantly below average intellectual functioning and adaptive behaviour that are approximately four of more standard deviations below the mean (less than approximately the 0.003rd percentile), based on appropriately normed, individually administered standardized tests or by comparable behavioural indicators when standardized testing is unavailable. Affected persons exhibit very limited language and capacity for acquisition of academic skills. They may also have motor impairments and typically require daily support in a supervised environment for adequate care, but may acquire basic self-care skills with intensive training. Severe and profound disorders of intellectual development are differentiated exclusively on the basis of adaptive behaviour differences because existing standardized tests of intelligence cannot reliably or validly distinguish among individuals with intellectual functioning below the 0.003rd percentile.
6A00.3 Disorder of intellectual development, profound
A profound disorder of intellectual development is a condition originating during the developmental period characterized by significantly below average intellectual functioning and adaptive behaviour that are approximately four of more standard deviations below the mean (approximately less than the 0.003rd percentile), based on individually administered appropriately normed, standardized tests or by comparable behavioural indicators when standardized testing is unavailable. Affected persons possess very limited communication abilities and capacity for acquisition of academic skills is restricted to basic concrete skills. They may also have co-occurring motor and sensory impairments and typically require daily support in a supervised environment for adequate care. Severe and profound disorders of intellectual development are differentiated exclusively on the basis of adaptive behaviour differences because existing standardized tests of intelligence cannot reliably or validly distinguish among individuals with intellectual functioning below the 0.003rd percentile.
6A00.4 Disorder of intellectual development, provisional
Disorder of intellectual development, provisional is assigned when there is evidence of a disorder of intellectual development but the individual is an infant or child under the age of four or it is not possible to conduct a valid assessment of intellectual functioning and adaptive behaviour because of sensory or physical impairments (e.g., blindness, pre-lingual deafness), locomotor disability, severe problem behaviours or co-occurring mental and behavioural disorders.
6A00.Z Disorders of intellectual development, unspecified
6A01 Developmental speech or language disorders
Developmental speech or language disorders arise during the developmental period and are characterized by difficulties in understanding or producing speech and language or in using language in context for the purposes of communication that are outside the limits of normal variation expected for age and level of intellectual functioning. The observed speech and language problems are not attributable to social or cultural factors (e.g., regional dialects) and are not fully explained by anatomical or neurological abnormalities. The presumptive etiology for Developmental speech or language disorders is complex, and in many individual cases is unknown.
6A01.0 Developmental speech sound disorder
Developmental speech sound disorder is characterized by difficulties in the acquisition, production and perception of speech that result in errors of pronunciation, either in number or types of speech errors made or the overall quality of speech production, that are outside the limits of normal variation expected for age and level of intellectual functioning and result in reduced intelligibility and significantly affect communication. The errors in pronunciation arise during the early developmental period and cannot be explained by social, cultural, and other environmental variations (e.g., regional dialects). The speech errors are not fully explained by a hearing impairment or a structural or neurological abnormality.
Inclusions: Functional speech articulation disorder
Exclusions: Deafness not otherwise specified (AB52)
Diseases of the nervous system (chapter 08)
Dysarthria (MA80.2)
6A01.1 Developmental speech fluency disorder
Developmental speech fluency disorder is characterized by persistent and frequent or pervasive disruption of the rhythmic flow of speech that arises during the developmental period and is outside the limits of normal variation expected for age and level of intellectual functioning and results in reduced intelligibility and significantly affects communication. It can involve repetitions of sounds, syllables or words, prolongations, word breaks, blockage of production, excessive use of interjections, and rapid short bursts of speech.
Exclusions: Tic disorders (8A05)
6A01.2 Developmental language disorder
Developmental language disorder is characterized by persistent difficulties in the acquisition, understanding, production or use of language (spoken or signed), that arise during the developmental period, typically during early childhood, and cause significant limitations in the individual’s ability to communicate. The individual’s ability to understand, produce or use language is markedly below what would be expected given the individual’s age and level of intellectual functioning. The language deficits are not explained by another neurodevelopmental disorder or a sensory impairment or neurological condition, including the effects of brain injury or infection.
Exclusions: Autism spectrum disorder (6A02)
Diseases of the nervous system (chapter 08)
Deafness not otherwise specified (AB52)
Selective mutism (6B06)
6A01.20 Developmental language disorder with impairment of receptive and expressive language
Developmental language disorder with impairment of receptive and expressive language is characterized by persistent difficulties in the acquisition, understanding, production, and use of language that arise during the developmental period, typically during early childhood, and cause significant limitations in the individual’s ability to communicate. The ability to understand spoken or signed language (i.e., receptive language) is markedly below the expected level given the individual’s age and level of intellectual functioning, and is accompanied by persistent impairment in the ability to produce and use spoken or signed language (i.e., expressive language).
Inclusions: developmental dysphasia or aphasia, receptive type
developmental Wernicke aphasia
Exclusions: acquired aphasia with epilepsy [Landau-Kleffner] (8A62.2)
Autism spectrum disorder (6A02)
Selective mutism (6B06)
dysphasia NOS (MA80.1)
Diseases of the nervous system (chapter 08)
Deafness not otherwise specified (AB52)
6A01.21 Developmental language disorder with impairment of mainly expressive language
Developmental language disorder with impairment of mainly expressive language is characterized by persistent difficulties in the acquisition, production, and use of language that arise during the developmental period, typically during early childhood, and cause significant limitations in the individual’s ability to communicate. The ability to produce and use spoken or signed language (i.e., expressive language) is markedly below the expected level given the individual’s age and level of intellectual functioning, but the ability to understand spoken or signed language (i.e., receptive language) is relatively intact.
Inclusions: Developmental dysphasia or aphasia, expressive type
Exclusions: acquired aphasia with epilepsy [Landau-Kleffner] (8A62.2)
Selective mutism (6B06)
dysphasia and aphasia: developmental, receptive type (6A01.20)
dysphasia NOS (MA80.1)
aphasia NOS (MA80.0)
Diseases of the nervous system (chapter 08)
Deafness not otherwise specified (AB52)
6A01.22 Developmental language disorder with impairment of mainly pragmatic language
Developmental language disorder with impairment of mainly pragmatic language is characterized by persistent and marked difficulties with the understanding and use of language in social contexts, for example making inferences, understanding verbal humour, and resolving ambiguous meaning. These difficulties arise during the developmental period, typically during early childhood, and cause significant limitations in the individual’s ability to communicate. Pragmatic language abilities are markedly below the expected level given the individual’s age and level of intellectual functioning, but the other components of receptive and expressive language are relatively intact. This qualifier should not be used if the pragmatic language impairment is better explained by Autism Spectrum Disorder or by impairments in other components of receptive or expressive language.
Exclusions: Autism spectrum disorder (6A02)
Diseases of the nervous system (chapter 08)
Selective mutism (6B06)
6A01.23 Developmental language disorder, with other specified language impairment
Developmental language disorder with other specified language impairment is characterized by persistent difficulties in the acquisition, understanding, production or use of language (spoken or signed), that arise during the developmental period and cause significant limitations in the individual’s ability to communicate. The pattern of specific deficits in language abilities is not adequately captured by any of the other developmental language disorder categories.
Exclusions: Autism spectrum disorder (6A02)
Diseases of the nervous system (chapter 08)
Disorders of intellectual development (6A00)
Selective mutism (6B06)
6A01.Y Other specified developmental speech or language disorders
6A01.Z Developmental speech or language disorders, unspecified
6A02 Autism spectrum disorder
Autism spectrum disorder is characterized by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests. The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities.
Inclusions: Autistic disorder
Pervasive developmental delay
Exclusions: Developmental language disorder (6A01.2)
Schizophrenia or other primary psychotic disorders (BlockL1‑6A2)
6A02.0 Autism spectrum disorder without disorder of intellectual development and with mild or no impairment of functional language
All definitional requirements for autism spectrum disorder are met, intellectual functioning and adaptive behaviour are found to be at least within the average range (approximately greater than the 2.3rd percentile), and there is only mild or no impairment in the individual's capacity to use functional language (spoken or signed) for instrumental purposes, such as to express personal needs and desires.
6A02.1 Autism spectrum disorder with disorder of intellectual development and with mild or no impairment of functional language
All definitional requirements for both autism spectrum disorder and disorder of intellectual development are met and there is only mild or no impairment in the individual's capacity to use functional language (spoken or signed) for instrumental purposes, such as to express personal needs and desires.
6A02.2 Autism spectrum disorder without disorder of intellectual development and with impaired functional language
All definitional requirements for autism spectrum disorder are met, intellectual functioning and adaptive behaviour are found to be at least within the average range (approximately greater than the 2.3rd percentile), and there is marked impairment in functional language (spoken or signed) relative to the individual’s age, with the individual not able to use more than single words or simple phrases for instrumental purposes, such as to express personal needs and desires.
6A02.3 Autism spectrum disorder with disorder of intellectual development and with impaired functional language
All definitional requirements for both autism spectrum disorder and disorder of intellectual development are met and there is marked impairment in functional language (spoken or signed) relative to the individual’s age, with the individual not able to use more than single words or simple phrases for instrumental purposes, such as to express personal needs and desires.
6A02.4 Autism spectrum disorder without disorder of intellectual development and with absence of functional language
All definitional requirements for autism spectrum disorder are met, intellectual functioning and adaptive behaviour are found to be at least within the average range (approximately greater than the 2.3rd percentile), and there is complete, or almost complete, absence of ability relative to the individual’s age to use functional language (spoken or signed) for instrumental purposes, such as to express personal needs and desires.
6A02.5 Autism spectrum disorder with disorder of intellectual development and with absence of functional language
All definitional requirements for both autism spectrum disorder and disorder of intellectual development are met and there is complete, or almost complete, absence of ability relative to the individual’s age to use functional language (spoken or signed) for instrumental purposes, such as to express personal needs and desires
6A02.Y Other specified autism spectrum disorder
6A02.Z Autism spectrum disorder, unspecified
6A03 Developmental learning disorder
Developmental learning disorder is characterized by significant and persistent difficulties in learning academic skills, which may include reading, writing, or arithmetic. The individual’s performance in the affected academic skill(s) is markedly below what would be expected for chronological age and general level of intellectual functioning, and results in significant impairment in the individual’s academic or occupational functioning. Developmental learning disorder first manifests when academic skills are taught during the early school years. Developmental learning disorder is not due to a disorder of intellectual development, sensory impairment (vision or hearing), neurological or motor disorder, lack of availability of education, lack of proficiency in the language of academic instruction, or psychosocial adversity.
Exclusions: Symbolic dysfunctions (MB4B)
6A03.0 Developmental learning disorder with impairment in reading
Developmental learning disorder with impairment in reading is characterized by significant and persistent difficulties in learning academic skills related to reading, such as word reading accuracy, reading fluency, and reading comprehension. The individual’s performance in reading is markedly below what would be expected for chronological age and level of intellectual functioning and results in significant impairment in the individual’s academic or occupational functioning. Developmental learning disorder with impairment in reading is not due to a disorder of intellectual development, sensory impairment (vision or hearing), neurological disorder, lack of availability of education, lack of proficiency in the language of academic instruction, or psychosocial adversity.
Inclusions: Developmental dyslexia
Exclusions: Disorders of intellectual development (6A00)
6A03.1 Developmental learning disorder with impairment in written expression
Developmental learning disorder with impairment in written expression is characterized by significant and persistent difficulties in learning academic skills related to writing, such as spelling accuracy, grammar and punctuation accuracy, and organization and coherence of ideas in writing. The individual’s performance in written expression is markedly below what would be expected for chronological age and level of intellectual functioning and results in significant impairment in the individual’s academic or occupational functioning. Developmental learning disorder with impairment in written expression is not due to a disorder of intellectual development, sensory impairment (vision or hearing), a neurological or motor disorder, lack of availability of education, lack of proficiency in the language of academic instruction, or psychosocial adversity.
Exclusions: Disorders of intellectual development (6A00)
6A03.2 Developmental learning disorder with impairment in mathematics
Developmental learning disorder with impairment in mathematics is characterized by significant and persistent difficulties in learning academic skills related to mathematics or arithmetic, such as number sense, memorization of number facts, accurate calculation, fluent calculation, and accurate mathematic reasoning. The individual’s performance in mathematics or arithmetic is markedly below what would be expected for chronological or developmental age and level of intellectual functioning and results in significant impairment in the individual’s academic or occupational functioning. Developmental learning disorder with impairment in mathematics is not due to a disorder of intellectual development, sensory impairment (vision or hearing), a neurological disorder, lack of availability of education, lack of proficiency in the language of academic instruction, or psychosocial adversity.
Exclusions: Disorders of intellectual development (6A00)
6A03.3 Developmental learning disorder with other specified impairment of learning
Developmental learning disorder with other specified impairment of learning is characterized by significant and persistent difficulties in learning academic skills other than reading, mathematics, and written expression. The individual’s performance in the relevant academic skill is markedly below what would be expected for chronological age and level of intellectual functioning and results in significant impairment in the individual’s academic or occupational functioning. Developmental learning disorder with other specified impairment of learning is not due to a disorder of intellectual development, sensory impairment (vision or hearing), neurological disorder, lack of availability of education, lack of proficiency in the language of academic instruction, or psychosocial adversity.
Exclusions: Disorders of intellectual development (6A00)
6A03.Z Developmental learning disorder, unspecified
6A04 Developmental motor coordination disorder
Developmental motor coordination disorder is characterized by a significant delay in the acquisition of gross and fine motor skills and impairment in the execution of coordinated motor skills that manifest in clumsiness, slowness, or inaccuracy of motor performance. Coordinated motor skills are substantially below that expected given the individual's chronological age and level of intellectual functioning. Onset of coordinated motor skills difficulties occurs during the developmental period and is typically apparent from early childhood. Coordinated motor skills difficulties cause significant and persistent limitations in functioning (e.g., in activities of daily living, school work, and vocational and leisure activities). Difficulties with coordinated motor skills are not solely attributable to a Disease of the Nervous System, Disease of the Musculoskeletal System or Connective Tissue, sensory impairment, and not better explained by a Disorder of Intellectual Development.
Exclusions: Abnormalities of gait and mobility (MB44)
Diseases of the musculoskeletal system or connective tissue (chapter 15)
Diseases of the nervous system (chapter 08)
6A05 Attention deficit hyperactivity disorder
Attention deficit hyperactivity disorder is characterized by a persistent pattern (at least 6 months) of inattention and/or hyperactivity-impulsivity, with onset during the developmental period, typically early to mid-childhood. The degree of inattention and hyperactivity-impulsivity is outside the limits of normal variation expected for age and level of intellectual functioning and significantly interferes with academic, occupational, or social functioning. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organization. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. The relative balance and the specific manifestations of inattentive and hyperactive-impulsive characteristics varies across individuals, and may change over the course of development. In order for a diagnosis of disorder the behaviour pattern must be clearly observable in more than one setting.
Inclusions: attention deficit disorder with hyperactivity
attention deficit syndrome with hyperactivity
Exclusions: Autism spectrum disorder (6A02)
Disruptive behaviour or dissocial disorders (BlockL1‑6C9)
6A05.0 Attention deficit hyperactivity disorder, predominantly inattentive presentation
All definitional requirements for attention deficit hyperactivity disorder are met and inattentive symptoms are predominant in the clinical presentation. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organization. Some hyperactive-impulsive symptoms may also be present, but these are not clinically significant in relation to the inattentive symptoms.
6A05.1 Attention deficit hyperactivity disorder, predominantly hyperactive-impulsive presentation
All definitional requirements for attention deficit hyperactivity disorder are met and hyperactive-impulsive symptoms are predominant in the clinical presentation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. Some inattentive symptoms may also be present, but these are not clinically significant in relation to the hyperactive-impulsive symptoms.
6A05.2 Attention deficit hyperactivity disorder, combined presentation
All definitional requirements for attention deficit hyperactivity disorder are met. Both inattentive and hyperactive-impulsive symptoms are clinically significant, with neither predominating in the clinical presentation. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organization. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences.
6A05.Y Attention deficit hyperactivity disorder, other specified presentation
6A05.Z Attention deficit hyperactivity disorder, presentation unspecified
6A06 Stereotyped movement disorder
Stereotyped movement disorder is characterized by voluntary, repetitive, stereotyped, apparently purposeless (and often rhythmic) movements that arise during the early developmental period, are not caused by the direct physiological effects of a substance or medication (including withdrawal), and markedly interfere with normal activities or result in self-inflicted bodily injury. Stereotyped movements that are non-injurious can include body rocking, head rocking, finger-flicking mannerisms, and hand flapping. Stereotyped self-injurious behaviours can include repetitive head banging, face slapping, eye poking, and biting of the hands, lips, or other body parts.
Exclusions: Tic disorders (8A05)
Trichotillomania (6B25.0)
Abnormal involuntary movements (MB46)
6A06.0 Stereotyped movement disorder without self-injury
This category should be applied to forms of Stereotyped movement disorder in which stereotyped behaviours markedly interfere with normal activities, but do not result in self-inflicted bodily injury. Stereotyped movement disorder without self-injury is characterized by voluntary, repetitive, stereotyped, apparently purposeless (and often rhythmic) movements that arise during the early developmental period, are not caused by the direct physiological effects of a substance or medication (including withdrawal), and markedly interfere with normal activities. Stereotyped movements that are non-injurious can include body rocking, head rocking, finger-flicking mannerisms, and hand flapping.
6A06.1 Stereotyped movement disorder with self-injury
This category should be applied to forms of Stereotyped movement disorder in which stereotyped behaviours result in self-inflicted bodily injury that is significant enough to require medical treatment, or would result in such injury if protective measures (e.g., helmet to prevent head injury) were not employed. Stereotyped movement disorder with self-injury is characterized by voluntary, repetitive, stereotyped, apparently purposeless (and often rhythmic) movements that arise during the early developmental period, are not caused by the direct physiological effects of a substance or medication (including withdrawal). Stereotyped movements that are self-injurious can include head banging, face slapping, eye poking, and biting of the hands, lips, or other body parts.
6A06.Z Stereotyped movement disorder, unspecified
6A0Y Other specified neurodevelopmental disorders
6A0Z Neurodevelopmental disorders, unspecified
Schizophrenia or other primary psychotic disorders (BlockL1‑6A2)
Schizophrenia and other primary psychotic disorders are characterized by significant impairments in reality testing and alterations in behavior manifest in positive symptoms such as persistent delusions, persistent hallucinations, disorganized thinking (typically manifest as disorganized speech), grossly disorganized behavior, and experiences of passivity and control, negative symptoms such as blunted or flat affect and avolition, and psychomotor disturbances. The symptoms occur with sufficient frequency and intensity to deviate from expected cultural or subcultural norms. These symptoms do not arise as a feature of another mental and behavioural disorder (e.g., a mood disorder, delirium, or a disorder due to substance use). The categories in this grouping should not be used to classify the expression of ideas, beliefs, or behaviours that are culturally sanctioned.
Coded Elsewhere: Substance-induced psychotic disorders
Secondary psychotic syndrome (6E61)
6A20 Schizophrenia
Schizophrenia is characterized by disturbances in multiple mental modalities, including thinking (e.g., delusions, disorganization in the form of thought), perception (e.g., hallucinations), self-experience (e.g., the experience that one's feelings, impulses, thoughts, or behaviour are under the control of an external force), cognition (e.g., impaired attention, verbal memory, and social cognition), volition (e.g., loss of motivation), affect (e.g., blunted emotional expression), and behaviour (e.g.,behaviour that appears bizarre or purposeless, unpredictable or inappropriate emotional responses that interfere with the organization of behaviour). Psychomotor disturbances, including catatonia, may be present. Persistent delusions, persistent hallucinations, thought disorder, and experiences of influence, passivity, or control are considered core symptoms. Symptoms must have persisted for at least one month in order for a diagnosis of schizophrenia to be assigned. The symptoms are not a manifestation of another health condition (e.g., a brain tumour) and are not due to the effect of a substance or medication on the central nervous system (e.g., corticosteroids), including withdrawal (e.g., alcohol withdrawal).
Exclusions: Schizotypal disorder (6A22)
schizophrenic reaction (6A22)
Acute and transient psychotic disorder (6A23)
6A20.0 Schizophrenia, first episode
Schizophrenia, first episode should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizophrenia (including duration) but who have never before experienced an episode during which diagnostic requirements for Schizophrenia were met.
6A20.00 Schizophrenia, first episode, currently symptomatic
All definitional requirements for Schizophrenia, first episode in terms of symptoms and duration are currently met, or have been met within the past one month.
6A20.01 Schizophrenia, first episode, in partial remission
All definitional requirements for Schizophrenia, first episode in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.
6A20.02 Schizophrenia, first episode, in full remission
All definitional requirements for Schizophrenia, first episode in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remission may have occurred in response to medication or other treatment.
6A20.0Z Schizophrenia, first episode, unspecified
6A20.1 Schizophrenia, multiple episodes
Schizophrenia, multiple episode should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizophrenia (including duration) and who have also previously experienced episodes during which diagnostic requirements were met, with substantial remission of symptoms between episodes. Some attenuated symptoms may remain during periods of remission, and remissions may have occurred in response to medication or other treatment.
6A20.10 Schizophrenia, multiple episodes, currently symptomatic
All definitional requirements for Schizophrenia, multiple episodes in terms of symptoms and duration are currently met, or have been met within the past one month.
6A20.11 Schizophrenia, multiple episodes, in partial remission
All definitional requirements for Schizophrenia, multiple episodes in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.
6A20.12 Schizophrenia, multiple episodes, in full remission
All definitional requirements for Schizophrenia, multiple episodes in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remission may have occurred in response to medication or other treatment.
6A20.1Z Schizophrenia, multiple episodes, unspecified
6A20.2 Schizophrenia, continuous
Symptoms fulfilling all definitional requirements of Schizophrenia have been present for almost all of the illness course over a period of at least one year, with periods of subthreshold symptoms being very brief relative to the overall course.
6A20.20 Schizophrenia, continuous, currently symptomatic
All definitional requirements for Schizophrenia, continuous in terms of symptoms and duration are currently met, or have been met within the past one month.
6A20.21 Schizophrenia, continuous, in partial remission
All definitional requirements for Schizophrenia, continuous in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.
6A20.22 Schizophrenia, continuous, in full remission
All definitional requirements for Schizophrenia, continuous in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remission may have occurred in response to medication or other treatment.
6A20.2Z Schizophrenia, continuous, unspecified
6A20.Y Other specified schizophrenia
6A20.Z Schizophrenia, unspecified
6A21 Schizoaffective disorder
Schizoaffective disorder is an episodic disorder in which the diagnostic requirements of schizophrenia and a manic, mixed, or moderate or severe depressive episode are met within the same episode of illness, either simultaneously or within a few days of each other. Prominent symptoms of schizophrenia (e.g. delusions, hallucinations, disorganization in the form of thought, experiences of influence, passivity and control) are accompanied by typical symptoms of a depressive episode (e.g. depressed mood, loss of interest, reduced energy), a manic episode (e.g., elevated mood, increase in the quality and speed of physical and mental activity) or a mixed episode. Psychomotor disturbances, including catatonia, may be present. Symptoms must have persisted for at least one month. The symptoms are not a manifestation of another health condition (e.g., a brain tumor) and are not due to the effect of a substance or medication on the central nervous system (e.g., corticosteroids), including withdrawal (e.g., alcohol withdrawal).
6A21.0 Schizoaffective disorder, first episode
Schizoaffective disorder, first episode should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizoaffective disorder (including duration) but who have never before experienced an episode during which diagnostic requirements for Schizoaffective disorder or Schizophrenia were met.
6A21.00 Schizoaffective disorder, first episode, currently symptomatic
All definitional requirements for Schizoaffective disorder, first episode in terms of symptoms and duration are currently met, or have been met within the past one month.
6A21.01 Schizoaffective disorder, first episode, in partial remission
All definitional requirements for Schizoaffective disorder, first episode in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.
6A21.02 Schizoaffective disorder, first episode, in full remission
All definitional requirements for Schizoaffective disorder, first episode in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remission may have occurred in response to medication or other treatment.
6A21.0Z Schizoaffective disorder, first episode, unspecified
6A21.1 Schizoaffective disorder, multiple episodes
Schizoaffective disorder, multiple episodes should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizoaffective disorder (including duration) and who have also previously experienced episodes during which diagnostic requirements for Schizoaffective disorder or Schizophrenia were met, with substantial remission of symptoms between episodes. Some attenuated symptoms may remain during period of remission, and remissions may have occurred in response to medication or other treatment.
6A21.10 Schizoaffective disorder, multiple episodes, currently symptomatic
All definitional requirements for Schizoaffective disorder, multiple episodes in terms of symptoms and duration are currently met, or have been met within the past one month.
6A21.11 Schizoaffective disorder, multiple episodes, in partial remission
All definitional requirements for Schizoaffective disorder, multiple episodes in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.
6A21.12 Schizoaffective disorder, multiple episodes, in full remission
All definitional requirements for Schizoaffective disorder, multiple episodes in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remission may have occurred in response to medication or other treatment.
6A21.1Z Schizoaffective disorder, multiple episodes, unspecified
6A21.2 Schizoaffective disorder, continuous
Symptoms fulfilling all definitional requirements of Schizoaffective disorder have been present for almost all of the illness course over a period of at least one year, with periods of subthreshold symptoms being very brief relative to the overall course.
6A21.20 Schizoaffective disorder, continuous, currently symptomatic
All definitional requirements for Schizoaffective disorder, continuous in terms of symptoms and duration are currently met, or have been met within the past one month.
6A21.21 Schizoaffective disorder, continuous, in partial remission
All definitional requirements for Schizoaffective disorder, continuous in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.
6A21.22 Schizoaffective disorder, continuous, in full remission
All definitional requirements for Schizoaffective disorder, continuous in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remission may have occurred in response to medication or other treatment.
6A21.2Z Schizoaffective disorder, continuous, unspecified
6A21.Y Other specified schizoaffective disorder
6A21.Z Schizoaffective disorder, unspecified
6A22 Schizotypal disorder
Schizotypal disorder is characterized by an enduring pattern (i.e., characteristic of the person’s functioning over a period of at least several years) of eccentricities in behavior, appearance and speech, accompanied by cognitive and perceptual distortions, unusual beliefs, and discomfort with— and often reduced capacity for— interpersonal relationships. Symptoms may include constricted or inappropriate affect and anhedonia (negative schizotypy). Paranoid ideas, ideas of reference, or other psychotic symptoms, including hallucinations in any modality, may occur (positive schizotypy), but are not of sufficient intensity or duration to meet the diagnostic requirements of schizophrenia, schizoaffective disorder, or delusional disorder. The symptoms cause distress or impairment in personal, family, social, educational, occupational or other important areas of functioning.
Inclusions: Schizotypal personality disorder
Exclusions: Autism spectrum disorder (6A02)
Personality disorder (6D10)
6A23 Acute and transient psychotic disorder
Acute and transient psychotic disorder is characterized by acute onset of psychotic symptoms that emerge without a prodrome and reach their maximal severity within two weeks. Symptoms may include delusions, hallucinations, disorganization of thought processes, perplexity or confusion, and disturbances of affect and mood. Catatonia-like psychomotor disturbances may be present. Symptoms typically change rapidly, both in nature and intensity, from day to day, or even within a single day. The duration of the episode does not exceed 3 months, and most commonly lasts from a few days to 1 month. The symptoms are not a manifestation of another health condition (e.g., a brain tumor) and are not due to the effect of a substance or medication on the central nervous system (e.g., corticosteroids), including withdrawal (e.g., alcohol withdrawal).