Tag Archives: mental health diagnosis

Personality Disorders Symptoms and DSM-V Diagnosis




Personality Disorders Symptoms and Diagnosis: An overview

Personality disorders symptoms are not always easy to distinguish from relatively normal behaviors, although the consequences can be tremendously different. Personality disorders are groups of traits and characteristics that have become very rigid and dysfunctional, severely limiting functioning and most often resulting in severe distress and impairment. These thinking and behavioral patterns have usually been identified in these individual for a long time and in most cases since late adolescence or early adulthood.

The characteristics associated with personality disorders should probably be considered dimensional rather than categorical in that they are also seen in normal individuals to a significantly lesser degree. The DSM-V however has continued the traditional structure of categories that has been used over the last 30 years.

Common Characteristics of the Personality Disorders:

In order to receive a diagnosis of a personality disorder there needs to be an enduring pattern of negative behaviors, thoughts, feelings and sensations that are substantially different from the individual’s culture. This pattern includes an individual’s affect, cognition, control of impulses, and interpersonal relationships. This pattern of behaving and thinking has to apply in a broad-based manner over the individual’s personal and social life.




Personality disorders usually begin in adolescence (sometimes childhood) or early adulthood and manifest themselves in many social and personal contexts and cause a high level of distress and disability in an individual’s working and educational experience, as well as social and personal functioning. These characteristics cannot be associated with substance abuse, other mental disorders, physical illness, other personality disorders or personality changes associated with other medical conditions. The hallmark of personality disorders is their level of early onset (most commonly late teens), intensity of characteristics and pervasive nature in that it affects multiple aspects of an individual’s life including work, personal and social life.

A couple of the problems associated with the recognition and diagnosis of personality disorders is that they are frequently overlooked and at other times may be over-diagnosed. Two of the more notorious over diagnosed personality disorders are probably the narcissistic and borderline personality disorders. In DSM-V Made Easy, James Morrissey identified several things for a clinician keep in mind when making a diagnosis of personality disorder.

1. Verify the duration of the symptoms. Make sure that your patient’s symptoms have been present at least since early adulthood (before age 15 for antisocial personality disorder).
2. Verify that the symptoms affect several areas of the patient’s life.
3. Make sure that the patient fully qualifies for the particular diagnosis in question.
4. If the patient is under age 18, make sure that the symptoms have been present for at least the past 12 months.
5. Rule out other mental pathology that may be more accurate and have greater potential for doing harm.
6. Search for other personality disorders. Evaluate the entire history to learn whether any additional personality disorders are present.
7. Record all personality and non-personality mental diagnosis.

The following are the most commonly diagnosed personality disorders:


Cluster A Personality Disorders:

The Cluster A personality disorders usually involve behaviors described as suspicious, cold, withdrawn and/or irrational.

F60.0 (301.0) Paranoid Personality Disorder
F60.1 (301.20) Schizoid Personality Disorder
F21 (301.22) Schizotypal Personality Disorder

Cluster B Personality Disorders:

People who experience Cluster B Personality Disorders usually tend to be dramatic, very emotional and attention seeking with shallow, fluctuating moods. They often have intense interpersonal problems.

F60.2 (301.7) Antisocial Personality Disorder
F60,3 (301.83) Borderline Personality Disorder
F60.4 (301.50) Histrionic Personality Disorder
F60.81 (301.81) Narcissistic Personality Disorder

Cluster C Personality Disorders:

The Cluster C Personality Disorders usually feature characteristics of being typically tense, anxious and being over controlled.

F60.6 (301.82) Avoidant Personality Disorder
F60.7 (301.6) Dependent Personality Disorder
F60.5 (301.4) Obsessive-Compulsive Personality Disorder

Other Personality Conditions:

F07.0 (301.1) Personality Change Due to Another Medical Condition
F60.89 (301.89) Other Specified Personality Disorder
F60.9 (301.9) Unspecified Personality Disorder

By Paul Susic Ph.D. Licensed Psychologist



Other Specified Depressive Disorder Symptoms and Related DSM-5 Diagnosis





Other Specified Depressive Disorder 311 (F32.8):

Information related to Other Specified Depressive Disorder as well as the specific symptoms follow below. While some of these Other Specified Depressive Disorder symptoms may be recognized by family, teachers, legal and medical professionals, and others, only properly trained mental health professionals (psychologists, psychiatrists, professional counselors etc.) can or should even attempt to make a mental health diagnosis. A multitude of factors are considered in addition to the psychological symptoms in making a proper diagnosis, including medical and psychological testing considerations. This information is for information purposes only and should never replace the judgment and comprehensive assessment of a trained mental health clinician.




Other Specified Depressive Disorder 311 (F32.8) diagnostic criteria:

This category applies to presentations in which symptoms characteristic of a depressive disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for any of the disorders in the depressive disorders diagnostic class. The Other Specified Depressive Disorder category is used in situations of when the clinician chooses to communicate the specific reason that the presentation does not meet the criteria for any specific depressive disorder. This is done by recording “other specified depressive disorder” followed by the specific reason such as “short-duration depressive disorder”.

Examples of presentations that can be specified using the “other specified” designation include the following:

1. Recurrent brief depression: Concurrent presence of depressed mood and at least four other symptoms of depression for 2-13 days at least once per month (not associated with the menstrual cycle) for at least 12 consecutive months in an individual whose presentation has never met criteria for any other depressive or bipolar disorder and does not currently meet active or residual criteria for any psychotic disorder.

2. Short-duration depressive disorder (4-13 days): Depressed affect and at least four of the other eight symptoms of a major depressive episode associated with clinically significant distress or impairment that persists for more than 4 days, but less than 14 days, in an individual whose presentation has never met criteria for any other depressive or bipolar disorder, does not currently meet active or residual criteria for any psychotic disorder, and does not meet criteria for recurrent brief depression.

3. Depressive episode with insufficient symptoms: Depressed affect and at least one of the other eight symptoms of a major depressive episode associated with clinically significant distress or impairment that persists for at least two weeks in an individual whose presentation has never met criteria for any other depressive or bipolar disorder, does not currently meet active or residual criteria for any psychotic disorder, and does not meet criteria for mixed anxiety and depressive disorders.

Adapted by Paul Susic Ph.D. Licensed Psychologist from the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) American Psychiatric Association


Depressive Disorder Due to Another Medical Condition Symptoms and Related DSM–5 Diagnosis





Depressive Disorder Due to Another Medical Condition:

Information related to Depressive Disorder Due to Another Medical Condition as well as the specific symptoms follow below. While some of these Depressive Disorder Due to Another Medical Condition symptoms may be recognized by family, teachers, legal and medical professionals, and others, only properly trained mental health professionals (psychologists, psychiatrists, professional counselors etc.) can or should even attempt to make a mental health diagnosis. A multitude of factors are considered in addition to the psychological symptoms in making a proper diagnosis, including medical and psychological testing considerations. This information is for information purposes only and should never replace the judgment and comprehensive assessment of a trained mental health clinician.





Depressive Disorder Due to Another Medical Condition diagnostic criteria:

A. A prominent and persistent period of depressed mood or markedly diminished interest or pleasure in all, or almost all, activities that predominates in the clinical picture.
B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is a direct pathophysiological consequence of another medical condition.
C. The disturbance is not better explained by another mental disorder such as adjustment disorder, with depressed mood, in which the stressor is a serious medical condition.
D. The disturbance does not occur exclusively during the course of a delirium.
E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Coding Note: The ICD-9-CM code for Depressive Disorder Due to Another Medical Condition is 293.83, which is assigned regardless of the specifier. The ICD-10-CM code depends on the specifier (see below).

Specify if:

(F06. 31) With depressive features: Full criteria are not met for major depressive episode.
(F06. 32) With major depressive-like episode: Full criteria are met (except criterion C) for major depressive episode.
(F06. 34 With mixed features: Symptoms of mania or hypomania are also present but do not predominate in the clinical picture.

Coding Note: Include the name of the other medical condition in the name of the mental disorder such as 293. 83 [F06.31] depressive disorder due to hypothyroidism, with depressive features. The other medical condition should also be coded and listed separately immediately before the Depressive Disorder Due to the Medical Condition such as 244.9 [E03.9] hypothyroidism; 293. 83 [F06.31] depressive disorder due to hypothyroidism, with depressive features.

Adapted by Paul Susic Ph.D. Licensed Psychologist from the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) American Psychiatric Association