Third Saturday of the Month Class Dec 16, 2006

Third Saturday of the Month Class: Dec 16, 2006 1. Take test and bring answers to class (NCA1 Test). 2. Read DSM IV Supervision Reading And Be Ready To Go Over In Class. 3. We will go over 15 question test taken in October 4. Be prepared to pass in 12 Core Test Pak answers. No answers: No Certificate!!!!! 5. The AA & NA tests are due this month 6. The Application to take the test will be passed out in class in December to start filling out. 7. Some people have not completed their registration!!!!!!!!! (Can not do #5 if this is not done.) 8. Some people have not gotten and/or paid for their Manual. 9. Some people have to catch up on the monthly fees, I will not be able to sign off on the application and supervision data if this is not caught up. GO TO NEXT PAGES FOR (1) TEST, (2) DSM IV STUDY GUIDE 1. To facilitate growth potential for staff of other agencies, you should be willing to: A. Act as a consultant to other agencies about effective ways to work with specific cases relating to drug or alcohol problems. B. Consult only with those agencies that share the same philosophy as you do on drug or Alcohol related problems. C. Provide only one consultation to each requesting agency, in order to stay on task at your own program. D. Let the other agencies learn on their own because they will better appreciate the education they receive. E. Allow their staff to sit in on your program's treatment groups. 2. Client education on HIV and other sexually transmitted diseases: A. Is only done at the request of the client. B. Should be given in specialty groups to those clients that are considered "high risk" to protect confidentiality. C. Should be contracted out to a physician or professional medical personnel who have expertise in this area. D. Should not be addressed until the client is ready for discharge. E. Is important information to incorporate in the treatment process of every client. 3. At the beginning of the initial counseling session with the child of an alcoholic, the child stubbornly refuses to leave the waiting room, even with parental coaxing. The counselor says to the child: “You are not sure that you want to be here today. You don't know me and you're not sure that you like me. I'll leave my office door open, and your mother and I will be in there. When you are ready, you can come in.” The counselor’s response is an example of: A. Paradoxical Intervention. B. Ignoring. C. Synthesizing. D. Compensating. E. Empathic reflection. 4. In group therapy, Sara consistently perceives Gary as an angry critical man (like her father) who cares little for other group members’ feelings although other group members perceive Gary as kind, caring, and gentle. This interpretation may be described as: A. Confrontation. B. Transference. C. Blaming. D. Stinking-Thinking. E. Empathic Failure. 5. AA members are often cautioned against "two-stepping." Which of the following is the BEST description of two-stepping? A. Members who change sponsors after the first two steps. B. Beginners who have completed the first two steps and cease working steps. C. Members who only stop drinking and then try to help all alcoholics. D. Members who attend more than one type of 12 step meetings at a time. E. Members who relapse after the first two steps. 6. The State Police call you because someone who identifies himself as your client has been charged with embezzlement. You should: A. Inform them that you cannot give information because as your client he has a right to confidentiality. B. Inform them of the rules regarding confidentiality. C. Inform them of the client's clean time and low potential for relapse. D. Release only information specifically requested. E. Direct the officer to a significant other who has no responsibility for confidentiality. 7. Which statement regarding the relationship between alcohol and other drug dependence and personality disorders is MOST accurate? A. The presence of personality disorder increases the chances of alcohol and/or other drug abuse. B. Alcoholism would more often be associated with a dependent personality disorder than an antisocial personality disorder. C. Alcoholism would more often be associated with a schizoid rather than a borderline personality disorder. D. Alcohol and/or drug dependence are not related to the personality disorders. E. A careful history can determine whether personality disorders are primary or secondary to alcohol and other drug abuse. 8. A woman in her early 30s presented for treatment for alcoholism following a five-year history of bipolar affective disorder. Her manic episodes had led to heavy drinking, which provided some degree of tranquilization. She established a dependent pattern of drinking. Which approach to treatment is indicated? A. The client should participate in treatment for chemical dependence and at the same time have a reassessment to the response to medication for bipolar illness. B. The client should establish a period of sobriety and gradually reduce her use of medication. C. Often the response to lithium is dramatic; her mania should come under control and the need for alcohol will be much less. D. It is difficult to know to what extent the use of alcohol produced the manic symptoms in the first place, so the client should first be encouraged to remain abstinent to see if the symptoms persist. E. The client should be given vitamin B supplements when treatment begins since manic behavior often occurs with drinkers who suffer malnutrition. 9. When an actively-using, alcohol-dependent client presents with depressive symptoms: A. Cognitive approaches to treating depression should be the focus of treatment. B. The presence of a primary depressive disorder should be assessed as soon as possible. C. He/she frequently responds quickly to the use of antidepressant medication. D. Depressive symptoms in the majority of cases will be significantly diminished after detoxification and abstinence. E. The client should be referred. 10. When a client reports experiencing an instant euphoric flash when using his/her drug, the most probable drug classification is a: A. Barbiturate. B. Narcotic. C. CNS Stimulant. D. Depressant. E. Hallucinogen. 11. While counseling a client in a methadone maintenance program, the client reports an increase in anxiety and “drug hunger.” What is MOST indicated for the client? A. Use of anxiolytics medication B. Distinguishing between normal anxiety and the onset of anxiety associated with withdrawal C. Deep relaxation training to learn more autonomous control of the anxiety response D. Referral to a hypnotist who specializes in anxiety reduction procedures E. Use of a narcotic antagonist to counteract the effects of toxic opiate levels 12. After several months in marital and family therapy the alcoholic spouse suffers a relapse. The MOST useful approach to the couple is to: A. Frame the relapse as a sign that marital therapy was moving too quickly, and it would be good to get back to the basics of early recovery. B. Inquire what the non-addicted spouse might be doing to enable the return to drinking. C. Frame the relapse as a sign of resistance to the marital therapy and consider with the couple what aspects of treatment are not working. D. Consider that family therapy may be needed since the basis of the relapse may be rooted in dynamics that involve other members of the family. E. Explore the relapse as a difficulty in the couple's ability to negotiate. 13. A client reports a history of amphetamine abuse which has, in the past, induced paranoid psychoses, hyperactivity, and assaultive behavior. The client informs you that he is in a “comedown period” and has used barbiturates to ease the distress. You should expect the client's behavior to be: A. Sedate because of the barbiturate. B. Depressed and flat. C. Easily influenced by those around him. D. Irritable and potentially volatile. E. Compulsive and rigid. 14. An alcoholic patient recovering in your treatment center admits to sexually abusing and beating his child. State law requires that the abuse be reported to a state agency, even if known via a confidential relationship. It is your professional responsibility to: A. Ask your client to sign a contract stating he will never again abuse the child and report the incident only if the contract is broken. B. Work with your client to get his life straightened out and then decide whether or not to report the abuse. C. Report the child abuse to authorities according to State guidelines. D. Inform your supervisor and let the agency deal with the issue. E. Obtain a release of information from your client and call the appropriate state agency. 15. If a counselor with four years recovery from alcoholism drinks part of one beer, he/she should: A. Inform only family members or significant others. B. Immediately enter inpatient treatment. C. Keep the issue confidential as it is a personal matter. D. Resign from the counseling position. E. Discuss the matter with a clinical supervisor and/or therapist and evaluate the need for treatment. 16. A client presents with non-healing ulcers, abscesses, brittle fingernails, and bruxism (teeth grinding). Abuse of which classification of drugs is MOST likely? A. Amphetamines B. Steroids C. Inhalants D. Narcotics E. Sedative Hypnotics DIAGNOSTIC CRITERIA FROM DSM-IV Substance Use Disorders SUBSTANCE DEPENDENCE A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period: (1) tolerance, as defined by either of the following: (a) a need for markedly increased amounts of the substance to achieve intoxication or desired effect (b) markedly diminished effort with continued use of the same amount of the substance (2) withdrawal, as manifested by either of the following: (a) the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substance) (b) the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms (3) the substance is often taken in larger amounts or over a longer period than was intended (4) there is a persistence desire or unsuccessful efforts to cut down or control substance use (5) a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recover from its effects (6) important social, occupational, or recreation activities are given up or reduced because of substance (7) the substance use is continued despite knowledge of having a persistent or recurring physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption) Specify if: With Physiological Dependence: evidence of tolerance or withdrawal (i.e., either Item 1 or 2 present) Without Physiological Dependence: no evidence of tolerance or withdrawal (i.e., neither item 1 nor 2 is present) Substance Use Disorders SUBSTANCE ABUSE A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12- month period: (1) recurrent substance use resulting in a failure to fulfill major role at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance related absences, suspensions, or expulsions from school; neglect of children or household) (2) recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use) (3) recurrent substance-related legal problems (e.g., arrests for substancerelated disorderly conduct) (4) continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights) B. The symptoms have never met the criteria for Substance Dependence for this class of substance. Substance-Induced Disorders Substance Intoxication A. The development of a reversible substance-specific syndrome due to recent ingestion of (or exposure to) a substance. Note: Different substance may produce similar or identical syndromes. B. Clinically significant maladaptive behavioral or psychological changes that are due to the effect of the substance on the central nervous system (belligerence, mood liability, cognitive impairment, impaired judgment, impaired social or occupational functioning) and develop during or shortly after use of the substance. C. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. Substance Withdrawal A. The development of a substance-specific syndrome due to the cessation of (or reduction in) substance use that has been heavy and prolonged. B. The substance-specific syndrome causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. C. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder. MULTIAXIAL CLASSIFICATION Using the DSM - IV Multiaxial Classification DSM - IV offers five axes on which to record the biopsychosocial assessment of your client. The first three axes are for recording the mental and physical diagnoses; the others enable you to note environmental problems and to provide and assessment of the client's functioning over the previous year. Here is how you can write up diagnosis. Axis I: Mental Disorders / On Axis I, record every diagnosis except the personality disorders and Mental Retardation. Nearly every client will have at least one Axis I diagnosis, and many will have more than one. For example, consider a client with two Axis I diagnoses: Bipolar I Disorder and Alcohol Dependence. Following the DSM - IV convention, first list the diagnosis most responsible for the current evaluation. In the example just cited, suppose that the client was a man who had been admitted after a heavy episode of drinking. He had been taking lithium and had no symptoms of mood disorder for two years. Then his diagnosis should read: Axis I 291.8 Alcohol Withdrawal 303.90 Alcohol Dependence 296.46 Bipolar I Disorder, Most Recent Episode Manic, In Full Remission In this example, the first diagnosis would have to be Alcohol Withdrawal (that's why the client sought treatment). But suppose that the client had taken disulfiram for a year, had not been drinking, and was currently experiencing a sever depression. The his Axis diagnosis would read: Axis I 296.53 Bipolar I Disorder, Most Recent Episode Depressed, Sever Without Psychotic Features 303.90 Alcohol Dependence, Sustained Full Remission Indicating Certainty of a Diagnosis When you are uncertain whether a diagnosis is correct, consider using the qualifier (Provisional). This term may be appropriate if you believe that a certain diagnosis is correct, but lack sufficient history to support your impression. Or perhaps it is still early in the course of your client's illness and you expect that more symptoms will develop shortly. Or perhaps you are waiting for laboratory tests to confirm the presence of a general medical condition that you suspect underlies your client's illness. Any of these situations could warrant a provisional diagnosis. Indicating Severity of a Disorder In the examples diagnosis above, the clinician indicated that the severity of the Mood Disorder. Some diagnostic categories (mood and substance-related disorders, Mental Retardation, Conduct Disorder) specify severity criteria. But if you wish, you can specify severity for any Axis I or Axis II diagnosis. Use these generic guidelines: Mild. The client has few symptoms other than the minimum criteria needed. Moderate. Intermediate between Mild and Severe Severe. The client has many more symptoms than the minimum criteria specify, or some symptoms are especially sever, or functioning in society or at work is especially compromised. In Partial Remission. The client previously met full criteria for the diagnosis; although some of then now remain, they are too few to fulfill criteria currently. In Full Remission. The client has been symptom-free for a period of time that seems clinically relevant to the diagnosis. Prior History. The client appears to have recovered from the disorder, but you feel that it is important to mention it. Axis II; Personality Disorders and Mental Retardation A separate axis for the personality disorders and Mental Retardation helps to ensure that they will not be ignored when you are dealing with your client's often more pressing Axis I pathology. Many clients have more than one Axis II diagnosis. For some clients, and Axis II condition is the most important reason for seeking evaluation. This is especially likely in those with Borderline or Antisocial Personality Disorder. In such a client, you can indicate that any Axis I disorder is not the focus of clinical attention by adding the words (Principal Diagnosis) after the Axis II diagnosis. Axis III: Physical Conditions and Disorders Physical illness may have a direct bearing on the client's Axis I diagnosis; this is especially true of the cognitive disorders. In other cases, physical illness may affect (or be affected by) the management of an Axis I or Axis II disorder. An example would be hypertension in a psychotic client who believes that the medication has been poisoned. Of course, you may make multiple diagnosis on Axis II . Axis IV: Psychosocial and Environmental Problems Use Axis IV to report any environmental or other psychosocial event or condition that might affect the diagnosis or management of your client. These may have been caused by the Axis I or Axis II disorder, or they may be independent events. They should have occurred within the year prior to your evaluation. If they occurred earlier, they must have contributed to the development of the mental disorder or must be a focus of treatment. When stating them on Axis IV, be as specific as possible. (Other problems are possible; these are samples.) Axis IV notations will usually relate to distressing conditions, but occasionally there may be a “positive stressor” (a marriage, a promotion at work). Mention only positive stressor that have caused problems for the client. Axis V: Global Assessment of Functioning (GAF) The GAF score reflects the client’s current overall, occupational, psychological, and social functioning. It is not supposed to reflect physical limitations or environmental problems. It is recorded as a single number on a 100-point scale. The scale specifics symptoms and behavioral guidelines to help you determine your client’s GAF score. Perhaps because of the subjectivity inherent in this scale, its greatest usefulness may be in tracking changes in a client’s level of functioning across time. The GAF scale is reproduced in another handout. Economic Problems. Examples: poverty; debt or credit problems; inadequate welfare or child support. Housing Problems. Examples: disagreements with landlord or neighbors; homelessness; poor housing; dangerous neighborhood. Problems with Primary Support Group. Examples: death of a relative; illness in relative; family disruption through divorce or separation; remarriage of parent; physical or sexual abuse, disagreements with relatives. Occupational Problems. Examples: stressful work conditions or schedule; change of job; dissatisfaction with job; disagreements with supervisor or coworkers; possibility of job loss; unemployment . Educational Problems. Examples: academic problems; disagreements with classmates or teachers; illiteracy; poor school environment. Problems Related to the Social Environment. Examples, loss or death of friend; acculturation problems; racial or sexual discrimination; retirement; living alone; social isolation. Problems Related to Interaction with the Legal System/Crime. Examples: being arrested; being incarcerated; suing or being sued; being a victim of crime. Other Psychosocial Problems. Examples: disagreement with care giving professionals (counselor, social workers, physician); exposure to war, natural disasters, or other catastrophes; unavailability of social service agencies. Problems with Access to Health Care Services. Examples: inadequate health care services; no or insufficient health insurance; unavailability of transportation to health care services. Psychosocial and environmental problems will nearly always be coded on Axis IV. However, occasionally one of these problems may be the focus for evaluation or treatment. Then it should be listed with the appropriate V-code number on Axis I, as in this example: Axis I V 62.2 Occupational Problem (disagreement with supervisor) DSM IV Explained The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition™ (DSM IV) is the manual physicians, psychiatrist, psychologists, therapists, and social workers use in order to diagnose mental illness. This manual spells out the specific diagnostic criteria. An example of this can be seen in the diagnosis of a major depressive episode. A person must exhibit at least five or more of the listed nine characteristics and the symptoms must be evident for at least the last two weeks for that person to be diagnosed with this disorder. When diagnosing a client the American Psychological Association recommends that the clinician use a multiaxial Assessment System. As follows: Axis I Clinical Disorders Axis II Axis III Axis IV Axis V Personality Disorders and Mental Retardation General Medical Condition Psychosocial and Environmental Factors Global Assessment of Functioning Axis I includes all the mental health conditions except personality disorders and mental retardation. If the client does not have a mental health diagnosis that belongs on Axis I, V71.09 is placed in the diagnosis spot to show there is no diagnosis. A person could suffer from more than one Axis I disorders and all are listed. Axis II is for reporting Mental Retardation and personality disorders. Axis III is used for reporting any major medical conditions that may be relevant to treatment of the mental health disorder. Axis IV is used to report psychosocial and environmental factors affecting the person. Some of examples of these factors include: (1) problems with primary support group (divorce); (2) problems with social environment (death of a friend); (3) educational problems; (4) housing problems; (5) economic problems; (6) occupational difficulties; (7) legal difficulties; and (8) transportation difficulties. These are some categories a clinician will look at to see how the client is doing in life situations. And Axis V, Global Assessment of Functioning, is the clinicians best guess of the client’s overall level of functioning. For example you would not expect a depressed severely retarded client to keep an elaborate journal of his feelings. An example of what a typical diagnostic assessment might be helpful. Axis I Axis I 296.21 Major Depressive Disorder , Single Episode 303.90 Alcohol Dependence Axis II 301.6 Dependent Personality Disorder Axis III Axis IV Axis V None Recent Divorce, unemployment 58 DSM-IV Diagnoses and Codes 316 V62.3 V62.4 308.3 309.9 Alphabetical [ Specified Psychological Factor ] Affecting [Indicate the General Medical Condition ] Academic Problem Acculturation Problem Acute Stress Disorder Adjustment Disorder Unspecified 309.24 Adjustment Disorder With Anxiety 309 309.3 309.28 309.4 Adjustment Disorder With Depressed Mood Adjustment Disorder With Disturbance of Conduct Adjustment Disorder With Mixed Anxiety and Depressed Mood Adjustment Disorder With Mixed Disturbance of Emotions and Conduct V71.01 Adult Antisocial Behavior 995.2 780.9 Adverse Effects of Medication NOS Age-Related Cognitive Decline 300.22 Agoraphobia Without History of Panic Disorder 305 303.9 303 291 Alcohol Abuse Alcohol Dependence Alcohol Intoxication Alcohol Intoxication Delirium 291.81 Alcohol Withdrawal 291 Alcohol Withdrawal Delirium 291.89 Alcohol-Induced Anxiety Disorder 291.89 Alcohol-Induced Mood Disorder 291.1 291.2 291.5 291.3 Alcohol-Induced Persisting Amnestic Disorder Alcohol-Induced Persisting Dementia Alcohol-Induced Psychotic Disorder, With Delusions Alcohol-Induced Psychotic Disorder, With Hallucinations 291.89 Alcohol-Induced Sexual Dysfunction 291.89 Alcohol-Induced Sleep Disorder 291.9 294 294.8 305.7 304.4 Alcohol-Related Disorder NOS Amnestic Disorder Due to...[Indicate the General Medical Condition] Amnestic Disorder NOS Amphetamine Abuse Amphetamine Dependence 292.89 Amphetamine Intoxication 292.81 Amphetamine Intoxication Delirium 292 Amphetamine Withdrawal 292.89 Amphetamine-Induced Anxiety Disorder 292.84 Amphetamine-Induced Mood Disorder 292.11 292.12 Amphetamine-Induced Psychotic Disorder, With Delusions Amphetamine-Induced Psychotic Disorder, With Hallucinations 292.89 Amphetamine-Induced Sexual Dysfunction 292.89 Amphetamine-Induced Sleep Disorder 292.9 Amphetamine-Related Disorder NOS 307.1 301.7 293.84 300 299.8 314.9 314.01 314.01 314 299 Anorexia Nervosa Antisocial Personality Disorder Anxiety Disorder Due to...[Indicate the General Medical Condition] Anxiety Disorder NOS Asperger's Disorder Attention-Deficit/Hyperactivity Disorder NOS Attention-Deficit/Hyperactivity Disorder, Combined Type Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type Autistic Disorder 301.82 Avoidant Personality Disorder V62.82 Bereavement 296.8 296.56 296.55 296.51 296.52 296.54 Bipolar Disorder NOS Bipolar I Disorder, Most Recent Episode Depressed, In Full Remission Bipolar I Disorder, Most Recent Episode Depressed, In Partial Remission Bipolar I Disorder, Most Recent Episode Depressed, Mild Bipolar I Disorder, Most Recent Episode Depressed, Moderate Bipolar I Disorder, Most Recent Episode Depressed, Severe With Psychotic Features 296.53 Bipolar I Disorder, Most Recent Episode Depressed, Severe Without Psychotic Features 296.5 296.4 296.46 296.45 296.41 296.42 296.44 296.43 296.4 296.66 296.65 296.61 296.62 296.64 Bipolar I Disorder, Most Recent Episode Depressed, Unspecified Bipolar I Disorder, Most Recent Episode Hypomanic Bipolar I Disorder, Most Recent Episode Manic, In Full Remission Bipolar I Disorder, Most Recent Episode Manic, In Partial Remission Bipolar I Disorder, Most Recent Episode Manic, Mild Bipolar I Disorder, Most Recent Episode Manic, Moderate Bipolar I Disorder, Most Recent Episode Manic, Severe With Psychotic Features Bipolar I Disorder, Most Recent Episode Manic, Severe Without Psychotic Features Bipolar I Disorder, Most Recent Episode Manic, Unspecified Bipolar I Disorder, Most Recent Episode Mixed, In Full Remission Bipolar I Disorder, Most Recent Episode Mixed, In Partial Remission Bipolar I Disorder, Most Recent Episode Mixed, Mild Bipolar I Disorder, Most Recent Episode Mixed, Moderate Bipolar I Disorder, Most Recent Episode Mixed, Severe With Psychotic Features 296.63 296.6 296.7 296.06 296.05 Bipolar I Disorder, Most Recent Episode Mixed, Severe Without Psychotic Features Bipolar I Disorder, Most Recent Episode Mixed, Unspecified Bipolar I Disorder, Most Recent Episode Unspecified Bipolar I Disorder, Single Manic Episode, In Full Remission Bipolar I Disorder, Single Manic Episode, In Partial Remission 296.01 Bipolar I Disorder, Single Manic Episode, Mild 296.02 296.04 296.03 296 Bipolar I Disorder, Single Manic Episode, Moderate Bipolar I Disorder, Single Manic Episode, Severe With Psychotic Features Bipolar I Disorder, Single Manic Episode, Severe Without Psychotic Features Bipolar I Disorder, Single Manic Episode, Unspecified 296.89 Bipolar II Disorder 300.7 Body Dysmorphic Disorder V62.89 Borderline Intellectual Functioning 301.83 Borderline Personality Disorder 780.59 Breathing-Related Sleep Disorder 298.8 Brief Psychotic Disorder 307.51 Bulimia Nervosa 305.9 Caffeine Intoxication 292.89 Caffeine-Induced Anxiety Disorder 292.89 Caffeine-Induced Sleep Disorder 292.9 305.2 304.3 Caffeine-Related Disorder NOS Cannabis Abuse Cannabis Dependence 292.89 Cannabis Intoxication 292.81 Cannabis Intoxication Delirium 292.89 Cannabis-Induced Anxiety Disorder 292.11 292.12 292.9 293.89 Cannabis-Induced Psychotic Disorder, With Delusions Cannabis-Induced Psychotic Disorder, With Hallucinations Cannabis-Related Disorder NOS Catatonic Disorder Due to...[Indicate the General Medical Condition] V71.02 Child or Adolescent Antisocial Behavior 299.1 Childhood Disintegrative Disorder 307.22 Chronic Motor or Vocal Tic Disorder 307.45 Circadian Rhythm Sleep Disorder 305.6 304.2 Cocaine Abuse Cocaine Dependence 292.89 Cocaine Intoxication 292.81 Cocaine Intoxication Delirium 292 Cocaine Withdrawal 292.89 Cocaine-Induced Anxiety Disorder 292.84 Cocaine-Induced Mood Disorder 292.11 292.12 Cocaine-Induced Psychotic Disorder, With Delusions Cocaine-Induced Psychotic Disorder, With Hallucinations 292.89 Cocaine-Induced Sexual Dysfunction 292.89 Cocaine-Induced Sleep Disorder 292.9 294.9 307.9 Cocaine-Related Disorder NOS Cognitive Disorder NOS Communication Disorder NOS 312.82 Conduct Disorder, Adolescent Onset Type 312.81 Conduct Disorder, Childhood Onset Type 300.11 Conversion Disorder 301.13 Cyclothymic Disorder 293 Delirium Due to...[Indicate the General Medical Condition] 780.09 Delirium NOS 297.1 290.1 294.1 294.1 294.1 294.1 290.1 294.1 294.8 Delusional Disorder Dementia Due to Creutzfeldt-Jakob Disease Dementia Due to Head Trauma Dementia Due to HIV Disease Dementia Due to Huntington's Disease Dementia Due to Parkinson's Disease Dementia Due to Pick's Disease Dementia Due to...[Indicate the General Medical Condition] Dementia NOS 290.1 290.11 290.12 290.13 290 290.3 290.2 290.21 301.6 300.6 311 315.4 799.9 799.9 313.9 315.2 312.9 Dementia of the Alzheimer's Type, With Early Onset, Uncomplicated Dementia of the Alzheimer's Type, With Early Onset, With Delirium Dementia of the Alzheimer's Type, With Early Onset, With Delusions Dementia of the Alzheimer's Type, With Early Onset, With Depressed Mood Dementia of the Alzheimer's Type, With Late Onset, Uncomplicated Dementia of the Alzheimer's Type, With Late Onset, With Delirium Dementia of the Alzheimer's Type, With Late Onset, With Delusions Dementia of the Alzheimer's Type, With Late Onset, With Depressed Mood Dependent Personality Disorder Depersonalization Disorder Depressive Disorder NOS Developmental Coordination Disorder Diagnosis Deferred on Axis II Diagnosis or Condition Deferred on Axis I Disorder of Infancy, Childhood, or Adolescence NOS Disorder of Written Expression Disruptive Behavior Disorder NOS 300.12 Dissociative Amnesia 300.15 Dissociative Disorder NOS 300.13 Dissociative Fugue 300.14 Dissociative Identity Disorder 302.76 Dyspareunia (Not Due to a General Medical Condition) 307.47 Dyssomnia NOS 300.4 307.5 787.6 307.7 307.6 302.4 Dysthymic Disorder Eating Disorder NOS Encopresis, With Constipation and Overflow Incontinence Encopresis, Without Constipation and Overflow Incontinence Enuresis (Not Due to a General Medical Condition) Exhibitionism 315.31 Expressive Language Disorder 300.19 Factitious Disorder NOS 300.19 300.19 300.16 Factitious Disorder With Combined Psychological and Physical Signs and Symptoms Factitious Disorder With Predominantly Physical Signs and Symptoms Factitious Disorder With Predominantly Psychological Signs and Symptoms 307.59 Feeding Disorder of Infancy or Early Childhood 625 625.8 Female Dyspareunia Due to...[Indicate the General Medical Condition] Female Hypoactive Sexual Desire Disorder Due to...[Indicate the General Medical Condition] 302.73 Female Orgasmic Disorder 302.72 Female Sexual Arousal Disorder 302.81 Fetishism 302.89 Frotteurism 302.85 Gender Identity Disorder in Adolescents or Adults 302.6 302.6 Gender Identity Disorder in Children Gender Identity Disorder NOS 300.02 Generalized Anxiety Disorder 305.3 304.5 Hallucinogen Abuse Hallucinogen Dependence 292.89 Hallucinogen Intoxication 292.81 Hallucinogen Intoxication Delirium 292.89 Hallucinogen Persisting Perception Disorder 292.89 Hallucinogen-Induced Anxiety Disorder 292.84 Hallucinogen-Induced Mood Disorder 292.11 292.12 292.9 301.5 307.44 Hallucinogen-Induced Psychotic Disorder, With Delusions Hallucinogen-Induced Psychotic Disorder, With Hallucinations Hallucinogen-Related Disorder NOS Histrionic Personality Disorder Hypersomnia Related to...[Indicate the Axis I or Axis II Disorder] 302.71 Hypoactive Sexual Desire Disorder 300.7 Hypochondriasis 313.82 Identity Problem 312.3 305.9 304.6 Impulse-Control Disorder NOS Inhalant Abuse Inhalant Dependence 292.89 Inhalant Intoxication 292.81 Inhalant Intoxication Delirium 292.89 Inhalant-Induced Anxiety Disorder 292.84 Inhalant-Induced Mood Disorder 292.82 Inhalant-Induced Persisting Dementia 292.11 292.12 292.9 307.42 Inhalant-Induced Psychotic Disorder, With Delusions Inhalant-Induced Psychotic Disorder, With Hallucinations Inhalant-Related Disorder NOS Insomnia Related to...[Indicate the Axis I or Axis II Disorder] 312.34 Intermittent Explosive Disorder 312.32 Kleptomania 315.9 296.36 296.35 Learning Disorder NOS Major Depressive Disorder, Recurrent, In Full Remission Major Depressive Disorder, Recurrent, In Partial Remission 296.31 Major Depressive Disorder, Recurrent, Mild 296.32 Major Depressive Disorder, Recurrent, Moderate 296.34 Major Depressive Disorder, Recurrent, Severe With Psychotic Features 296.33 Major Depressive Disorder, Recurrent, Severe Without Psychotic Features 296.3 296.26 296.25 Major Depressive Disorder, Recurrent, Unspecified Major Depressive Disorder, Single Episode, In Full Remission Major Depressive Disorder, Single Episode, In Partial Remission 296.21 Major Depressive Disorder, Single Episode, Mild 296.22 296.24 296.23 296.2 608.89 Major Depressive Disorder, Single Episode, Moderate Major Depressive Disorder, Single Episode, Severe With Psychotic Features Major Depressive Disorder, Single Episode, Severe Without Psychotic Features Major Depressive Disorder, Single Episode, Unspecified Male Dyspareunia Due to...[Indicate the General Medical Condition] 302.72 Male Erectile Disorder 607.84 608.89 Male Erectile Disorder Due to...[Indicate the General Medical Condition] Male Hypoactive Sexual Desire Disorder Due to...[Indicate the Medical Condition] 302.74 Male Orgasmic Disorder V65.2 315.1 333.9 333.1 293.9 Malingering Mathematics Disorder Medication-Induced Movement Disorder NOS Medication-Induced Postural Tremor Mental Disorder NOS Due to...[Indicate the General Medical Condition] 319 317 Mental Retardation, Severity Unspecified Mild Mental Retardation 315.32 Mixed Receptive-Expressive Language Disorder 318 293.83 296.9 Moderate Mental Retardation Mood Disorder Due to...[Indicate the General Medical Condition] Mood Disorder NOS 301.81 Narcissistic Personality Disorder 347 Narcolepsy V61.21 Neglect of Child 995.52 Neglect of Child (if focus of attention is on victim) 333.92 Neuroleptic Malignant Syndrome 333.99 Neuroleptic-Induced Acute Akathisia 333.7 332.1 Neuroleptic-Induced Acute Dystonia Neuroleptic-Induced Parkinsonism 333.82 Neuroleptic-Induced Tardive Dyskinesia 305.1 292 292.9 Nicotine Dependence Nicotine Withdrawal Nicotine-Related Disorder NOS 307.47 Nightmare Disorder V71.09 No Diagnosis on Axis II V71.09 No Diagnosis or Condition on Axis I V15.81 Noncompliance With Treatment 300.3 Obsessive-Compulsive Disorder 301.4 V62.2 305.5 304 Obsessive-Compulsive Personality Disorder Occupational Problem Opioid Abuse Opioid Dependence 292.89 Opioid Intoxication 292.81 Opioid Intoxication Delirium 292 Opioid Withdrawal 292.84 Opioid-Induced Mood Disorder 292.11 292.12 Opioid-Induced Psychotic Disorder, With Delusions Opioid-Induced Psychotic Disorder, With Hallucinations 292.89 Opioid-Induced Sexual Dysfunction 292.89 Opioid-Induced Sleep Disorder 292.9 Opioid-Related Disorder NOS 313.81 Oppositional Defiant Disorder 305.9 304.9 Other (or Unknown) Substance Abuse Other (or Unknown) Substance Dependence 292.89 Other (or Unknown) Substance Intoxication 292 292.89 Other (or Unknown) Substance Withdrawal Other (or Unknown) Substance-Induced Anxiety Disorder 292.81 Other (or Unknown) Substance-Induced Delirium 292.84 Other (or Unknown) Substance-Induced Mood Disorder 292.83 Other (or Unknown) Substance-Induced Persisting Amnestic Disorder 292.82 292.11 292.12 292.89 292.89 292.9 Other (or Unknown) Substance-Induced Persisting Dementia Other (or Unknown) Substance-Induced Psychotic Disorder, With Delusions Other (or Unknown) Substance-Induced Psychotic Disorder, With Hallucinations Other (or Unknown) Substance-Induced Sexual Dysfunction Other (or Unknown) Substance-Induced Sleep Disorder Other (or Unknown) Substance-Related Disorder NOS 312.89 Other Conduct Disorder 625.8 608.89 307.89 307.8 Other Female Sexual Dysfunction Due to...[Indicate the General Medical Condition] Other Male Sexual Dysfunction Due to...[Indicate the General Medical Condition] Pain Disorder Associated With Both Psychological Factors and a General Medical Condition Pain Disorder Associated With Psychological Factors 300.21 Panic Disorder With Agoraphobia 300.01 Panic Disorder Without Agoraphobia 301 302.9 Paranoid Personality Disorder Paraphilia NOS 307.47 Parasomnia NOS V61.20 Parent-Child Relational Problem V61.10 Partner Relational Problem 312.31 Pathological Gambling 302.2 310.1 301.9 299.8 Pedophilia Personality Change Due to...[Indicate the General Medical Condition] Personality Disorder NOS Pervasive Developmental Disorder NOS V62.89 Phase of Life Problem 305.9 Phencyclidine Abuse 304.60 Phencyclidine Dependence 292.89 Phencyclidine Intoxication 292.81 Phencyclidine Intoxication Delirium 292.89 Phencyclidine-Induced Anxiety Disorder 292.84 Phencyclidine-Induced Mood Disorder 292.11 292.12 292.9 Phencyclidine-Induced Psychotic Disorder, With Delusions Phencyclidine-Induced Psychotic Disorder, With Hallucinations Phencyclidine-Related Disorder NOS 315.39 Phonological Disorder V62.83 Physical Abuse of Adult (if by person other than partner) V61.12 Physical Abuse of Adult (if by partner) 995.81 Physical Abuse of Adult (if focus of attention is on victim) V61.21 Physical Abuse of Child 995.54 Physical Abuse of Child (if focus of attention is on victim) 307.52 Pica 304.8 Polysubstance Dependence 309.81 Posttraumatic Stress Disorder 302.75 Premature Ejaculation 307.44 Primary Hypersomnia 307.42 Primary Insomnia 318.2 293.81 293.82 298.9 Profound Mental Retardation Psychotic Disorder Due to...[Indicate the General Medical Condition], With Delusions Psychotic Disorder Due to...[Indicate the General Medical Condition], With Hallucinations Psychotic Disorder NOS 312.33 Pyromania 313.89 315 Reactive Attachment Disorder of Infancy or Early Childhood Reading Disorder V62.81 Relational Problem NOS V61.9 Relational Problem Related to a Mental Disorder or General Medical Condition V62.89 Religious or Spiritual Problem 299.8 Rett's Disorder 307.53 Rumination Disorder 295.7 301.2 Schizoaffective Disorder Schizoid Personality Disorder 295.2 295.1 295.3 295.6 295.9 295.4 Schizophrenia, Catatonic Type Schizophrenia, Disorganized Type Schizophrenia, Paranoid Type Schizophrenia, Residual Type Schizophrenia, Undifferentiated Type Schizophreniform Disorder 301.22 Schizotypal Personality Disorder 305.4 304.1 Sedative, Hypnotic, or Anxiolytic Abuse Sedative, Hypnotic, or Anxiolytic Dependence 292.89 Sedative, Hypnotic, or Anxiolytic Intoxication 292.81 292 292.81 292.89 292.84 292.83 292.82 292.11 292.12 Sedative, Hypnotic, or Anxiolytic Intoxication Delirium Sedative, Hypnotic, or Anxiolytic Withdrawal Sedative, Hypnotic, or Anxiolytic Withdrawal Delirium Sedative-, Hypnotic-, or Anxiolytic-Induced Anxiety Disorder Sedative-, Hypnotic-, or Anxiolytic-Induced Mood Disorder Sedative-, Hypnotic-, or Anxiolytic-Induced Persisting Amnestic Disorder Sedative-, Hypnotic-, or Anxiolytic-Induced Persisting Dementia Sedative-, Hypnotic-, or Anxiolytic-Induced Psychotic Disorder, With Delusions Sedative-, Hypnotic-, or Anxiolytic-Induced Psychotic Disorder, With Hallucinations 292.89 292.89 292.9 Sedative-, Hypnotic-, or Anxiolytic-Induced Sexual Dysfunction Sedative-, Hypnotic-, or Anxiolytic-Induced Sleep Disorder Sedative-, Hypnotic-, or Anxiolytic-Related Disorder NOS 313.23 Selective Mutism 309.21 Separation Anxiety Disorder 318.1 Severe Mental Retardation V61.12 Sexual Abuse of Adult (if by partner) V62.83 995.81 Sexual Abuse of Adult (if by person other than partner) Sexual Abuse of Adult (if focus of attention is on victim) V61.21 Sexual Abuse of Child 995.53 Sexual Abuse of Child (if focus of attention is on victim) 302.79 Sexual Aversion Disorder 302.9 302.7 Sexual Disorder NOS Sexual Dysfunction NOS 302.83 Sexual Masochism 302.84 Sexual Sadism 297.3 V61.8 780.52 Shared Psychotic Disorder Sibling Relational Problem Sleep Disorder Due to...[Indicate the General Medical Condition], Insomnia Type 780.54 Sleep Disorder Due to...[Indicate the General Medical Condition], Hypersomnia Type 780.59 780.59 Sleep Disorder Due to...[Indicate the General Medical Condition], Mixed Type Sleep Disorder Due to...[Indicate the General Medical Condition], Parasomnia Type 307.46 Sleep Terror Disorder 307.46 Sleepwalking Disorder 300.23 Social Phobia 300.81 Somatization Disorder 300.82 Somatoform Disorder NOS 300.29 Specific Phobia 307.3 307 307.2 Stereotypic Movement Disorder Stuttering Tic Disorder NOS 307.23 Tourette's Disorder 307.21 Transient Tic Disorder 302.3 Transvestic Fetishism 312.39 Trichotillomania 300.82 Undifferentiated Somatoform Disorder 300.9 306.51 290.4 Unspecified Mental Disorder (nonpsychotic) Vaginismus (Not Due to a General Medical Condition) Vascular Dementia, Uncomplicated 290.41 Vascular Dementia, With Delirium 290.42 Vascular Dementia, With Delusions 290.43 Vascular Dementia, With Depressed Mood 302.82 Voyeurism