GLOSSARY OF MENTAL DISORDERS

 The psychiatric terms which appear in Chapter 5, "Mental Disorders," are
 listed here in alphabetic sequence. Many of the glossary descriptions
 originally appeared in the section on Mental Disorders in the International
 Classification of Diseases, 9th Revision, and others are included to define
 the psychiatric conditions added to ICD-9-CM. The additional definitions are
 based on material furnished by the American Psychiatric Association's Task
 Force on Nomenclature and Statistics(2) and from A Psychiatric Glossary(3).
 In a few instances definitions were obtained from Dorland's Illustrated
 Medical Dictionary(4) and from Stedman's Medical Dictionary, Illustrated.(5)

 1. Manual of the International Classification of Diseases, Injuries, and
     Causes of Death, 9th Revision, World Health Organization, Geneva,
     Switzerland, 1975.

 2. American Psychiatric Association, Task Force on Nomenclature and
    Statistics, Robert L. Spitzer, Chairman.

 3. A Psychiatric Glossary, Fourth Edition, American Psychiatric Association,
     Washington, D.C., 1975.

 4. Dorland's Illustrated Medical Dictionary, Twenty-fifth Edition, W. B.
     Saunders Company, Philadelphia, 1974.

 5. Stedman's Medical Dictionary, Illustrated, Twenty-third Edition, the
     Williams and Williams Company, Baltimore, 1976.


Academic underachievement disorder: Failure to achieve in most school tasks
     despite adequate intellectual capacity, a supportive and encouraging
     social environment, and apparent effort. The failure occurs in the
     absence of a demonstrable specific learning disability and is caused by
     emotional conflict not clearly associated with any other mental
     disorder.(2)

Adaptation reaction -- see Adjustment reaction

Adjustment reaction or disorder: Mild or transient disorders lasting longer
     than acute stress reactions which occur in individuals of any age without
     any apparent pre-existing mental disorder. Such disorders are often
     relatively circumscribed or situation specific, are generally reversible,
     and usually last only a few months. They are usually closely related in
     time and content to stresses such as bereavement, migration, or other
     experiences. Reactions to major stress that last longer than a few days
     are also included. In children such disorders are associated with no
     significant distortion of development.(1)

        conduct disturbance: Mild or transient disorders in which the main
          disturbance predominantly involves a disturbance of conduct
          (e.g., an adolescent grief reaction resulting in aggressive or
          antisocial disorder).(1)

        depressive reaction: States of depression, not specifiable as
          manic-depressive, psychotic, or neurotic.(1)

           brief: Generally transient, in which the depressive symptoms are
             usually closely related in time and content to some stressful
             event.(1)

           prolonged: Generally long-lasting, usually developing in association
             with prolonged exposure to a stressful situation.(1)

          emotional disturbance: An adjustment disorder in which the main
             symptoms are emotional in type (e.g., anxiety, fear, worry) but
             not specifically depressive.(1)

          mixed conduct and emotional disturbance: An adjustment reaction in
             which both emotional disturbance and disturbance of conduct are
             prominent features.(1)

Affective psychoses: Mental disorders, usually recurrent, in which there is a
   severe disturbance of mood (mostly compounded of depression and anxiety but
   also manifested as elation, and excitement) which is accompanied by one or
   more of the following: delusions, perplexity, disturbed attitude to self,
   disorder of perception and behavior; these are all in keeping with the
   individual's prevailing mood (as are hallucinations when they occur). There
   is a strong tendency to suicide. For practical reasons, mild disorders of
   mood may also be included here if the symptoms match closely the
   descriptions given; this applies particularly to mild hypomania.(1)

     bipolar: A manic-depressive psychosis which has appeared in both the
        depressive and manic form, either alternating or separated by an
        interval of normality.(1)

          atypical: An episode of affective psychosis with some, but not all,
            of the features of the one form of the disorder in individuals who
            have had a previous episode of the other form of the disorder.(2)

          depressed: A manic-depressive psychosis, circular type, in which the
            depressive form is currently present.(1)

          manic: A manic-depressive psychosis, circular type, in which the
            manic form is currently present.(1)

          mixed: A manic-depressive psychosis, circular type, in which both
            manic and depressive symptoms are present at the same time.(1)

     depressed type: A manic-depressive psychosis in which there is a
       widespread depressed mood of gloom and wretchedness with some degree of
       anxiety. There is often reduced activity but there may be restlessness
       and agitation. There is marked tendency to recurrence; in a few cases
       this may be at regular intervals.(1)

          atypical: An affective depressive disorder that cannot be classified
            as a manic-depressive psychosis, depressed type, or chronic
            depressive personality disorder, or as an adjustment disorder.(2)

          manic type: A manic-depressive psychosis characterized by states of
            elation or excitement out of keeping with the individual's
            circumstances and varying from enhanced liveliness (hypomania) to
            violent, almost uncontrollable, excitement. Aggression and anger,
            flight of ideas, distractibility impaired judgment, and grandiose
            ideas are common.(1)

          mixed type: Manic-depressive psychosis syndromes corresponding to
            both the manic and depressed types, but which for other reasons
            cannot be classified more specifically.(1)

Aggressive personality -- see Personality disorder, explosive type

Agoraphobia -- see agoraphobia under Phobia

Alcohol dependence syndrome: A state, psychic and usually also physical,
   resulting from taking alcohol, characterized by behavioral and other
   responses that always include a compulsion to take alcohol on a continuous
   or periodic basis in order to experience its psychic effects, and sometimes
   to avoid the discomfort of its absence; tolerance may or may not be present.
   A person may be dependent on alcohol and other drugs; if so, also record the
   diagnosis of drug dependence to identify the agent. If alcohol dependence is
   associated with alcoholic psychosis or with physical complications, both
   diagnoses should be recorded.(1)

 Alcohol intoxication

     acute: A psychic and physical state resulting from alcohol ingestion
       characterized by slurred speech, unsteady gait, poor coordination,
       flushed facies, nystagmus, sluggish reflexes, fetor alcoholica, loud
       speech, emotional instability (e.g., jollity followed by lugubrious-
       ness), excessive conviviality, loquacity, and poorly inhibited sexual
       and aggressive behavior.(2)

     idiosyncratic: Acute psychotic episodes induced by relatively small
       amounts of alcohol. These are regarded as individual idiosyncratic
       reactions to alcohol, not due to excessive consumption and without
       conspicuous neurological signs of intoxication.(1)

     pathological -- see Alcohol intoxication, idiosyncratic

Alcoholic psychoses: Organic psychotic states due mainly to excessive
  consumption of alcohol; defects of nutrition are thought to play an important
  role.(1)

     alcohol abstinence syndrome -- see alcohol withdrawal syndrome below

     alcohol amnestic syndrome: A syndrome of prominent and lasting reduction
       of memory span, including striking loss of recent memory, disordered
       time appreciation and confabulation, occurring in alcoholics as the
       sequel to an acute alcoholic psychosis (especially delirium tremens) or,
       more rarely, in the course of chronic alcoholism. It is usually accomp-
       anied by peripheral neuritis and may be associated with Wernicke's
       encephalopathy.(1)

     alcohol withdrawal delirium [delirium tremens]: Acute or subacute organic
       psychotic states in alcoholics, characterized by clouded consciousness,
       disorientation, fear, illusions, delusions, hallucinations of any kind,
       notably visual and tactile, and restlessness, tremor and sometimes
       fevers.(1)

     alcohol withdrawal hallucinosis: A psychosis usually of less than six
       months' duration, with slight or no clouding of consciousness and much
       anxious restlessness in which auditory hallucinations, mostly of voices
       uttering insults and threats, predominate.(1)

     alcohol withdrawal syndrome: Tremor of hands, tongue, and eyelids follow-
       ing cessation of prolonged heavy drinking of alcohol. Nausea and vomit-
       ing, dry mouth, headache, heavy perspiration, fitful sleep, acute
       anxiety attacks, mood depression, feelings of guilt and remorse, and
       irritability are associated features.(2)

     alcohol delirium -- see alcohol withdrawal delirium above

     alcoholic dementia: Nonhallucinatory dementias occurring in association
       with alcoholism, but not characterized by the features of either alcohol
       withdrawal delirium [delirium tremens] or alcohol amnestic syndrome
       [Korsakoff's alcoholic psychosis].(1)

     alcoholic hallucinosis -- see alcohol withdrawal hallucinosis above

     alcoholic jealousy: Chronic paranoid psychosis characterized by delusional
       jealousy and associated with alcoholism.

     alcoholic paranoia -- see Alcoholic jealousy

     alcoholic polyneuritic psychosis -- see alcohol amnestic syndrome above

 Alcoholism

     acute -- see Alcohol intoxication, acute

     chronic -- see Alcohol dependence syndrome

Alexia: Loss of a previously possessed reading facility that cannot be
  explained by defective visual acuity.(3)

Amnesia, psychogenic: A form of dissociative hysteria in which there is a temp-
  orary disturbance in the ability to recall important personal information
  which has already been registered and stored in memory. The sudden onset of
  this disturbance in the absence of an underlying organic mental disorder, and
  the extent of the disturbance being too great to be explained by ordinary
  forgetfulness, are the essential features.(2)
 
Amnestic syndrome: A syndrome of prominent and lasting reduction of memory
  span, including striking loss of recent memory, disordered time appreciation,
  and confabulation. The commonest causes are chronic alcoholism [alcohol amne-
  stic syndrome; Korsakoff's alcoholic psychosis], chronic barbiturate depend-
  ence, and malnutrition. An amnestic syndrome may be the predominating distur-
  bance in the early states of presenile and senile dementia, arteriosclerotic
  dementia, and in encephalitis and other inflammatory and degenerative diseas-
  es in which there is particular bilateral involvement of the temporal lobes,
  and certain temporal lobe tumors.(2)

Alcoholic -- see alcohol amnestic syndrome under Alcoholic psychoses

Amoral personality -- see Personality disorder, antisocial type

Anancastic [anankastic] neurosis -- see Neurotic disorder, obsessive compulsive

Anancastic [anankastic] personality -- see Personality disorder, compulsive
  type

Anorexia nervosa: A disorder in which the main features are persistent active
  refusal to eat and marked loss of weight. The level of activity and alertness
  is characteristically high in relation to the degree of emaciation. Typically
  the disorder begins in teenage girls but it may sometimes begin before puber-
  ty and rarely it occurs in males. Amenorrhea is usual and there may be a var-
  iety of other physiological changes including slow pulse and respiration, low
  body temperature, and dependent edema. Unusual eating habits and attitudes
  toward food are typical and sometimes starvation follows or alternates with
  periods of overeating. The accompanying psychiatric symptoms are diverse.(1)

Anxiety hysteria -- see phobia under Neurotic disorders

Anxiety state (neurotic): Apprehension, tension, or uneasiness that stems from
  the anticipation of danger, the source of which is largely unknown or unre-
  cognized.(3)

     atypical: An anxiety disorder that does not fulfill the criteria of gen-
       eralized or panic attack anxiety. An example might be an individual
       with a single morbid fear.(2)

     generalized: A disorder of at least six months' duration in which the pre-
       dominant feature is limited to diffuse and persistent anxiety without
       the specific symptoms that characterize phobic disorders, panic disord-
       er, or obsessive-compulsive disorder.(2)
 
     panic attack: An episodic and often chronic, recurrent disorder in which
       the predominant features are anxiety attacks and nervousness. The anx-
       iety attacks are manifested by discrete periods of sudden onset of in-
       tense apprehension, fearfulness, or terror often associated with feel-
       ings of impending doom.(2)

Aphasia, developmental: A delay in the production of spoken language. Rarely,
  there is also a developmental delay in the comprehension of speech sounds.(1)

Arteriosclerotic dementia: Dementia attributable, because of physical signs
  (on examination of the central nervous system), to degenerative arterial dis-
  ease of the brain. Symptoms suggesting a focal lesion in the brain are com-
  mon. There may be a fluctuating or patchy intellectual defect with insight,
  and an intermittent course is common. Clinical differentiation from senile or
  presenile dementia, which may coexist with it, may be very difficult or im-
  possible. The diagnosis of cerebral atherosclerosis should also be record-
  ed.(1)

Asocial personality -- see Personality disorder, antisocial type

Astasia-abasia, hysterical: A form of conversion hysteria in which the individ-
  ual is unable to stand or walk although the legs are otherwise under
  control.(4)

Asthenia, psychogenic -- see neurasthenia under Neurotic disorders

Asthenic personality -- see Personality disorder, dependent type

Attention deficit disorder -- see attention deficit disorder under Hyperkinetic
  syndrome of childhood.

Autism, infantile: A syndrome present from birth or beginning almost invariably
  in the first 30 months. Responses to auditory and sometimes to visual stimuli
  are abnormal, and there are usually severe problems in the understanding of
  spoken language. Speech is delayed and, if it develops, is characterized by
  echolalia, the reversal of pronouns, immature grammatical structure, and ina-
  bility to use abstract terms. There is generally an impairment in the social
  use of both verbal and gestural language. Problems in social relationships
  are most severe before the age of five years and include an impairment in the
  development of eye-to-eye gaze, social attachments, and cooperative play.
  Ritualistic behavior is usual and may include abnormal routines, resistance
  to change, attachment to odd objects, and stereotyped patterns of play. The
  capacity for abstract or symbolic thought and for imaginative play is dimin-
  ished. Intelligence ranges from severely subnormal to normal or above. Per-
  formance is usually better on tasks involving rote memory or visuospatial
  skills than on those requiring symbolic or linguistic skills.(1)

Avoidant personality -- see Personality disorder, avoidant type

"Bad trips": Acute intoxication from hallucinogen abuse, manifested by hallu-
   cinatory states lasting only a few days or less.(1)

Barbiturate abuse: Cases where an individual has taken the drug to the detri-
  ment of his health or social functioning, in doses above or for periods be-
  yond those normally regarded as therapeutic.(1)

Bestiality -- see Zoophilia

Bipolar disorder -- see Affective psychosis, bipolar

     atypical -- see Affective psychosis, bipolar, atypical

Body-rocking -- see Stereotyped repetitive movements

Borderline personality -- see Personality disorder, borderline type

Borderline psychosis of childhood -- see Psychosis, atypical childhood

Borderline schizophrenia -- see Schizophrenia, latent

Bouffee delirante -- see Paranoid reaction, acute

Briquet's disorder -- see somatization disorder under Neurotic disorders

Bulimia: An episodic pattern of overeating [binge eating] accompanied by an
  awareness of the disordered eating pattern with a fear of not being able to
  stop eating voluntarily. Depressive moods and self-deprecating thoughts
  follow the episodes of binge eating.(2)

Catalepsy schizophrenia -- see Schizophrenia, catatonic type

Catastrophic stress -- see Gross stress reaction

Catatonia (schizophrenic) -- see Schizophrenia, catatonic type

Character neurosis -- see Personality disorders

Childhood autism -- see Autism, infantile

Childhood type schizophrenia -- see Psychosis, child

Chronic alcoholic brain syndrome -- see alcoholic dementia under Alcoholic
  psychoses
 
Clay-eating -- see Pica

Clumsiness syndrome -- see coordination disorder under Developmental delay dis-
  orders, specific

Combat fatigue -- see Posttraumatic disorder, acute

Compensation neurosis -- see compensation neurosis under Neurotic disorders

Compulsive conduct disorder -- see impulse control disorders under Conduct dis-
  orders

Compulsive neurosis -- see Neurotic disorder, obsessive-compulsive

Compulsive personality -- see Personality disorder, compulsive type

Concentration camp syndrome -- see Posttraumatic stress disorder, prolonged

Conduct disorders: Disorders mainly involving aggressive and destructive be-
  havior and disorders involving delinquency. It should be used for abnormal
  behavior, in individuals of any age, which gives rise to social disapproval
  but which is not part of any other psychiatric condition. Minor emotional
  disturbances may also be present. To be included, the behavior, as judged by
  its frequency, severity, and type of associations with other symptoms, must
  be abnormal in its context. Disturbances of conduct are distinguished from an
  adjustment reaction by a longer duration and by a lack of close relationship
  in time and content to some stress. They differ from a personality disorder
  by the absence of deeply ingrained maladaptive patterns of behavior present
  from adolescence or earlier.(1)

     impulse control disorders: A failure to resist an impulse, drive, or temp-
       tation to perform some action which is harmful to the individual or to
       others. The impulse may or may not be consciously resisted, and the
       act may or may not be premeditated or planned. Prior to committing the
       act, there is an increasing sense of tension, and at the time of comm-
       itting the act, there is an experience of either pleasure, gratificat-
       ion, or release. Immediately following the act, there may or may not be
       genuine regret, self-reproach, or guilt.(2)
       See also Intermittent explosive disorder, Isolated explosive disorder,
       Kleptomania, Pathological gambling, and Pyromania.

     mixed disturbance of conduct and emotions: A disorder characterized by
       features of undersocialized and socialized disturbance of conduct, but
       in which there is also considerable emotional disturbance as shown, for
       example, by anxiety, misery, or obsessive manifestations.(1)

     socialized conduct disorder: Conduct disorders in individuals who have
       acquired the values or behavior of a delinquent peer group to whom they
       are loyal and with whom they characteristically steal, play truant, and
       stay out late at night. There may also be sexual promiscuity.(1)

      undersocialized conduct disturbance

          aggressive type: A disorder characterized by a persistent pattern of
            disrespect for the feelings and well-being of others (bullying,
            physical aggression, cruel behavior, hostility, verbal abusiveness,
            impudence, defiance, negativism), aggressive antisocial behavior
            (destructiveness, stealing, persistent lying, frequent truancy,
            and vandalism), and failure to develop close and stable relation-
            ships with others.(2)

          unaggressive type: A disorder in which there is a lack of concern for
            the rights and feelings of others to a degree which indicates a
            failure to establish a normal degree of affection, empathy, or
            bond with others. There are two patterns of behavior found. In one,
            the child is fearful and timid, lacking self-assertiveness, resorts
            to self-protective and manipulative lying, indulges in whining
            demandingness and temper tantrums, feels rejected and unfairly
            treated, and is mistrustful of others. In the other pattern of the
            disorder, the child approaches others strictly for his own gains
            and acts exclusively because of exploitative and extractive goals.
            The child lies brazenly and steals, appearing to feel no guilt, and
            forms no social bonds to other individuals.(2)

Confusion, psychogenic -- see Psychosis, reactive confusion

Confusion, reactive -- see Psychosis, reactive confusion

 Confusional state

     acute -- see Delirium, acute

     epileptic -- see Delirium, acute

     subacute -- see Delirium, subacute

Conversion hysteria -- see hysteria, conversion type under Neurotic disorders
 
Coordination disorder -- see coordination disorder under Developmental delay
  disorders specific

Culture shock: A form of stress reaction associated with an individual's ass-
  imilation into a new culture which is vastly different from that in which
  he was raised.(5)

Cyclic schizophrenia -- see Schizophrenia, schizo-affective type

Cyclothymic personality or disorder -- see Personality disorder, cyclothymic
  type

Delirium: Transient organic psychotic conditions with a short course in which
  there is a rapidly developing onset of disorganization of higher mental pro-
  cesses manifested by some degree of impairment of information processing,
  impaired or abnormal attention, perception, memory, and thinking. Clouded
  consciousness, confusion, disorientation, delusions, illusions, and often
  vivid hallucinations predominate in the clinical picture.(1,2)

     acute: short-lived states, lasting hours or days, of the above type.(1)

     subacute: states of the above type in which the symptoms, usually less
       florid, last for several weeks or longer, during which they may show
       marked fluctuations in intensity.(1)

Delirium tremens -- see alcohol withdrawal delirium under Alcoholic psychoses

Delusions, systematized -- see Paranoia

Dementia: A decrement in intellectual functioning of sufficient severity to
  interfere with occupational or social performance, or both. There is impair-
  ment of memory and abstract thinking, the ability to learn new skills,
  problem solving, and judgment. There is often also personality change or
  impairment in impulse control. Dementia in organic psychoses may be of a
  chronic or progressive nature, which if untreated are usually irreversible
  and terminal.(1,2)

     alcoholic -- see alcoholic dementia under Alcoholic psychoses

     arteriosclerotic -- see Arteriosclerotic dementia

     multi-infarct -- see Arteriosclerotic dementia

     presenile -- see Presenile dementia

     repeated infarct -- see Arteriosclerotic dementia

     senile -- see Senile dementia

Depersonalization syndrome -- see depersonalization syndrome under Neurotic
  disorders

Depression: States of depression, usually of moderate but occasionally of
  marked intensity, which have no specifically manic depressive or other psy-
  chotic depressive features, and which do not appear to be associated with
  stressful events or other features specified under neurotic depression.(1)

     anxiety -- see depression under Neurotic disorders

     endogenous -- see Affective psychosis, depressed type

     monopolar -- see Affective psychosis, depressed type

     neurotic -- see depression under Neurotic disorders

     psychotic -- see Affective psychosis, depressed type

     psychotic reactive -- see Psychosis, depressive

     reactive -- see depression under Neurotic disorders
 
     reactive psychotic -- see Psychosis, depressive

Depressive personality or character -- see Personality disorder, chronic
  depressive type

Depressive reaction -- see depressive reaction under Adjustment reaction

Depressive psychosis -- see Affective psychosis, depressed type

Derealization (neurotic) -- see depersonalization syndrome under Neurotic
  disorders

Developmental delay disorders, specific: A group of disorders in which a
  specific delay in development is the main feature. For many the delay is not
  explicable in terms of general intellectual retardation or of inadequate
  schooling. In each case development is related to biological maturation, but
  it is also influenced by nonbiological factors. A diagnosis of a specific
  developmental delay carries no etiological implications. A diagnosis of spec-
  ific delay in development should not be made if it is due to a known neuro-
  logical disorder.(1)

     arithmetical disorder: Disorders in which the main feature is a serious
       impairment in the development of arithmetical skills.(1)
 
     articulation disorder: A delay in the development of normal word-sound
       production resulting in defects of articulation. Omissions or substit-
       utions of consonants are most frequent.(1)
         
     coordination disorder: Disorders in which the main feature is a serious
       impairment in the development of motor coordination which is not explic-
       able in terms of general intellectual retardation. The clumsiness
       is commonly associated with perceptual difficulties.(1)

     mixed development disorder: A delay in the development of one specific
       skill (e.g., reading, arithmetic, speech, or coordination) is frequently
       associated with lesser delays in other skills. When this occurs the dia-
       gnosis should be made according to the skill most seriously impaired.
       The mixed category should be used only where the mixture of delayed
       skills is such that no one skill is preponderantly affected.(1)

     motor retardation -- see coordination disorder above

     reading disorder or retardation: Disorders in which the main feature is a
       serious impairment in the development of reading or spelling skills
       which is not explicable in terms of general intellectual retardation or
       of inadequate schooling. Speech or language difficulties, impaired
       right-left differ-entiation, perceptuo-motor problems, and coding diff-
       iculties are frequently associated. Similar problems are often present
       in other members of the family. Adverse psychosocial factors may be
       present.(1)

     speech or language disorder: Disorders in which the main feature is a
       serious impairment in the development of speech or language (syntax or
       semantic) which is not explicable in terms of general intellectual re-
       tardation. Most commonly there is a delay in the development of normal
       word-sound production resulting in defects of articulation. Omissions or
       substitutions of consonants are most frequent. There may also be a delay
       in the production of spoken language. Rarely, there is also a develop-
       mental delay in the comprehension of sounds. Includes cases in which
       delay is largely due to environmental privation.(1)

Dipsomania -- see Alcohol dependence syndrome

Disorganized schizophrenia -- see Schizophrenia, disorganized type

Dissociative hysteria -- see hysteria, dissociative type under Neurotic
  disorders

Drug abuse: Includes cases where an individual, for whom no other diagnosis is
  possible, has come under medical care because of the maladaptive effect of a
  drug on which he is not dependent (see Drug dependence) and that he has taken
  on his own initiative to the detriment of his health or social functioning.
  When drug abuse is secondary to a psychiatric disorder, record the disorder
  as an additional diagnosis.(1)

Drug dependence: A state, psychic and sometimes also physical, resulting from
  taking a drug, characterized by behavioral and other responses that always
  include a compulsion to take a drug on a continuous or periodic basis in
  order to experience its psychic effects, and sometimes to avoid the discom-
  fort of its absence. Tolerance may or may not be present. A person may be
  dependent on more than one drug.(1)

Drug psychoses: Organic mental syndromes which are due to consumption of drugs
  (notably amphetamines, barbiturates, and opiate and LSD groups) and solvents.
  Some of the syndromes in this group are not as severe as most conditions
  labeled "psychotic," but they are included here for practical reasons. The
  drug should be identified, and also a diagnosis of drug dependence should be
  recorded, if present.(1)

     drug-induced hallucinosis: Hallucinatory states of more than a few days,
       but not more than a few months' duration, associated with large or pro-
       longed intake of drugs, notably of the amphetamine and LSD groups.
       Auditory hallucinations usually predominate and there may be anxiety or
       restlessness. States following LSD or other hallucinogens lasting only
       a few days or less ["bad trips"] are not included.(1)

     drug-induced organic delusional syndrome: Paranoid states of more than a
       few days, but not more than a few months' duration, associated with
       large or prolonged intake of drugs, notably of the amphetamine and LSD
       groups.(1)

     drug withdrawal syndrome: States associated with drug withdrawal ranging
       from severe, as specified for alcohol withdrawal delirium [delirium
       tremens], to less severe states characterized by one or more symptoms
       such as convulsions, tremor, anxiety, restlessness, gastrointestinal and
       muscular complaints, and mild disorientation and memory disturbance.(1)

Drunkenness:
     
     acute -- see Alcohol intoxication, acute

     pathologic -- see Alcohol intoxication, idiosyncratic

     simple: A state of inebriation due to alcohol consumption without conspic-
       uous neurological signs of intoxication.(2)

     sleep: An inability to fully arouse from the sleep state characterized by
       failure to attain full consciousness after arousal.(2)
 
Dyscalculia -- see arithmetical disorder under Developmental delay disorders,
  specific

Dyslalia -- see articulation disorder under Developmental delay disorders,
  specific

Dyslexia, developmental: A disorder in which the main feature is a serious
  impairment of reading skills which is not explicable in terms of general
  intellectual retardation or of inadequate schooling. Word-blindness and
  strephosymbolia (tendency to reverse letters and words in reading) are in-
  cluded.(1,3)

Dysmenorrhea, psychogenic: Painful menstruation due to disturbance of psychic
  control.(4)

Dyspareunia, functional -- see functional dyspareunia under Psychosexual dys-
  functions

Dyspraxia syndrome -- see coordination disorder under Developmental delay
  disorders, specific

Dyssocial personality -- see Personality disorder, antisocial type

Dysuria, psychogenic: Difficulty in passing urine due to psychic factors.(4)

Eating disorders: A group of disorders characterized by a conspicuous disturb-
  ance in eating behavior.(2) See also Bulimia, Pica, and Rumination, psycho-
  genic.

Eccentric personality -- see Personality disorder, eccentric type

Elective mutism: A pervasive and persistent refusal to speak in situations not
  attributable to a mental disorder. In some cases the behavior may manifest a
  form of withdrawal reaction to a specific stressful situation, or as a pre-
  dominant feature in children exhibiting shyness or social withdrawal disord-
  ers.(2)

Emancipation disorder: An adjustment reaction in adolescents or young adults in
  which there is symptomatic expression (e.g., difficulty in making independent
  decisions, increased dependence on parental advice, adoption of values delib-
  erately oppositional to parents) of a conflict over independence following
  the recent assumption of a status in which the individual is more independent
  of parental control or supervision.(2)

Emotional disturbances specific to childhood and adolescence: Less well-
  differentiated emotional disorders characteristic of the childhood period.
  When the emotional disorder takes the form of a neurosis, the appropriate
  diagnosis should be made. These disorders differ from adjustment reactions in
  terms of longer duration and by the lack of close relationship in time and
  content to some stress.(1) See also Academic underachievement disorder,
  Elective mutism, Identity disorder, Introverted disorder of childhood, Misery
  and unhappiness disorder, Oppositional disorder, Overanxious disorder, and
  Shyness disorder of childhood.

Encopresis: A disorder in which the main manifestation is the persistent volun-
  tary or involuntary passage of formed stools of normal or near-normal consis-
  tency into places not intended for that purpose in the individual's own soc-
  iocultural setting. Sometimes the child has failed to gain bowel control, and
  sometimes he has gained control but then later again became encopretic. There
  may be a variety of associated psychiatric symptoms and there may be smearing
  of feces. The condition would not usually be diagnosed under the age of four
  years.(1)

Endogenous depression -- see Affective psychosis, depressed type

Enuresis: A disorder in which the main manifestation is a persistent involunt-
  ary voiding of urine by day or night which is considered abnormal for the
  age of the individual. Sometimes the child will have failed to gain bladder
  control and in other cases he will have gained control and then lost it.
  Episodic or fluctuating enuresis should be included. The disorder would not
  usually be diagnosed under the age of four years.(1)

Epileptic confusional or twilight state -- see Delirium, acute

 Excitation

     catatonic -- see Schizophrenia, catatonic type

     psychogenic -- see Psychosis, excitative type

     reactive -- see Psychosis, excitative type

Exhaustion delirium -- see Stress reaction, acute

Exhibitionism: Sexual deviation in which the main sexual pleasure and
  gratification is derived from exposure of the genitals to a person of the
  opposite sex.(1)

Explosive personality disorder -- see Personality disorder, explosive type

Factitious illness: A form of hysterical neurosis in which there are physical
  or psychological symptoms that are not real, genuine, or natural, which are
  produced by the individual and are under his voluntary control.(2)

     physical symptom type: The presentation of physical symptoms that may be
       total fabrication, self-inflicted, an exaggeration or exacerbation of a
       pre-existing physical condition, or any combination or variation of
       these.(2)
 
     psychological symptom type: The voluntary production of symptoms suggest-
       ive of a mental disorder. Behavior may mimic psychosis or, rather, the
       individual's idea of psychosis.(2)

Fanatic personality -- see Personality disorder, paranoid type

Fatigue neurosis -- see neurasthenia under Neurotic disorders

Feeble-minded -- see Mental retardation, mild

Fetishism: A sexual deviation in which nonliving objects are utilized as a
  preferred or exclusive method of stimulating erotic arousal.(2)

Finger-flicking -- see Stereotyped repetitive movements

Folie a deux -- see Shared paranoid disorder

Frigidity: A psychosexual dysfunction in which there is partial or complete
  failure to attain or maintain the lubrication-swelling response of sexual
  excitement until completion of the sexual act.(2)

Frontal lobe syndrome: Changes in behavior following damage to the frontal
  areas of the brain or following interference with the connections of those
  areas. There is a general diminution of self control, foresight, creativity,
  and spontaneity, which may be manifest as increased irritability, selfish-
  ness, restlessness and lack of concern for others. Conscientiousness and
  powers of concentration are often diminished, but measurable deterioration
  of intellect or memory is not necessarily present. The overall picture is
  often one of emotional dullness, lack of drive, and slowness; but, particu-
  larly in persons previously with energetic, restless, or aggressive charact-
  eristics, there may be a change towards impulsiveness, boastfulness, temper
  outbursts, silly fatuous humor, and the development of unrealistic ambitions;
  the direction of change usually depends upon the previous personality. A
  considerable degree of recovery is possible and may continue over the course
  of several years.(1)

Fugue, psychogenic: A form of dissociative hysteria characterized by an episode
  of wandering with inability to recall one's prior identity. Both onset and
  recovery are rapid. Following recovery there is no recollection of events
  which took place during the fugue state.(2)

Ganser's syndrome (hysterical): A form of factitious illness in which the
  patient voluntarily produces symptoms suggestive of a mental disorder.(2)

Gender identity disorder -- see gender identity disorder under Psychosexual
  identity disorders

Gilles de La Tourette's disorder or syndrome -- see Gilles de La Tourette's
  disorder under Tics

Grief reaction -- see depressive reaction, brief under Adjustment reaction

Gross stress reaction -- see Stress reaction, acute

Group delinquency -- see socialized conduct disorder under Conduct disorders

Habit spasm -- see chronic motor tic disorder under Tics

Hangover (alcohol) -- see Drunkenness, simple

Head-banging -- see Stereotyped repetitive movements

Hebephrenia -- see Schizophrenia, disorganized type

Heller's syndrome -- see Psychosis, disintegrative

High grade defect -- see Mental retardation, mild

Homosexuality: Exclusive or predominant sexual attraction for persons of the
  same sex with or without physical relationship. Record homosexuality as a
  diagnosis whether or not it is considered as a mental disorder.(1)

Hospital addiction syndrome -- see Munchausen syndrome

Hospital hoboes -- see Munchausen syndrome

Hospitalism: A mild or transient adjustment reaction characterized by with-
  drawal seen in hospitalized patients. In young children this may be mani-
  fested by elective mutism.(1)

Hyperkinetic syndrome of childhood: Disorders in which the essential features
  are short attention-span and distractibility. In early childhood the most
  striking symptom is disinhibited, poorly organized and poorly regulated ex-
  treme overactivity but in adolescence this may be replaced by under activity.
  Impulsiveness, marked mood fluctuations, and aggression are also common symp-
  toms. Delays in the development of specific skills are often present and
  disturbed, poor relationships are common. If the hyperkinesis is symptomatic
  of an underlying disorder, the diagnosis of the underlying disorder is re-
  corded instead.(1)

     attention deficit disorder: Cases of hyperkinetic syndrome in which short
       attention span, distractibility, and overactivity are the main manifest-
       ations without significant disturbance of conduct or delay in specific
       skills.(1)

     hyperkinesis with developmental delay: Cases in which the hyperkinetic
       syndrome is associated with speech delay, clumsiness, reading difficult-
       ies, or other delays of specific skills.(1)

     hyperkinetic conduct disorder: Cases in which the hyperkinetic syndrome is
       associated with marked conduct disturbance but not developmental
       delay.(1)

Hypersomnia: A disorder of initiating arousal from sleep or maintaining wake-
  fulness.(2)

     persistent: Chronic difficulty in initiating arousal from sleep or main-
       taining wakefulness associated with major or minor depressive mental
       disorders.(2)

     transient: Episodes of difficulty in arousal from sleep or maintaining
       wakefulness associated with acute or intermittent emotional reactions
       or conflicts.(2)

Hypochondriasis -- see hypochondriasis under Neurotic disorders

Hypomania -- see Affective psychosis, manic type

Hypomanic personality -- see Personality disorder, chronic hypomanic type

Hyposomnia -- see Insomnia

Hysteria -- see hysteria under Neurotic disorders
   
     anxiety -- see phobia under Neurotic disorders

     psychosis -- see Psychosis, reactive

          acute -- see Psychosis, excitative type

Hysterical personality -- see Personality disorder, histrionic type

Identity disorder: An emotional disorder caused by distress over the inability
  to reconcile aspects of the self into a relatively coherent and acceptable
  sense of self, not secondary to another mental disorder. The disturbance is
  manifested by intense subjective distress regarding uncertainty about a var-
  iety of issues relating to identity, including long-term goals, career
  choice, friendship patterns, values, and loyalties.(2)

Idiocy -- see Mental retardation, profound

Imbecile -- see Mental retardation, moderate

Impotence: A psychosexual dysfunction in which there is partial or complete
  failure to attain or maintain erection until completion of the sexual act.(2)

Impulse control disorder -- see impulse control disorders under Conduct
  disorders

Inadequate personality -- see Personality disorder, dependent type

Induced paranoid disorder -- see Shared paranoid disorder

Inebriety -- see Drunkenness, simple

Infantile autism -- see Autism, infantile

Insomnia: A disorder of initiating or maintaining sleep.(2)

     persistent: A chronic state of sleeplessness associated with chronic
       anxiety, major or minor depressive disorders, or psychoses.(2)

     transient: Episodes of sleeplessness associated with acute or intermittent
       emotional reactions or conflicts.(2)

Intermittent explosive disorder: Recurrent episodes of sudden and significant
  loss of control of aggressive impulses, not accounted for by any other ment-
  al disorder, which results in serious assault or destruction of property. The
  magnitude of the behavior during an episode is grossly out of proportion to
  any psychosocial stressors which may have played a role in eliciting the
  episode of lack of control. Following each episode there is genuine regret or
  self-reproach at the consequences of the action and the inability to control
  the aggressive impulse.(2)

Introverted disorder of childhood: An emotional disturbance in children chiefly
  manifested by a lack of interest in social relationships and indifference to
  social praise or criticism.(2)

Introverted personality -- see Personality disorder, introverted type

Involutional melancholia -- see Affective psychosis, depressed type

Involutional paranoid state -- see Paraphrenia

Isolated explosive disorder: A disorder of impulse control in which there is a
  single discrete episode characterized by failure to resist an impulse which
  leads to a single, violent externally-directed act, which has a catastrophic
  impact on others, and for which the available information does not justify
  the diagnosis of another mental disorder.(2)

Isolated phobia -- see simple phobia under Phobia

Jet lag syndrome: A phase-shift disruption of the 24-hour sleep-wake cycle due
  to rapid time-zone changes experienced in long-distance travel.(2)

Kanner's syndrome -- see Autism, infantile

Kleptomania: A disorder of impulse control characterized by a recurrent failure
  to resist impulses to steal objects not for immediate use or their monetary
  value. An increasing sense of tension is experienced prior to committing the
  act, with an intense experience of gratification at the time of committing
  the theft.(2)

Korsakoff's psychosis:

     alcoholic -- see alcohol amnestic syndrome under Alcoholic psychoses

     nonalcoholic -- see Amnestic syndrome

Latent schizophrenia -- see Schizophrenia, latent

Lesbianism -- see Homosexuality

Lobotomy syndrome -- see Frontal lobe syndrome

LSD reaction: Acute intoxication from hallucinogen abuse, manifested by
  hallucinatory states lasting only a few days or less.(1)

Major depressive disorder -- see Affective psychosis, depressed type

Malingering: A clinical picture in which the predominant feature is the pre-
  sentation of fake or grossly exaggerated physical or psychiatric illness
  apparently under voluntary control. In contrast to factitious illness, the
  symptoms produced in malingering are in pursuit of a goal which, when known,
  is recognizable and obviously understandable in light of knowledge of the
  individual's circumstances. Examples of understandable goals include, but are
  not limited to, becoming a "patient" in order to avoid conscription or
  military duty, avoid work, obtain financial compensation, evade criminal
  prosecution, and obtain drugs.(2)

Mania (monopolar) -- see Affective psychosis, manic type

 Manic-depressive psychosis

     circular type -- see Affective psychosis, bipolar

     depressed type -- see Affective psychosis, depressed type

     manic type -- see Affective psychosis, manic type

     mixed type -- see Affective psychosis, mixed type

Manic disorder -- see Affective psychosis, manic type
 
     atypical -- see Affective psychosis, manic type, atypical

Masochistic personality -- see Personality disorder, masochistic type

Melancholia -- see Affective psychoses

     involutional -- see Affective psychosis, depressed type

Mental retardation: A condition of arrested or incomplete development of mind
  which is especially characterized by subnormality of intelligence. The cod-
  ing should be made on the individual's current level of functioning without
  regard to its nature or causation, such as psychosis, cultural deprivation,
  Down's syndrome, etc. Where there is a specific cognitive handicap--such as
  in speech--the diagnosis of mental retardation should be based on assessments
  of cognition outside the area of specific handicap. The assessment of intell-
  ectual level should be based on whatever information is available, including
  clinical evidence, adaptive behavior, and psychometric findings. The IQ
  levels given are based on a test with a mean of 100 and a standard deviation
  of 15, such as the Wechsler scales. They are provided only as a guide and
  should not be applied rigidly. Mental retardation often involves psychiatric
  disturbances and may often develop as a result of some physical disease or
  injury. In these cases, an additional diagnosis should be recorded to identi-
  fy any associated condition, psychiatric or physical.(1)

     mild mental retardation: IQ criteria 50-70. Individuals with this level of
       retardation are usually educable. During the preschool period they can
       develop social and communication skills, have minimal retardation in
       sensorimotor areas, and often are not distinguished from normal children
       until a later age. During the school age period they can learn academic
       skills up to approximately the sixth-grade level. During the adult
       years, they can usually achieve social and vocational skills adequate
       for minimum self-support, but may need guidance and assistance when
       under social or economic stress.(2)

     moderate mental retardation: IQ criteria 35-49. Individuals with this
       level of retardation are usually trainable. During the preschool period
       they can talk or learn to communicate. They have poor social awareness
       and fair motor development. During the school age period they can profit
       from training in social and occupational skills, but they are unlikely
       to progress beyond the second-grade level in academic subjects. During
       their adult years they may achieve self-maintenance in unskilled or
       semi-skilled work under sheltered conditions. They need supervision and
       guidance when under mild social or economic stress.(2)

     severe mental retardation: IQ criteria 20-34. Individuals with this level
       of retardation evidence poor motor development, minimal speech, and are
       generally unable to profit from training and self-help during the pre-
       school period. During the school age period they can talk or learn to
       communicate, can be trained in elementary health habits, and may profit
       from systematic habit training. During the adult years they may contrib-
       ute partially to self-maintenance under complete supervision.(2)

     profound mental retardation: IQ criteria under 20. Individuals with this
       level of retardation evidence minimal capacity for sensorimotor funct-
       ioning and need nursing care during the preschool period. During the
       school age period some further motor development may occur, and they may
       respond to minimal or limited training in self-help. During the adult
       years some motor and speech development may occur, and they may achieve
       very limited self-care and need nursing care.(2)

Merycism -- see Rumination, psychogenic

Minimal brain dysfunction [MBD] -- see Hyperkinetic syndrome of childhood

Misery and unhappiness disorder: An emotional disorder characteristic of child-
  hood in which the main symptoms involve misery and unhappiness. There may
  also be eating and sleep disturbances.(1)

Mood swings (brief compensatory) (rebound): Mild disorders of mood (depression
  and anxiety or elation and excitement, occurring alternatingly or episodic-
  ally) seen in affective psychosis.(1)

Motor tic disorders -- see Tics

Motor-verbal tic disorder -- see Gilles de La Tourette's disorder under Tics

Multi-infarct dementia or psychosis -- see Arteriosclerotic dementia

Multiple operations syndrome -- see Munchausen syndrome

Multiple personality: A form of dissociative hysteria in which there is the
  domination of the individual at any one time by one of two or more distinct
  personalities. Each personality is a fully-integrated and complex unit with
  memories, behavior patterns and social friendships which determine the
  nature of the individual's acts when uppermost in consciousness.(2)

Munchausen syndrome: A chronic form of factitious illness in which the individ-
  ual demonstrates a plausible presentation of voluntarily produced physical
  symptomatology of such a degree that he is able to obtain and sustain
  multiple hospitalizations.(1)

Narcissistic personality -- see Personality disorder, narcissistic type

Nervous debility -- see neurasthenia under Neurotic disorders

Neurasthenia -- see neurasthenia under Neurotic disorders

Neurotic delinquency -- see mixed disturbance of conduct and emotions under
  Conduct disorders

Neurotic disorders: Neurotic disorders are mental disorders without any
  demonstrable organic basis in which the individual may have considerable
  insight and has unimpaired reality testing, in that he usually does not
  confuse his morbid subjective experiences and fantasies with external
  reality. Behavior may be greatly affected although usually remaining within
  socially acceptable limits, but personality is not disorganized. The
  principal manifestations include excessive anxiety, hysterical symptoms,
  phobias, obsessional and compulsive symptoms, and depression.(1)

     anxiety states: Various combinations of physical and mental manifestations
       of anxiety, not attributable to real danger and occurring either in
       attacks [see Anxiety state, panic attacks] or as a persisting state
       [see Anxiety state, generalized]. The anxiety is usually diffuse and may
       extend to panic. Other neurotic features such as obsessional or hyster-
       ical symptoms may be present but do not dominate the clinical
       picture.(1)

     compensation neurosis: Certain unconscious neurotic reactions in which
       features of secondary gain, such as a situational or financial
       advantage, are prominent.(3)

     depersonalization: A neurotic disorder with an unpleasant state of dis-
       turbed perception in which external objects or parts of one's own body
       are experienced as changed in their quality, unreal, remote, or auto-
       matized. The patient is aware of the subjective nature of the change he
       experiences. If deper-sonalization occurs as a feature of anxiety,
       schizophrenia, or other mental disorder, the condition is classified
       according to the major psychiatric disorder.(1)

     depression: A neurotic disorder characterized by disproportionate depress-
       ion which has usually recognizably ensued on a distressing experience;
       it does not include among its features delusions or hallucinations, and
       there is often preoccupation with the psychic trauma which preceded the
       illness, e.g., loss of a cherished person or possession. Anxiety is also
       frequently present and mixed states of anxiety and depression should be
       included here. The distinction between depressive neurosis and psychosis
       should be made not only upon the degree of depression but also on the
       presence or absence of other neurotic and psychotic characteristics, and
       upon the degree of disturbance of the individual's behavior.(1)

     hypochondriasis: A neurotic disorder in which the conspicuous features are
       excessive concern with one's health in general or the integrity and
       functioning of some part of one's body, or less frequently, one's
       mind. It is usually associated with anxiety and depression. It may occur
       as a feature of some other severe mental disorder (e.g., manic-depress-
       ive psychosis, depressed type, schizophrenia, hysteria) and in that case
       should be classified according to the corresponding major disorder.(1)

     hysteria: A neurotic mental disorder in which motives, of which the
       patient seems unaware, produce either a restriction of the field of
       consciousness or disturbances of motor or sensory function which may
       seem to have psychological advantage or symbolic value.(1) There are
       three subtypes:

          conversion type: The chief or only symptoms of the hysterical neuros-
            is consist of psychogenic disturbance of function in some part of
            the body, e.g., paralysis, tremor, blindness, deafness, seizures.
            (1)

          dissociative type: The most prominent feature of the hysterical
            neurosis is a narrowing of the field of consciousness which seems
            to serve an unconscious purpose and is commonly accompanied or
            followed by a selective amnesia. There may be dramatic but essent-
            ially superficial changes of personality [multiple personality], or
            sometimes the patient enters into a wandering state [fugue].(1)

          factitious illness: Physical or psychological symptoms that are not
            real, genuine, or natural, which are produced by the individual
            and are under his voluntary control.(2)

     neurasthenia: A neurotic disorder characterized by fatigue, irritability,
       headache, depression, insomnia, difficulty in concentration, and lack of
       capacity for enjoyment [anhedonia]. It may follow or accompany an in-
       fection or exhaustion, or arise from continued emotional stress. If
       neurasthenia is associated with a physical disorder, the latter should
       also be recorded as a diagnosis.(1)

     obsessive-compulsive: States in which the outstanding symptom is a feeling
       of subjective compulsion, which must be resisted, to carry out some
       action, to dwell on an idea, to recall an experience, or to ruminate on
       an abstract topic. Unwanted thoughts which intrude, the insistency of
       words or ideas, ruminations or trains of thought are perceived by the
       individual to be inappropriate or nonsensical. The obsessional urge or
       idea is recognized as alien to the personality but as coming from within
       the self. Obsessional actions may be quasi-ritual performances designed
       to relieve anxiety, e.g., washing the hands to cope with contamination.
       Attempts to dispel the unwelcome thoughts or urges may lead to a severe
       inner struggle, with intense anxiety.(1)

     occupational: A neurosis characterized by a functional disorder of a group
       of muscles used chiefly in one's occupation, marked by the occurrence of
       spasm, paresis, or incoordination on attempt to repeat the habitual
       movements (e.g., writers' cramp).(5)

     phobic disorders: Neurotic states with abnormally intense dread of certain
       objects or specific situations which would not normally have that
       effect. If the anxiety tends to spread from a specified situation or
       object to a wider range of circumstances, it becomes akin to or identic-
       al with anxiety state and should be classified as such.(1) See also
       Phobia.

     somatization disorder: A chronic, but fluctuating, neurotic disorder which
       begins early in life and is characterized by recurrent and multiple som-
       atic complaints for which medical attention is sought but which are not
       apparently due to any physical illness. Complaints are presented in a
       dramatic, vague, or exaggerated way, or are part of a complicated
       medical history in which often many specific diagnoses have allegedly
       been made by other physicians. Complaints invariably refer to many organ
       systems (headache, fatigue, palpitations, fainting, nausea and vomiting,
       abdominal pains, bowel trouble, allergies, menstrual and sexual diff-
       iculties), and the individual frequently receives medical care from a
       number of physicians, sometimes simultaneously.(2)

Neurosis -- see Neurotic disorders

Nightmares: Anxiety attacks occurring in dreams during REM sleep.(2)

Night terrors: A pathology of arousal from stage 4 sleep in which the individ-
  ual experiences excessive terror and extreme panic (screaming, verbalizat-
  ions), symptoms of autonomic activity, confusion, and poor recall for event.
  (2)

Nymphomania: Abnormal and excessive need or desire in the woman for sexual
  intercourse.(3)

Obsessional personality -- see Personality disorder, compulsive type

Occupational neurosis -- see Neurotic disorder, occupational

Oneirophrenia -- see Schizophrenia, acute episode

Oppositional disorder of childhood or adolescence: A disorder characterized by
  pervasive opposition to all in authority regardless of self-interest, a con-
  tinuous argumentativeness, and an unwillingness to respond to reasonable per-
  suasion, not accounted for by a conduct disorder, adjustment disorder, or a
  psychosis of childhood. The oppositional behavior in this disorder is evoked
  by any demand, rule, suggestion, request, or admonishment placed on the
  individual.(2)

Organic affective syndrome: A clinical picture in which the predominating
  symptoms closely resemble those seen in either the depressive or manic affec-
  tive disorders, occurring in the presence of evidence or history of a specif-
  ic organic factor which is etiologically related to the disturbance, such as
  head trauma, endocranial tumors, and exocranial tumors secreting neurotoxic
  diatheses (e.g., pancreatic carcinoma). Excessive use of steroids, Cushing's
  syndrome, and other endocrine disorders may lead to an organic affective
  syndrome.(2)

Organic personality syndrome: Chronic, mild states of memory disturbance and
  intellectual deterioration, of non-psychotic nature, often accompanied by
  increased irritability, querulousness, lassitude, and complaints of physical
  weakness. These states are often associated with old age, and may precede
  more severe states due to brain damage classifiable under senile or pre-
  senile dementia, dementia associated with other chronic organic psychotic
  brain syndromes, or delirium, delusions, hallucinosis, and depression in
  transient organic psychotic conditions.(1)

Organic psychosyndrome, focal (partial): A nonpsychotic organic mental disorder
  resembling the postconcussion syndrome associated with localized diseases of
  the brain or surrounding tissues.(1)

Organic psychotic conditions: Syndromes in which there is impairment of orient-
  ation, memory, comprehension, calculation, learning capacity, and judgment.
  These are the essential features but there may also be shallowness or labil-
  ity of affect, or a more persistent disturbance of mood, lowering of ethical
  standards and exaggeration or emergence of personality traits, and diminished
  capacity for independent decision.(1)
  See also Alcohol psychoses, Arteriosclerotic dementia, Drug psychoses,
  Presenile dementia, and Senile dementia.

     mixed paranoid and affective: Organic psychosis in which depressive and
       paranoid symptoms are the main features.(1)

     transient: States characterized by clouded consciousness, confusion,
       disorientation, illusions, and often vivid hallucinations. They are
       usually due to some intra- or extracerebral toxic, infectious, metabolic
       or other systemic disturbance and are generally reversible. Depressive
       and paranoid symptoms may also be present but are not the main feature.
       The diagnosis of the associated physical or neurological condition
       should also be recorded.(1)

          acute delirium: Short-lived states, lasting hours or days, of the
            above type.(1)

          subacute delirium: States of the above type in which the symptoms,
            usually less florid, last for several weeks or longer during which
            they may show marked fluctuations in intensity.(1)

Organic reaction -- see Organic psychotic conditions, transient

Overanxious disorder: An ill-defined emotional disorder characteristic of
  childhood in which the main symptoms involve anxiety and fearfulness.(1)

Panic disorder -- see panic attack under Anxiety state

Paranoia: A rare chronic psychosis in which logically constructed systematized
  delusions have developed gradually without concomitant hallucinations or the
  schizophrenic type of disordered thinking. The delusions are mostly of grand-
  eur (the paranoiac prophet or inventor), persecution, or somatic abnormality.
  (1)
    
     alcoholic -- see alcoholic jealousy under Alcoholic psychoses

     querulans: A paranoid state which, though in many ways akin to schizo-
       phrenic or affective states, differs from other paranoid states and
       psychogenic paranoid psychosis.(1)
     
    senile -- see Paraphrenia

Paranoid personality -- see Personality disorder, paranoid type

Paranoid reaction, acute: Paranoid states apparently provoked by some emotional
  stress. The stress is often misconstrued as an attack or threat. Such states
  are particularly prone to occur in prisoners or as acute reactions to a
  strange and threatening environment, e.g., in immigrants.(1)

Paranoid schizophrenia -- see Schizophrenia, paranoid type

 Paranoid state

     involutional -- see Paraphrenia

     senile -- see Paraphrenia

     simple: A psychosis, acute or chronic, not classifiable as schizophrenia
       or affective psychosis, in which delusions, especially of being influ-
       enced, persecuted, or treated in some special way, are the main sympt-
       oms. The delusions are of a fairly fixed, elaborate, and systematized
       kind.(1)

paranoid traits -- see Personality disorder, paranoid type

Paraphilia -- see Sexual deviations

Paraphrenia: Paranoid psychosis in which there are conspicuous hallucinations,
  often in several modalities. Affective symptoms and disordered thinking, if
  present, do not dominate the clinical picture, and the personality is well
  preserved.(1)

Paraphrenic schizophrenia -- see Schizophrenia, paranoid type

Passive-aggressive personality -- see Personality disorder, passive aggressive
  type

Passive personality -- see Personality disorder, dependent type

Pathological

     alcohol intoxication -- see Alcohol intoxication, idiosyncratic
    
     drug intoxication: Individual idiosyncratic reactions to comparatively
       small quantities of a drug, which take the form of acute, brief psychot-
       ic states of any type.(1)
     
     drunkenness -- see Alcohol intoxication, idiosyncratic

     gambling: A disorder of impulse control characterized by a chronic and
       progressive preoccupation with gambling and urge to gamble, with subse-
       quent gambling behavior that compromises, disrupts, or damages personal,
       family, and vocational pursuits.(2)

     personality -- see Personality disorder

Pedophilia: Sexual deviations in which an adult engages in sexual activity with
  a child of the same or opposite sex.(1)

Peregrinating patient -- see Malingering
 
Personality disorders: Deeply ingrained maladaptive patterns of behavior gener-
  ally recognizable by the time of adolescence or earlier and continuing throu-
  ghout most of adult life, although often becoming less obvious in middle or
  old age. The personality is abnormal either in the balance of its components,
  their quality and expression, or in its total aspect. Because of this deviat-
  ion or psychopathy the patient suffers or others have to suffer, and there is
  an adverse effect upon the individual or on society. It includes what is
  sometimes called psychopathic personality, but if this is determined primari-
  ly by malfunctioning of the brain, it should be classified as one of the non-
  psychotic organic brain syndromes. When the patient exhibits an anomaly of
  personality directly related to his neurosis or psychosis, e.g., schizoid
  personality and schizophrenia or anancastic personality and obsessive compul-
  sive neurosis, the relevant neurosis or psychosis which is in evidence should
  be diagnosed in addition.(1)

     affective type: A chronic personality disorder characterized by lifelong
       predominance of a pronounced mood. The illness does not have a clear
       onset, and there may be intermittent periods of disturbed mood
       separated by periods of normal mood.(1)

     anancastic [anankastic] type -- see Personality disorder, compulsive type

     antisocial type: A personality disorder characterized by disregard for
       social obligations, lack of feeling for others, and impetuous violence
       or callous unconcern. There is a gross disparity between behavior and
       the prevailing social norms. Behavior is not readily modifiable by
       experience, including punishment. People with this personality are often
       affectively cold, and may be abnormally aggressive or irresponsible.
       Their tolerance to frustration is low; they blame others or offer
       plausible rationalizations for the behavior which brings them into
       conflict with society.(1)
 
     asthenic type -- see Personality disorder, dependent type

     avoidant type: Individuals with this disorder exhibit excessive social
       inhibitions and shyness, a tendency to withdraw from opportunities for
       developing close relationships, and a fearful expectation that they will
       be belittled and humiliated. Desires for affection and acceptance are
       strong, but they are unwilling to enter relationships unless given un-
       usually strong guarantees that they will be uncritically accepted.
       Therefore, they have few close relationships and suffer from feelings of
       loneliness and isolation.(2)
 
     borderline type: Individuals with this disorder are characterized by in-
     stability in a variety of areas, including interpersonal relationships,
     behavior, mood, and self image. Interpersonal relationships are often
     intense and unstable with marked shifts of attitude over time. Frequently
     there is impulsive and unpredictable behavior which is potentially phys-
     ically self-damaging. There may be problems tolerating being alone,
     and chronic feelings of emptiness or boredom.(2)

     chronic depressive type: An affective personality disorder characterized
       by lifelong predominance of a chronic nonpsychotic disturbance involving
       either intermittent or sustained periods of depressed mood (marked by
       worry, pessimism, low output of energy, and a sense of futility).(2)

     chronic hypomanic type: An affective personality disorder characterized by
       lifelong predominance of a chronic nonpsychotic disturbance involving
       either intermittent or sustained periods of abnormally elevated mood
       (unshakable optimism and an enhanced zest for life and activity).(2)

     compulsive type: A personality disorder characterized by feelings of per-
       sonal insecurity, doubt, and incompleteness leading to excessive cons-
       cientiousness, checking, stubbornness, and caution. There may be in-
       sistent and unwelcome thoughts or impulses which do not attain the
       severity of an obsessional neurosis. There is perfectionism and meticul-
       ous accuracy and a need to check repeatedly in an attempt to ensure
       this. Rigidity and excessive doubt may be conspicuous.(1)

     cyclothymic type: A chronic nonpsychotic disturbance involving depressed
       and elevated mood, lasting at least two years, separated by periods of
       normal mood.(2)

     dependent type: A personality disorder characterized by passive compliance
       with the wishes of elders and others and a weak inadequate response to
       the demands of daily life. Lack of vigor may show itself in the intell-
       ectual or emotional spheres; there is little capacity for enjoyment.(1)

     eccentric type: A personality disorder characterized by oddities of behav-
       ior which do not conform to the clinical syndromes of personality dis-
       orders described elsewhere.(2)

     explosive type: A personality disorder characterized by instability of
       mood with liability to intemperate outbursts of anger, hate, violence,
       or affection. Aggression may be expressed in words or in physical
       violence. The outbursts cannot readily be controlled by the affected
       persons, who are not otherwise prone to antisocial behavior.(1)

     histrionic type: A personality disorder characterized by shallow, labile
       affectivity, dependence on others, craving for appreciation and attent-
       ion, suggestibility, and theatricality. There is often sexual immatur-
       ity, e.g., frigidity and over-responsiveness to stimuli. Under stress
       hysterical symptoms [neurosis] may develop.(1)

     hysterical type -- see Personality disorder, histrionic type

     inadequate type -- see Personality disorder, dependent type

     introverted type: A form of schizoid personality in which the essential
       features are a profound defect in the ability to form social relation-
       ships and to respond to the usual forms of social reinforcements. Such
       patients are characteristically "loners" who do not appear distressed
       by their social distance and are not interested in greater social
       involvement.(2)

     masochistic type: A personality disorder in which the individual appears
       to arrange life situations so as to be defeated and humiliated.(2)

     narcissistic type: A personality disorder in which interpersonal diffic-
       ulties are caused by an inflated sense of self-worth, and indifference
       to the welfare of others. Achievement deficits and social irresponsi-
       bilities are justified and sustained by a boastful arrogance, expansive
       fantasies, facile rationalization, and frank prevarication.(2)

     paranoid type: A personality disorder in which there is excessive sensit-
       iveness to setbacks or to what are taken to be humiliations and rebuffs,
       a tendency to distort experience by misconstruing the neutral or friend-
       ly actions of others as hostile or contemptuous, and a combative and
       tenacious sense of personal rights. There may be a proneness to jealousy
       or excessive self-importance. Such persons may feel helplessly humiliat-
       ed and put upon; others, likewise excessively sensitive, are aggressive
       and insistent. In all cases there is excessive self-reference.(1)

     passive-aggressive type: A personality disorder characterized by aggress-
       ive behavior manifested in passive ways, such as obstructionism, pout-
       ing, procrastination, intentional inefficiency, or stubbornness. The
        aggression often arises from resentment at failing to find gratificat-
        ion in a relationship with an individual or institution upon which the
        individual is overdependent.(3)

     passive type -- see Personality disorder, dependent type

     schizoid type: A personality disorder in which there is withdrawal from
       affection, social, and other contacts with autistic preference for fan-
       tasy and introspective reserve. Behavior may be slightly eccentric or
       indicate avoidance of competitive situations. Apparent coolness and de-
       tachment may mask an incapacity to express feeling.(1)

     schizotypal type: A form of schizoid personality in which individuals with
       this disorder manifest various oddities of thinking, perception, commun-
       ication, and behavior. The disturbance in thinking may be expressed as
       magical thinking, ideas of reference, or paranoid ideation. Perceptual
       disturbances may include recurrent illusions and derealization [deper-
       sonalization]. Frequently, but not invariably, the behavioral manifest-
       ations include social isolation and constricted or inappropriate affect
       which interferes with rapport in face-to-face interaction without any of
       the frank psychotic features which characterize schizophrenia.(2)

Phobia: Neurotic states with abnormally intense dread of certain objects or
  specific situations which would not normally have that effect. If the anxiety
  tends to spread from a specified situation or object to a wider range of cir-
  cumstances, it becomes akin to or identical with anxiety state, and should be
  classified as such.(1)

     acrophobia: Fear of heights

     agoraphobia: Fear of leaving the familiar setting of the home, and is
       almost always preceded by a phase during which there are recurrent panic
       attacks. Because of the anticipatory fear of helplessness when having
       a panic attack, the patient is reluctant or refuses to be alone, travel
       or walk alone, or to be in situations where there is no ready access to
       help, such as in crowds, closed or open spaces, or crowded stores.(2)
 
     ailurophobia: Fear of cats(3)
 
     algophobia: Fear of pain(3)

     claustrophobia: Fear of closed spaces(3)
 
     isolated phobia -- see simple phobia below

     mysophobia: Fear of dirt or germs(3)

     obsessional -- see Neurotic disorder, obsessive-compulsive

     panphobia: Fear of everything(3)

     simple phobia: Fear of a discrete object or situation which is neither
       fear of leaving the familiar setting of the home [agoraphobia], or of
       being observed by others in certain situations [social phobia]. Exampl-
       es of simple phobia are fear of animals, acrophobia and claustrophobia.
       (2)

     social phobia: Fear of situations in which the subject is exposed to poss-
       ible scrutiny by others, and the possibility exists that he may act in
       a fashion that will be considered shameful. The most common social
       phobias are fears of public speaking, blushing, eating in public,
       writing in front of others, or using public lavatories.(2)
   
     xenophobia: Fear of strangers(3)

Pica: Perverted appetite of nonorganic origin in which there is persistent eat-
  ing of non-nutritional substances. Typically, infants ingest paint, plaster,
  string, hair, or cloth. Older children may have access to animal droppings,
  sand, bugs, leaves, or pebbles. In the adult, eating of starch or clay-earth
  has been observed.(2)

Postconcussion syndrome: States occurring after generalized contusion of the
  brain, in which the symptom picture may resemble that of the frontal lobe
  syndrome or that of any of the neurotic disorders, but in which in addition,
  headache, giddiness, fatigue, insomnia, and a subjective feeling of impaired
  intellectual ability are usually prominent. Mood may fluctuate, and quite
  ordinary stress may produce exaggerated fear and apprehension. There may be
  marked intolerance of mental and physical exertion, undue sensitivity to
  noise, and hypochondriacal preoccupation. The symptoms are more common in
  persons who have previously suffered from neurotic or personality disorders,
  or when there is a possibility of compensation. This syndrome is particularly
  associated with the closed type of head injury when signs of localized brain
  damage are slight or absent, but it may also occur in other conditions.(1)

Postcontusion syndrome or encephalopathy -- see Postconcussion syndrome

Postencephalitic syndrome: A nonpsychotic organic mental disorder resembling
  the postconcussion syndrome associated with central nervous system
  infections.(1)

Postleucotomy syndrome -- see Frontal lobe syndrome

Posttraumatic brain syndrome, nonpsychotic -- see Postconcussion syndrome
 
Posttraumatic organic psychosis -- see Organic psychotic conditions, transient

Posttraumatic stress disorder: The development of characteristic symptoms
  (reexperiencing the traumatic event, numbing of responsiveness to or involve-
  ment with the external world, and a variety of other autonomic, dysphoric, or
  cognitive symptoms) after experiencing a psychologically traumatic event or
  events outside the normal range of human experience (e.g., rape or assault,
  military combat, natural catastrophes such as flood or earthquake, or other
  disaster, such as airplane crash, fires, bombings)(2)

     acute: Brief, episodic, or recurrent disorders lasting less than six
       months' duration after the onset of trauma.(2)

     prolonged: Chronic disorders of the above type lasting six months or more
       following the trauma.(2)

Premature ejaculation -- see premature ejaculation under Psychosexual
  dysfunctions

Prepsychotic schizophrenia -- see Schizophrenia, latent

Presbyophrenia -- see Organic personality syndrome

Presenile dementia: Dementia occurring usually before the age of 65 in patients
  with the relatively rare forms of diffuse or lobar cerebral atrophy. The
  associated neurological condition (e.g., Alzheimer's disease, Pick's disease,
  Jakob-Creutzfeldt disease) should also be recorded as a diagnosis.(1)

Prodromal schizophrenia -- see Schizophrenia, latent

Pseudoneurotic schizophrenia -- see Schizophrenia, latent

Psychalgia: Pains of mental origin, e.g., headache or backache, for which a
  more precise medical or psychiatric diagnosis cannot be made.(1)

Psychasthenia: A functional neurosis marked by stages of pathological fear or
  anxiety, obsessions, fixed ideas, tics, feelings of inadequacy, self-accusat-
  ion, and peculiar feelings of strangeness, unreality, and depersonalization.
  (4)

Psychic shock: A sudden disturbance of mental equilibrium produced by strong
  emotion in response to physical or mental stress.(4)

Psychic factors associated with physical diseases: Mental disturbances or psy-
  chic factors of any type thought to have played a major part in the etiology
  of physical conditions, usually involving tissue damage, classified else-
  where. The mental disturbance is usually mild and nonspecific, and the psych-
  ic factors (worry, fear, conflict, etc.) may be present without any overt
  psychiatric disorder. Examples of these conditions are asthma, dermatitis,
  eczema, duodenal ulcer, ulcerative colitis and urticaria, specified as due to
  psychogenic factors.

     Use an additional diagnosis to identify the physical condition. In the
     rare instance that an overt psychiatric disorder is thought to have caused
     the physical condition, the psychiatric diagnosis should be recorded in
     addition.(1)

Psychoneurosis -- see Neurotic disorders

Psycho-organic syndrome -- see Organic psychotic conditions, transient

Psychopathic constitutional state -- see Personality disorders

Psychopathic personality -- see Personality disorders

Psychophysiological disorders: A variety of physical symptoms or types of phys-
  iological malfunctions of mental origin, not involving tissue damage, and
  usually mediated through the autonomic nervous system. The disorders are
  classified according to the body system involved. If the physical symptom is
  secondary to a psychiatric disorder classifiable elsewhere, the physical
  symptom is not classified as a psychophysiological disorder. If tissue damage
  is involved, then the diagnosis is classified as a Psychic factor associated
  with diseases classified elsewhere.(1)

Psychosexual dysfunctions: A group of disorders in which there is recurrent and
  persistent dysfunction encountered during sexual activity. The dysfunction
  may be lifelong or acquired, generalized or situational, and total or
  partial.(2)

     functional dyspareunia: Recurrent and persistent genital pain associated
       with coitus.(2)

     functional vaginismus: A history of recurrent and persistent involuntary
       spasm of the musculature of the outer one-third of the vagina that
       interferes with sexual activity.(2)

     inhibited female orgasm: Recurrent and persistent inhibition of the female
       orgasm as manifested by a delay or absence of orgasm following a normal
       sexual excitement phase during sexual activity.(2)

     inhibited male orgasm: Recurrent and persistent inhibition of the male
       orgasm as manifested by a delay or absence of either the emission or
       ejaculation phases, or more usually, both following an adequate
       phase of sexual excitement.(2)

     inhibited sexual desire: Persistent inhibition of desire for engaging in a
       particular form of sexual activity.(2)

     inhibited sexual excitement: Recurrent and persistent inhibition of sexual
       excitement during sexual activity, manifested either by partial or com-
       plete failure to attain or maintain erection until completion of the
       sexual act [impotence], or partial or complete failure to attain or
       maintain the lubrication-swelling response of sexual excitement until
       completion of the sexual act [frigidity].(2)

     premature ejaculation: Ejaculation occurs before the individual wishes it,
       because of recurrent and persistent absence of reasonable voluntary
       control of ejaculation and orgasm during sexual activity.(2)

Psychosexual gender identity disorders: Behavior occurring in preadolescents of
  immature psychosexuality, or in adults, in which there is an incongruence
  between the individual's anatomic sex and gender identity.(2)

     gender identity disorder: In children or in adults a condition in which
       the individual would prefer to be of the other sex, and strongly pref-
       ers the clothes, toys, activities, and companionship of the other sex.
       Cross-dressing is intermittent, although it may be frequent. In children
       the commonest form is feminism in boys.(2)

     trans-sexualism: A psychosexual identity disorder centered around fixed
       beliefs that the overt bodily sex is wrong. The resulting behavior is
       directed towards either changing the sexual organs by operation, or
       completely concealing the bodily sex by adopting both the dress and
       behavior of the opposite sex.(1)

Psychosomatic disorders -- see Psychophysiological disorders

Psychosis: Mental disorders in which impairment of mental function has devel-
  oped to a degree that interferes grossly with insight, ability to meet some
  ordinary demands of life or to maintain adequate contact with reality. It is
  not an exact or well defined term. Mental retardation is excluded.(1)

     affective -- see Affective psychoses

     alcoholic -- see Alcoholic psychoses
 
     atypical childhood: A variety of atypical infantile psychoses which may
       show some, but not all, of the features of infantile autism. Symptoms
       may include stereotyped repetitive movements, hyperkinesis, self-injury,
       retarded speech development, echolalia, and impaired social relation-
       ships. Such disorders may occur in children of any level of intellig-
       ence but are particularly common in those with mental retardation.(1)

     borderline, of childhood -- see Psychosis, atypical childhood

     child: A group of disorders in children, characterized by distortions in
       the timing, rate, and sequence of many psychological functions involving
       language development and social relations in which the severe qualitat-
       ive abnormalities are not normal for any stage of development.(2) See
       also Autism, infantile, Psychosis, disintegrative, Psychosis, atypical
       childhood.

     depressive -- see Affective psychosis, depressed type

     depressive type: A depressive psychosis which can be similar in its symp-
       toms to manic-depressive psychosis, depressed type but is apparently
       provoked by saddening stress such as a bereavement, or a severe dis-
       appointment or frustration. There may be less diurnal variation of symp-
       toms than in manic-depressive psychosis, depressed type, and the delus-
       ions are more often understandable in the context of the life experienc-
       es. There is usually a serious disturbance of behavior, e.g., major
       suicidal attempt.(1)

     disintegrative: A disorder in which normal or near-normal development for
       the first few years is followed by a loss of social skills and of
       speech, together with a severe disorder of emotions, behavior, and
       relationships. Usually this loss of speech and of social competence
       takes place over a period of a few months and is accompanied by the
       emergence of overactivity and of stereotypes. In most cases there
       is intellectual impairment, but this is not a necessary part of the
       disorder. The condition may follow overt brain disease, such as measles
       encephalitis, but it may also occur in the absence of any known organic
       brain disease or damage. Any associated neurological disorder should
       also be recorded.(1)

     epileptic: An organic psychotic condition associated with epilepsy.(1)
 
     excitative type: An affective psychosis similar in its symptoms to
       manic-depressive psychosis, manic type, but apparently provoked by
       emotional stress.(1)
 
     hypomanic -- see Affective psychosis, manic type

     hysterical -- see Psychosis, reactive

          acute -- see Psychosis, excitative type

     induced -- see Shared paranoid disorder

     infantile -- see Autism, infantile

     infective -- see Organic psychotic conditions, transient
     
     Korsakoff's:

          alcoholic -- see alcohol amnestic syndrome under Alcoholic psychoses

          nonalcoholic -- see Amnestic syndrome

     manic-depressive -- see Affective psychoses

     multi-infarct -- see Arteriosclerotic dementia

      paranoid

          chronic -- see Paranoia

          protracted reactive -- see Psychosis, paranoid, psychogenic

          psychogenic: Psychogenic or reactive paranoid psychosis of any type
            which is more protracted than the reactions described under
            Paranoid reaction, acute.(1)

           acute -- see Paranoid reaction, acute

     postpartum -- see Psychosis, puerperal

     psychogenic -- see Psychosis, reactive

          depressive -- see Psychosis, depressive type
  
     puerperal: Any psychosis occurring within a fixed period (approximately
       90 days) after childbirth.(3) The diagnosis should be classified accord-
       ing to the predominant symptoms or characteristics, such as schizophren-
       ia, affective psychosis, paranoid states, or other specified psychosis.

     reactive: A psychotic condition which is largely or entirely attributable
       to a recent life experience. This diagnosis is not used for the wider
       range of psychoses in which environmental factors play some, but
       not the major, part in etiology.(1)

           brief: A florid psychosis of at least a few hours' duration but
             lasting no more than two weeks, with sudden onset immediately
             following a severe environmental stress and eventually
             terminating in complete recovery to the pre-psychotic state.(2)

           confusion: Mental disorders with clouded consciousness, disorientat-
             ion (though less marked than in organic confusion), and diminished
             accessibility often accompanied by excessive activity and
             apparently provoked by emotional stress.(1)
 
           depressive -- see Psychosis, depressive type

     schizo-affective -- see Schizophrenia, schizo-affective type

     schizophrenic -- see Schizophrenia

     schizophreniform -- see Schizophrenia

           affective type -- see Schizophrenia, schizo-affective type

           confusional type -- see Schizophrenia, acute episode

     senile -- see Senile dementia, delusional type

Pyromania: A disorder of impulse control characterized by a recurrent failure
  to resist impulses to set fires without regard for the consequences, or with
  deliberate destructive intent. Invariably there is intense fascination with
  the setting of fires, seeing fires burn, and a satisfaction with the result-
  ant destruction.(2)

Relationship problems of childhood: Emotional disorders characteristic of
  childhood in which the main symptoms involve relationship problems.(1)
   
Repeated infarct dementia -- see Arteriosclerotic dementia
     
Residual schizophrenia -- see Schizophrenia, residual type
     
Restzustand (schizophrenia) -- see Schizophrenia, residual type
     
Rumination:

     obsessional: The constant preoccupation with certain thoughts, with
       inability to dismiss them from the mind.(4) See Neurotic disorder,
       obsessive-compulsive.

     psychogenic: In children the regurgitation of food, with failure to thrive
       or weight loss developing after a period of normal functioning. Food is
       brought up without nausea, retching, or disgust. The food is then
       ejected from the mouth, or chewed and reswallowed.(2)

Sander's disease -- see Paranoia

Satyriasis: Pathologic or exaggerated sexual desire or excitement in the
  man.(3)

Schizoid personality disorder -- see Personality disorder, schizoid type

Schizophrenia: A group of psychoses in which there is a fundamental disturbance
  of personality, a characteristic distortion of thinking, often a sense of
  being controlled by alien forces, delusions which may be bizarre, disturbed
  perception, abnormal affect out of keeping with the real situation, and aut-
  ism. Nevertheless, clear consciousness and intellectual capacity are usually
  maintained. The disturbance of personality involves its most basic functions
  which give the normal person his feeling of individuality, uniqueness, and
  self-direction. The most intimate thoughts, feelings, and acts are often felt
  to be known to or shared by others and explanatory delusions may develop, to
  the effect that natural or supernatural forces are at work to influence the
  schizophrenic person's thoughts and actions in ways that are often bizarre.
  He may see himself as the pivot of all that happens. Hallucinations, espec-
  ially of hearing, are common and may comment on the patient or address him.
  Perception is frequently disturbed in other ways; there may be perplexity,
  irrelevant features may become all-important and accompanied by passivity
  feelings, may lead the patient to believe that everyday objects and situat-
  ions possess a special, usually sinister, meaning intended for him. In the
  characteristic schizophrenic disturbance of thinking, peripheral and irrelev-
  ant features of a total concept, which are inhibited in normal directed
  mental activity, are brought to the forefront and utilized in place of the
  elements relevant and appropriate to the situation. Thus, thinking becomes
  vague, elliptical and obscure, and its expression in speech sometimes incom-
  prehensible. Breaks and interpolations in the flow of consecutive thought are
  frequent, and the patient may be convinced that his thoughts are being with-
  drawn by some outside agency. Mood may be shallow, capricious, or incongr-
  uous. Ambivalence and disturbance of volition may appear as inertia, negativ-
  ism, or stupor. Catatonia may be present. The diagnosis "schizophrenia"
  should not be made unless there is, or has been evident during the same ill-
  ness, characteristic disturbance of thought, perception, mood, conduct, or
  personality--preferably in at least two of these areas. The diagnosis should
  not be restricted to conditions running a protracted, deteriorating, or
  chronic course. In addition to making the diagnosis on the criteria just
  given, effort should be made to specify one of the following subtypes of
  schizophrenia, according to the predominant symptoms.(1)

     acute (undifferentiated): Schizophrenia of florid nature which cannot be
       classified as simple, catatonic, hebephrenic, paranoid, or any other
       types.(1)

     acute episode: Schizophrenic disorders, other than simple, hebephrenic,
       catatonic, and paranoid, in which there is a dream-like state with
       slight clouding of consciousness and perplexity. External things,
       people, and events may become charged with personal significance for the
       patient. There may be ideas of reference and emotional turmoil. In many
       such cases remission occurs within a few weeks or months, even without
       treatment.(1)
 
     atypical -- see Schizophrenia, acute (undifferentiated)

     borderline -- see Schizophrenia, latent

     catatonic type: Includes as an essential feature prominent psychomotor
       disturbances often alternating between extremes such as hyperkinesis and
       stupor, or automatic obedience and negativism. Constrained attitudes may
       be maintained for long periods: if the patient's limbs are put in some
       unnatural position they may be held there for some time after the exter-
       nal force has been removed. Severe excitement may be a striking feature
       of the condition. Depressive or hypomanic concomitants may be
       present.(1)

     cenesthopathic -- see Schizophrenia, acute (undifferentiated)
      
     childhood type -- see Psychosis, child

     chronic undifferentiated -- see Schizophrenia, residual

     cyclic -- see Schizophrenia, schizo-affective type

     disorganized type: A form of schizophrenia in which affective changes are
       prominent, delusions and hallucinations fleeting and fragmentary, behav-
       ior irresponsible and unpredictable, and mannerisms common. The mood is
       shallow and inappropriate, accompanied by giggling or self-satisfied,
       self absorbed smiling, or by a lofty manner, grimaces, mannerisms,
       pranks, hypochondriacal complaints, and reiterated phrases. Thought is
       disorganized. There is a tendency to remain solitary, and behavior
       seems empty of purpose and feeling. This form of schizophrenia usually
       starts between the ages of 15 and 25 years.(1)
 
     hebephrenic type: -- see Schizophrenia, disorganized type

     latent: It has not been possible to produce a generally acceptable
       description for this condition. It is not recommended for general use,
       but a description is provided for those who believe it to be useful: a
       condition of eccentric or inconsequent behavior and anomalies of affect
       which give the impression of schizophrenia though no definite and char-
       acteristic schizophrenic anomalies, present or past have been
       manifest.(1)

     paranoid type: The form of schizophrenia in which relatively stable delus-
       ions, which may be accompanied by hallucinations, dominate the clinical
       picture. The delusions are frequently of persecution, but may take other
       forms (for example, of jealousy, exalted birth, Messianic mission, or
       bodily change). Hallucinations and erratic behavior may occur; in some
       cases conduct is seriously disturbed from the outset, thought disorder
       may be gross, and affective flattening with fragmentary delusions and
       hallucinations may develop.(1)

     prepsychotic -- see Schizophrenia, latent

     prodromal -- see Schizophrenia, latent

     pseudoneurotic -- see Schizophrenia, latent

     pseudopsychopathic -- see Schizophrenia, latent

     residual: A chronic form of schizophrenia in which the symptoms that
       persist from the acute phase have mostly lost their sharpness. Emotion-
       al response is blunted and thought disorder, even when gross, does not
       prevent the accomplishment of routine work.(1)

     schizo-affective type: A psychosis in which pronounced manic or depressive
       features are intermingled with schizophrenic features and which tends
       towards remission without permanent defect, but which is prone to recur.
       The diagnosis should be made only when both the affective and schizo-
       phrenic symptoms are pronounced.(1)

     simple type: A psychosis in which there is insidious development of oddit-
       ies of conduct, inability to meet the demands of society, and decline in
       total performance. Delusions and hallucinations are not in evidence and
       the condition is less obviously psychotic than are the hebephrenic,
       catatonic, and paranoid types of schizophrenia. With increasing social
       impoverishment vagrancy may ensue and the patient becomes self-absorbed,
       idle, and aimless. Because the schizophrenic symptoms are not clear-cut,
       diagnosis of this form should be made sparingly, if at all.(1)

     simplex -- see Schizophrenia, simple type

Schizophrenic syndrome of childhood -- see Psychosis, child

 Schizophreniform

     attack -- see Schizophrenia, acute episode

     disorder -- see Schizophrenia, acute episode

     psychosis -- see Schizophrenia

          affective type -- see Schizophrenia, schizo-affective type

          confusional type -- see Schizophrenia, acute episode

Schizotypal personality -- see Personality disorder, schizotypal type

Senile dementia--Dementia occurring usually after the age of 65 in which any
  cerebral pathology other than that of senile atrophic change can be
  reasonably excluded.(1)

     delirium: Senile dementia with a superimposed reversible episode of acute
       confusional state.(1)

     delusional type: A type of senile dementia characterized by development
       in advanced old age, progressive in nature, in which delusions, varying
       from simple poorly formed paranoid delusions to highly formed
       paranoid delusional states, and hallucinations are also present.(1,2)

     depressed type: A type of senile dementia characterized by development in
       advanced old age, progressive in nature, in which depressive features,
       ranging from mild to severe forms of manic-depressive affective psy-
       chosis, are also present. Disturbance of the sleep-waking cycle and
       preoccupation with dead people are often particularly prominent.(1,2)
        
     paranoid type -- see Senile dementia, delusional type

     simple type -- see Senile dementia

Sensitizer Beziehungswahn: A paranoid state which, though in many ways akin to
  schizophrenic or affective states, differs from paranoia, simple paranoid
  state, shared paranoid disorder, or psychogenic psychosis.(1)

Sensitivity reaction of childhood or adolescence -- see Shyness disorder of
  childhood
 
Separation anxiety disorder: A clinical disorder in children in which the
  predominant disturbance is exaggerated distress at separation from parents,
  home, or other familial surroundings. When separation is instituted, the
  child may experience anxiety to the point of panic. In adults a similar dis-
  order is seen in agoraphobic reactions.(2)

Sexual deviations: Abnormal sexual inclinations or behavior which are part of
  a referral problem. The limits and features of normal sexual behavior have
  not been stated absolutely in different societies and cultures, but are
  broadly such as serve approved social and biological purposes. The sexual
  activity of affected persons is directed primarily either towards people not
  of the opposite sex, or towards sexual acts not associated with coitus
  normally, or towards coitus performed under abnormal circumstances. If the
  anomalous behavior becomes manifest only during psychosis or other mental
  illness the condition should be classified under the major illness. It is
  common for more than one anomaly to occur together in the same individual; in
  that case the predominant deviation is classified. It is preferable not to
  diagnose sexual deviation in individuals who perform deviant sexual acts when
  normal sexual outlets are not available to them.(1) See also Exhibitionism,
  Fetishism, Homosexuality, Nymphomania, Pedophilia, Satyriasis, Sexual maso-
  chism, Sexual sadism, Transvestism, Voyeurism, and Zoophilia.

     Gender identity disorder and transsexualism are considered to be psycho-
       sexual gender identity disorders and are not included here.

Sexual masochism: A sexual deviation in which sexual arousal and pleasure is
  produced in an individual by his own physical or psychological suffering,
  and in which there are insistent and persistent fantasies wherein sexual
  excitement is produced as a result of suffering.(2)

Sexual sadism: A sexual deviation in which physical or psychological suffering
  inflicted on another person is utilized as a method of stimulating erotic
  excitement and orgasm, and in which there are insistent and persistent
  fantasies wherein sexual excitement is produced as a result of suffering
  inflicted on the partner.(2)

Shared paranoid disorder: Mainly delusional psychosis, usually chronic and
  often without florid features, which appears to have developed as a result of
  a close, if not dependent, relationship with another person who already has
  an established similar psychosis. The delusions are at least partly shared.
  The rare cases in which several persons are affected should also be included
  here.(1)

Shifting sleep-work schedule: A sleep disorder in which the phase shift dis-
  ruption of the 24-hour sleep-wake cycle occurs due to rapid changes in the
  individual's work schedule.(2)

Short sleeper: Individuals who typically need only 4-6 hours of sleep within
  the 24-hour cycle.(2)

Shyness disorder of childhood: A persistent and excessive shrinking from famil-
  iarity or contact with all strangers of sufficient severity as to interfere
  with peer functioning, yet there are warm and satisfying relationships with
  family members. A critical feature of this disorder is that the avoidant
  behavior with strangers persists even after prolonged exposure or contact.(2)

Sibling jealousy or rivalry: An emotional disorder related to competition
  between siblings for the love of a parent or for other recognition or
  gain.(3)

Simple phobia -- see simple phobia under Phobia

Situational disturbance, acute -- see Stress reaction, acute

Social phobia -- see social phobia under Phobia

Social withdrawal of childhood -- see Introverted disorder of childhood

Socialized conduct disorder -- see socialized conduct disorder under Conduct
  disorders

Somatization disorder -- see somatization disorder under Neurotic disorders

Somatoform disorder, atypical -- see hypochondriasis under Neurotic disorders

Spasmus nutans -- see Stereotyped repetitive movements

Specific academic or work inhibition: An adjustment reaction in which a specif-
  ic academic or work inhibition occurs in an individual whose intellectual
  capacity, skills, and previous academic or work performance have been at
  least adequate, and in which the inhibition occurs despite apparent effort
  and is not due to any other mental disorder.(2)

Stammering -- see Stuttering

Starch-eating -- see Pica

Status postcommotio cerebri -- see Postconcussion syndrome

Stereotyped repetitive movements: Disorders in which voluntary repetitive
  stereotyped movements, which are not due to any psychiatric or neurological
  condition, constitute the main feature. Includes head-banging, spasmus
  nutans, rocking, twirling, finger flicking mannerisms, and eye poking. Such
  movements are particularly common in cases of mental retardation with sensory
  impairment or with environmental monotony.(1)

Stereotypies -- see Stereotyped repetitive movements

 Stress reaction

     acute: Acute transient disorders of any severity and nature of emotions,
       consciousness, and psychomotor states (singly or in combination) which
       occur in individuals, without any apparent pre-existing mental disorder,
       in response to exceptional physical or mental stress, such as natural
       catastrophe or battle, and which usually subside within hours or
       days.(1)

     chronic -- see Adjustment reaction

 Stupor
     
     catatonic -- see Schizophrenia, catatonic type
     
     psychogenic -- see Psychosis, reactive

Stuttering: Disorders in the rhythm of speech, in which the individual knows
  precisely what he wishes to say, but at the time is unable to say it because
  of an involuntary, repetitive prolongation or cessation of a sound.(1)

Subjective insomnia complaint: A complaint of insomnia made by the individual,
  which has not been investigated or proven.(2)

Tension headache: Headache of mental origin for which a more precise medical
  or psychiatric diagnosis cannot be made.(1)

Systematized delusions -- see Paranoia

Tics: Disorders of no known organic origin in which the outstanding feature
  consists of quick, involuntary, apparently purposeless, and frequently re-
  peated movements which are not due to any neurological condition. Any part of
  the body may be involved but the face is most frequently affected. Only one
  form of tic may be present, or there may be a combination of tics which are
  carried out simultaneously, alternatively, or consecutively.(1)

     chronic motor tic disorder: A tic disorder starting in childhood and
       persisting into adult life. The tic is limited to no more than three
       motor areas, and rarely has a verbal component.(2)
 
    Gilles de La Tourette's disorder [motor-verbal tic disorder]: A rare dis-
      order occurring in individuals of any level of intelligence in which
      facial tics and tic-like throat noises become more marked and more gen-
      eralized, and in which later whole words or short sentences (often with
      obscene content) are ejaculated spasmodically and involuntarily. There is
      some overlap with other varieties of tic.(1)

     transient tic disorder of childhood: Facial or other tics beginning in
       childhood, but limited to one year in duration.(2)

Tobacco use disorder: Cases in which tobacco is used to the detriment of a
  person's health or social functioning or in which there is tobacco depend-
  ence. Dependence is included here rather than under drug dependence because
  tobacco differs from other drugs of dependence in its psycho toxic
  effects.(1)

Tranquilizer abuse: Cases where an individual has taken the drug to the detri-
  ment of his health or social functioning, in doses above or for periods be-
  yond those normally regarded as therapeutic.(1)

Transient organic psychotic condition -- see Organic psychotic conditions,
  transient

Trans-sexualism -- see trans-sexualism under Psychosexual identity disorders

Transvestism: Sexual deviation in which there is recurrent and persistent
  dressing in clothes of the opposite sex, and initially in the early stage of
  the illness, for the purpose of sexual arousal.(2)

 Twilight state

     confusional -- see Delirium, acute
     
     psychogenic -- see Psychosis, reactive confusion

Undersocialized conduct disorder -- see undersocialized conduct disorder under
  Conduct disorders

Unsocialized aggressive disorder -- see under socialized conduct disorder,
  aggressive type under Conduct disorders

Vaginismus, functional -- see functional vaginismus under Psychosexual
  dysfunctions

Vorbeireden: The symptom of the approximate answer or talking past the point,
  seen in the Ganser syndrome, a form of factitious illness.(2)

Voyeurism: A sexual deviation in which the individual repetitively seeks out
  situations in which he engages in looking at unsuspecting women who are
  either naked, in the act of disrobing, or engaging in sexual activity.
  The act of looking is accompanied by sexual excitement, frequently with
  orgasm. In its severe form, the act of peeping constitutes the preferred or
  exclusive sexual activity of the individual.(2)

Wernicke-Korsakoff syndrome -- see alcohol amnestic syndrome under Alcoholic
  psychoses

Withdrawal reaction of childhood or adolescence -- see Introverted disorder of
  childhood

Word-deafness: A developmental delay in the comprehension of speech sounds.(1)

Zoophilia: Sexual or anal intercourse with animals.(1)



 1. Manual of the International Classification of Diseases, Injuries and Causes
    of Death, 9th Revision, World Health Organization, Geneva Switzerland 1975.

 2. American Psychiatric Association, Task Force on Nomenclature and
    Statistics, Robert L. Spitzer, Chairman.

 3. A Psyehiatric Glossary, Fourth Edition, American Psychiatric Association,
    Washington, D.C., 1975.

 4. Dorland's Illustrated Medical Dictionary, Twenty-fifth Edition, W. B.
    Saunders Company, Philadelphia, 1974.

 5. Stedman's Medical Dictionary, Illustrated, Twenty-third Edition, the
    Williams and Williams Company, Baltimore, 1976.