Pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood; ≥4 of 7: suspects exploitation/harm/deception; preoccupied with unjustified doubts about loyalty; reluctant to confide; reads hidden threatening meanings; bears grudges; perceives attacks on character not apparent to others; recurrent suspicions about fidelity of partner
Criteria met for a personality disorder (enduring pattern of inner experience/behaviour deviating markedly from cultural expectations; pervasive; inflexible; stable; leading to distress/impairment)
Pervasive pattern of social/interpersonal deficits with acute discomfort in close relationships, cognitive/perceptual distortions, and eccentricities of behaviour, beginning by early adulthood; ≥5 of 9: ideas of reference; odd beliefs/magical thinking; unusual perceptual experiences; odd thinking/speech; suspiciousness/paranoid ideation; inappropriate/constricted affect; odd/eccentric behaviour/appearance; lacks close friends; excessive social anxiety
Pervasive pattern of disregard for/violation of rights of others since age 15: ≥3 of 7: failure to conform to lawful behaviours; deceitfulness; impulsivity; irritability/aggressiveness; reckless disregard for safety; consistent irresponsibility; lack of remorse
Pervasive pattern of instability of interpersonal relationships, self-image, and affect, with marked impulsivity beginning by early adulthood; ≥5 of 9: frantic efforts to avoid abandonment; unstable intense relationships; identity disturbance; impulsivity in ≥2 damaging areas; suicidal/self-mutilating behaviour; affective instability; chronic emptiness; inappropriate intense anger; transient stress-related paranoia/dissociation
Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood; ≥4 of 7: avoids occupational activities involving interpersonal contact due to fears of criticism; unwilling to get involved unless certain of being liked; shows restraint in intimate relationships due to fear of shame; preoccupied with being criticised/rejected; inhibited in new interpersonal situations; views self as socially inept/unappealing/inferior; unusually reluctant to take risks or engage in new activities
≥1 month of ≥1 delusion(s)
Pervasive and excessive need to be taken care of, leading to submissive and clinging behaviour and fears of separation, beginning by early adulthood; ≥5 of 8: difficulty making everyday decisions without advice/reassurance; needs others to assume responsibility for major areas of life; difficulty expressing disagreement out of fear; difficulty initiating projects alone; goes to excessive lengths to obtain nurturance/support; feels uncomfortable/helpless when alone; urgently seeks a replacement relationship when one ends; preoccupied with fears of being left to care for self
Pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood; ≥5 of 8: uncomfortable when not the centre of attention; inappropriate sexually seductive or provocative behaviour; rapidly shifting shallow emotions; uses physical appearance to draw attention; impressionistic/lacking-in-detail speech; theatrical/exaggerated emotional expression; suggestible; considers relationships more intimate than they are
Pervasive pattern of grandiosity, need for admiration, and lack of empathy beginning by early adulthood; ≥5 of 9: grandiose sense of self-importance; preoccupation with fantasies of unlimited success/power/brilliance/beauty/love; believes he/she is special; requires excessive admiration; sense of entitlement; interpersonally exploitative; lacks empathy; envious of others or believes others are envious; arrogant
Pervasive pattern of preoccupation with orderliness, perfectionism, and mental/interpersonal control (at the expense of flexibility, openness, and efficiency), beginning by early adulthood; ≥4 of 8: preoccupation with details/rules/order; perfectionism interfering with task completion; excessively devoted to work; overconscientious about morality/ethics; unable to discard worthless objects; reluctant to delegate; miserly; rigidity/stubbornness
Persistent personality disturbance representing a change from the individual's previous characteristic personality pattern
Pervasive pattern of detachment from social relationships and restricted range of emotional expression, beginning by early adulthood; ≥4 of 7: neither desires nor enjoys close relationships; almost always chooses solitary activities; little/no interest in sexual experiences; few/no pleasurable activities; lacks close friends; appears indifferent to praise/criticism; shows emotional coldness/detachment/flat affect
Hypomanic episode threshold has been met.
Depressed mood most of the day, more days than not, for ≥2 years (≥1 yr children/adolescents)
Repetitive/persistent pattern of behaviour violating rights of others or major societal norms; ≥3 of 15 criteria in past 12 months (≥1 in past 6): aggression to people/animals; destruction of property; deceitfulness/theft; serious rule violations
≥1 full manic episode (abnormally elevated/expansive/irritable mood + ↑energy, ≥7 days or any duration if hospitalised)
≥1 of: delusions; hallucinations; disorganised speech; grossly disorganised/catatonic behaviour
≥2 years (≥1 yr children/adolescents) of hypomanic AND depressive symptoms not meeting full episode criteria
Prominent depressive episode directly attributable to physiological effects of a medical condition
Severe recurrent temper outbursts (verbal or behavioural), grossly disproportionate to situation, ≥3×/week
≥5 of 9 SIG-E-CAPS symptoms for ≥2 weeks; ≥1 must be depressed mood or anhedonia
Symptoms characteristic of a depressive disorder causing clinically significant distress/impairment
Symptoms characteristic of a schizophrenia spectrum/other psychotic disorder causing clinically significant distress/impairment
Symptoms characteristic of a bipolar/related disorder causing clinically significant distress/impairment
≥5 symptoms in final week before menses, improve within days of onset, become minimal/absent post-menses
Prominent hallucinations or delusions
Same symptom criteria as Schizophrenia (≥2 of the 5 symptom clusters; ≥1 must be delusions, hallucinations, or disorganised speech)
Prominent hallucinations or delusions
Symptoms characteristic of a bipolar/related disorder causing clinically significant distress/impairment
Emotional or behavioural symptoms in response to an identifiable stressor, within 3 months of stressor onset
Disruption of identity characterised by ≥2 distinct personality states/possession experiences with marked discontinuity in sense of self and agency, accompanied by alterations in affect, behaviour, consciousness, memory, perception, cognition, and/or sensory-motor functioning
Uninterrupted period of illness including a major mood episode (MDE or manic) concurrent with Schizophrenia Criterion A symptoms
Exposure to actual/threatened death, serious injury, or sexual violence (same exposure types as PTSD Criterion A)
Prominent anxiety, panic attacks, or obsessions/compulsions directly attributable to physiological effects of another medical condition
≥6 inattentive symptoms and/or ≥6 hyperactive-impulsive symptoms (≥5 for age ≥17) for ≥6 months, inconsistent with developmental level and negatively impacting activities
Eating/feeding disturbance (apparent lack of interest; sensory-based avoidance; concern about aversive consequences) → persistent failure to meet nutritional/energy needs
Preoccupation with ≥1 perceived defect(s) or flaw(s) in physical appearance (not observable or only slightly observable to others)
Disturbances in normal fluency and time patterning of speech inappropriate for age and language skills; ≥1 of: sound/syllable repetitions; sound prolongations; broken words; audible/silent blocking; circumlocutions; words produced with excess physical tension; monosyllabic whole-word repetitions
Persistent or recurrent experiences of depersonalisation (feelings of unreality/detachment from one's mind/body) and/or derealisation (feelings of unreality of surroundings)
Recurrent skin picking resulting in skin lesions
Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception in self (imposed on self) or in another person (imposed on another)
≥1 of: marked delay in, marked infrequency of, or absence of orgasm; markedly reduced intensity of orgasmic sensations — on almost all occasions (≥75–100%) of sexual activity
Absent/reduced sexual interest/arousal; ≥3 of: absent/reduced interest in sexual activity; absent/reduced sexual/erotic thoughts or fantasies; no/reduced initiation of sexual activity and unreceptive to partner's attempts; absent/reduced sexual excitement/pleasure during sexual activity in ≥75–100% encounters; absent/reduced sexual interest/arousal in response to any internal/external erotic cues; absent/reduced genital or non-genital sensations during sexual activity in ≥75–100% encounters
Criteria met for major or mild NCD
≥1 symptom of altered voluntary motor or sensory function
Excessive anxiety/worry about multiple events/activities, more days than not for ≥6 months
Persistent or recurrent difficulties with ≥1 of: vaginal penetration during intercourse; marked vulvovaginal or pelvic pain during intercourse or penetration attempts; marked fear/anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a result of vaginal penetration; marked tensing or tightening of pelvic floor muscles during vaginal penetration attempts
Persistent difficulty discarding or parting with possessions, regardless of their actual value
Self-reported excessive sleepiness (hypersomnolence) despite main sleep period of ≥7 hrs; ≥1 of: recurrent lapses into sleep during same day; prolonged main sleep episode (>9 hrs) that is non-restorative; difficulty being fully awake after abrupt awakening
Preoccupation with having or acquiring a serious illness
Predominant complaint of dissatisfaction with sleep quantity/quality: ≥1 of: difficulty initiating sleep; difficulty maintaining sleep (frequent awakenings); early morning awakening with inability to return to sleep
Criteria met for major or mild NCD with insidious onset and gradual progression
Substantial cognitive decline in ≥1 domain (complex attention, executive function, learning/memory, language, perceptual-motor, social cognition) based on concern + objective evidence
Persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies AND desire for sexual activity; clinician judges deficiency considering age and general/sociocultural context
Modest cognitive decline in ≥1 domain (concern of individual, knowledgeable informant, or clinician; supported by objective performance evidence)
Criteria met for major or mild NCD
Criteria met for major or mild NCD
Criteria met for major or mild NCD
Presence of obsessions (recurrent/persistent intrusive thoughts/urges/images + attempts to suppress or neutralise), compulsions (repetitive behaviours/mental acts driven by rigid rules aimed at reducing distress/feared event), or both
≥4 symptoms from: angry/irritable mood (loses temper; touchy/easily annoyed; angry/resentful); argumentative/defiant behaviour (argues with authority; defies rules; deliberately annoys; blames others); or vindictiveness — for ≥6 months, exhibited during interaction with ≥1 non-sibling individual
Medication-induced movement symptoms causing clinically significant distress or impairment
Symptoms characteristic of an anxiety disorder causing clinically significant distress/impairment
Symptoms characteristic of a disruptive, impulse-control, or conduct disorder causing clinically significant distress/impairment
Symptoms characteristic of a dissociative disorder causing clinically significant distress/impairment
Symptoms characteristic of a feeding/eating disorder causing clinically significant distress/impairment
Symptoms characteristic of an OCD-related disorder causing clinically significant distress/impairment
Symptoms characteristic of a somatic symptom/related disorder causing clinically significant distress/impairment
Symptoms characteristic of a trauma/stressor-related disorder causing clinically significant distress/impairment
Recurrent unexpected panic attacks (abrupt surge reaching peak within minutes; ≥4 of 13 symptoms)
Single or multiple motor OR vocal tics (but not both motor and vocal) have been present at some time
Death of someone close to the bereaved person ≥12 months ago (≥6 months in children/adolescents)
Single or multiple motor and/or vocal tics
Consistent pattern of inhibited, emotionally withdrawn behaviour toward caregivers; ≥2 of: rarely seeks/responds to comfort when distressed; minimal positive affect; unexplained irritability/sadness/fearfulness
Repeated episodes of arousal during sleep associated with vocalisation and/or complex motor behaviours
Repeated regurgitation of food for ≥1 month; regurgitated food may be re-chewed, re-swallowed, or spat out
Excessive fear/anxiety about separation from attachment figures; ≥3 of 8 specified symptoms
Persistent difficulties in social use of verbal/nonverbal communication; ≥1 of: deficits in using communication for social purposes; inability to change communication to match context; difficulty following rules for conversations and storytelling; difficulty understanding what is not explicitly stated
Marked fear/anxiety about ≥1 social situation with possible scrutiny by others
Difficulties learning and using academic skills despite intervention; ≥1 of 6 symptoms for ≥6 months: inaccurate/slow word reading; difficulty decoding; poor spelling; difficulties with written expression; poor number sense; mathematical reasoning difficulties
Repetitive, seemingly driven, and apparently purposeless motor behaviour (e.g. hand shaking/waving, body rocking, head banging, self-biting, hitting own body)
Recurrent pulling out of one's hair, resulting in hair loss
Criteria met for major or mild NCD
Problematic pattern of alcohol use leading to clinically significant impairment/distress; ≥2 of 11 criteria within 12 months (impaired control ×4; social impairment ×3; risky use ×2; pharmacological criteria ×2)
Persistent deficits in social communication/interaction across multiple contexts (≥3 components: social-emotional reciprocity; nonverbal communicative behaviours; developing/maintaining relationships)
Recurrent binge eating episodes associated with ≥3 of: eating faster; eating until uncomfortably full; eating large amounts when not physically hungry; eating alone due to embarrassment; feeling disgusted/depressed/guilty afterwards
Persistent or recurrent pattern of sleep disruption primarily due to alteration of the circadian system or misalignment between endogenous circadian rhythm and sleep-wake schedule
Acquisition and execution of coordinated motor skills is substantially below expected for chronological age and opportunity for skill learning
Pattern of culturally inappropriate, overly familiar behaviour with relatively unfamiliar adults; ≥2 of: reduced/absent reticence; overly familiar verbal/physical behaviour; diminished checking back with caregiver; willingness to go with unfamiliar adult
Over ≥6 months, recurrent and intense sexual arousal from the exposure of one's genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviours
Over ≥6 months, recurrent and intense sexual arousal from either the use of non-living objects or a highly specific focus on non-genital body part(s), as manifested by fantasies, urges, or behaviours
Over ≥6 months, recurrent and intense sexual arousal from touching or rubbing against a non-consenting person, as manifested by fantasies, urges, or behaviours
Deficits in intellectual functions (reasoning, problem-solving, planning, abstract thinking, judgement, academic learning, experiential learning) confirmed by clinical assessment and standardised testing
Recurrent outbursts of failure to control aggressive impulses; ≥1 of: verbal aggression or physical aggression toward property/animals/individuals ≥2×/week (on average) for ≥3 months; ≥3 aggressive outbursts involving damage/injury within a 12-month period
Persistent difficulties in acquisition and use of language across modalities (spoken, written, sign, or other) due to deficits in comprehension or production, including reduced vocabulary, limited sentence structure, and impairments in discourse
Criteria met for major or mild NCD
Criteria met for major or mild NCD
Recurrent episodes of incomplete awakening from sleep, usually occurring during the first third of the major sleep episode, accompanied by either sleepwalking (complex behaviour without full consciousness) or sleep terrors (abrupt awakenings with intense fear/autonomic arousal; difficult to console)
Recurrent and intense sexual arousal to atypical objects, situations, or individuals, as manifested by fantasies, urges, or behaviours, for ≥6 months
Over ≥6 months, recurrent, intense sexually arousing fantasies, urges, or behaviours involving sexual activity with a prepubescent child or children (generally ≤13 years)
Exposure to actual/threatened death, serious injury, or sexual violence (direct, witnessed, learning about close person, or repeated indirect exposure)
Over ≥6 months, recurrent and intense sexual arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer, as manifested by fantasies, urges, or behaviours
Over ≥6 months, recurrent and intense sexual arousal from physical or psychological suffering of another person, as manifested by fantasies, urges, or behaviours
≥1 somatic symptom that is distressing or results in significant disruption of daily life
Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages
Both multiple motor tics AND ≥1 vocal tic present at some time during the illness, though not necessarily simultaneously
Over ≥6 months, recurrent and intense sexual arousal from cross-dressing, as manifested by fantasies, urges, or behaviours
Over ≥6 months, recurrent and intense sexual arousal from observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, as manifested by fantasies, urges, or behaviours
≥2 of: delusions; hallucinations; disorganised speech; grossly disorganised/catatonic behaviour; negative symptoms — ≥1 must be delusions, hallucinations, or disorganised speech
Intoxication: reversible substance-specific syndrome due to recent ingestion; Withdrawal: substance-specific syndrome due to cessation/reduction after heavy/prolonged use
Marked fear/anxiety about ≥2 of 5 situations: public transport; open spaces; enclosed places; standing in line/crowds; being outside home alone
Recent ingestion of alcohol
Cessation or reduction of heavy/prolonged alcohol use
≥3 of the following within days of stopping/reducing an antidepressant (after ≥1 month use): FINISH symptoms — flu-like; insomnia; nausea; imbalance; sensory disturbances; hyperarousal/anxiety
Intoxication: recent cannabis use with clinically significant maladaptive behavioural/psychological changes; Withdrawal: cessation/reduction of heavy prolonged use
≥3 of 12 catatonia symptoms: stupor; catalepsy; waxy flexibility; mutism; negativism; posturing; mannerism; stereotypy; agitation; grimacing; echolalia; echopraxia
Evidence by polysomnography of ≥5 central apnoeas per hour of sleep
Either of: marked delay in ejaculation; marked infrequency or absence of ejaculation, on almost all occasions of partnered sexual activity (≥75–100%), without desire for delay
Inability to recall important autobiographical information (usually traumatic/stressful) inconsistent with ordinary forgetting; may include dissociative fugue (purposeful travel or bewildered wandering)
≥1 of 3 symptoms on almost all occasions (≥75–100%) of sexual activity: marked difficulty attaining an erection; marked difficulty maintaining an erection until completion of sexual activity; marked decrease in erectile rigidity
Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value
Evidence by polysomnography of ≥5 obstructive apnoeas/hypopnoeas per hour of sleep + ≥1 of: nocturnal breathing disturbances (snoring, snorting, gasping, breathing pauses); daytime sleepiness/fatigue/unrefreshing sleep not explained by another disorder; OR ≥15 obstructive apnoeas/hypopnoeas per hour of sleep regardless of accompanying symptoms
Intoxication: recent opioid use; Withdrawal: cessation/reduction after heavy prolonged use, or administration of opioid antagonist
Persistent eating of non-nutritive, non-food substances for ≥1 month
Persistent or recurrent pattern of ejaculation occurring during partnered sexual activity within ≈1 minute of vaginal penetration and before the individual wishes it, on ≥75–100% of occasions
Deliberate and purposeful fire setting on more than one occasion
Urge to move the legs, usually accompanied by uncomfortable sensations in the legs, that begins or worsens during rest/inactivity, is partially or totally relieved by movement, and occurs primarily in the evening or night
Intoxication: recent sedative/hypnotic/anxiolytic use; Withdrawal: cessation/reduction after prolonged heavy use
Consistent failure to speak in specific social situations (despite speaking in others)
Marked fear/anxiety about a specific object or situation
Intoxication: recent stimulant use; Withdrawal: cessation/reduction after prolonged heavy use
Restriction of energy intake → significantly low body weight for age, sex, developmental trajectory, and physical health
Disturbance of attention (reduced ability to direct, focus, sustain, shift attention) and awareness (reduced orientation to environment)
Marked incongruence between one's experienced/expressed gender and assigned gender, ≥6 months; in adolescents/adults: ≥2 of: incongruence between experienced gender and primary/secondary sex characteristics; strong desire to be rid of primary/secondary sex characteristics; strong desire for sex characteristics of experienced gender; strong desire to be of experienced gender; strong desire to be treated as experienced gender; strong conviction of having typical feelings/reactions of experienced gender
Subjective complaints of restlessness after exposure to medication
Abnormal and prolonged contraction of muscles of eyes, face, neck, limbs, or trunk developing in association with medication use
Recurrent periods of irrepressible need to sleep, lapsing into sleep, or napping within same day, for ≥3 months; ≥1 of: cataplexy (brief episodes of bilateral muscle tone loss) ≥few times/month; hypocretin deficiency (CSF hypocretin-1 ≤110 pg/mL); REM sleep latency ≤15 min on MSLT (or mean sleep latency ≤8 min with ≥2 sleep-onset REM periods)
Involuntary movements (tardive dystonia: sustained/repetitive muscle contractions; tardive akathisia: subjective restlessness + repetitive movements) developing in association with neuroleptic use, persisting ≥4 weeks