coll. - Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS

FIFTH EDITION

DSM-5

Officers 20122013
PRESIDENT DILIP V. JESTE, M.D.
PRESIDENT-ELECT JEFFREY A. LIEBERMAN, M.D.
TREASURER DAVID FASSLER, M.D.
SECRETARY ROGER PEELE, M.D.

Assembly
SPEAKER R. SCOTT BENSON, M.D.
SPEAKER-ELECT MELINDA L. YOUNG, M.D.

Board of Trustees
JEFFREY AKAKA, M.D.
CAROL A. BERNSTEIN, M.D.
BRIAN CROWLEY, M.D.
ANITA S. EVERETT, M.D.
JEFFREY GELLER, M.D., M.P.H.
MARC DAVID GRAFF, M.D.
JAMES A. GREENE, M.D.
JUDITH F. KASHTAN, M.D.
MOLLY K. MCVOY, M.D.
JAMES E. NININGER, M.D.
JOHN M. OLDHAM, M.D.
ALAN F. SCHATZBERG, M.D.
ALIK S. WIDGE, M.D., PH.D.

ERIK R. VANDERLIP, M.D.,
MEMBER-IN-TRAINING TRUSTEE-ELECT

DIAGNOSTIC AND STATISTICAL
MANUAL OF
MENTAL DISORDERS

FIFTH EDITION

DSM-5

Copyright 2013 American Psychiatric Association

DSM and DSM-5 are registered trademarks of the American Psychiatric Association. Use of these terms is prohibited without permission of the American Psychiatric Association.

ALL RIGHTS RESERVED. Unless authorized in writing by the APA, no part of this book may be reproduced or used in a manner inconsistent with the APAs copyright. This prohibition applies to unauthorized uses or reproductions in any form, including electronic applications.

Correspondence regarding copyright permissions should be directed to DSM Permissions, American Psychiatric Publishing, 1000 Wilson Boulevard, Suite 1825, Arlington, VA 22209-3901.

Manufactured in the United States of America on acid-free paper.

ISBN 978-0-89042-554-1 (Hardcover) 2nd printing June 2013

ISBN 978-0-89042-555-8 (Paperback) 2nd printing June 2013

American Psychiatric Association
1000 Wilson Boulevard
Arlington, VA 22209-3901
www.psych.org

The correct citation for this book is American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.

Library of Congress Cataloging-in-Publication Data

Diagnostic and statistical manual of mental disorders : DSM-5. 5th ed.

p. ; cm.

DSM-5

DSM-V

Includes index.

ISBN 978-0-89042-554-1 (hardcover : alk. paper) ISBN 978-0-89042-555-8 (pbk. : alk. paper)

I. American Psychiatric Association. II. American Psychiatric Association. DSM-5 Task Force. III. Title: DSM-5. IV. Title: DSM-V.

[DNLM: 1. Diagnostic and statistical manual of mental disorders. 5th ed. 2. Mental Disordersclassification. 3. Mental Disordersdiagnosis. WM 15]

RC455.2.C4

616.89075dc23

2013011061

British Library Cataloguing in Publication Data
A CIP record is available from the British Library.

Text DesignTammy J. Cordova

ManufacturingR.R. Donnelley

DAVID J. KUPFER, M.D.
Task Force Chair

DARREL A. REGIER, M.D., M.P.H.
Task Force Vice-Chair

William E. Narrow, M.D., M.P.H., Research Director

Dan G. Blazer, M.D., Ph.D., M.P.H.

Jack D. Burke Jr., M.D., M.P.H.

William T. Carpenter Jr., M.D.

F. Xavier Castellanos, M.D.

Wilson M. Compton, M.D., M.P.E.

Joel E. Dimsdale, M.D.

Javier I. Escobar, M.D., M.Sc.

Jan A. Fawcett, M.D.

Bridget F. Grant, Ph.D., Ph.D. (2009)

Steven E. Hyman, M.D. (20072012)

Dilip V. Jeste, M.D. (20072011)

Helena C. Kraemer, Ph.D.

Daniel T. Mamah, M.D., M.P.E.

James P. McNulty, A.B., Sc.B.

Howard B. Moss, M.D. (20072009)

Susan K. Schultz, M.D., Text Editor

Emily A. Kuhl, Ph.D., APA Text Editor

Charles P. OBrien, M.D., Ph.D.

Roger Peele, M.D.

Katharine A. Phillips, M.D.

Daniel S. Pine, M.D.

Charles F. Reynolds III, M.D.

Maritza Rubio-Stipec, Sc.D.

David Shaffer, M.D.

Andrew E. Skodol II, M.D.

Susan E. Swedo, M.D.

B. Timothy Walsh, M.D.

Philip Wang, M.D., Dr.P.H. (20072012)

William M. Womack, M.D.

Kimberly A. Yonkers, M.D.

Kenneth J. Zucker, Ph.D.

Norman Sartorius, M.D., Ph.D., Consultant

Darrel A. Regier, M.D., M.P.H., Director, Division of Research

William E. Narrow, M.D., M.P.H., Associate Director

Emily A. Kuhl, Ph.D., Senior Science Writer; Staff Text Editor

Diana E. Clarke, Ph.D., M.Sc., Research Statistician

Lisa H. Greiner, M.S.S.A., DSM-5 Field Trials Project Manager

Eve K. Moscicki, Sc.D., M.P.H., Director, Practice Research Network

S. Janet Kuramoto, Ph.D. M.H.S., Senior Scientific Research Associate, Practice Research Network

Amy Porfiri, M.B.A. Director of Finance and Administration

Jennifer J. Shupinka, Assistant Director, DSM Operations

Seung-Hee Hong, DSM Senior Research Associate

Anne R. Hiller, DSM Research Associate

Alison S. Beale, DSM Research Associate

Spencer R. Case, DSM Research Associate

Joyce C. West, Ph.D., M.P.P., Health Policy Research Director, Practice Research Network

Farifteh F. Duffy, Ph.D., Quality Care Research Director, Practice Research Network

Lisa M. Countis, Field Operations Manager, Practice Research Network

Christopher M. Reynolds, Executive Assistant

JAMES H. SCULLY JR., M.D.
Medical Director and CEO

Michael B. First, M.D.

Maria N. Ward, M.Ed., RHIT, CCS-P

DAVID SHAFFER, M.D.
Chair

F. XAVIER CASTELLANOS, M.D.
Co-Chair

Paul J. Frick, Ph.D., Text Coordinator

Glorisa Canino, Ph.D.

Terrie E. Moffitt, Ph.D.

Joel T. Nigg, Ph.D.

Luis Augusto Rohde, M.D., Sc.D.

Rosemary Tannock, Ph.D.

Eric A. Taylor, M.B.

Richard Todd, Ph.D., M.D. (d. 2008)

KATHARINE A. PHILLIPS, M.D.
Chair

Michelle G. Craske, Ph.D., Text Coordinator

J. Gavin Andrews, M.D.

Susan M. Bgels, Ph.D.

Matthew J. Friedman, M.D., Ph.D.

Eric Hollander, M.D. (20072009)

Roberto Lewis-Fernndez, M.D., M.T.S.

Robert S. Pynoos, M.D., M.P.H.

Scott L. Rauch, M.D.

H. Blair Simpson, M.D., Ph.D.

David Spiegel, M.D.

Dan J. Stein, M.D., Ph.D.

Murray B. Stein, M.D.

Robert J. Ursano, M.D.

Hans-Ulrich Wittchen, Ph.D.

DANIEL S. PINE, M.D.
Chair

Ronald E. Dahl, M.D.

E. Jane Costello, Ph.D. (20072009)

Regina Smith James, M.D.

Rachel G. Klein, Ph.D.