F90 | Hyperkinetic disorders | |||||||
A group of disorders characterized by an early onset (usually in the first five years of life), lack of persistence in activities that require cognitive involvement, and a tendency to move from one activity to another without completing any one, together with disorganized, ill-regulated, and excessive activity. Several other abnormalities may be associated. Hyperkinetic children are often reckless and impulsive, prone to accidents, and find themselves in disciplinary trouble because of unthinking breaches of rules rather than deliberate defiance. Their relationships with adults are often socially disinhibited, with a lack of normal caution and reserve. They are unpopular with other children and may become isolated. Impairment of cognitive functions is common, and specific delays in motor and language development are disproportionately frequent. Secondary complications include dissocial behaviour and low self-esteem. | ||||||||
Excludes: | anxiety disorders
mood [affective] disorders pervasive developmental disorders schizophrenia |
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F90.0 | Disturbance of activity and attention | |||||||
Attention deficit:
· disorder with hyperactivity · hyperactivity disorder · syndrome with hyperactivity |
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Excludes: | hyperkinetic disorder associated with conduct disorder
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F90.1 | Hyperkinetic conduct disorder | |||||||
Hyperkinetic disorder associated with conduct disorder
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F90.8 | Other hyperkinetic disorders | |||||||
F90.9 | Hyperkinetic disorder, unspecified | |||||||
Hyperkinetic reaction of childhood or adolescence NOS
Hyperkinetic syndrome NOS |
F91 | Conduct disorders | |||||||
Disorders characterized by a repetitive and persistent pattern of dissocial, aggressive, or defiant conduct. Such behaviour should amount to major violations of age-appropriate social expectations; it should therefore be more severe than ordinary childish mischief or adolescent rebelliousness and should imply an enduring pattern of behaviour (six months or longer). Features of conduct disorder can also be symptomatic of other psychiatric conditions, in which case the underlying diagnosis should be preferred.
Examples of the behaviours on which the diagnosis is based include excessive levels of fighting or bullying, cruelty to other people or animals, severe destructiveness to property, fire-setting, stealing, repeated lying, truancy from school and running away from home, unusually frequent and severe temper tantrums, and disobedience. Any one of these behaviours, if marked, is sufficient for the diagnosis, but isolated dissocial acts are not.
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Excludes: | mood [affective]
pervasive developmental disorders schizophrenia when associated with: · emotional disorders · hyperkinetic disorders |
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F91.0 | Conduct disorder confined to the family context | |||||||
Conduct disorder involving dissocial or aggressive behaviour (and not merely oppositional, defiant, disruptive behaviour), in which the abnormal behaviour is entirely, or almost entirely, confined to the home and to interactions with members of the nuclear family or immediate household. The disorder requires that the overall criteria for F91.- be met; even severely disturbed parent-child relationships are not of themselves sufficient for diagnosis. | ||||||||
F91.1 | Unsocialized conduct disorder | |||||||
Disorder characterized by the combination of persistent dissocial or aggressive behaviour (meeting the overall criteria for F91.- and not merely comprising oppositional, defiant, disruptive behaviour) with significant pervasive abnormalities in the individual's relationships with other children. | ||||||||
Conduct disorder, solitary aggressive type
Unsocialized aggressive disorder |
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F91.2 | Socialized conduct disorder | |||||||
Disorder involving persistent dissocial or aggressive behaviour (meeting the overall criteria for F91.- and not merely comprising oppositional, defiant, disruptive behaviour) occurring in individuals who are generally well integrated into their peer group. | ||||||||
Conduct disorder, group type
Group delinquency Offences in the context of gang membership Stealing in company with others Truancy from school |
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F91.3 | Oppositional defiant disorder | |||||||
Conduct disorder, usually occurring in younger children, primarily characterized by markedly defiant, disobedient, disruptive behaviour that does not include delinquent acts or the more extreme forms of aggressive or dissocial behaviour. The disorder requires that the overall criteria for F91.- be met; even severely mischievous or naughty behaviour is not in itself sufficient for diagnosis. Caution should be employed before using this category, especially with older children, because clinically significant conduct disorder will usually be accompanied by dissocial or aggressive behaviour that goes beyond mere defiance, disobedience, or disruptiveness. | ||||||||
F91.8 | Other conduct disorders | |||||||
F91.9 | Conduct disorder, unspecified | |||||||
Childhood:
· behavioural disorder NOS · conduct disorder NOS |
F93 | Emotional disorders with onset specific to childhood | |||||||
Mainly exaggerations of normal developmental trends rather than phenomena that are qualitatively abnormal in themselves. Developmental appropriateness is used as the key diagnostic feature in defining the difference between these emotional disorders, with onset specific to childhood, and the neurotic disorders (F40-F48). | ||||||||
Excludes: | when associated with conduct disorder
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F93.0 | Separation anxiety disorder of childhood | |||||||
Should be diagnosed when fear of separation constitutes the focus of the anxiety and when such anxiety first arose during the early years of childhood. It is differentiated from normal separation anxiety when it is of a degree (severity) that is statistically unusual (including an abnormal persistence beyond the usual age period), and when it is associated with significant problems in social functioning. | ||||||||
Excludes: | mood [affective] disorders
neurotic disorders phobic anxiety disorder of childhood social anxiety disorder of childhood |
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F93.1 | Phobic anxiety disorder of childhood | |||||||
Fears in childhood that show a marked developmental phase specificity and arise (to some extent) in a majority of children, but that are abnormal in degree. Other fears that arise in childhood but that are not a normal part of psychosocial development (for example agoraphobia) should be coded under the appropriate category in section F40-F48. | ||||||||
Excludes: | generalized anxiety disorder
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F93.2 | Social anxiety disorder of childhood | |||||||
In this disorder there is a wariness of strangers and social apprehension or anxiety when encountering new, strange, or socially threatening situations. This category should be used only where such fears arise during the early years, and are both unusual in degree and accompanied by problems in social functioning. | ||||||||
Avoidant disorder of childhood or adolescence
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F93.3 | Sibling rivalry disorder | |||||||
Some degree of emotional disturbance usually following the birth of an immediately younger sibling is shown by a majority of young children. A sibling rivalry disorder should be diagnosed only if the degree or persistence of the disturbance is both statistically unusual and associated with abnormalities of social interaction. | ||||||||
Sibling jealousy
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F93.8 | Other childhood emotional disorders | |||||||
Identity disorder
Overanxious disorder |
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Excludes: | gender identity disorder of childhood
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F93.9 | Childhood emotional disorder, unspecified |
F94 | Disorders of social functioning with onset specific to childhood and adolescence | |||||||
A somewhat heterogeneous group of disorders that have in common abnormalities in social functioning which begin during the developmental period, but which (unlike the pervasive developmental disorders) are not primarily characterized by an apparently constitutional social incapacity or deficit that pervades all areas of functioning. In many instances, serious environmental distortions or privations probably play a crucial role in etiology. | ||||||||
F94.0 | Elective mutism | |||||||
Characterized by a marked, emotionally determined selectivity in speaking, such that the child demonstrates a language competence in some situations but fails to speak in other (definable) situations. The disorder is usually associated with marked personality features involving social anxiety, withdrawal, sensitivity, or resistance. | ||||||||
Selective mutism
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Excludes: | pervasive developmental disorders
schizophrenia specific developmental disorders of speech and language transient mutism as part of separation anxiety in young children |
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F94.1 | Reactive attachment disorder of childhood | |||||||
Starts in the first five years of life and is characterized by persistent abnormalities in the child's pattern of social relationships that are associated with emotional disturbance and are reactive to changes in environmental circumstances (e.g. fearfulness and hypervigilance, poor social interaction with peers, aggression towards self and others, misery, and growth failure in some cases). The syndrome probably occurs as a direct result of severe parental neglect, abuse, or serious mishandling. | ||||||||
Use additional code, if desired, to identify any associated failure to thrive or growth retardation. | ||||||||
Excludes: | Asperger's syndrome
disinhibited attachment disorder of childhood maltreatment syndromes normal variation in pattern of selective attachment sexual or physical abuse in childhood, resulting in psychosocial problems |
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F94.2 | Disinhibited attachment disorder of childhood | |||||||
A particular pattern of abnormal social functioning that arises during the first five years of life and that tends to persist despite marked changes in environmental circumstances, e.g. diffuse, nonselectively focused attachment behaviour, attention-seeking and indiscriminately friendly behaviour, poorly modulated peer interactions; depending on circumstances there may also be associated emotional or behavioural disturbance. | ||||||||
Affectionless psychopathy
Institutional syndrome |
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Excludes: | Asperger's syndrome
hospitalism in children hyperkinetic disorders reactive attachment disorder of childhood |
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F94.8 | Other childhood disorders of social functioning | |||||||
F94.9 | Childhood disorder of social functioning, unspecified |
F98 | Other behavioural and emotional disorders with onset usually occurring in childhood and adolescence | |||||||
A heterogeneous group of disorders that share the characteristic of an onset in childhood but otherwise differ in many respects. Some of the conditions represent well-defined syndromes but others are no more than symptom complexes that need inclusion because of their frequency and association with psychosocial problems, and because they cannot be incorporated into other syndromes. | ||||||||
Excludes: | breath-holding spells
gender identity disorder of childhood Kleine-Levin syndrome obsessive-compulsive disorder sleep disorders due to emotional causes |
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F98.0 | Nonorganic enuresis | |||||||
A disorder characterized by involuntary voiding of urine, by day and by night, which is abnormal in relation to the individual's mental age, and which is not a consequence of a lack of bladder control due to any neurological disorder, to epileptic attacks, or to any structural abnormality of the urinary tract. The enuresis may have been present from birth or it may have arisen following a period of acquired bladder control. The enuresis may or may not be associated with a more widespread emotional or behavioural disorder. | ||||||||
Enuresis (primary)(secondary) of nonorganic origin
Functional enuresis Psychogenic enuresis Urinary incontinence of nonorganic origin |
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Excludes: | enuresis NOS
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F98.1 | Nonorganic encopresis | |||||||
Repeated, voluntary or involuntary passage of faeces, usually of normal or near-normal consistency, in places not appropriate for that purpose in the individual's own sociocultural setting. The condition may represent an abnormal continuation of normal infantile incontinence, it may involve a loss of continence following the acquisition of bowel control, or it may involve the deliberate deposition of faeces in inappropriate places in spite of normal physiological bowel control. The condition may occur as a monosymptomatic disorder, or it may form part of a wider disorder, especially an emotional disorder (F93.-) or a conduct disorder (F91.-). | ||||||||
Functional encopresis
Incontinence of faeces of nonorganic origin Psychogenic encopresis |
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Use additional code, if desired, to identify the cause of any coexisting constipation. | ||||||||
Excludes: | encopresis NOS
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F98.2 | Feeding disorder of infancy and childhood | |||||||
A feeding disorder of varying manifestations usually specific to infancy and early childhood. It generally involves food refusal and extreme faddiness in the presence of an adequate food supply, a reasonably competent caregiver, and the absence of organic disease. There may or may not be associated rumination (repeated regurgitation without nausea or gastrointestinal illness). | ||||||||
Rumination disorder of infancy
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Excludes: | anorexia nervosa and other eating disorders
feeding: · difficulties and mismanagement · problems of newborn pica of infancy or childhood |
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F98.3 | Pica of infancy and childhood | |||||||
Persistent eating of non-nutritive substances (such as soil, paint chippings, etc.). It may occur as one of many symptoms that are part of a more widespread psychiatric disorder (such as autism), or as a relatively isolated psychopathological behaviour; only the latter is classified here. The phenomenon is most common in mentally retarded children and, if mental retardation is also present, F70-F79 should be selected as the main diagnosis. | ||||||||
F98.4 | Stereotyped movement disorders | |||||||
Voluntary, repetitive, stereotyped, nonfunctional (and often rhythmic) movements that do not form part of any recognized psychiatric or neurological condition. When such movements occur as symptoms of some other disorder, only the overall disorder should be recorded. The movements that are of a non self-injurious variety include: body-rocking, head-rocking, hair-plucking, hair-twisting, finger-flicking mannerisms, and hand-flapping. Stereotyped self-injurious behaviour includes repetitive head-banging, face-slapping, eye-poking, and biting of hands, lips or other body parts. All the stereotyped movement disorders occur most frequently in association with mental retardation (when this is the case, both should be recorded). If eye-poking occurs in a child with visual impairment, both should be coded: eye-poking under this category and the visual condition under the appropriate somatic disorder code. | ||||||||
Stereotype/habit disorder
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Excludes: | abnormal involuntary movements
movement disorders of organic origin nail-biting nose-picking stereotypies that are part of a broader psychiatric condition thumb-sucking tic disorders trichotillomania |
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F98.5 | Stuttering [stammering] | |||||||
Speech that is characterized by frequent repetition or prolongation of sounds or syllables or words, or by frequent hesitations or pauses that disrupt the rhythmic flow of speech. It should be classified as a disorder only if its severity is such as to markedly disturb the fluency of speech. | ||||||||
Excludes: | cluttering
tic disorders |
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F98.6 | Cluttering | |||||||
A rapid rate of speech with breakdown in fluency, but no repetitions or hesitations, of a severity to give rise to diminished speech intelligibility. Speech is erratic and dysrhythmic, with rapid jerky spurts that usually involve faulty phrasing patterns. | ||||||||
Excludes: | stuttering
tic disorders |
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F98.8 | Other specified behavioural and emotional disorders with onset usually occurring in childhood and adolescence | |||||||
Attention deficit disorder without hyperactivity
Excessive masturbation Nail-biting Nose-picking Thumb-sucking |
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F98.9 | Unspecified behavioural and emotional disorders with onset usually occurring in childhood and adolescence |