4. Ataque de nervios (attack of nerves): See “Glossary of Cultural Concepts of Distress" in the Appendix.
300.00 (F41.9)
This category applies to presentations in which symptoms characteristic of an anxiety dis- order that cause clinically significant distress or impairment in social, occupational, or oth- er important areas of functioning predominate but do not meet the full criteria for any of the disorders in the anxiety disorders diagnostic class. The unspecified anxiety disorder cate- gory is used in situations in which the clinician chooses not to specify the reason that the criteria are not met for a specific anxiety disorder, and includes presentations in which there is insufficient information to make a more specific diagnosis (e.g., in emergency room settings).
.. r.,,__.... .0. W .._,. W disorder (OCD), body dysmorphic disorder, hoarding disorder, trichotillomania (hair- pulling disorder), excoriation (skin—picking) disorder, substance/medication-induced ob- sessive-compulsive and related disorder, obsessive-compulsive and related disorder due to another medical condition, and other specified obsessive—compulsive and related dis— order and unspecified obsessive-compulsive and related disorder (e.g., body-focused re- petitive behavior disorder, obsessional jealousy).
OCD is characterized by the presence of obsessions and / or compulsions. Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted, whereas compulsions are repetitive behaviors or mental acts that an indi- vidual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. Some other obsessive-compulsive and related disorders are also char- acterized by preoccupations and by repetitive behaviors or mental acts in response to the preoccupations. Other obsessive-compulsive and related disorders are characterized pri- marily by recurrent body-focused repetitive behaviors (e.g., hair pulling, skin picking) and repeated attempts to decrease or stop the behaviors.
The inclusion of a chapter on obsessive-compulsive and related disorders in DSM-5 re- ﬂects the increasing evidence of these disorders’ relatedness to one another in terms of a range of diagnostic validators as well as the clinical utility of grouping these disorders in the same chapter. Clinicians are encouraged to screen for these conditions in individuals who present with one of them and be aware of overlaps between these conditions. At the same time, there are important differences in diagnostic validators and treatment ap- proaches across these disorders. Moreover, there are close relationships between the anx- iety disorders and some of the obsessive-compulsive and related disorders (e.g., 0CD), which is reﬂected in the sequence of DSM-5 chapters, with obsessive—compulsive and re- lated disorders following anxiety disorders.
The obsessive-compulsive and related disorders differ from developmentally norma- appropriate periods. The distinction between the presence of subclinical symptoms and a clinical disorder requires assessment of a number of factors, including the individual’s level of distress and impairment in functioning.
The chapter begins with 0CD. It then covers body dysmorphic disorder and hoarding disorder, which are characterized by cognitive symptoms such as perceived defects or ﬂaws in physical appearance or the perceived need to save possessions, respectively. The disorder, which are characterized by recurrent body-focused repetitive behaviors. Finally, it covers substance/medication-induced obsessive-compulsive and related disorder, obsessive-compulsive and related disorder due to another medical condition, and other sive and related disorder.