Mental Disorders Guide - Letra T

Complex post traumatic stress disorder

Complex Transtorno de estresse pós-traumático (Complex PTSD) is a transtorno that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g. torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). All diagnostic requirements for PTSD are met. In addition, Complex PTSD is characterised by grave and persistent 1) problems in affect regulation; 2) beliefs about oneself as diminished, defeated or worthless, accompanied by feelings of shame, guilt or failure related to the traumatic event; and 3) difficulties in sustaining relationships and in feeling close to others. These symptoms cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Trance disorder

Trance transtorno is characterised by trance states in which there is a marked alteration in the individual’s state of consciousness or a loss of the individual’s customary sense of personal identity in which the individual experiences a narrowing of awareness of immediate surroundings or unusually narrow and selective focusing on environmental stimuli and restriction of movements, postures, and speech to repetition of a small repertoire that is experienced as being outside of one’s control. The trance state is not characterised by the experience of being replaced by an alternate identity. Trance episodes are recurrent or, if the diagnosis is based on a single episódio, the episódio has lasted for at least several days. The trance state is involuntary and unwanted and is not accepted as a part of a collective cultural or religious practice. The symptoms do not occur exclusively during another dissociative transtorno and are not better explained by another mental, behavioural or neurodevelopmental transtorno. The symptoms are not due to the direct effects of a substance or medication on the central nervous system, including abstinência effects, exhaustion, or to hypnagogic or hypnopompic states, and are not due to a disease of the nervous system, head trauma, or a sleep-wake transtorno. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Bipolar type I disorder

Transtorno bipolar tipo I is an episodic mood transtorno defined by the occurrence of one or more manic or mixed episodes. A manic episódio is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterised by euphoria, irritability, or expansiveness, and by increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behaviour, and rapid changes among different mood states (i.e., mood lability). A mixed episódio is characterised by the presence of several prominent manic and several prominent depressive symptoms consistent com those observed in manic episodes and depressive episodes, which either occur simultaneously or alternate very rapidly (from day to day or within the same day). Symptoms must include an altered mood state consistent com a manic and/or depressive episódio (i.e., depressed, dysphoric, euphoric or expansive mood), and be present most of the day, nearly every day, during a period of at least 2 weeks, unless shortened by a treatment intervention. Although the diagnosis can be made based on evidence of a single manic or mixed episódio, typically manic or mixed episodes alternate com depressive episodes over the course of the transtorno.

Bipolar type I disorder, current episode depressive, severe with psychotic symptoms

Transtorno bipolar tipo I, atual episódio depressive, grave, com psychotic symptoms is diagnosed when the definitional requirements for Transtorno bipolar tipo I are met and the atual episódio is grave and there are delusions or hallucinations during the episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a grave depressive episódio, many or most symptoms of a Depressive episódio are present to a marked degree, or a smaller number of symptoms are present and manifest to an intense degree. The individual has serious difficulty continuing to function in most domains (personal, family, social, educational, occupational, or other important domains).

Bipolar type I disorder, current episode depressive, severe without psychotic symptoms

Transtorno bipolar tipo I, atual episódio depressive, grave, sem psychotic symptoms is diagnosed when the definitional requirements for Transtorno bipolar tipo I are met and the atual episódio is grave and there are no delusions or hallucinations during the episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a grave depressive episódio, many or most symptoms of a Depressive episódio are present to a marked degree, or a smaller number of symptoms are present and manifest to an intense degree. The individual has serious difficulty continuing to function in most domains (personal, family, social, educational, occupational, or other important domains).

Bipolar type I disorder, current episode depressive, mild

Transtorno bipolar tipo I, atual episódio depressive, leve is diagnosed when the definitional requirements for Transtorno bipolar tipo I have been met and the atual episódio is depressive at a leve level of severity. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a leve depressive episódio, the individual is usually distressed by the symptoms and has some difficulty in continuing to function in one or more domains (personal, family, social, educational, occupational, or other important domains). There are no delusions or hallucinations during the episódio.

Bipolar type I disorder, current episode depressive, moderate with psychotic symptoms

Transtorno bipolar tipo I, atual episódio depressive, moderado, com psychotic symptoms diagnosed when the definitional requirements for Transtorno bipolar tipo I have been met and the atual episódio is depressive at a moderado level of severity and there are delusions or hallucinations during the episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a moderado depressive episódio, several symptoms of a depressive episódio are present to a marked degree, or a large number of depressive symptoms of lesser severity are present overall. The individual typically has considerable difficulty functioning in multiple domains (personal, family, social, educational, occupational, or other important domains).

Bipolar type I disorder, current episode depressive, moderate without psychotic symptoms

Transtorno bipolar tipo I, atual episódio depressive, moderado, sem psychotic symptoms is diagnosed when the definitional requirements for Transtorno bipolar tipo I have been met and the atual episódio is depressive at a moderado level of severity and there are no delusions or hallucinations during the episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a moderado depressive episódio, several symptoms of a depressive episódio are present to a marked degree, or a large number of depressive symptoms of lesser severity are present overall. The individual typically has considerable difficulty functioning in multiple domains (personal, family, social, educational, occupational, or other important domains).

Bipolar type I disorder, current episode depressive, unspecified severity

Transtorno bipolar tipo I, atual episódio depressive, não especificado severity is diagnosed when the definitional requirements for Transtorno bipolar tipo I have been met and the atual episódio is depressive, but there is insufficient information to determine the severity of the atual depressive episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. The symptoms are associated com at least some difficulty in continuing com ordinary work, social, or domestic activities.

Bipolar type I disorder, current episode hypomanic

Transtorno bipolar tipo I, atual episódio hypomanic is diagnosed when the definitional requirements for Transtorno bipolar tipo I have been met and the atual episódio is hypomanic. A hypomanic episódio is a persistent mood state lasting at least several days characterised by leve elevation of mood or increased irritability and increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid speech, rapid or racing thoughts, increased self-esteem, an increase in sexual drive or sociability, decreased need for sleep, distractibility, or impulsive or reckless behaviour. The symptoms are not grave enough to cause marked impairment in occupational functioning or in usual social activities or relationships com others, does not necessitate hospitalization, and there are no accompanying delusions or hallucinations.

Bipolar type I disorder, current episode manic, with psychotic symptoms

Transtorno bipolar tipo I, atual episódio manic com psychotic symptoms is diagnosed when the definitional requirements for Transtorno bipolar tipo I have been met, the atual episódio is Manic and there are delusions or hallucinations present during the episódio. A manic episódio is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterised by euphoria, irritability, or expansiveness, and by increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behaviour, and rapid changes among different mood states (i.e., mood lability). If the individual has experienced Manic or Mixed Episodes in the past, a duration of one week is not required in order to diagnose a atual episódio if all other diagnostic requirements are met.

Bipolar type I disorder, current episode manic, without psychotic symptoms

Transtorno bipolar tipo I, atual episódio manic, sem psychotic symptoms is diagnosed when the definitional requirements for Transtorno bipolar tipo I are met, the atual episódio is manic, and there are no delusions or hallucinations present during the episódio. A manic episódio is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterised by euphoria, irritability, or expansiveness, and by increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behaviour, and rapid changes among different mood states (i.e., mood lability). If the individual has experienced Manic or Mixed Episodes in the past, a duration of one week is not required in order to diagnose a atual episódio if all other diagnostic requirements are met.

Bipolar type I disorder, current episode mixed, with psychotic symptoms

Transtorno bipolar tipo I, atual episódio mixed, com psychotic symptoms is diagnosed when the definitional requirements for Transtorno bipolar tipo I are met and the atual episódio is mixed and there are delusions or hallucinations present during the episódio. A mixed episódio is characterised by the presence of several prominent manic and several prominent depressive symptoms consistent com those observed in manic episodes and depressive episodes, which either occur simultaneously or alternate very rapidly (from day to day or within the same day). Symptoms must include an altered mood state consistent com a manic and/or depressive episódio (i.e., depressed, dysphoric, euphoric or expansive mood), and be present most of the day, nearly every day, during a period of at least 2 weeks, unless shortened by a treatment intervention. If the individual has experienced Manic or Mixed Episodes in the past, a duration of 2 weeks is not required in order to diagnose a atual episódio if all other diagnostic requirements are met.

Bipolar type I disorder, current episode mixed, without psychotic symptoms

Transtorno bipolar tipo I, atual episódio mixed, sem psychotic symptoms is diagnosed when the definitional requirements for Transtorno bipolar tipo I are met and the atual episódio is mixed and there are no delusions or hallucinations present during the episódio. A mixed episódio is characterised by the presence of several prominent manic and several prominent depressive symptoms consistent com those observed in manic episodes and depressive episodes, which either occur simultaneously or alternate very rapidly (from day to day or within the same day). Symptoms must include an altered mood state consistent com a manic and/or depressive episódio (i.e., depressed, dysphoric, euphoric or expansive mood), and be present most of the day, nearly every day, during a period of at least 2 weeks, unless shortened by a treatment intervention. If the individual has experienced Manic or Mixed Episodes in the past, a duration of 2 weeks is not required in order to diagnose a atual episódio if all other diagnostic requirements are met.

Bipolar type I disorder, currently in full remission

Transtorno bipolar tipo I, currently in completa remissão is diagnosed when the completa definitional requirements for Bipolar I transtorno have been met in the past but there are no longer any significant mood symptoms.

Bipolar type I disorder, currently in partial remission, most recent episode depressive

Transtorno bipolar tipo I, currently in parcial remissão, most recent episódio depressive is diagnosed when the definitional requirements for Transtorno bipolar tipo I have been met and the most recent episódio was a depressive episódio. The completa definitional requirements for the episódio are no longer met but some significant depressive symptoms remain.

Bipolar type I disorder, currently in partial remission, most recent episode manic or hypomanic

Transtorno bipolar tipo I, currently in parcial remissão, most recent episódio manic or hypomanic is diagnosed when the definitional requirements for Transtorno bipolar tipo I have been met and the most recent episódio was a manic or hypomanic episódio. The completa definitional requirements for a manic or hypomanic episódio are no longer met but some significant mood symptoms remain. In some cases, residual mood symptoms may be depressive rather than manic or hypomanic, but do not satisfy the definitional requirements for a depressive episódio.

Bipolar type I disorder, currently in partial remission, most recent episode mixed

Transtorno bipolar tipo I, currently in parcial remissão, most recent episódio mixed is diagnosed when the definitional requirements for Transtorno bipolar tipo I have been met and the most recent episódio was a mixed episódio. The completa definitional requirements for the episódio are no longer met but some significant mood symptoms remain.

Bipolar type I disorder, currently in partial remission, most recent episode unspecified

Transtorno bipolar tipo I, currently in parcial remissão, most recent episódio não especificado is diagnosed when the definitional requirements for Transtorno bipolar tipo I have been met but there is insufficient information to determine the nature of the most recent mood episódio. The completa definitional requirements for a mood episódio are no longer met but some significant mood symptoms remain.

Bipolar type II disorder

Transtorno bipolar tipo II is an episodic mood transtorno defined by the occurrence of one or more hypomanic episodes and at least one depressive episódio. A hypomanic episódio is a persistent mood state lasting for at least several days characterised by persistent elevation of mood or increased irritability as well as increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as increased talkativeness, rapid or racing thoughts, increased self-esteem, decreased need for sleep, distractability, and impulsive or reckless behavior. The symptoms represent a change from the individual’s typical mood, energy level, and behavior but are not grave enough to cause marked impairment in functioning. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as changes in appetite or sleep, psychomotor agitation or retardation, fatigue, feelings of worthless or excessive or inappropriate guilt, feelings or hopelessness, difficulty concentrating, and suicidality. There is no history of manic or mixed episodes.

Bipolar type II disorder, current episode depressive, severe with psychotic symptoms

Transtorno bipolar tipo II, atual episódio depressive, grave, com psychotic symptoms is diagnosed when the definitional requirements for Transtorno bipolar tipo II are met and the atual episódio is grave and there are delusions or hallucinations during the episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a grave depressive episódio, many or most symptoms of a Depressive episódio are present to a marked degree, or a smaller number of symptoms are present and manifest to an intense degree. The individual has serious difficulty continuing to function in most domains (personal, family, social, educational, occupational, or other important domains).

Bipolar type II disorder, current episode depressive, severe without psychotic symptoms

Transtorno bipolar tipo II, atual episódio depressive, grave, sem psychotic symptoms is diagnosed when the definitional requirements for Transtorno bipolar tipo II are met and the atual episódio is grave and there are no delusions or hallucinations during the episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a grave depressive episódio, many or most symptoms of a Depressive episódio are present to a marked degree, or a smaller number of symptoms are present and manifest to an intense degree. The individual has serious difficulty continuing to function in most domains (personal, family, social, educational, occupational, or other important domains).

Bipolar type II disorder, current episode depressive, mild

Transtorno bipolar tipo II, atual episódio depressive, leve is diagnosed when the definitional requirements for Transtorno bipolar tipo II have been met and the atual episódio is depressive at a leve level of severity. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a leve depressive episódio, the individual is usually distressed by the symptoms and has some difficulty in continuing to function in one or more domains (personal, family, social, educational, occupational, or other important domains). There are no delusions or hallucinations during the episódio.

Bipolar type II disorder, current episode depressive, moderate with psychotic symptoms

Transtorno bipolar tipo II, atual episódio depressive, moderado, com psychotic symptoms diagnosed when the definitional requirements for Transtorno bipolar tipo II have been met and the atual episódio is depressive at a moderado level of severity and there are delusions or hallucinations during the episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a moderado depressive episódio, several symptoms of a depressive episódio are present to a marked degree, or a large number of depressive symptoms of lesser severity are present overall. The individual typically has considerable difficulty functioning in multiple domains (personal, family, social, educational, occupational, or other important domains).

Bipolar type II disorder, current episode depressive, moderate without psychotic symptoms

Transtorno bipolar tipo II, atual episódio depressive, moderado, sem psychotic symptoms is diagnosed when the definitional requirements for Transtorno bipolar tipo II have been met and the atual episódio is depressive at a moderado level of severity and there are no delusions or hallucinations during the episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a moderado depressive episódio, several symptoms of a depressive episódio are present to a marked degree, or a large number of depressive symptoms of lesser severity are present overall. The individual typically has considerable difficulty functioning in multiple domains (personal, family, social, educational, occupational, or other important domains).

Bipolar type II disorder, current episode depressive, unspecified severity

Transtorno bipolar tipo II, atual episódio depressive, não especificado severity is diagnosed when the definitional requirements for Transtorno bipolar tipo II have been met and the atual episódio is depressive, but there is insufficient information to determine the severity of the atual depressive episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. The symptoms are associated com at least some difficulty in continuing com ordinary work, social, or domestic activities.

Bipolar type II disorder, current episode hypomanic

Transtorno bipolar tipo II, atual episódio hypomanic is diagnosed when the definitional requirements for Transtorno bipolar tipo II have been met and the atual episódio is hypomanic. A hypomanic episódio is a persistent mood state lasting at least several days characterised by leve elevation of mood or increased irritability and increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid speech, rapid or racing thoughts, increased self-esteem, an increase in sexual drive or sociability, decreased need for sleep, distractibility, or impulsive or reckless behaviour. The symptoms are not grave enough to cause marked impairment in occupational functioning or in usual social activities or relationships com others, does not necessitate hospitalization, and there are no accompanying delusions or hallucinations.

Bipolar type II disorder, currently in full remission

Transtorno bipolar tipo II, currently in completa remissão, is diagnosed when the definitional requirements for Transtorno bipolar tipo II have been met but there are no longer any significant mood symptoms.

Bipolar type II disorder, currently in partial remission, most recent episode depressive

Transtorno bipolar tipo II, currently in parcial remissão, most recent episódio depressive is diagnosed when the definitional requirements for Transtorno bipolar tipo II have been met and the most recent episódio was a depressive episódio. The completa definitional requirements for the episódio are no longer met but some significant depressive symptoms remain.

Bipolar type II disorder, currently in partial remission, most recent episode hypomanic

Transtorno bipolar tipo II, currently in parcial remissão, most recent episódio hypomanic is diagnosed when the definitional requirements for Transtorno bipolar tipo II have been met and the most recent episódio was a hypomanic episódio. The completa definitional requirements for a hypomanic episódio are no longer met but some significant mood symptoms remain. In some cases, residual mood symptoms may be depressive rather than hypomanic, but do not satisfy the definitional requirements for a depressive episódio.

Bipolar type II disorder, currently in partial remission, most recent episode unspecified

Transtorno bipolar tipo II, currently in parcial remissão, most recent episódio não especificado is diagnosed when the definitional requirements for Transtorno bipolar tipo II have been met but there is insufficient information to determine the nature of the most recent mood episódio. The completa definitional requirements for a mood episódio are no longer met but some significant mood symptoms remain.

Cyclothymic disorder

Transtorno ciclotímico is characterised by a persistent instability of mood over a period of at least 2 years, involving numerous periods of hypomanic (e.g., euphoria, irritability, or expansiveness, psychomotor activation) and depressive (e.g., feeling down, diminished interest in activities, fatigue) symptoms that are present during more of the time than not. The hypomanic symptomatology may or may not be sufficiently grave or prolonged to meet the completa definitional requirements of a hypomanic episódio (see Transtorno bipolar tipo II), but there is no history of manic or mixed episodes (see Transtorno bipolar tipo I). The depressive symptomatology has never been sufficiently grave or prolonged to meet the diagnostic requirements for a depressive episódio (see Transtorno bipolar tipo II). The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Developmental motor coordination disorder

Transtorno da coordenação motora is characterised by a significant delay in the acquisition of gross and fine motor skills and impairment in the execution of coordinated motor skills that manifest in clumsiness, slowness, or inaccuracy of motor performance. Coordinated motor skills are markedly below that expected given the individual's chronological age and level of intellectual functioning. Onset of coordinated motor skills difficulties occurs during the developmental period and is typically apparent from early childhood. Coordinated motor skills difficulties cause significant and persistent limitations in functioning (e.g. in activities of daily living, school work, and vocational and leisure activities). Difficulties com coordinated motor skills are not solely attributable to a Disease of the Nervous System, Disease of the Musculoskeletal System or Connective Tissue, sensory impairment, and not better explained by a transtorno of Intellectual Development.

Hoarding disorder

Transtorno de acumulação is characterised by accumulation of possessions that results in living spaces becoming cluttered to the point that their uso or safety is compromised. Accumulation occurs due to both repetitive urges or behaviours related to amassing items and difficulty discarding possessions due to a perceived need to save items and distress associated com discarding them. If living areas are uncluttered this is only due to the intervention of third parties (e.g., family members, cleaners, authorities). Amassment may be passive (e.g. accumulation of incoming flyers or mail) or active (e.g. excessive acquisition of free, purchased, or stolen items). The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Hoarding disorder with fair to good insight

All definitional requirements of Transtorno de acumulação are met. The individual recognizes that hoarding-related beliefs and behaviours (pertaining to excessive acquisition, difficulty discarding, or clutter) are problematic. This qualifier level may still be applied if, at circumscribed times (e.g., when being forced to discard items), the individual demonstrates no insight.

Hoarding disorder with poor to absent insight

All definitional requirements of Transtorno de acumulação are met. Most or all of the time, the individual is convinced that that hoarding-related beliefs and behaviours (pertaining to excessive acquisition, difficulty discarding, or clutter) are not problematic, despite evidence to the contrary. The lack of insight exhibited by the individual does not vary markedly as a function of anxiety level.

Adjustment disorder

Transtorno de ajustamento is a maladaptive reaction to an identifiable psychosocial stressor or multiple stressors (e.g. divorce, illness or disability, socio-economic problems, conflicts at home or work) that usually emerges within a month of the stressor. The transtorno is characterised by preoccupation com the stressor or its consequences, including excessive worry, recurrent and distressing thoughts about the stressor, or constant rumination about its implications, as well as by failure to adapt to the stressor that causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. The symptoms are not better explained by another mental transtorno (e.g., Mood transtorno, another transtorno Specifically Associated com Stress) and typically resolve within 6 months, unless the stressor persists for a longer duration.

Separation anxiety disorder

Transtorno de ansiedade de separação is characterised by marked and excessive fear or anxiety about separation from specific attachment figures. In children and adolescents, separation anxiety typically focuses on caregivers, parents or other family members and the fear or anxiety is beyond what would be considered developmentally normative. In adults, the focus is typically a romantic partner or children. Manifestations of separation anxiety may include thoughts of harm or untoward events befalling the attachment figure, reluctance to go to school or work, recurrent excessive distress upon separation, reluctance or refusal to sleep away from the attachment figure, and recurrent nightmares about separation. The symptoms persist for at least several months and are sufficiently grave to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.

Generalised anxiety disorder

Transtorno de ansiedade generalizada is characterised by marked symptoms of anxiety that persist for at least several months, for more days than not, manifested by either general apprehension (i.e. ‘free-floating anxiety’) or excessive worry focused on multiple everyday events, most often concerning family, health, finances, and school or work, together com additional symptoms such as muscular tension or motor restlessness, sympathetic autonomic over-activity, subjective experience of nervousness, difficulty maintaining concentration, irritability, or sleep disturbance. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. The symptoms are not a manifestation of another health condition and are not due to the effects of a substance or medication on the central nervous system.

Social anxiety disorder

Transtorno de ansiedade social is characterised by marked and excessive fear or anxiety that consistently occurs in one or more social situations such as social interactions (e.g. having a conversation), doing something while feeling observed (e.g. eating or drinking in the presence of others), or performing in front of others (e.g. giving a speech). The individual is concerned that he or she will act in a way, or show anxiety symptoms, that will be negatively evaluated by others. Relevant social situations are consistently avoided or else endured com intense fear or anxiety. The symptoms persist for at least several months and are sufficiently grave to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.

Reactive attachment disorder

Transtorno de apego reativo is characterised by grossly abnormal attachment behaviours in early childhood, occurring in the context of a history of grossly inadequate child care (e.g., grave neglect, maltreatment, institutional deprivation). Even when an adequate primary caregiver is newly available, the child does not turn to the primary caregiver for comfort, support and nurture, rarely displays security-seeking behaviours towards any adult, and does not respond when comfort is offered. Transtorno de apego reativo can only be diagnosed in children, and features of the transtorno develop within the first 5 years of life. However, the transtorno cannot be diagnosed before the age of 1 year (or a developmental age of less than 9 months), when the capacity for selective attachments may not be fully developed, or in the context of Transtorno do espectro autista.

Developmental learning disorder

Transtorno de aprendizagem is characterised by significant and persistent difficulties in learning academic skills, which may include reading, writing, or arithmetic. The individual’s performance in the affected academic skill(s) is markedly below what would be expected for chronological age and general level of intellectual functioning, and results in significant impairment in the individual’s academic or occupational functioning. Transtorno de aprendizagem first manifests when academic skills are taught during the early school years. Transtorno de aprendizagem is not due to a transtorno of intellectual development, sensory impairment (vision or hearing), neurological or motor transtorno, lack of availability of education, lack of proficiency in the language of academic instruction, or psychosocial adversity.

Developmental learning disorder with impairment in mathematics

Transtorno de aprendizagem com impairment in mathematics is characterised by significant and persistent difficulties in learning academic skills related to mathematics or arithmetic, such as number sense, memorization of number facts, accurate calculation, fluent calculation, and accurate mathematic reasoning. The individual’s performance in mathematics or arithmetic is markedly below what would be expected for chronological or developmental age and level of intellectual functioning and results in significant impairment in the individual’s academic or occupational functioning. Transtorno de aprendizagem com impairment in mathematics is not due to a transtorno of intellectual development, sensory impairment (vision or hearing), a neurological transtorno, lack of availability of education, lack of proficiency in the language of academic instruction, or psychosocial adversity.

Developmental learning disorder with impairment in reading

Transtorno de aprendizagem com impairment in reading is characterised by significant and persistent difficulties in learning academic skills related to reading, such as word reading accuracy, reading fluency, and reading comprehension. The individual’s performance in reading is markedly below what would be expected for chronological age and level of intellectual functioning and results in significant impairment in the individual’s academic or occupational functioning. Transtorno de aprendizagem com impairment in reading is not due to a transtorno of intellectual development, sensory impairment (vision or hearing), neurological transtorno, lack of availability of education, lack of proficiency in the language of academic instruction, or psychosocial adversity.

Developmental learning disorder with impairment in written expression

Transtorno de aprendizagem com impairment in written expression is characterised by significant and persistent difficulties in learning academic skills related to writing, such as spelling accuracy, grammar and punctuation accuracy, and organisation and coherence of ideas in writing. The individual’s performance in written expression is markedly below what would be expected for chronological age and level of intellectual functioning and results in significant impairment in the individual’s academic or occupational functioning. Transtorno de aprendizagem com impairment in written expression is not due to a transtorno of intellectual development, sensory impairment (vision or hearing), a neurological or motor transtorno, lack of availability of education, lack of proficiency in the language of academic instruction, or psychosocial adversity.

Developmental learning disorder with other specified impairment of learning

Transtorno de aprendizagem com outro especificado impairment of learning is characterised by significant and persistent difficulties in learning academic skills other than reading, mathematics, and written expression. The individual’s performance in the relevant academic skill is markedly below what would be expected for chronological age and level of intellectual functioning and results in significant impairment in the individual’s academic or occupational functioning. Transtorno de aprendizagem com outro especificado impairment of learning is not due to a transtorno of intellectual development, sensory impairment (vision or hearing), neurological transtorno, lack of availability of education, lack of proficiency in the language of academic instruction, or psychosocial adversity.

Binge eating disorder

Transtorno de compulsão alimentar is characterised by frequent, recurrent episodes of binge eating (e.g. once a week or more over a period of several months). A binge eating episódio is a distinct period of time during which the individual experiences a subjective loss of control over eating, eating notably more or differently than usual, and feels unable to stop eating or limit the type or amount of food eaten. Binge eating is experienced as very distressing, and is often accompanied by negative emotions such as guilt or disgust. However, unlike in Bulimia nervosa, binge eating episodes are not regularly followed by inappropriate compensatory behaviours aimed at preventing weight gain (e.g. self-induced vomiting, misuse of laxatives or enemas, strenuous exercise). There is marked distress about the padrão of binge eating or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Attention deficit hyperactivity disorder

Transtorno de déficit de atenção e hiperatividade is characterised by a persistent padrão (at least 6 months) of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social functioning. There is evidence of significant inattention and/or hyperactivity-impulsivity symptoms prior to age 12, typically by early to mid-childhood, though some individuals may first come to clinical attention later. The degree of inattention and hyperactivity-impulsivity is outside the limits of normal variation expected for age and level of intellectual functioning. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems com organisation. Hyperactivity refers to excessive motor activity and difficulties com remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, sem deliberation or consideration of the risks and consequences. The relative balance and the specific manifestations of inattentive and hyperactive-impulsive characteristics varies across individuals and may change over the course of development. In order for a diagnosis to be made, manifestations of inattention and/or hyperactivity-impulsivity must be evident across multiple situations or settings (e.g., home, school, work, com friends or relatives), but are likely to vary according to the structure and demands of the setting. Symptoms are not better accounted for by another mental, behavioural, or neurodevelopmental transtorno and are not due to the effect of a substance or medication.

Attention deficit hyperactivity disorder, combined presentation

All definitional requirements for Transtorno de déficit de atenção e hiperatividade are met. Both inattentive and hyperactive-impulsive symptoms are clinically significant, com neither predominating in the clinical presentation. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems com organisation. Hyperactivity refers to excessive motor activity and difficulties com remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, sem deliberation or consideration of the risks and consequences.

Attention deficit hyperactivity disorder, predominantly hyperactive-impulsive presentation

All definitional requirements for Transtorno de déficit de atenção e hiperatividade are met and hyperactive-impulsive symptoms are predominant in the clinical presentation. Hyperactivity refers to excessive motor activity and difficulties com remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, sem deliberation or consideration of the risks and consequences. Some inattentive symptoms may also be present, but these are not clinically significant in relation to the hyperactive-impulsive symptoms.

Attention deficit hyperactivity disorder, predominantly inattentive presentation

All definitional requirements for Transtorno de déficit de atenção e hiperatividade are met and inattentive symptoms are predominant in the clinical presentation. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems com organisation. Some hyperactive-impulsive symptoms may also be present, but these are not clinically significant in relation to the inattentive symptoms.

Excoriation disorder

Transtorno de escoriação is characterised by recurrent picking of one’s own skin leading to skin lesions, accompanied by unsuccessful attempts to decrease or stop the behaviour. The most commonly picked sites are the face, arms and hands, but many individuals pick from multiple body sites. Skin picking may occur in brief episodes scattered throughout the day or in less frequent but more sustained periods. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Post traumatic stress disorder

Transtorno de estresse pós-traumático (PTSD) may develop following exposure to an extremely threatening or horrific event or series of events. It is characterised by all of the following: 1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares. Re-experiencing may occur via one or multiple sensory modalities and is typically accompanied by strong or overwhelming emotions, particularly fear or horror, and strong physical sensations; 2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event(s); and 3) persistent perceptions of heightened atual threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. The symptoms persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Gambling disorder

Transtorno de jogo patológico is characterised by a padrão of persistent or recurrent gambling behaviour, which may be online (i.e., over the internet) or offline, manifested by: 1. impaired control over gambling (e.g., onset, frequency, intensity, duration, termination, context); 2. increasing priority given to gambling to the extent that gambling takes precedence over other life interests and daily activities; and 3. continuation or escalation of gambling despite the occurrence of negative consequences. The padrão of gambling behaviour may be continuous or episodic and recurrent. The padrão of gambling behaviour results in significant distress or in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. The gambling behaviour and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are grave.

Gambling disorder, predominantly offline

!markdown Transtorno de jogo patológico, predominantly offline is characterised by a padrão of persistent or recurrent gambling behaviour that is not primarily conducted over the internet and is manifested by: 1. impaired control over gambling (e.g., onset, frequency, intensity, duration, termination, context); 2. increasing priority given to gambling to the extent that gambling takes precedence over other life interests and daily activities; and 3. continuation or escalation of gambling despite the occurrence of negative consequences. The behaviour padrão is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. The padrão of gambling behaviour may be continuous or episodic and recurrent. The gambling behaviour and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are grave.

Gambling disorder, predominantly online

!markdown Transtorno de jogo patológico, predominantly online is characterised by a padrão of persistent or recurrent gambling behaviour that is primarily conducted over the internet and is manifested by: 1. impaired control over gambling (e.g., onset, frequency, intensity, duration, termination, context); 2. increasing priority given to gambling to the extent that gambling takes precedence over other life interests and daily activities; and 3. continuation or escalation of gambling despite the occurrence of negative consequences. The behaviour padrão is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. The padrão of gambling behaviour may be continuous or episodic and recurrent. The gambling behaviour and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are grave.

Prolonged grief disorder

Transtorno de luto prolongado is a disturbance in which, following the death of a partner, parent, child, or other person close to the bereaved, there is persistent and pervasive grief response characterised by longing for the deceased or persistent preoccupation com the deceased accompanied by intense emotional pain (e.g. sadness, guilt, anger, denial, blame, difficulty accepting the death, feeling one has lost a part of one’s self, an inability to experience positive mood, emotional numbness, difficulty in engaging com social or other activities). The grief response has persisted for an atypically long period of time following the loss (more than 6 months at a minimum) and clearly exceeds expected social, cultural or religious norms for the individual’s culture and context. Grief reactions that have persisted for longer periods that are within a normative period of grieving given the person’s cultural and religious context are viewed as normal bereavement responses and are not assigned a diagnosis. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Stereotyped movement disorder

Transtorno de movimento estereotipado is characterised by the persistent (e.g., lasting several months) presence of voluntary, repetitive, stereotyped, apparently purposeless (and often rhythmic) movements that arise during the early developmental period, are not caused by the direct physiological effects of a substance or medication (including abstinência), and markedly interfere com normal activities or result in self-inflicted bodily injury. Stereotyped movements that are non-injurious can include body rocking, head rocking, finger-flicking mannerisms, and hand flapping. Stereotyped self-injurious behaviours can include repetitive head banging, face slapping, eye poking, and biting of the hands, lips, or other body parts.

Stereotyped movement disorder with self-injury

This category should be applied to forms of Transtorno de movimento estereotipado in which stereotyped behaviours result in self-inflicted bodily injury that is significant enough to require medical treatment, or would result in such injury if protective measures (e.g., helmet to prevent head injury) were not employed. Transtorno de movimento estereotipado com self-injury is characterised by voluntary, repetitive, stereotyped, apparently purposeless (and often rhythmic) movements that arise during the early developmental period, are not caused by the direct physiological effects of a substance or medication (including abstinência). Stereotyped movements that are self-injurious can include head banging, face slapping, eye poking, and biting of the hands, lips, or other body parts.

Stereotyped movement disorder without self-injury

This category should be applied to forms of Transtorno de movimento estereotipado in which stereotyped behaviours markedly interfere com normal activities, but do not result in self-inflicted bodily injury. Transtorno de movimento estereotipado sem self-injury is characterised by voluntary, repetitive, stereotyped, apparently purposeless (and often rhythmic) movements that arise during the early developmental period, are not caused by the direct physiological effects of a substance or medication (including abstinência), and markedly interfere com normal activities. Stereotyped movements that are non-injurious can include body rocking, head rocking, finger-flicking mannerisms, and hand flapping.

Panic disorder

Transtorno de pânico is characterised by recurrent unexpected panic attacks that are not restricted to particular stimuli or situations. Panic attacks are discrete episodes of intense fear or apprehension accompanied by the rapid and concurrent onset of several characteristic symptoms (e.g. palpitations or increased heart rate, sweating, trembling, shortness of breath, chest pain, dizziness or lightheadedness, chills, hot flushes, fear of imminent death). In addition, Transtorno de pânico is characterised by persistent concern about the recurrence or significance of panic attacks, or behaviours intended to avoid their recurrence, that results in significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. The symptoms are not a manifestation of another medical condition and are not due to the effects of a substance or medication on the central nervous system.

Personality disorder

Transtorno de personalidade is characterised by problems in functioning of aspects of the self (e.g., identity, self-worth, accuracy of self-view, self-direction), and/or interpersonal dysfunction (e.g., ability to develop and maintain close and mutually satisfying relationships, ability to understand others’ perspectives and to manage conflict in relationships) that have persisted over an extended period of time (e.g., 2 years or more). The disturbance is manifest in patterns of cognition, emotional experience, emotional expression, and behaviour that are maladaptive (e.g., inflexible or poorly regulated) and is manifest across a range of personal and social situations (i.e., is not limited to specific relationships or social roles). The patterns of behaviour characterizing the disturbance are not developmentally appropriate and cannot be explained primarily by social or cultural factors, including socio-political conflict. The disturbance is associated com substantial distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Olfactory reference disorder

Transtorno de referência olfativa is characterised by persistent preoccupation com the belief that one is emitting a perceived foul or offensive body odour or breath that is either unnoticeable or only slightly noticeable to others. Individuals experience excessive self-consciousness about the perceived odour, often com ideas of reference (i.e., the conviction that people are taking notice, judging, or talking about the odour). In response to their preoccupation, individuals engage in repetitive and excessive behaviours such as repeatedly checking for body odour or checking the perceived source of the smell, or repeatedly seeking reassurance, excessive attempts to camouflage, alter, or prevent the perceived odour, or marked avoidance of social situations or triggers that increase distress about the perceived foul or offensive odour. The symptoms are sufficiently grave to result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Olfactory reference disorder with fair to good insight

All definitional requirements of Transtorno de referência olfativa are met. Much of the time, the individual is able to entertain the possibility that his or her transtorno-specific beliefs may not be true and is willing to accept an alternative explanation for his or her experience. At circumscribed times (e.g., when highly anxious), the individual may demonstrate no insight.

Olfactory reference disorder with poor to absent insight

All definitional requirements of Transtorno de referência olfativa are met. Most or all of the time, the individual is convinced that the transtorno-specific beliefs are true and cannot accept an alternative explanation for their experience. The lack of insight exhibited by the individual does not vary markedly as a function of anxiety level.

Delusional disorder

Transtorno delirante is characterised by the development of a delusion or set of related delusions, typically persisting for at least 3 months and often much longer, in the absence of a Depressive, Manic, or Mixed mood episódio. The delusions are variable in content across individuals, but typically stable within individuals, although they may evolve over time. Other characteristic symptoms of Esquizofrenia (i.e. clear and persistent hallucinations, negative symptoms, disorganised thinking, or experiences of influence, passivity, or control) are not present, although various forms of perceptual disturbances (e.g. hallucinations, illusions, misidentifications of persons) thematically related to the delusion are still consistent com the diagnosis. Apart from actions and attitudes directly related to the delusion or delusional system, affect, speech, and behavior are typically unaffected. The symptoms are not a manifestation of another medical condition (e.g., a brain tumour) and are not due to the effect of a substance or medication on the central nervous system (e.g. corticosteroids), including abstinência effects (e.g. alcohol abstinência).

Delusional disorder, currently symptomatic

All definitional requirements for Transtorno delirante in terms of symptoms and duration are currently met, or have been met within the past one month.

Delusional disorder, in full remission

All definitional requirements for Transtorno delirante in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remissão may have occurred in response to medication or other treatment.

Delusional disorder, in partial remission

All definitional requirements for Transtorno delirante in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the transtorno have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated com functional impairment. The parcial remissão may have occurred in response to medication or other treatment.

Recurrent depressive disorder

Transtorno depressivo recorrente is characterised by a history of at least two depressive episodes separated by at least several months sem significant mood disturbance. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. There have never been any prior manic, hypomanic, or mixed episodes, which would indicate the presence of a Bipolar transtorno.

Recurrent depressive disorder, current episode severe, with psychotic symptoms

Transtorno depressivo recorrente, atual episódio grave, com psychotic symptoms is diagnosed when the definitional requirements for Transtorno depressivo recorrente are met and the atual episódio is grave and there are delusions or hallucinations during the episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a grave depressive episódio, many or most symptoms of a Depressive episódio are present to a marked degree, or a smaller number of symptoms are present and manifest to an intense degree. The individual has serious difficulty continuing to function in most domains (personal, family, social, educational, occupational, or other important domains). In a grave depressive episódio, many or most symptoms of a Depressive episódio are present to a marked degree, or a smaller number of symptoms are present and manifest to an intense degree. The individual has serious difficulty continuing to function in most domains (personal, family, social, educational, occupational, or other important domains).

Recurrent depressive disorder, current episode severe, without psychotic symptoms

Transtorno depressivo recorrente, atual episódio grave, sem psychotic symptoms is diagnosed when the definitional requirements for Transtorno depressivo recorrente are met and the atual episódio is grave and there are no delusions or hallucinations during the episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a grave depressive episódio, many or most symptoms of a Depressive episódio are present to a marked degree, or a smaller number of symptoms are present and manifest to an intense degree. The individual has serious difficulty continuing to function in most domains (personal, family, social, educational, occupational, or other important domains).

Recurrent depressive disorder, current episode mild

Transtorno depressivo recorrente, atual episódio leve is diagnosed when the definitional requirements for Transtorno depressivo recorrente have been met and there is currently a depressive episódio of leve severity. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a leve depressive episódio, the individual is usually distressed by the symptoms and has some difficulty in continuing to function in one or more domains (personal, family, social, educational, occupational, or other important domains). There are no delusions or hallucinations during the episódio.

Recurrent depressive disorder, current episode moderate, with psychotic symptoms

Transtorno depressivo recorrente, atual episódio moderado, com psychotic symptoms is diagnosed when the definitional requirements for Transtorno depressivo recorrente have been met and there is currently a depressive episódio of moderado severity, and there are delusions or hallucinations during the episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a moderado depressive episódio, several symptoms of a depressive episódio are present to a marked degree, or a large number of depressive symptoms of lesser severity are present overall. The individual typically has considerable difficulty functioning in multiple domains (personal, family, social, educational, occupational, or other important domains).

Recurrent depressive disorder, current episode moderate, without psychotic symptoms

Transtorno depressivo recorrente, atual episódio moderado, sem psychotic symptoms is diagnosed when the definitional requirements for Transtorno depressivo recorrente have been met and there is currently a depressive episódio of moderado severity, and there are no delusions or hallucinations during the episódio. A depressive episódio is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. In a moderado depressive episódio, several symptoms of a depressive episódio are present to a marked degree, or a large number of depressive symptoms of lesser severity are present overall. The individual typically has considerable difficulty functioning in multiple domains (personal, family, social, educational, occupational, or other important domains).

Recurrent depressive disorder, current episode, unspecified severity

Transtorno depressivo recorrente atual episódio, não especificado severity is diagnosed when the definitional requirements of a depressive episódio have been met and there is a history of prior depressive episodes, but there is insufficient information to determine the severity of the atual depressive episódio. A depressive episódio is characterised by a period of almost daily depressed mood or diminished interest in activities lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. The symptoms are associated com at least some difficulty in continuing com ordinary work, social, or domestic activities.

Recurrent depressive disorder, currently in full remission

Transtorno depressivo recorrente, currently in completa remissão is diagnosed when the definitional requirements for Transtorno depressivo recorrente have been met but currently there are no significant mood symptoms.

Recurrent depressive disorder, currently in partial remission

Transtorno depressivo recorrente, currently in parcial remissão, is diagnosed when the definitional requirements for Transtorno depressivo recorrente have been met; the completa definitional requirements for a depressive episódio are no longer met but some significant mood symptoms remain.

Body dysmorphic disorder

Transtorno dismórfico corporal is characterised by persistent preoccupation com one or more perceived defects or flaws in appearance that are either unnoticeable or only slightly noticeable to others. Individuals experience excessive self-consciousness, often com ideas of reference (i.e., the conviction that people are taking notice, judging, or talking about the perceived defect or flaw). In response to their preoccupation, individuals engage in repetitive and excessive behaviours that include repeated examination of the appearance or severity of the perceived defect or flaw, excessive attempts to camouflage or alter the perceived defect, or marked avoidance of social situations or triggers that increase distress about the perceived defect or flaw. The symptoms are sufficiently grave to result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Body dysmorphic disorder with fair to good insight

All definitional requirements of Transtorno dismórfico corporal are met. Much of the time, the individual is able to entertain the possibility that his or her transtorno-specific beliefs may not be true and is willing to accept an alternative explanation for his or her experience. At circumscribed times (e.g., when highly anxious), the individual may demonstrate no insight.

Body dysmorphic disorder with poor to absent insight

All definitional requirements of Transtorno dismórfico corporal are met. Most or all of the time, the individual is convinced that the transtorno-specific beliefs are true and cannot accept an alternative explanation for their experience. The lack of insight exhibited by the individual does not vary markedly as a function of anxiety level.

Dissociative identity disorder

Transtorno dissociativo de identidade is characterised by disruption of identity in which there are two or more distinct personality states (dissociative identities) associated com marked discontinuities in the sense of self and agency. Each personality state includes its own padrão of experiencing, perceiving, conceiving, and relating to self, the body, and the environment. At least two distinct personality states recurrently take executive control of the individual’s consciousness and functioning in interacting com others or com the environment, such as in the performance of specific aspects of daily life such as parenting, or work, or in response to specific situations (e.g., those that are perceived as threatening). Changes in personality state are accompanied by related alterations in sensation, perception, affect, cognition, memory, motor control, and behaviour. There are typically episodes of amnesia, which may be grave. The symptoms are not better explained by another mental, behavioural or neurodevelopmental transtorno and are not due to the direct effects of a substance or medication on the central nervous system, including abstinência effects, and are not due to a disease of the nervous system or a sleep-wake transtorno. The symptoms result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Autism spectrum disorder

Transtorno do espectro autista is characterised by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour, interests or activities that are clearly atypical or excessive for the individual’s age and sociocultural context. The onset of the transtorno occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently grave to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a completa range of intellectual functioning and language abilities.

Autism spectrum disorder with disorder of intellectual development and with absence of functional language

All definitional requirements for both Transtorno do espectro autista and transtorno of intellectual development are met and there is complete, or almost complete, absence of ability relative to the individual’s age to uso functional language (spoken or signed) for instrumental purposes, such as to express personal needs and desires

Autism spectrum disorder with disorder of intellectual development and with impaired functional language

All definitional requirements for both Transtorno do espectro autista and transtorno of intellectual development are met and there is marked impairment in functional language (spoken or signed) relative to the individual’s age, com the individual not able to uso more than single words or simple phrases for instrumental purposes, such as to express personal needs and desires.

Autism spectrum disorder with disorder of intellectual development and with mild or no impairment of functional language

All definitional requirements for both Transtorno do espectro autista and transtorno of intellectual development are met and there is only leve or no impairment in the individual's capacity to uso functional language (spoken or signed) for instrumental purposes, such as to express personal needs and desires.

Autism spectrum disorder without disorder of intellectual development and with impaired functional language

All definitional requirements for Transtorno do espectro autista are met, intellectual functioning and adaptive behaviour are found to be at least within the average range (approximately greater than the 2.3rd percentile), and there is marked impairment in functional language (spoken or signed) relative to the individual’s age, com the individual not able to uso more than single words or simple phrases for instrumental purposes, such as to express personal needs and desires.

Autism spectrum disorder without disorder of intellectual development and with mild or no impairment of functional language

All definitional requirements for Transtorno do espectro autista are met, intellectual functioning and adaptive behaviour are found to be at least within the average range (approximately greater than the 2.3rd percentile), and there is only leve or no impairment in the individual's capacity to uso functional language (spoken or signed) for instrumental purposes, such as to express personal needs and desires.

Schizoaffective disorder

Transtorno esquizoafetivo is an episodic transtorno in which the diagnostic requirements of Esquizofrenia and a manic, mixed, or moderado or grave depressive episódio are met within the same episódio of illness, either simultaneously or within a few days of each other. Prominent symptoms of Esquizofrenia (e.g. delusions, hallucinations, disorganisation in the form of thought, experiences of influence, passivity and control) are accompanied by typical symptoms of a moderado or grave depressive episódio (e.g. depressed mood, loss of interest, reduced energy), a manic episódio (e.g. an extreme mood state characterised by euphoria, irritability, or expansiveness; increased activity or a subjective experience of increased energy) or a mixed episódio. Psychomotor disturbances, including Catatonia, may be present. Symptoms must have persisted for at least one month. The symptoms are not a manifestation of another medical condition (e.g. a brain tumor) and are not due to the effect of a substance or medication on the central nervous system (e.g. corticosteroids), including abstinência (e.g. alcohol abstinência).

Schizoaffective disorder, continuous

Symptoms fulfilling all definitional requirements of Transtorno esquizoafetivo have been present for almost all of the illness course over a period of at least one year, com periods of subthreshold symptoms being very brief relative to the overall course.

Schizoaffective disorder, continuous, currently symptomatic

All definitional requirements for Transtorno esquizoafetivo, continuous in terms of symptoms and duration are currently met, or have been met within the past one month.

Schizoaffective disorder, continuous, in full remission

All definitional requirements for Transtorno esquizoafetivo, continuous in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remissão may have occurred in response to medication or other treatment.

Schizoaffective disorder, continuous, in partial remission

All definitional requirements for Transtorno esquizoafetivo, continuous in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the transtorno have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated com functional impairment. The parcial remissão may have occurred in response to medication or other treatment.

Schizoaffective disorder, first episode

Transtorno esquizoafetivo, first episódio should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Transtorno esquizoafetivo (including duration) but who have never before experienced an episódio during which diagnostic requirements for Transtorno esquizoafetivo or Esquizofrenia were met.

Schizoaffective disorder, first episode, currently symptomatic

All definitional requirements for Transtorno esquizoafetivo, first episódio in terms of symptoms and duration are currently met, or have been met within the past one month.

Schizoaffective disorder, first episode, in full remission

All definitional requirements for Transtorno esquizoafetivo, first episódio in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remissão may have occurred in response to medication or other treatment.

Schizoaffective disorder, first episode, in partial remission

All definitional requirements for Transtorno esquizoafetivo, first episódio in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the transtorno have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated com functional impairment. The parcial remissão may have occurred in response to medication or other treatment.

Schizoaffective disorder, multiple episodes

Transtorno esquizoafetivo, multiple episodes should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Transtorno esquizoafetivo and who have also previously experienced episodes during which diagnostic requirements for Transtorno esquizoafetivo or Esquizofrenia were met, com substantial remissão of symptoms between episodes. Some attenuated symptoms may remain during period of remissão, and remissions may have occurred in response to medication or other treatment.

Schizoaffective disorder, multiple episodes, currently symptomatic

All definitional requirements for Transtorno esquizoafetivo, multiple episodes in terms of symptoms and duration are currently met, or have been met within the past one month.

Schizoaffective disorder, multiple episodes, in full remission

All definitional requirements for Transtorno esquizoafetivo, multiple episodes in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remissão may have occurred in response to medication or other treatment.

Schizoaffective disorder, multiple episodes, in partial remission

All definitional requirements for Transtorno esquizoafetivo, multiple episodes in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the transtorno have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated com functional impairment. The parcial remissão may have occurred in response to medication or other treatment.

Schizotypal disorder

Transtorno esquizotípico is characterised by an enduring padrão (i.e. characteristic of the person’s functioning over a period of at least several years) of eccentricities in behaviour, appearance and speech, accompanied by cognitive and perceptual distortions, unusual beliefs, and discomfort com— and often reduced capacity for— interpersonal relationships. Symptoms may include constricted or inappropriate affect and anhedonia. Paranoid ideas, ideas of reference, or other psychotic symptoms, including hallucinations in any modality, may occur, but are not of sufficient intensity or duration to meet the diagnostic requirements of Esquizofrenia, Transtorno esquizoafetivo, or Transtorno delirante. The symptoms cause distress or impairment in personal, family, social, educational, occupational or other important areas of functioning.

Mixed depressive and anxiety disorder

Transtorno misto de ansiedade e depressão is characterised by symptoms of both anxiety and depression more days than not for a period of two weeks or more. Depressive symptoms include depressed mood or markedly diminished interest or pleasure in activities. There are multiple anxiety symptoms, which may include feeling nervous, anxious, or on edge, not being able to control worrying thoughts, fear that something awful will happen, having trouble relaxing, muscle tension, or sympathetic autonomic symptoms. Neither set of symptoms, considered separately, is sufficiently grave, numerous, or persistent to justify a diagnosis of another depressive transtorno or an anxiety or fear-related transtorno. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning. There is no history of manic or mixed episodes, which would indicate the presence of a bipolar transtorno.

Obsessive-compulsive disorder

Transtorno obsessivo-compulsivo is characterised by the presence of persistent obsessions or compulsions, or most commonly both. Obsessions are repetitive and persistent thoughts, images, or impulses/urges that are intrusive, unwanted, and are commonly associated com anxiety. The individual attempts to ignore or suppress obsessions or to neutralize them by performing compulsions. Compulsions are repetitive behaviours including repetitive mental acts that the individual feels driven to perform in response to an obsession, according to rigid rules, or to achieve a sense of ‘completeness’. In order for Transtorno obsessivo-compulsivo to be diagnosed, obsessions and compulsions must be time consuming (e.g. taking more than an hour per day) or result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.

Obsessive-compulsive disorder with fair to good insight

All definitional requirements of Transtorno obsessivo-compulsivo are met. Much of the time, the individual is able to entertain the possibility that his or her transtorno-specific beliefs may not be true and is willing to accept an alternative explanation for his or her experience. At circumscribed times (e.g., when highly anxious), the individual may demonstrate no insight.

Obsessive-compulsive disorder with poor to absent insight

All definitional requirements of Transtorno obsessivo-compulsivo are met. Most or all of the time, the individual is convinced that the transtorno-specific beliefs are true and cannot accept an alternative explanation for their experience. The lack of insight exhibited by the individual does not vary markedly as a function of anxiety level.

Disorder of intellectual development, severe

A grave transtorno of intellectual development is a condition originating during the developmental period characterised by significantly below average intellectual functioning and adaptive behaviour that are approximately four or more standard deviations below the mean (less than approximately the 0.003rd percentile), based on appropriately normed, individually administered standardized tests or by comparable behavioural indicators when standardized testing is unavailable. Affected persons exhibit very limited language and capacity for acquisition of academic skills. They may also have motor impairments and typically require daily support in a supervised environment for adequate care, but may acquire basic self-care skills com intensive training. grave and profound Transtornos do desenvolvimento intelectual are differentiated exclusively on the basis of adaptive behaviour differences because existing standardized tests of intelligence cannot reliably or validly distinguish among individuals com intellectual functioning below the 0.003rd percentile.

Disorder of intellectual development, mild

A leve transtorno of intellectual development is a condition originating during the developmental period characterised by significantly below average intellectual functioning and adaptive behaviour that are approximately two to three standard deviations below the mean (approximately 0.1 – 2.3 percentile), based on appropriately normed, individually administered standardized tests or by comparable behavioural indicators when standardized testing is unavailable. Affected persons often exhibit difficulties in the acquisition and comprehension of complex language concepts and academic skills. Most master basic self-care, domestic, and practical activities. Persons affected by a leve transtorno of intellectual development can generally achieve relatively independent living and employment as adults but may require appropriate support.

Disorder of intellectual development, moderate

A moderado transtorno of intellectual development is a condition originating during the developmental period characterised by significantly below average intellectual functioning and adaptive behaviour that are approximately three to four standard deviations below the mean (approximately 0.003 – 0.1 percentile), based on appropriately normed, individually administered standardized tests or by comparable behavioural indicators when standardized testing is unavailable. Language and capacity for acquisition of academic skills of persons affected by a moderado transtorno of intellectual development vary but are generally limited to basic skills. Some may master basic self-care, domestic, and practical activities. Most affected persons require considerable and consistent support in order to achieve independent living and employment as adults.

Disorder of intellectual development, profound

A profound transtorno of intellectual development is a condition originating during the developmental period characterised by significantly below average intellectual functioning and adaptive behaviour that are approximately four or more standard deviations below the mean (approximately less than the 0.003rd percentile), based on individually administered appropriately normed, standardized tests or by comparable behavioural indicators when standardized testing is unavailable. Affected persons possess very limited communication abilities and capacity for acquisition of academic skills is restricted to basic concrete skills. They may also have co-occurring motor and sensory impairments and typically require daily support in a supervised environment for adequate care. grave and profound Transtornos do desenvolvimento intelectual are differentiated exclusively on the basis of adaptive behaviour differences because existing standardized tests of intelligence cannot reliably or validly distinguish among individuals com intellectual functioning below the 0.003rd percentile.

Disorder of intellectual development, provisional

transtorno of intellectual development, provisional is assigned when there is evidence of a transtorno of intellectual development but the individual is an infant or child under the age of four or it is not possible to conduct a valid assessment of intellectual functioning and adaptive behaviour because of sensory or physical impairments (e.g., blindness, pre-lingual deafness), motor or communication impairments, grave problem behaviours or co-occurring mental and behavioural transtornos.

Gaming disorder

Transtorno por jogos eletrônicos is characterised by a padrão of persistent or recurrent gaming behaviour (‘digital gaming’ or ‘video-gaming’), which may be online (i.e., over the internet) or offline, manifested by: 1. impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context); 2. increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; and 3. continuation or escalation of gaming despite the occurrence of negative consequences. The padrão of gaming behaviour may be continuous or episodic and recurrent. The padrão of gaming behaviour results in marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. The gaming behaviour and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are grave.

Gaming disorder, predominantly offline

!markdown Transtorno por jogos eletrônicos, predominantly offline is characterised by a padrão of persistent or recurrent gaming behaviour (‘digital gaming’ or ‘video-gaming’) that is not primarily conducted over the internet and is manifested by: 1. impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context); 2. increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; and 3. continuation or escalation of gaming despite the occurrence of negative consequences. The behaviour padrão is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. The padrão of gaming behaviour may be continuous or episodic and recurrent. The gaming behaviour and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are grave.

Gaming disorder, predominantly online

!markdown Transtorno por jogos eletrônicos, predominantly online is characterised by a padrão of persistent or recurrent gaming behaviour (‘digital gaming’ or ‘video-gaming’) that is primarily conducted over the internet and is manifested by: 1. impaired control over gaming (e.g., onset, frequency, intensity, duration, termination, context); 2. increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities; and 3. continuation or escalation of gaming despite the occurrence of negative consequences. The behaviour padrão is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. The padrão of gaming behaviour may be continuous or episodic and recurrent. The gaming behaviour and other features are normally evident over a period of at least 12 months in order for a diagnosis to be assigned, although the required duration may be shortened if all diagnostic requirements are met and symptoms are grave.

Acute and transient psychotic disorder

Transtorno psicótico agudo e transitório is characterised by acute onset of psychotic symptoms that emerge sem a prodrome and reach their maximal severity within two weeks. Symptoms may include delusions, hallucinations, disorganisation of thought processes, perplexity or confusion, and disturbances of affect and mood. Catatonia-like psychomotor disturbances may be present. Symptoms typically change rapidly, both in nature and intensity, from day to day, or even within a single day. The duration of the episódio does not exceed 3 months, and most commonly lasts from a few days to 1 month. The symptoms are not a manifestation of another medical condition (e.g. a brain tumour) and are not due to the effect of a substance or medication on the central nervous system (e.g. corticosteroids), including abstinência (e.g. alcohol abstinência).

Acute and transient psychotic disorder, first episode

Transtorno psicótico agudo e transitório, first episódio should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Transtorno psicótico agudo e transitório but who have never before experienced a similar episódio.

Acute and transient psychotic disorder, first episode, currently symptomatic

All definitional requirements for Transtorno psicótico agudo e transitório, first episódio in terms of symptoms and duration are currently met, or have been met within the past one month.

Acute and transient psychotic disorder, first episode, in full remission

All definitional requirements for Transtorno psicótico agudo e transitório, first episódio in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remissão may have occurred in response to medication or other treatment.

Acute and transient psychotic disorder, first episode, in partial remission

All definitional requirements for Transtorno psicótico agudo e transitório, first episódio in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the transtorno have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated com functional impairment. The parcial remissão may have occurred in response to medication or other treatment.

Acute and transient psychotic disorder, multiple episodes

Transtorno psicótico agudo e transitório, multiple episodes should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Transtorno psicótico agudo e transitório and who have experienced similar episodes in the past.

Acute and transient psychotic disorder, multiple episodes, currently symptomatic

All definitional requirements for Transtorno psicótico agudo e transitório, multiple episodes in terms of symptoms and duration are currently met, or have been met within the past one month.

Acute and transient psychotic disorder, multiple episodes, in full remission

All definitional requirements for Transtorno psicótico agudo e transitório, multiple episodes in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remissão may have occurred in response to medication or other treatment.

Acute and transient psychotic disorder, multiple episodes, in partial remission

All definitional requirements for Transtorno psicótico agudo e transitório, multiple episodes in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the transtorno have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated com functional impairment. The parcial remissão may have occurred in response to medication or other treatment.

Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, with psychotic symptoms

A syndrome associated com pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioural features, including delusions, hallucinations, or other psychotic symptoms. Mood symptoms (depressive and/or manic) are also typically present. If the symptoms meet the diagnostic requirements for a specific mental transtorno, that diagnosis should also be assigned.

Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, without psychotic symptoms

A syndrome associated com pregnancy or the puerperium (commencing within about 6 weeks after delivery) that involves significant mental and behavioural features, most commonly depressive symptoms. The syndrome does not include delusions, hallucinations, or other psychotic symptoms. If the symptoms meet the diagnostic requirements for a specific mental transtorno, that diagnosis should also be assigned. This designation should not be used to describe leve and transient depressive symptoms that do not meet the diagnostic requirements for a depressive episódio, which may occur soon after delivery (so-called postpartum blues).

Developmental speech or language disorders

Transtornos do desenvolvimento da fala ou linguagem arise during the developmental period and are characterised by difficulties in understanding or producing speech and language or in using language in context for the purposes of communication that are outside the limits of normal variation expected for age and level of intellectual functioning. The observed speech and language problems are not attributable to regional, social, or cultural/ethnic language variations and are not fully explained by anatomical or neurological abnormalities. The presumptive aetiology for Transtornos do desenvolvimento da fala ou linguagem is complex, and in many individual cases, is unknown.

Disorders of intellectual development

Transtornos do desenvolvimento intelectual are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning and adaptive behaviour that are approximately two or more standard deviations below the mean (approximately less than the 2.3rd percentile), based on appropriately normed, individually administered standardized tests. Where appropriately normed and standardized tests are not available, diagnosis of Transtornos do desenvolvimento intelectual requires greater reliance on clinical judgment based on appropriate assessment of comparable behavioural indicators.

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Disorders due to use of caffeine

transtornos due to uso of caffeine are characterised by the padrão and consequences of caffeine uso. Caffeine is a leve psychostimulant and diuretic that is found in the beans of the coffee plant (Coffea species) and is a constituent of coffee, cola drinks, chocolate, a range of proprietary 'energy drinks' and weight-loss aids. It is the most commonly used psychoactive substance worldwide and several clinical conditions related to its uso are described, although grave transtornos are comparatively rare considering its ubiquity. Caffeine intoxicação related to consumption of relatively higher doses (i.e., > 1 g per day) is described. Caffeine abstinência is common upon cessation of uso among individuals who have used caffeine for a prolonged period or in large amounts. Caffeine-Induced Anxiety transtorno has been described, often following intoxicação or heavy uso.

Disorders due to use of dissociative drugs including ketamine and phencyclidine [PCP]

transtornos due to uso of dissociative drugs including ketamine and phencyclidine [PCP] are characterised by the padrão and consequences of dissociative drug uso. Dissociative drugs include ketamine and phencyclidine (PCP) and their (comparatively rare) chemical analogues. Ketamine is an intravenous anaesthetic widely used in low- and middle-income countries, particularly in Africa, and in emergency situations. Ketamine is also undergoing evaluation for treatment of some mental transtornos (e.g., treatment resistant Depressive transtornos). It is also a widespread drug of nonmedical uso in many countries and may be taken by the oral or nasal routes or injected. It produces a sense of euphoria but depending on the dose, emergent hallucinations and dissociation are recognised as unpleasant side effects. Phencyclidine has a more restricted worldwide distribution and also has euphoric and dissociative effects. Its uso may result in bizarre behaviour uncharacteristic for the individual, including self-harm. Dissociative Drug dependência is described but a abstinência syndrome is not recognized by most authorities. Several Dissociative Drug-Induced Mental transtornos are recognised.

Disorders due to use of hallucinogens

transtornos due to uso of hallucinogens are characterised by the padrão and consequences of hallucinogen uso. Several thousand compounds have hallucinogenic properties, many of which are found in plants (e.g., mescaline) and fungi (e.g., psilocybin) or are chemically synthesized (e.g., lysergic acid diethylamide [LSD]). These compounds have primarily hallucinogenic properties, but some may also be stimulants. Much of the morbidity associated com these compounds arises from the acute effects related to Hallucinogen intoxicação. Hallucinogen dependência is rare and Hallucinogen abstinência is not described. Among the mental transtornos related to hallucinogen uso, Hallucinogen-Induced Psychotic transtorno is the most frequently seen, although worldwide it is still fairly uncommon.

Disorders due to use of MDMA or related drugs, including MDA

transtornos due to uso of MDMA or related drugs, including MDA are characterised by the padrão and consequences of MDMA or related drug uso. MDMA is methylene-dioxymethamphetamine and is a common drug of abuse in many countries especially among young people. It is predominantly available in tablet form known as ‘ecstasy’. Pharmacologically, MDMA has stimulant and empathogenic properties and these encourage its uso among young people for social and other interactions. Considering its wide prevalence in many countries and among many sub-groups of young people, MDMA and Related Drug dependência and MDMA and Related Drug abstinência are comparatively uncommon. Substance-Induced Mental transtornos may arise from its uso. Several analogues of MDMA exist, including MDA (methylene-dioxyamphetamine).

Disorders due to use of multiple specified psychoactive substances, including medications

transtornos due to uso of multiple specified psychoactive substances, including medications are characterised by the padrão and consequences of multiple psychoactive substances. Although this grouping is provided for coding purposes, in most clinical situations it is recommended that multiple specific transtornos due to substance uso be assigned rather than using categories from this grouping.

Disorders due to use of non-psychoactive substances

transtornos due to uso of non-psychoactive substances are characterised by the padrão and consequences of non-medical uso of non-psychoactive substances. Non-psychoactive substances include laxatives, anabolic steroids, growth hormone, erythropoietin, and non-steroidal anti-inflammatory drugs. They may also include proprietary or over-the-counter medicines and folk remedies. Non-medical uso of these substances may be associated com harm to the individual due to the direct or secondary toxic effects of the non-psychoactive substance on body organs and systems, or a nocivo route of administration (e.g., infections due to intravenous self-administration). They are not associated com intoxicação or com a dependência or abstinência syndrome and are not recognized causes of substance-induced mental transtornos.

Disorders due to use of other specified psychoactive substances, including medications

transtornos due to uso of outro especificado psychoactive substances, including medications are characterised by the padrão and consequences of psychoactive substances that are not included among the major substance classes specifically identified. Examples include khat, antidepressants, medications com anticholinergic properties (e.g., benztropine), and some antihistamines.

Disorders due to use of sedatives, hypnotics or anxiolytics

transtornos due to uso of sedatives, hypnotics or anxiolytics are characterised by the padrão and consequences of uso of these substances. Sedatives, hypnotics, and anxiolytics are typically prescribed for the short-term treatment of anxiety or insomnia and are also employed to provide sedation for medical procedures. They include the benzodiazepines and the non-benzodiazepine positive allosteric modulators of GABA receptors (i.e., ‘Z-drugs’) as well as many other compounds. Sedatives, hypnotics, and anxiolytics include barbiturates, which are available much less commonly now than in previous decades. Sedatives, hypnotics, and anxiolytics have dependência-inducing properties that are related to the dose and duration of their uso. They may cause intoxicação, dependência and abstinência. Several other mental transtornos induced by sedatives, hypnotics, or anxiolytics are recognized.

Disorders due to use of stimulants including amphetamines, methamphetamine or methcathinone

transtornos due to uso of stimulants including amphetamines, methamphetamine or methcathinone are characterised by the padrão and consequences of uso of these substances. There is a wide array of naturally occurring and synthetically produced psychostimulants other than cocaine. The most numerous of this group are the amphetamine-type substances, including methamphetamine. Prescribed stimulants including dexamphetamine are indicated for a limited number of conditions such as for Transtorno de déficit de atenção e hiperatividade. Methcathinone, known in many countries as ephedrone, is a synthetic potent stimulant that is a structural analogue of methamphetamine and is related to cathinone. All these drugs have primarily psychostimulant properties and are also vasoconstrictors to a varying degree. They induce euphoria and hyperactivity as may be seen in Stimulant intoxicação. They have potent dependência-producing properties, which may lead to the diagnosis of Stimulant dependência and Stimulant abstinência following the cessation of uso. Several Stimulant-Induced Mental transtornos are described.

Disorders due to use of synthetic cannabinoids

transtornos due to uso of synthetic cannabinoids are characterised by the padrão and consequences of synthetic cannabinoid uso. Synthetic cannabinoids are synthesized diverse chemical compounds that are potent agonists for endogenous cannabinoid receptors. There are several hundred such compounds. The synthetic compound is typically sprayed onto a vehicle such as cannabis or tea leaves and then smoked. The effect of these compounds is distinctly different from smoking naturally cultivated cannabis in that the euphoric effects are typically accompanied or dominated by psychotic-like symptoms (e.g., paranoia, hallucinations, and disorganized behavior). Synthetic Cannabinoid intoxicação may therefore present more frequently com psychotic symptoms in addition to the more typical effects of cannabis. Synthetic cannabinoids are also dependência-producing and Synthetic Cannabinoid dependência and Synthetic Cannabinoid abstinência are recognized. Synthetic Cannabinoid-Induced Mental transtornos also occur; in particular Synthetic Cannabinoid-Induced Psychotic transtorno is recognized.

Disorders due to use of synthetic cathinones

transtornos due to uso of synthetic cathinones are characterised by the padrão and consequences of synthetic cathinone uso. Synthetic cathinones (also known as ‘bath salts’) are synthetic compounds com stimulant properties related to cathinone found in the khat plant, Catha edulis. The uso of synthetic cathinones is common in young populations in many countries. They may produce a range of transtornos including Synthetic Cathinone intoxicação, Synthetic Cathinone dependência and Synthetic Cathinone abstinência. Several synthetic cathinone-induced mental transtornos are recognised.

Disorders due to use of unknown or unspecified psychoactive substances

transtornos due to uso of unknown or não especificado psychoactive substances are characterised by the padrão and consequences of psychoactive substance uso when the specific substance is unknown or não especificado. These categories may be used in clinical situations in which it is clear that the disturbance is due to substance uso but the specific class of substance is unknown. Once the relevant substance is identified, the disturbance should be recoded under the appropriate substance class.

Disorders due to use of volatile inhalants

transtornos due to uso of volatile inhalants are characterised by the padrão and consequences of volatile inhalant uso. Volatile inhalants include a range of compounds that are in the gaseous or vapour phase at ambient temperatures and include various organic solvents, glues, gasoline (petrol), nitrites and gases such as nitrous oxide, trichloroethane, butane, toluene, fluorocarbons, ether and halothane. They have a range of pharmacological properties but are predominantly central nervous system depressants, com many also having vasoactive effects. They tend to be used by younger persons and may be used when access to alternative psychoactive substances is difficult or impossible. Volatile Inhalant intoxicação is well recognized. Volatile inhalants have dependência-producing properties and Volatile Inhalant dependência and Volatile Inhalant abstinência is recognized although comparatively uncommon worldwide. Volatile Inhalant-Induced Mental transtornos are described. They may also cause neurocognitive impairment, including Demência.

Mental, behavioural or neurodevelopmental disorders

Mental, behavioural and Transtornos do neurodesenvolvimento are syndromes characterised by clinically significant disturbance in an individual's cognition, emotional regulation, or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes that underlie mental and behavioural functioning. These disturbances are usually associated com distress or impairment in personal, family, social, educational, occupational, or other important areas of functioning.

Disorders due to use of alcohol

Transtornos por uso de álcool are characterised by the padrão and consequences of alcohol uso. Alcohol—more specifically termed ethyl alcohol or ethanol—is an intoxicating compound produced by fermentation of sugars usually in agricultural products such as fruits, cereals, and vegetables com or sem subsequent distillation. There are a wide variety of alcoholic drinks, com alcohol concentrations typically ranging from 1.5% to 60%. Alcohol is predominantly a central nervous system depressant. In addition to ability to produce Alcohol intoxicação, alcohol has dependência-producing properties, resulting in Alcohol dependência in some people and Alcohol abstinência when alcohol uso is reduced or discontinued. Unlike most other substances, elimination of alcohol from the body occurs at a constant rate, such that its clearance follows a linear rather than a logarithmic course. Alcohol is implicated in a wide range of harms affecting most organs and systems of the body (e.g., cirrhosis of the liver, gastrointestinal cancers, pancreatitis). Harm to others resulting from behaviour during Alcohol intoxicação is well recognized and is included in the definitions of nocivo uso of alcohol (i.e., episódio of nocivo uso of Alcohol and nocivo padrão of uso of Alcohol). Several alcohol-induced mental transtornos (e.g., Alcohol-Induced Psychotic transtorno) and alcohol-related forms of neurocognitive impairment (e.g., Demência Due to uso of Alcohol) are recognized.

Disorders due to use of cannabis

Transtornos por uso de cannabis are characterised by the padrão and consequences of cannabis uso. Cannabis is the collective term for a range of psychoactive preparations of the cannabis plant, Cannabis sativa, and related species and hybrids. Cannabis contains cannabinoids, a class of diverse chemical compounds that act on endogenous cannabinoid receptors that modulate neurotransmitter release in the brain. The principal psychoactive cannabinoid is δ-9-tetrahydrocannabinol (THC). Cannabis is typically smoked in the form of the flowering heads or leaves of the marijuana plant; tobacco is often mixed com cannabis when smoked. There are also cannabis oils that are prepared from these same sources. These preparations vary considerably in their THC potency. Cannabis has predominantly central nervous system depressant effects and produces a characteristic euphoria that may be part of the presenting features of Cannabis intoxicação, which may also include impairment in cognitive and psychomotor functioning. Cannabis has dependência-producing properties resulting in Cannabis dependência in some people and Cannabis abstinência when uso is reduced or discontinued. Cannabis is associated com a range of Cannabis-Induced Mental transtornos.

Disorders due to use of cocaine

Transtornos por uso de cocaína are characterised by the padrão and consequences of cocaine uso. Cocaine is a compound found in the leaves of the coca plant, Erythroxylum coca, which is indigenous to countries in northern regions of South America. Cocaine has a limited place in medical treatment as an anaesthetic and vasoconstrictive agent. It is commonly used illicitly and widely available across the world, where it is found in two main forms: cocaine hydrochloride and cocaine freebase (also known as ‘crack’). Cocaine is a central nervous system stimulant, and Cocaine intoxicação typically includes a state of euphoria and hyperactivity. Cocaine has potent dependência-producing properties and Cocaine dependência is a common cause of morbidity and of clinical presentations. Cocaine abstinência has a characteristic course that includes lethargy and depressed mood. A range of Cocaine-Induced Mental transtornos is described.

Disorders due to use of nicotine

Transtornos por uso de nicotina are characterised by the padrão and consequences of nicotine uso. Nicotine is the active dependência-producing constituent of the tobacco plant, Nicotiana tabacum. Nicotine is used overwhelmingly through smoking cigarettes. Increasingly, it is also used in electronic cigarettes that vaporize nicotine dissolved in a carrier solvent for inhalation (i.e., “vaping”). Pipe smoking, chewing tobacco and inhaling snuff are minor forms of uso. Nicotine is a highly potent addictive compound and is the third most common psychoactive substance used worldwide after caffeine and alcohol. Nicotine dependência and Nicotine abstinência are well described and Nicotine-Induced Mental transtornos are recognized.

Disorders due to use of opioids

Transtornos por uso de opioides are characterised by the padrão and consequences of opioid uso. Opioids is a generic term that encompasses the constituents or derivatives of the opium poppy Papaver somniferum as well as a range of synthetic and semisynthetic compounds, some related to morphine and others chemically distinct but all having their primary actions on the µ opioid receptor. Examples of opioids include morphine, diacetylmorphine (heroin), fentanyl, pethidine, oxycodone, hydromorphone, methadone, buprenorphine, codeine and d-propoxyphene. The opioids all have analgesic properties of different potencies and are primarily central nervous system depressants. They suppress respiration as well as other vital functions and are a common cause of overdose and related deaths. Certain opioids are used or administered parenterally, including heroin, a common and potent opioid that is primarily used non-medically. Therapeutic opioids are prescribed for a range of indications worldwide, and are essential for pain management in cancer pain and palliative care, although they are also used for non-therapeutic reasons. In some countries morbidity and mortality related to therapeutic opioids is greater than that related to heroin. All opioids may result in Opioid intoxicação, Opioid dependência and Opioid abstinência. A range of Opioid-Induced transtornos occur, some of which occur following Opioid abstinência.

Trichotillomania

Tricotilomania is characterised by recurrent pulling of one’s own hair leading to significant hair loss, accompanied by unsuccessful attempts to decrease or stop the behaviour. Hair pulling may occur from any region of the body in which hair grows but the most common sites are the scalp, eyebrows, and eyelids. Hair pulling may occur in brief episodes scattered throughout the day or in less frequent but more sustained periods. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning.