第五章　精神[心智]與行為疾患

Transcription

1 行 (F00-F99) Chapter V Mental and behavioural disorders (F00-F99) 理 ( ) 狀 臨 異 類 (R00-R99) Includes:disorders of psychological development Excludes: symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) 列 ( ) This chapter contains the following blocks: F00-F09 ( 狀 ) 精神 [ ] ( ) F00-F09 Organic, including symptomatic, mental disorders F10-F19 精神 精神 [ ] 行 ( ) F10-F19 Mental and behavioural disorders due to psychoactive substance use F20-F29 精神 裂 ( ) 精神 裂 ( ) ( ) F20-F29 Schizophrenia, schizotypal and delusional disorders F30-F39 [ ( )] ( ) F30-F39 Mood [affective] disorders F40-F48 精神 力 ( ) F40-F48 Neurotic, stress-related and somatoform disorders F50-F59 ( ) 理 ( 亂 ) 行 F50-F59 Behavioural syndromes associated with physiological disturbances and physical factors F60-F69 行 ( ) F60-F69 Disorders of adult personality and behaviour F70-F79 不 F70-F79 Mental retardation F80-F89 理 ( ) F80-F89 Disorders of psychological development F90-F98 ( ) 年 行 ( ) F90-F98 Behavioural and emotional disorders with onset usually occurring in childhood and adolescence F99 精神 [ ] ( ) F99 Unspecified mental disorder 311

2 類 Asterisk categories for this chapter are provided as follows: F00* ( ) ( ) ( ) F02* 類 ( ) ( ) F00* Dementia in Alzheimer's disease F02* Dementia in other diseases classified elsewhere ( 狀 ) ( ) (F00-F09) 精神 ( ) 不良 ( ) 不良 ( ) ( ) ( ) (F00-F03) ( ) 行 ( ) ( 亂 ) ( ) 理 力 力 力 識狀 ( 不 ) ( ) 行 更 ( ) ( ) Organic, including symptomatic, mental disorders (F00-F09) This block comprises a range of mental disorders grouped together on the basis of their having in common a demonstrable etiology in cerebral disease, brain injury, or other insult leading to cerebral dysfunction. The dysfunction may be primary, as in diseases, injuries, and insults that affect the brain directly and selectively; or secondary, as in systemic diseases and disorders that attack the brain only as one of the multiple organs or systems of the body that are involved. Dementia (F00-F03) is a syndrome due to disease of the brain, usually of a chronic or progressive nature, in which there is disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not clouded. The impairments of cognitive function are commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behaviour, or motivation. This syndrome occurs in Alzheimer s disease, in cerebrovascular disease, and in other conditions primarily or secondarily affecting the brain. Use additional code, if desired, to identify the underlying disease. 312

3 F00* ( ) ( ) ( ) (G30.- ) ( ) 不 ( ) 神 理 神 不 不 數年 行 F00* Dementia in Alzheimer s disease (G30.- ) Alzheimer s disease is a primary degenerative cerebral disease of unknown etiology with characteristic neuropathological and neurochemical features. The disorder is usually insidious in onset and develops slowly but steadily over a period of several years. F00.0* ( ) ( ) ( ) (G30.0 ) ( ) ( ) ( ) 65 惡 ( ) ( ) ( ) F00.0* Dementia in Alzheimer s disease with early onset (G30.0 ) Dementia in Alzheimer s disease with onset before the age of 65, with a relatively rapid deteriorating course and with marked multiple disorders of the higher cortical functions. ( ) Alzheimer s disease, type 2 老 ( ) ( ) ( ) ( ) 老 Presenile dementia, Alzheimer s type Primary degenerative dementia of the Alzheimer s type, presenile onset F00.1* ( ) ( ) ( ) (G30.1 ) ( ) ( ) 臨 ( 不 ) F00.1* Dementia in Alzheimer s disease with late onset (G30.1 ) Dementia in Alzheimer s disease with onset after the age of 65, usually in the late 70s or thereafter, with a slow progression, and with memory impairment as the principal feature. ( ) Alzheimer s disease, type 1 ( ) ( ) 老年 老年 ( ) ( ) Primary degenerative dementia of the Alzheimer s type, senile onset Senile dementia, Alzheimer s type F00.2* ( ) ( ) ( ) (G30.8 ) ( ) ( ) F00.9* ( ) ( ) ( ) (G30.9 ) F00.2* Dementia in Alzheimer s disease, atypical or mixed type (G30.8 ) Atypical dementia, Alzheimer s type F00.9* Dementia in Alzhelmer s disease unspecified (G30.9 ) F01 ( ) F01 Vascular dementia 313

4 塞 塞 ( ) 累 來 年 ( ) Vascular dementia is the result of infarction of the brain due to vascular disease, including hypertensive cerebrovascular disease. The infarcts are usually small but cumulative in their effect. Onset is usually in later life. Includes: arteriosclerotic dementia F01.0 ( ) 連 塞 數 塞 F01.0 Vascular dementia of acute onset Usually develops rapidly after a succession of strokes from cerebrovascular thrombosis, embolism or haemorrhage. In rare cases, a single large infarction may be the cause. F01.1 塞 ( ) F01.1 Multi-infarct dementia 度 塞累 ( ) Gradual in onset, following a number of transient ischaemic episodes which produce an accumulation of infarcts in the cerebral parenchyma. Predominantly cortical dementia F01.2 ( ) F01.2 Subcortical vascular dementia ( ) ( ) 臨 狀 Includes cases with a history of hypertension and foci of ischaemic destruction in the deep white matter of the cerebral hemispheres. The cerebral cortex is usually preserved and this contrasts with the clinical picture which may closely resemble that of dementia in Alzheimer s disease. F01.3 ( ) F01.3 Mixed cortical and subcortical vascular dementia F01.8 ( ) F01.8 Other vascular dementia F01.9 ( ) F01.9 Vascular dementia, unspecified F02* 類 ( ) ( ) 來 ( ) ( ) F02* Dementia in other diseases classified elsewhere Cases of dementia due, or presumed to be due, to causes other than Alzheimer s disease or cerebrovascular disease. Onset 314

5 老年 may be at any time in life, though rarely in old age. F02.0* Pick( ) ( ) ( ) (G31.0 ) ( ) 年 [* 50~60 ] 行 力 ( ) 路 ( ) F02.0* Dementia in Pick s disease (G31.0 ) A progressive dementia, commencing in middle age, characterized by early, slowly progressing changes of character and social deterioration, followed by impairment of intellect, memory, and language functions, with apathy, euphoria and, occasionally, extrapyramidal phenomena. F02.1* Creutzfeldt-Jakob( ) ( ) ( ) (A81.0 ) ( ) 神 ( ) 神 理 [ ] 年 更 年 F02.1* Dementia in Creutzfeldt-Jakob disease (A81.0 ) A progressive dementia with extensive neurological signs, due to specific neuropathological changes that are presumed to be caused by a transmissible agent. Onset is usually in middle or later life, but may be at any adult age. The course is subacute, leading to death within one to two years. F02.2* Huntington ( ) ( ) ( ) (G10 ) 狀 10~15 年 Huntington ( ) ( ) ( ) F02.2* Dementia in Huntington s disease (G10 ) A dementia occurring as part of a widespread degeneration of the brain. The disorder is transmitted by a single autosomal dominant gene. Symptoms typically emerge in the third and fourth decade. Progression is slow, leading to death usually within 10 to 15 years. Dementia in Huntington s chorea F02.3* 金 ( ) ( ) ( ) (G20 ) 立 金 ( ) [ 度 ] 臨 列 ( ) ( ) F02.3* Dementia in Parkinson s disease (G20 ) A dementia developing in the course of established Parkinson s disease. No particular distinguishing clinical features have yet been demonstrated. Dementia in: 315

6 金 ( ) paralysis agitans parkinsonism F02.4* 類 [HIV] ( ) ( ) (B22.0 ) 類 [HIV] 了 HIV 臨 F02.4* Dementia in human immunodeficiency virus [HIV] disease (B22.0 ) Dementia developing in the course of HIV disease, in the absence of a concurrent illness or condition other than HIV infection that could explain the clinical features. F02.8* 類 ( ) ( ) F02.8* Dementia in other specified diseases classified elsewhere 列 ( ) ( ) ( 類 ) ( 沈 沈 (E75.- ) (G40.- ) Dementia in: cerebral lipidosis (E75.- ) epilepsy (G40.- ) 狀 ( ) (E83.0 ) hepatolenticular degeneration (E83.0 ) (E83.5 ) hypercalcaemia (E83.5 ) 狀 (E01, E03.- ) hypothyroidism, acquired (E01,E03.- ) (T36-T65 ) intoxications (T36-T65 ) ( ) (G35 ) multiple sclerosis (G35 ) 神 (A52.1 ) neurosyphilis (A52.1 ) ( )[ ] (E52 ) niacin deficiency [pellagra] (E52 ) (M30.0 ) 狼 ( ) (M32.- ) ( ) ( B56.- B57.- ) ( )B 12 ( ) (E53.8 ) polyarteritis nodosa (M30.0 ) systemic lupus erythcmatosus (M32.- ) trypanosomiasis (B56.-, B57.- ) vitamin B12 deficiency (E53.8 ) F03 ( ) F03 Unspecified dementia *[ ( ) 類 ( ) (F00.0-F02.9) ( ) ] ( 列 ) 老 Presenile: ( ) dementia NOS 精神 ( ) psychosis NOS ( ) Primary degenerative dementia NOS ( 列 ) 老年 ( 列 ) ( ) Senile: dementia: 316

7 NOS depressed or paranoid type 精神 ( ) 老年 ( ) ( ) 亂狀 (F05.1) 老 [ 老 ] (R54) psychosis NOS Excludes: senile dementia with delirium or acute confusional state (F05.1) senility NOS (R54) F04 精 精神 力 力 降 ( ) Korsakov ( ) 精神 ( ) 精 ( 列 ) (R41.3) 行 (R41.1) 離 (F44.0) 行 (R41.2) Korsakov ( ) 精 [ 精 ] (F10.6) 精神 (F11-F ) F04 Organic amnesic syndrome, not induced by alcohol and other psychoactive substances A syndrome of prominent impairment of recent and remote memory while immediate recall is preserved, with reduced ability to learn new material and disorientation in time. Confabulation may be a marked feature, but perception and other cognitive functions, including the intellect, are usually intact. The prognosis depends on the course of the underlying lesion. Korsakov s psychosis or syndrome, nonalcoholic Excludes: amnesia: NOS (R41.3) anterograde (R41.1) dissociative (F44.0) retrograde (R41.2) Korsakov s syndrome: alcohol-induced or unspecified (F10.6) induced by other psychoactive substances (F11-F19 with common fourth character.6) F05 精 精神 識 力 精神 行 ( 亂 ) 不 度不 F05 Delirium, not induced by alcohol and other psychoactive substances An etiologically nonspecific organic cerebral syndrome characterized by concurrent disturbances of consciousness and attention, perception, thinking, memory, psychomotor behaviour, emotion, and the sleep-wake schedule. The duration is variable and the 317

8 degree of severity ranges from mild to very severe. ( 列 ) Includes: acute or subacute: brain syndrome ( 精 ) 亂狀 confusional state (nonalcoholic) 精神 ( ) infective psychosis organic reaction 精神 psycho-organic syndrome 精 (F10.4) Excludes: delirium tremens, alcohol-induced or unspecified (F10.4) F05.0 ( ) ( ) F05.0 Delirium not superimposed on dementia, so described F05.1 ( ) ( ) F05.1 Delirium superimposed on dementia ( ) ( ) (F00-F03) ( ) Conditions meeting the above criteria but developing in the course of a dementia (F00-F03). F05.8 ( ) F05.8 Other delirium ( ) Delirium of mixed origin F05.9 ( ) F05.9 Delirium, unspecified F06 ( ) 不良 ( 異 ) 精神 ( ) 類 ( ) ( ) ( ) ( ) 泌 F06 Other mental disorders due to brain damage and dysfunction and to physical disease Includes miscellaneous conditions causally related to brain disorder due to primary cerebral disease, to systemic disease affecting the brain secondarily, to exogenous toxic substances or hormones, to endocrine disorders, or to other somatic illnesses. ( 列 ) Excludes: associated with: ( ) (F05.-) delirium (F05.-) 類 F00-F03 ( ) dementia as classified in F00-F03 ( ) 精 精神 (F10-F19) resulting from use of alcohol and other psychoactive substances (F10-F19) F06.0 F06.0 Organic hallucinosis 318

9 識 狀 識 識不 臨 識 ( 精 ) 狀 精 (F10.5) 精神 裂 ( ) (F20.-) A disorder of persistent or recurrent hallucinations, usually visual or auditory, that occur in clear consciousness and may or may not be recognized by the subject as such. Delusional elaboration of the hallucinations may occur, but delusions do not dominate the clinical picture; insight may be preserved. Organic hallucinatory state (nonalcoholic) Excludes: alcoholic hallucinosis (F10.5) schizophrenia (F20.-) F06.1 F06.1 Organic catatonic disorder 精神 ( ) ( ) 狀 兩 精神 ( ) A disorder of diminished (stupor) or increased (excitement) psychomotor activity associated with catatonic symptoms. The extremes of psychomotor disturbance may alternate. 精神 裂 ( ) (F20.2) ( 列 ) (R40.1) 離 (F44.2) Excludes: catatonic schizophrenia (F20.2) stupor: NOS (R40.1) dissociative (F44.2) F06.2 [ 精神 裂 ] ( ) 臨 ( ) 精神 裂 ( ) 例 異 F06.2 Organic delusional [schizophrenia-like] disorder A disorder in which persistent or recurrent delusions dominate the clinical picture. The delusions may be accompanied by hallucinations. Some features suggestive of schizophrenia, such as bizarre hallucinations or thought disorder, may be present. 狀 ( ) 類 精神 裂 ( ) 精神 ( ) ( 列 ) 精神 (F23.-) 319 Paranoid and paranoid-hallucinatory organic states Schizophrenia-like psychosis in epilepsy Excludes: disorder: acute and transient psychotic (F23.-) (F22.-) persistent delusional (F22.-) 精神 [ 精神 ] (F11-F19 4 psychotic drug-induced (F11-F19 with common fourth

10 .5 ) character.5) 精神 裂 ( ) (F20.-) schizophrenia (F20.-) F06.3 [ ] ( ) F06.3 Organic mood [affective] disorders ( ) 量 ( 參 F30-F32) [ ] (F30-F39) Disorders characterized by a change in mood or affect, usually accompanied by a change in the overall level of activity, depressive, hypomanic, manic or bipolar (see F30-F32), but arising as a consequence of an organic disorder. Excludes: mood disorders, nonorganic or unspecified (F30-F39) F06.4 ( ) (F41.1) (F41.0) 兩 [ ] ( ) (F41.-) F06.4 Organic anxiety disorder A disorder characterized by the essential descriptive features of a generalized anxiety disorder (F41.1), a panic disorder (F41.0), or a combination of both, but arising as a consequence of an organic disorder. Excludes: anxiety disorders, nonorganic or unspecified (F41.-) F06.5 離 ( ) F06.5 Organic dissociative disorder 識 ( 參 F44.-) [ ] 離 [ ] ( ) (F44.-) A disorder characterized by a partial or complete loss of the normal integration between memories of the past, awareness of identity and immediate sensations, and control of bodily movements (see F44.-), but arising as a consequence of an organic disorder. Excludes: dissociative [conversion] disorders, nonorganic or unspecified (F44.-) F06.6 不 [ ] F06.6 Organic emotionally labile [asthenic] disorder 不 易 累 不 ( 例 暈 ) [ ] A disorder characterized by emotional incontinence or lability, fatigability, and a variety of unpleasant physical sensations (e.g.dizziness) and pains, but arising as a consequence of an organic disorder. ( ) Excludes: somatoform disorders, nonorganic 320

11 (F45.-) or unspecified (F45.-) F06.7 度 ( ) F06.7 Mild cognitive disorder ( 不 ) 力 力 ( 力 ) 不 狀 不 ( ) (F00-F03) ( )(F05.-) 連 若 F10-F99 精神 不 不 ( ) (F07.1) (F07.2) 不 狀 度 A disorder characterized by impairment of memory, learning difficulties, and reduced ability to concentrate on a task for more than brief periods. There is often a marked feeling of mental fatigue when mental tasks are attempted, and new learning is found to be subjectively difficult even when objectively successful. None of these symptoms is so severe that a diagnosis of either dementia (F00-F03) or delirium (F05.-) can be made. This diagnosis should be made only in association with a specified physical disorder, and should not be made in the presence of any of the mental or or behavioural disorders classified to F10-F99. The disorder may precede accompany, or follow a wide variety of infections and physical disorders, both cerebral and systemic, but direct evidence of cerebral involvement is not necessarily present. It can be differentiated from postencephalitic syndrome (F07.1) and postconcussional syndrome (F07.2) by its different etiology, more restricted range of generally milder symptoms, and usually shorter duration. F06.8 ( ) 不良 ( 異 ) 精神 精神 ( ) F06.8 Other specified mental disorders due to brain damage and dysfunction and to physical disease Epileptic psychosis NOS F06.9 ( ) 不良 ( 異 ) 精神 ( ) ( 列 ) 精神 ( ) F06.9 Unspecified mental disorder due to brain damage and dysfunction and to physical disease Organic: brain syndrome NOS mental disorder NOS 321

12 F07 ( ) 不良 ( 異 ) 行 ( ) 行 ( ) 不良 ( 異 ) F07 Personality and behavioural disorders due to brain disease, damage and dysfunction Alteration of personality and behaviour can be a residual or concomitant disorder of brain disease, damage or dysfunction. F07.0 ( ) F07.0 Organic personality disorder 臨 ( 列 ) 精神 ( 列 ) 葉 葉 葉切 切 A disorder characterized by a significant alteration of the habitual patterns of behaviour displayed by the subject premorbidly, involving the expression of emotions, needs and impulses. Impairment of cognitive and thought functions, and altered sexuality may also be part of the clinical picture. Organic: pseudpsychopathic personality pseudoretarded personality Syndrome: frontal lobe limbic epilepsy personality lobotomy postleucotomy ( 列 ) Excludes: enduring personality change after: 歷 (F62.0) catastrophic experience (F62.0) 精神 ( 不 ) (F62.1) psychiatric illness (F62.1) (F07.2) postconcussional syndrome (F07.2) (F07.1) postencephalitic syndrome (F07.1) ( ) specific personality disorder (F60.-) (F60.-) F07.1 F07.1 Postencephalitic syndrome 來 復 行 不 復 ( ) 322 Residual nonspecific and variable behavioural change following recovery from either viral or bacterial encephalitis. The principal difference between this disorder and the organic personality disorders is that it is reversible. Excludes: organic personality disorder (F07.0)

13 (F07.0) F07.2 F07.2 Postconcussional syndrome ( 識 ) 不 狀 諸 暈 ( 暈 ) 力 精 力 A syndrome that occurs following head trauma (usually sufficiently severe to result in loss of consciousness) and includes a number of disparate symptoms such as headache, dizziness, fatigue, irritability, difficulty in concentration and performing mental tasks, impairment of memory, insomnia, and reduced tolerance to stress, emotional excitement, or alcohol. ( ) Postcontusional syndrome (encephalopathy) 精神 Post-traumatic brain syndrome, nonpsychotic F07.8 ( ) 不良 ( 異 ) 行 ( ) ( ) F07.9 ( ) 不良 ( 異 ) 行 ( ) 精神 F07.8 Other organic personality and behavioural disorders due to brain disease, damage and dysfunction Right hemispheric organic affective disorder F07.9 Unspecified organic personality and behavioural disorder due to brain disease, damage and dysfunction Organic psychosyndrome F09 狀 精神 ( ) ( 列 ) 精神 ( ) 狀 精神 ( ) (F29) F09 Unspecified organic or symptomatic mental disorder Psychosis: organic NOS symptomatic NOS Excludes: psychosis NOS (F29) [ ] 行 ( ) (F10-F19) 了 不 度 臨 更 精神 精神 類 3 4 臨 狀 來 Mental and behavioural disorders due to psychoactive substance use (F10-F19) This block contains a wide variety of disorders that differ in severity and clinical form but that are all attributable to the use of one or more psychoactive substances, which may or may not have been medically prescribed. The third character of the code identifies the substance involved, and the 323

14 來 4 都 ( ) 精神 臨 來 料 狀 臨 行 ( ) 不 臨 狀 ( 類 ) 類 精神 量 ( 4.0 ) ( 4.1 ) ( 4.2 ) ( ) 精神 亂 不 精神 精神 精神 (F19.-) 濫 (F55) fourth character specifies the clinical state. The codes should be used, as required, for each substance specified, but it should be noted that not all fourth-character codes are applicable to all substances. Identification of the psychoactive substance should be based on as many sources of information as possible. These include self-report data, analysis of blood and other body fluids, characteristic physical and psychological symptoms, clinical signs and behaviour, and other evidence such as a drug being in the patient's possession or reports from informed third parties. Many drug users take more than one type of psychoactive substance. The main diagnosis should be classified, whenever possible, according to the substance or class of substances that has caused or contributed most to the presenting clinical syndrome. Other diagnoses should be coded when other psychoactive substances have been taken in intoxicating amounts (common fourth character. 0) or to the extent of causing harm (common fourth character.1), dependence (common fourth character.2) or other disorders (common fourth character.3-.9). Only in cases in which patterns of psychoactive substance-taking are chaotic and indiscriminate, or in which the contributions of different psychoactive substances are inextricably mixed, should the diagnosis of disorders resulting from multiple drug use (F19.-) be used. Excludes: abuse of non-dependence-producing substances (F55) 列 4 類 F10-F19 類 The following fourth-character subdivisions are for use with categories F10-F19:.0 精神 ( 亂 ) 識 行 理 理 理 ( 亂 ) 復.0 Acute intoxication A condition that follows the administration of a psychoactive substance resulting in disturbances in level of consciousness, cognition, perception, affect or behaviour, or other psychophysiological functions and responses. The disturbances are directly related to the acute pharmacological effects of the substance and resolve with time, with complete 324

15 ( ) 療 精神 理 類 ( ) ( ) 旅 ( ) 精神 ( ) ( ) recovery, except where tissue damage or other complications have arisen. Complications may include trauma, inhalation of vomitus, delirium, coma, convulsions, and other medical complications. The nature of these complications depends on the pharmacological class of substance and mode of administration. Acute drunkenness in alcoholism "Bad trips" (drugs) Drunkenness NOS Pathological intoxication Trance and possession disorders in psychoactive substance intoxication.1.1 Harmful use 精神 ( 精神 ) 精神 [ ] ( 量 ( ) ) A pattern of psychoactive substance use that is causing damage to health. The damage may be physical (as in cases of hepatitis from the self-administration of injected psychoactive substances) or mental (e.g. episodes of depressive disorder secondary to heavy consumption of alcohol). 精神 濫 Psychoactive substance abuse.2 ( ).2 Dependence syndrome 精神 行 理 烈 精神 精神 力 狀 ( ) 精神 ( 精 diazepam) 類 ( 類 ) 更 理 ( ) 精神 A cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state. The dependence syndrome may be present for a specific psychoactive substance (e.g. tobacco, alcohol, or diazepam), for a class of substances (e.g. opioid drugs), or for a wider range of pharmacologically different psychoactive substances. 325

16 [ 精 ] [ ] Chronic alcoholism Dipsomania Drug addiction.3 狀.3 Withdrawal state 精神 不 不 度 狀 狀 精神 類 ( ) 量 狀 ( ) A group of symptoms of variable clustering and severity occurring on absolute or relative withdrawal of a psychoactive substance after persistent use of that substance. The onset and course of the withdrawal state are time-limited and are related to the type of psychoactive substance and dose being used immediately before cessation or reduction of use. The withdrawal state may be complicated by convulsions..4 ( ) 狀.4 Withdrawal state with delirium 4.3 狀 F05.- ( ) 若 列 類 F05.8 ( 精 精 ) ( ) A condition where the withdrawal state as defined in the common fourth character.3 is complicated by delirium as defined in F05.-. Convulsions may also occur. When organic factors are also considered to play a role in the etiology, the condition should be classified to F05.8. Delirium tremens (alcohol-induced).5 精神 ( ).5 Psychotic disorder 精神 精神 ( ) 狀 ( 不 ) ( ) 精神 ( ) 異 ( 度 ) 度 識 不 亂 A cluster of psychotic phenomena that occur during or following psychoactive substance use but that are not explained on the basis of acute intoxication alone and do not form part of a withdrawal state. The disorder is characterized by hallucinations (typically auditory, but often in more than one sensory modality), perceptual distortions, delusions(often of a paranoid or persecutory nature), psychomotor disturbances (excitement or stupor), and an abnormal affect, which may range from intense fear to ecstasy. The sensorium is usually clear but some degree of clouding of consciousness, though not severe confusion, may be present. 326

17 ( 列 ) 精 Alcoholic: hallucinosis jealousy paranoia 精神 ( ) psychosis NOS 精 精神 留 精神 ( ) (F10-F ) Excludes: alcohol- or other psychoactive substance-induced residual and late-onset psychotic disorder (F10-F19 with common fourth character.7).6.6 Amnesic syndrome 更 不 都 更 ( ) 精 精神 Korsakov ( ) 精神 ( ) 精 精神 精 Korsakov ( ) 精神 ( ) (F04) A syndrome associated with chronic prominent impairment of recent and remote memory. Immediate recall is usually preserved and recent memory is characteristically more disturbed than remote memory. Disturbances of time sense and ordering of events are usually evident, as are difficulties in learning new material. Confabulation may be marked but is not invariably present. Other cognitive functions are usually relatively well preserved and amnesic defects are out of proportion to other disturbances. Amnesic disorder, alcohol- or drug-induced Korsakov's psychosis or syndrome, alcohol- or other psychoactive substance-induced or unspecified Excludes: nonalcoholic Korsakov's psychosis or syndrome (F04).7 精神 ( ).7 Residual and late-onset psychotic disorder 精 精神 行 精神 更 精神 類精神 例 烈 327 A disorder in which alcohol- or psychoactive substance-induced changes of cognition, affect, personality, or behaviour persist beyond the period during which a direct psychoactive substance-related effect might reasonably be assumed to be operating. Onset of the disorder should be directly related to

18 精神 類 類 精神 狀 精 精神 the use of the psychoactive substance. Cases in which initial onset of the state occurs later than episode(s) of such substance use should be coded here only where clear and strong evidence is available to attribute the state to the residual effect of the psychoactive substance. Flashbacks may be distinguished from psychotic state partly by their episodic nature, frequently of very short duration, and by their duplication of previous alcohol- or other psychoactive substance-related experiences. 精 ( ) 精 ( ) ( 不 ) 精神 精神 ( ) ( ) ( 列 ) ( ) 行 ( ) 精 精神 Korsakov ( ) (F10-F ) 精神 狀 (F10-F ) Alcoholic dementia NOS Chronic alcoholic brain syndrome Dementia and other milder forms of persisting impairment of cognitive functions Flashbacks Late-onset psychoactive substance-induced psychotic disorder Posthallucinogen perception disorder Residual: affective disorder disorder of personality and behaviour Excludes: alcohol- or psychoactive substance-induced: Korsakov's syndrome (F10-F19 with common fourth character.6) psychotic state (F10-F19 with common fourth character.5).8 精神 [ ] 行 ( ).8 Other mental and behavioural disorders.9 精神 [ ] 行 ( ).9 Unspecified mental and behavioural disorder F10.- 精 精神 [ ] 行 ( ) F10.- Mental and behavioural disorders due to use of alcohol [ 參 324~328 類 ] [See pages 324~328 for subdivisions] 328

19 F11.- 類 精神 [ ] 行 ( ) F11.- Mental and behavioural disorders due to use of opioids [ 參 324~328 類 ] [See pages 324~328 for subdivisions] F12.- 類 精神 [ ] 行 ( ) F12.- Mental and behavioural disorders due to use of cannabinoids [ 參 324~328 類 ] [See pages 324~328 for subdivisions] F13.- ( ) ( ) 精神 [ ] 行 ( ) F13.- Mental and behavioural disorders due to use of sedatives or hypnotics [ 參 324~328 類 ] [See pages 324~328 for subdivisions] F14.- 精神 [ ] 行 ( ) F14.- Mental and behavioural disorders due to use of cocaine [ 參 324~328 類 ] [See pages 324~328 for subdivisions] F15.- ( ) [ ] 精神 [ ] 行 ( ) F15.- Mental and behavioural disorders due to use of other stimulants, including caffeine [ 參 324~328 類 ] [See pages 324~328 for subdivisions] F16.- [ ] 精神 [ ] 行 ( ) F16.- Mental and behavioural disorders due to use of hallucinogens [ 參 324~328 類 ] [See pages 324~328 for subdivisions] F17.- 精神 [ ] 行 ( ) F17.- Mental and behavioural disorders due to use of tobacco [ 參 324~328 類 ] [See pages 324~328 for subdivisions] F18.- 精神 [ ] 行 ( ) F18.- Mental and behavioural disorders due to use of volatile solvents [ 參 324~328 類 ] [See pages 324~328 for subdivisions] F19.- 精神 精神 [ ] 行 ( ) F19.- Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances [ 參 324~328 類 ] [See pages 324~328 for subdivisions] 類 精神 ( ) 329 This category should be used when two or more psychoactive substances are known to be involved, but it is impossible to assess which

20 精神 諸 精神 不 substance is contributing most to the disorders. It should also be used when the exact identity of some or even all the psychoactive substances being used is uncertain or unknown, since many multiple drug users themselves often do not know the details of what they are taking. Includes: misuse of drugs NOS 裂 ( ) 裂 ( ) ( ) (F20-F29) 精神 裂 ( )( 類 ) 精神 裂 ( ) ( ) 更 精神 ( ) 裂 ( ) 論 留 類 Schizophrenia, schizotypal and delusional disorders (F20-F29) This block brings together schizophrenia, as the most important member of the group, schizotypal disorder, persistent delusional disorders, and a larger group of acute and transient psychotic disorders. Schizoaffective disorders have been retained here in spite of their controversial nature. F20 精神 裂 ( ) 精神 裂 ( ) ( ) 不 來 識 力 精神 理 論 ( ) 狀 F20 Schizophrenia The schizophrenic disorders are characterized in general by fundamental and characteristic distortions of thinking and perception, and affects that are inappropriate or blunted. Clear consciousness and intellectual capacity are usually maintained although certain cognitive deficits may evolve in the course of time. The most important psychopathological phenomena include thought echo; thought insertion or withdrawal; thought broadcasting; delusional perception and delusions of control; influence or passivity; hallucinatory voices commenting or discussing the patient in the third person; thought disorders and negative symptoms. 精神 裂 ( ) ( ) 行 ( ) 不 若 狀 精神 裂 狀 不 精神 裂 ( ) 若 ( ) The course of schizophrenic disorders can be either continuous, or episodic with progressive or stable deficit, or there can be one or more episodes with complete or incomplete remission. The diagnosis of schizophrenia should not be made in the presence of extensive depressive or manic symptoms unless it is clear that schizophrenic symptoms antedate the 330

21 不 精神 裂 ( ) 若 類 類 F06.2 精神 類 F10-F 精神 裂 ( ) ( ) (F23.2) (F25.2) 精神 裂 ( ) (F23.2) 精神 裂 ( ) (F21) affective disturbance. Nor should schizophrenia be diagnosed in the presence of overt brain disease or during states of drug intoxication or withdrawal. Similar disorders developing in the presence of epilepsy or other brain disease should be classified under F06.2, and those induced by psychoactive substances under F10-F19 with common fourth character.5. Excludes: schizophrenia: acute (undifferentiated) (F23.2) cyclic (F25.2) schizophrenic reaction (F23.2) schizotypal disorder (F21) F20.0 精神 裂 ( ) F20.0 Paranoid schizophrenia 精神 裂 ( ) 臨 狀 不 若 不 老年 精神 裂 ( ) 更年 狀 (F22.8) (F22.0) Paranoid schizophrenia is dominated by relatively stable, often paranoid delusions, usually accompanied by hallucinations, particularly of the auditory variety, and perceptual disturbances. Disturbances of affect, volition and speech, and catatonic symptoms, are either absent or relatively inconspicuous. Paraphrenic schizophrenia Excludes: involutional paranoid state (F22.8) paranoia (F22.0) F20.1 精神 裂 ( ) F20.1 Hebephrenic schizophrenia 精神 裂 ( ) 不 行 不 不 零亂 狀 力 不 年 A form of schizophrenia in which affective changes are prominent, delusions and hallucinations fleeting and fragmentary, behaviour irresponsible and unpredictable, and mannerisms common. The mood is shallow and inappropriate, thought is disorganized, and speech is incoherent. There is a tendency to social isolation. Usually the prognosis is poor because of the rapid development of "negative" symptoms, particularly flattening of affect and loss of volition. Hebephrenia should normally be diagnosed only in adolescents or young adults. 331

22 精神 裂 ( ) 精神 裂 ( ) Disorganized schizophrenia Hebephrenia F20.2 精神 裂 ( ) F20.2 Catatonic schizophrenia 臨 精神 狀 兩 不 度 暴力 狀 ( ) 狀 Catatonic schizophrenia is dominated by prominent psychomotor disturbances that may alternate between extremes such as hyperkinesis and stupor, or automatic obedience and negativism. Constrained attitudes and postures may be maintained for long periods. Episodes of violent excitement may be a striking feature of the condition. The catatonic phenomena may he combined with a dream-like (oneiroid) state with vivid scenic hallucinations. Catatonic stupor 精神 裂 Schizophrenic: ( ) catalepsy catatonia 蠟 flexibilitas cerea F20.3 精神 裂 ( ) F20.3 Undifferentiated schizophrenia 精神 裂 ( ) 精神 ( 參 F20) 類 F Psychotic conditions meeting the general diagnostic criteria for schizophrenia but not conforming to any of the subtypes in F20.0-F20.2, or exhibiting the features of more than one of them without a clear predominance of a particular set of diagnostic characteristics. 精神 裂 ( ) 類精神 裂 ( ) 精神 (F23.2) 精神 裂 ( ) (F20.5) Atypical schizophrenia Excludes: acute schizophrenia-like psychotic disorder (F23.2) chronic undifferentiated schizophrenia (F20.5) 精神 裂 ( ) (F20.4) post-schizophrenic depression (F20.4) F20.4 精神 裂 ( ) F20.4 Post-schizophrenic depression 精神 裂 ( ) 精神 裂 狀 不 ( ) A depressive episode, which may he prolonged, arising in the aftermath of a schizophrenic illness. Some schizophrenic 332

23 殺 若 精神 裂 狀 ( ) (F32.-) 若 精 精神 裂 狀 類 精神 裂 (F20.0-F20.3) symptoms, either "positive" or "negative", must still be present but they no longer dominate the clinical picture. These depressive states are associated with an increased risk of suicide. If the patient no longer has any schizophrenic symptoms, a depressive episode should be diagnosed (F32.-). If schizophrenic symptoms are still florid and prominent, the diagnosis should remain that of the appropriate schizophrenic subtype (F20.0-F20.3). F20.5 留 精神 裂 ( ) F20.5 Residual schizophrenia 精神 裂 不 不 復 狀 臨 精神 量 神 料 A chronic stage in the development of a schizophrenic illness in which there has been a clear progression from an early stage to a later stage characterized by long-term, though not necessarily irreversible, "negative" symptoms, e.g. psychomotor slowing; underactivity; blunting and lack of initiative; poverty of quantity or content of speech; poor nonverbal communication by facial expression, eye contact, voice modulation and posture; poor self-care and social performance. 精神 裂 ( ) ( 精神 裂 ) 留狀 精神 裂 留狀 Chronic undifferentiated schizophrenia Restzustand (schizophrenic) Schizophrenic residual state F20.6 精神 裂 ( ) F20.6 Simple schizophrenia 精神 行 異 行 切 力 降 留 ( 力 ) 精神 狀 A disorder in which there is an insidious but progressive development of oddities of conduct, inability to meet the demands of society, and decline in total performance. The characteristic negative features of residual schizophrenia (e.g. blunting of affect and loss of volition) develop without being preceded by any overt psychotic symptoms. F20.8 精神 裂 ( ) F20.8 Other schizophrenia 精神 裂 ( ) Cenesthopathic schizophrenia ( 列 ) 精神 裂 ( ) Schizophreniform: 333

24 ( ) 精神 ( ) 精神 裂 ( ) (F23.2) disorder NOS psychosis NOS Excludes: brief schizophreniform disorders (F23.2) F20.9 精神 裂 ( ) F20.9 Schizophrenia, unspecified F21 精神 裂 ( ) 異行 異 精神 裂 ( ) 見 類 精神 裂 異 狀 不 樂 異行 ( ) 異離 念 見 精神 類 刺 類 ( ) F21 Schizotypal disorder A disorder characterized by eccentric behaviour and anomalies of thinking and affect which resemble those seen in schizophrenia, though no definite and characteristic schizophrenic anomalies occur at any stage. The symptoms may include a cold or inappropriate affect; anhedonia; odd or eccentric behaviour; a tendency to social withdrawal; paranoid or bizarre ideas not amounting to true delusions; obsessive ruminations; thought disorder and perceptual disturbances; occasional transient quasi-psychotic episodes with intense illusions, auditory or other hallucinations, and delusion-like ideas, usually occurring without external provocation. There is no definite onset and evolution and course are usually those of a personality disorder. ( ) 精神 裂 ( ) Latent schizophrenic reaction ( 列 ) 精神 裂 ( ) Schizophrenia: ( ) borderline latent 精神 [ ] prepsychotic prodromal 精神 pseudoneurotic 精神 pseudopsychopathic 精神 裂 ( ) ( ) Schizotypal personality disorder Asperger ( ) (F84.5) Excludes: Asperger's syndrome (F84.5) 裂 ( ) (F60.1) schizoid personality disorder (F60.1) F22 ( ) F22 Persistent delusional disorders Includes a variety of disorders in which 334

25 臨 類 精神 裂 ( ) 類 F23.- ( ) long-standing delusions constitute the only, or the most conspicuous, clinical characteristic and which cannot be classified as organic, schizophrenic or affective. Delusional disorders that have lasted for less than a few months should be classified, at least temporarily, under F23.-. F22.0 ( ) F22.0 Delusional disorder 若 ( ) 精神 裂 狀 ( ) 不 老年 精神 裂 ( ) 臨 不 Paranoia ( 列 ) ( ) Paranoid: 精神 ( ) psychosis 狀 state ( ) 精神 ( ) Paraphrenia (late) [* 老年 精神 ( )] A disorder characterized by the development either of a single delusion or of a set of related delusions that are usually persistent and sometimes lifelong. The content of the delusion or delusions is very variable. Clear and persistent auditory hallucinations (voices), schizophrenic symptoms such as delusions of control and marked blunting of affect, and definite evidence of brain disease are all incompatible with this diagnosis. However, the presence of occasional or transitory auditory hallucinations, particularly in elderly patients, does not rule out this diagnosis, provided that they are not typically schizophrenic and form only a small part of the overall clinical picture. Sensitiver Beziehungswahn ( ) Excludes: paranoid: ( ) (F60.0) personality disorder (F60.0) 精神 ( ) (F23.3) psychosis, psychogenic (F23.3) (F23.3) reaction (F23.3) 精神 裂 ( ) (F20.0) schizophrenia (F20.0) F22.8 ( ) F22.8 Other persistent delusional disorders 狀 ( ) 精神 裂 狀 不 立 精神 裂 ( )(F20.-) 335 Disorders in which the delusion or delusions are accompanied by persistent hallucinatory voices or by schizophrenic symptoms that do not justify a diagnosis of schizophrenia

26 更年 ( ) 狀 (F20.-). Delusional dysmorphophobia Involutional paranoid state Paranoia querulans F22.9 F22.9 Persistent delusional disorder, unspecified F23 精神 ( ) 類 度異 精神 狀 行 異 臨 類 狀 不 立 (F05.-) 復 若 狀 類 不 力 F23 Acute and transient psychotic disorders A heterogeneous group of disorders characterized by the acute onset of psychotic symptoms such as delusions, hallucinations, and perceptual disturbances, and by the severe disruption of ordinary behaviour. Acute onset is defined as a crescendo development of a clearly abnormal clinical picture in about two weeks or less. For these disorders there is no evidence of organic causation. Perplexity and puzzlement are often present but disorientation for time, place and person is not persistent or severe enough to justify a diagnosis of organically caused delirium (F05.-). Complete recovery usually occurs within a few months, often within a few weeks or even days. If the disorder persists, a change in classification will be necessary. The disorder may or may not be associated with acute stress, defined as usually stressful events preceding the onset by one to two weeks. F23.0 精神 ( ) ( ) 精神 裂 狀 F23.0 Acute polymorphic psychotic disorder without symptoms of schizophrenia 精神 ( ) 都 不 不 烈 樂 ( ) 不 臨 異 精神 不 立精神 裂 ( )(F20.-) 336 An acute psychotic disorder in which hallucinations, delusions or perceptual disturbances are obvious but markedly variable, changing from day to day or even from hour to hour. Emotional turmoil with intense transient feelings of happiness or ecstasy, or anxiety and irritability, is also frequently present. The polymorphism and instability are characteristic for the overall

27 不 復 若 狀 (* 例 ) 更 (F22.-) clinical picture and the psychotic features do not justify a diagnosis of schizophrenia (F20.-). These disorders often have an abrupt onset, developing rapidly within a few days, and they frequently show a rapid resolution of symptoms with no recurrence. If the symptoms persist the diagnosis should be changed to persistent delusional disorder (F22.-). Bouffée délirante ( ) ( ) 精神 裂 ( ) 狀 精神 ( ) ( ) 精神 裂 ( ) 狀 Bouffée délirante without symptoms of schizophrenia or unspecified Cycloid psychosis without symptoms of schizophrenia or unspecified F23.1 精神 ( ) ( ) 精神 裂 狀 精神 ( ) 不 臨 F23.0 不 精神 裂 狀 若精神 裂 狀 (* 例 ) 更 精神 裂 ( )(F20.-) F23.1 Acute polymorphic psychotic disorder with symptoms of schizophrenia An acute psychotic disorder in which the polymorphic and unstable clinical picture is present, as described in F23.0; despite this instability, however, some symptoms typical of schizophrenia are also in evidence for the majority of the time. If the schizophrenic symptoms persist the diagnosis should be changed to schizophrenia (F20.-). Bouffée délirante ( ) ( ) 精神 裂 ( ) 狀 精神 ( ) ( ) 精神 裂 ( ) 狀 Bouffée délirante with symptoms of schizophrenia Cycloid psychosis with symptoms of schizophrenia F23.2 類精神 裂 ( ) 精神 ( ) 精神 ( ) 精神 狀 立 精神 裂 ( ) F23.0 不 臨 若精神 裂 狀 更 精神 裂 ( )(F20.-) ( ) 精神 裂 ( ) ( 列 ) 精神 裂 F23.2 Acute schizophrenia-like psychotic disorder An acute psychotic disorder in which the psychotic symptoms are comparatively stable and justify a diagnosis of schizophrenia, but have lasted for less than about one month; the polymorphic unstable features, as described in F23.0, are absent. If the schizophrenic symptoms persist the diagnosis should be changed to schizophrenia (F20.-). Acute (undifferentiated) schizophrenia Brief schizophreniform: 337

28 ( ) disorder 精神 ( ) psychosis 精神 ( ) 精神 裂 [ 類精神 裂 ( ) ] ( ) (F06.2) 精神 裂 ( ) (F20.8) Oneirophrenia Schizophrenic reaction Excludes: organic delusional [schizophrenia -like] disorder (F06.2) schizophreniform disorder NOS (F20.8) F23.3 精神 ( ) 精神 ( ) 臨 不 立精神 裂 ( )(F20.-) 若 狀 更 (F22.-) F23.3 Other acute predominantly delusional psychotic disorders Acute psychotic disorders in which comparatively stable delusions or hallucinations are the main clinical features, but do not justify a diagnosis of schizophrenia (F20.-). If the delusions persist the diagnosis should be changed to persistent delusional disorder (F22.-). 精神 ( ) Paranoid reaction Psychogenic paranoid psychosis F23.8 精神 ( ) 類 F23.0-F23.3 精神 ( ) F23.8 Other acute and transient psychotic disorders Any other specified acute psychotic disorders for which there is no evidence of organic causation and which do not justify classification to F23.0-F23.3. F23.9 精神 ( ) 精神 ( ) 精神 ( ) F23.9 Acute and transient psychotic disorder, unspecified Brief reactive psychosis NOS Reactive psychosis F24 ( ) 連 罹 ( ) 精神 ( ) 來 離 F24 Induced delusional disorder A delusional disorder shared by two or more people with close emotional links. Only one of the people suffers from a genuine psychotic disorder; the delusions are induced in the other(s) and usually disappear when the people are separated. 狀 Folie à deux 338

29 ( 列 ) ( ) ( ) Induced: paranoid disorder 精神 ( ) psychotic disorder F25 裂 ( ) ( ) 精神 裂 狀 不 立精神 裂 ( ) ( ) 若 狀 精神 裂 ( ) 類 F20-F29 不 精神 狀若 不 立 裂 ( ) F25 Schizoaffective disorders Episodic disorders in which both affective and schizophrenic symptoms are prominent but which do not justify a diagnosis of either schizophrenia or depressive or manic episodes. Other conditions in which affective symptoms are superimposed on a pre-existing schizophrenic illness, or co-exist or alternate with persistent delusional disorders of other kinds, are classified under F20-F29. Mood-incongruent psychotic symptoms in affective disorders do not justify a diagnosis of schizoaffective disorder. F25.0 裂 ( ) F25.0 Schizoaffective disorder, manic type ( ) 精神 裂 狀 不 精神 裂 ( ) 類 復 ( ) 數 裂 ( ) A disorder in which both schizophrenic and manic symptoms are prominent so that the episode of illness does not justify a diagnosis of either schizophrenia or a manic episode. This category should be used for both a single episode and a recurrent disorder in which the majority of episodes are schizoaffective, manic type. 裂 精神 ( ) 精神 裂 精神 ( ) Schizoaffective psychosis, manic type Schizophreniform psychosis, manic type F25.1 裂 ( ) F25.1 Schizoaffective disorder, depressive type ( ) 精神 裂 ( ) 狀 不 立 精神 裂 ( ) 類 復 ( ) 裂 ( ) 裂 精神 ( ) 339 A disorder in which both schizophrenic and depressive symptoms are prominent so that the episode of illness does not justify a diagnosis of either schizophrenia or a depressive episode. This category should be used for both a single episode and a recurrent disorder in which the majority of episodes are schizoaffective, depressive type. Schizoaffective psychosis, depressive type 精神 裂 精神 ( ) Schizophreniform psychosis, depressive type

30 F25.2 裂 ( ) 精神 裂 ( ) 精神 裂 精神 ( ) F25.2 Schizoaffective disorder, mixed type Cyclic schizophrenia Mixed schizophrenic and affective psychosis F25.8 裂 ( ) F25.8 Other schizoaffective disorders F25.9 裂 ( ) 裂 精神 ( ) F25.9 Schizoaffective disorder, unspecified Schizoaffective psychosis NOS F28 精神 ( ) ( ) 臨 不 立 精神 裂 ( )(F20.-) (F22.-) 精神 (F23.-) 精神 (F30.2) 度 (F32.3) 精神 ( ) F28 Other nonorganic psychotic disorders Delusional or hallucinatory disorders that do not justify a diagnosis of schizophrenia (F20.-), persistent delusional disorders (F22.-), acute and transient psychotic disorders (F23.-), psychotic types of manic episode (F30.2), or severe depressive episode (F32.3). Chronic hallucinatory psychosis F29 精神 ( ) 精神 ( ) 精神 [ ] (F99) F29 Unspecified nonorganic psychosis Psychosis NOS Excludes: mental disorder NOS (F99) 狀 精神 ( ) (F09) organic or symptomatic psychosis NOS (F09) [ ( )] ( ) (F30-F39) ( 亂 ) ( ) ( ) 量 數 狀 都 來 易 了 數 復 力 Mood [affective] disorders (F30-F39) This block contains disorders in which the fundamental disturbance is a change in affect or mood to depression (with or without associated anxiety) or to elation. The mood change is usually accompanied by a change in the overall level of activity; most of the other symptoms are either secondary to, or easily understood in the context of, the change in mood and activity. Most of these disorders tend to be recurrent and the onset of individual episodes can often be related to stressful events or situations. 340

31 F30 類 類 罹 若 ( ) ( ) 都 類 ( ) (F31.-) ( ) ( ) F30 Manic episode All the subdivisions of this category should be used only for a single episode. Hypomanic or manic episodes in individuals who have had one or more previous affective episodes (depressive, hypomanic, manic, or mixed) should be coded as bipolar affective disorder (F31.-). Includes: bipolar disorder, single manic episode F30.0 F30.0 Hypomania ( ) ( 數 ) 力 量 切都 利 力良 說 度 度 不 易 怒 行 見 樂 行 行 ( ) A disorder characterized by a persistent mild elevation of mood, increased energy and activity, and usually marked feelings of well-being and both physical and mental efficiency. Increased sociability, talkativeness, over-familiarity, increased sexual energy, and a decreased need for sleep are often present but not to the extent that they lead to severe disruption of work or result in social rejection. Irritability, conceit, and boorish behaviour may take the place of the more usual euphoric sociability. The disturbances of mood and behaviour are not accompanied by hallucinations or delusions. F30.1 ( ) 精神 狀 不 樂 ( ) 狀 力 度 說 力不 易 力 率 魯 不 不 行 F30.1 Mania without psychotic symptoms Mood is elevated out of keeping with the patient's circumstances and may vary from carefree joviality to almost uncontrollable excitement. Elation is accompanied by increased energy, resulting in overactivity, pressure of speech, and a decreased need for sleep. Attention cannot be sustained, and there is often marked distractibility. Self-esteem is often inflated with grandiose ideas and overconfidence. Loss of normal social inhibitions may result in behaviour that is reckless, foolhardy, or inappropriate to the circumstances, and out of character. 341

32 F30.2 ( ) 精神 狀 F30.2 Mania with psychotic symptoms 了 F30.1 臨 ( ) ( 說 ) ( ) 度 度 念 理 ( ) ( ) 精神 狀 ( ) 不 精神 狀 In addition to the clinical picture described in F30.1, delusions (usually grandiose) or hallucinations (usually of voices speaking directly to the patient) are present, or the excitement, excessive motor activity, and flight of ideas are so extreme that the subject is incomprehensible or inaccessible to ordinary communication. Mania with: mood-congruent psychotic symptoms mood-incongruent psychotic symptoms Manic stupor F30.8 ( ) F30.8 Other manic episodes F30.9 ( ) F30.9 Manic episode, unspecified Mania NOS F31 ( ) ( ) ( ) 量 量 力 ( ) 量 力降 ( ) 類 (F31.8) F31 Bipolar affective disorder A disorder characterized by two or more episodes in which the patient's mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (hypomania or mania) and on others of a lowering of mood and decreased energy and activity (depression). Repeated episodes of hypomania or mania only are classified as bipolar (F31.8). ( 不 ) Includes: manic-depressive: illness 精神 ( ) psychosis reaction ( ) ( ) (F30.-) Excludes: bipolar disorder, single manic episode (F30.-) ( ) (F34.0) cyclothymia (F34.0) F31.0 ( ) ( ) F31.0 Bipolar affective disorder, current episode hypomanic ( ) 342 The patient is currently hypomanic, and has had at least one other affective episode (hypomanic, manic, depressive, or mixed) in

33 the past. F31.1 ( ) ( ) ( ) 精神 狀 ( ) 精神 狀 (F30.1) ( ) F31.1 Bipolar affective disorder, current episode manic without psychotic symptoms The patient is currently manic, without psychotic symptoms (as in F30.1), and has had at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past. F31.2 ( ) ( ) ( ) 精神 狀 精神 (F30.2) ( ) F31.2 Bipolar affective disorder, current episode manic with psychotic symptoms The patient is currently manic, with psychotic symptoms (as in F30.2), and has had at least one other affective episode (hypomanic, manic, depressive, or mixed) in the past. F31.3 ( ) ( ) ( ) 度 度 ( ) 度 度 ( ) (F32.0 F32.1) F31.3 Bipolar affective disorder, current episode mild or moderate depression The patient is currently depressed, as in a depressive episode of either mild or moderate severity (F32.0 or F32.1), and has had at least one authenticated hypomanic, manic, or mixed affective episode in the past. F31.4 ( ) ( ) ( ) 精神 狀 度 ( ) ( ) 精神 狀 度 (F32.2) F31.4 Bipolar affective disorder, current episode severe depression without psychotic symptoms The patient is currently depressed, as in severe depressive episode without psychotic symptoms (F32.2), and has had at least one authenticated hypomanic, manic, or mixed affective episode in the past. F31.5 ( ) ( ) ( ) 精神 狀 度 ( ) ( ) 精神 狀 度 F31.5 Bipolar affective disorder, current episode severe depression with psychotic symptoms The patient is currently depressed, as in severe depressive episode with psychotic 343