DSM-IV-TR Classification Disorders Usually First Diagnosed In Infancy, Childhood, or Adolescence MENTAL RETARDATION (41) Note There are coded on Axis II 317 Mild mental retardation (43) 318.0 Moderate mental retardation (43) 318.1 Severe mental retardation (43) 318.2 Profound mental retardation (44) 319 Mental retardation, severity unspecified (44) LEARNING DISORDER (49) 315.0 Reading disorder (51) 315.1 Mathemathics disorder (53) 315.2 Disorder of written expression (54) 315.9 Learning disorder NOS (56) MOTOR SKILL DISORDER 315.4 Developmental coordination disorder (56) COMUNICATION DISORDER 315.31 Expressive language disorder (58) 315.32 Mixed receptive expressive language disorder (62) 315.39 Phonological disorder (65) 307.0 Stuttering (67) 307.9 Communication disorder NOS (69) PERVASIVE DEVELOPMENTAL DISORDER ()69 299.00 Autistic disorder (70) 299.80 Rett’s disorder (76) 299.10 Childhood disintegrated disorder (77) 299.80 Asperger’s disorder (80) 299.80 Pervasive developmental disorder NOS (84)
ATTENTION DEFICIT AND DISRUPTIVE BEHAVIOR DISORDER (85) 314.xx Attention deficit/Hyperactivity disorder (85) .01 Combined type .00 Predominantly inattentive type .01 Predominantly hyperactive impulsive type 314.9 Attention deficit/Hyperactinity disorder NOS (93) 312.xx Conduct disorder (93) .81 Childhood onset type .82 Adolescence onset type .89 Unspecified onset 313.81 Oppositional defiant disorder (100) 312.9 Disruptive behavior disorder NOS (103) FEEDING AND EATING DISORDERS OF INFANCY OR EARLY CHILDHOOD(103) 307.52 Pica (103) 307.52 Rumination Disorder (105) 307.59 Feeding disorder of infacy or early childhood (107) TIC DISORDER (108) 307.23 Tourette’s disorder (111) 307.22 Chronic motor or vocal tic disorder (114) 307.21 Transient tic disorder (115) specify if : single episode / recurrent
307.20
Tic disorder NOS (116)
ELIMINATION DISORDER (116) -.Encopresis (116) 787.6 With constipation and overflow incontinence 307.7 Without constipation and overflow incontinence 307.6 Enuresis (not due to a general medical condition) (118) specify type : nocturnal only / diurnal only / nocturnal and diurnal
OTHER DISORDER OF INFANCY, CHILDHOOD, OR ADOLESCENCE (121) 309.21 Separation anxiety disorder (121) specify if : early onset
313.23 Selective mutism (125) 313.89 Reactive attachment disorder of infancy or early childhood (127) 307.3 Stereotypic movement disorder (131) specify if : with self injurious behavior
313.9
Disorder of infancy, childhood, or adolescence NOS (134)
Delirium, Dementia, and Amnestic and Other Cognitive Disorder DELIRIUM 293.0 Delirium due to ……(indicate the general medical condition) (141) -.Substance intoxication delirium (refer to substance-related disorder for substance specific codes) (143) -.Substance withdrawal delirium (refer to substance-related disorder for substance specific code) (143) -.Delirium due to multiple etiologies (code each of the specific etiologies) (146) 780.09 Delirium NOS (147) DEMENTIA (147) 294.xx Dementia of the alzheimer’s type with early onset (also code 331.0 alzheimer’s disease on Axis III) (154) .10 Without behavioral disturbance .11 With behavioral disturbance 294.xx Dementia of the alzheimer’s type with late onset (also code 331.0 alzheimer’s disease on Axis III) (154) .10 Without behavioral disturbance .11 With behavioral disturbance 290.xx Vascular dementia (158) .40 Uncomplicated .41 With delirium .42 With delusion .43 With depressed mood 294.1x Dementia due to HIV disease (also code 042 HIV on Axis III) (163) 294.1x Dementia due to head trauma (also code 854.00 haed injury on Axis III) (164) 294.1x Dementia due to parkinson’s disease disease (also code 332.0 parkinson’s disease on Axis III) (164) 294.1x Dementia due to huntington’s disease (also code 333.4 huntington’s disease on Axis III) (165) 294.1x Dementia due to pick’s disease (also code 331.1 pick’s disease on Axis III) (165) 294.1x Dementia due to creutzfeldt’s jakob disease (also code 046.1 creutzfeldt’s jakob disease on Axis III) (166) 294.1x Dementia due to …(indicated the general medical condition not listen above) (also code the general medical condition on Axis III) (167) -.Substance induced persisting dementia (refer to substance-related disorder for substance specific code) (168) -.Dementia due to multiple etiologies (code each of the specific etiologies) (170) 294.8 Dementia NOS (171)
AMNESTIC DISORDER (172)
294.0
Amnestic disorder due to ……(indicate the general medical condition (175) Specify if : transient / chronic
-.-
Substance induced persisting amnestic disorder (refer to substance-related disorder for substance specific codes) (177) 780.09 Amnestic disorder NOS (179) OTHER COGNITIVE DISORDER (179) 294.9 Cognitive disorder NOS (179)
Mental Disorder Due To A Generaal Medical Condition Not Elsewhere Classified (181) 293.89 310.1
Catatonic disorder due to ……(indicate the general medical condition (185) Personality change disorder due to ……(indicate the general medical condition (187) Specify type : labile type / disinhibited type / aggressive type / apathetic type / paranoid type / other type / combined type / unspecified type
780.09
Mental disorder NOS due to ……(indicate the general medical condition (190)
Substance Related Disorders (191) The following specifiers apply to substance dependence as noted : a with physiological dependence / without physiological dependence b early full remission / early partial remission / sustained full remission / sustained partial remission c in a controlled environment d on agonist therapy the following specifiers apply to substance inducted disorders as noted : I with onset during intoxication / W during with onset withdrawal ALCOHOL RELATED DISORDER (212) Alcohol use disorder (213) 303.90 Alcohol dependencea,b,c (213) 305.00 Alcohol abuse (214)
Alcohol induced disorder (214)
303.00 291.81 291.0 291.0 291.2 291.1 291.x .5 .3 291.89 291.89 291.89 291.89 291.9
Alcohol intoxication (214) Alcohol withdrawal (215) specify if : with perceptual disturbance Alcohol intoxication delirium (143) Alcohol withdrawal delirium (143) Alcohol induced persisting dementia (168) Alcohol induced persisting amnestic disorder (177) Alcohol induced psychotic disorder (338) With delusions I,W With hallucinations I,W Alcohol induced mood disorder I,W (405) Alcohol induced anxiety disorder I,W (479) Alcohol induced sexual dysfunction I (562) Alcohol induced sleep disorder I,W (655) Alcohol related disorder NOS (223)
AMPHETAMINE (OR AMPHETAMINE LIKE) RELATED DISORDERS (223) Amphetamine use disorders (224) 340.40 Amphetamine dependence a,b,c (224) Amphetamine abuse (225) Amphetamine induced disorder (226) 292.89 Amphetamine intoxication (226) specify if : with perceptual disturbance 292.0 Amphetamine withdrawal (227) 292.81 Amphetamine intoxication delirium (143) 292.xx Amphetamine induced psychotic disorder (338) .11 With delusions I .12 With hallucinations I 292.84 Amphetamine induced mood disorder I,W (405) 292.89 Amphetamine induced anxiety disorder I (479) 292.89 Amphetamine induced sexual dysfunction I (562) 292.89 Amphetamine induced sleep disorder I,W (655) 292.9 Amphetamine related disorder NOS (231) CAFFEINE RELATED DISORDER (231) Caffeine induced disorders (232) 305.90 Caffeine intoxication (232) 292.89 Caffeine induced anxiety disorder I (479) 292.89 Caffeine induced sleep disorder I (655) 292.9 Caffeine related disorder NOS (234) CANNABIS RELATED DISORDERS (234) Cannabis use disorders (236) 304.30 Cannabis dependence a,b,c (236) 304.20 Cannabis abuse (236) Cannabis induced disorders (237)
292.89 292.81 292.xx .11 .12 292.89 292.9
Cannabis intoxication (237) specify if : with perceptual disturbance Cannabis intoxication delirium (143) Cannabis induced psychotic disorder (338) With delusions I With hallucinations I Cannabis induced anxiety disorder I (479) Cannabis related disorder NOS (241)
COCAINE RELATED DISORDER (241) Cocaine use disorder (242) 304.20 Cocaine dependence a,b,c (242) 304.60 Cocaine abuse (243) Cocaine induced disorder (244) 292.89 Cocaine intoxication (244) specify if : with perceptual disturbance 292.0 Cocaine withdrawal (245) 292.81 Cocaine intoxication delirium (143) 292.xx Cocaine induced psychotic disorder (338) .11 With delusions I .12 With hallucinations I 292.84 Cocaine induced mood disorder I,W (405) 292.89 Cocaine induced anxiety disorder I,W (479) 292.89 Cocaine induced sexual dysfunction I (562) 292.89 Cocaine induced sleep disorder I,W (655) 292.9 Cocaine related disorder NOS (250) HALLUCINOGEN RELATED DISORDERS (251) Hallucinogen use disorder (251) 304.50 Hallucinogen dependence b,c (251) 305.30 Hallucinogen abuse (252) Hallucinogen induced disorder (252) 292.89 Hallucinogen intoxication (252) 292.89 Hallucinogen persisting perception disorder (flashback)(253) 292.81 Hallucinogen intoxication delirium (143) 292.xx Hallucinogen induced psychotic disorder (338) .11 With delusions I,W .12 With hallucinations I,W 292.84 Hallucinogen induced mood disorder I (405) 292.89 Hallucinogen induced anxiety disorder I (479) 292.9 Alcohol related disorder NOS (256)
INHALANT RELATED DISORDERS (257)
Inhalant use disorders (258) 304.60 Inhalant dependence b,c (258) 305.90 Inhalant abuse (259) Inhalant induced disorders (259) 292.89 Inhalant intoxication (259) 292.89 Inhalant intoxication delirium (143) 292.81 Inhalant indued persisting dementia (168) 292.xx Inhalant induced psychotic disorder (338) .11 With delusions I,W .12 With hallucinations I,W 292.84 Inhalant induced mood disorder I (405) 292.89 Inhalant induced anxiety disorder I (479) 292.9 Inhalant related disorder NOS (263) NICOTINE RELATED DISORDERS (264) Nicotine use disorder (264) 305.1 Nicotine dependence b,c (264) Nicotine induced disorder (265) 292.0 Nicotine withdrawal (265) 292.9 Nicotine related disorder NOS (269) OPIOID RELATED DISORDER (269) Opioid use disorder (270) Note There are coded on Axis II 304.00 Opioid dependence a,b,c (258) 305.50 Opioid abuse (259) Opioid induced disorders (271) 292.89 Opioid intoxication (271) specify if : with perceptual disturbance 292.0 Opioid withdrawal (272) 292.81 Opioid intoxication delirium (143) 292.xx Opioid induced psychotic disorder (338) .11 With delusions I .12 With hallucinations I 292.84 Opioid induced mood disorder I,W (405) 292.89 Opioid induced sexual dysfunction I (562) 292.89 Opioid induced sleep disorder I,W (655) 292.9 Opioid related disorder NOS (277)
PHENCYCLIDINE (OR PHENCYCLIDINE LIKE) RELATED DISORDER (278)
Phencyclidine use disorder (279) 304.60 Phencyclidine dependence b,c (279) 305.90 Phencyclidine abuse (279) Phencyclidine induced disorders (280) 292.89 Phencyclidine intoxication (280) specify if : with perceptual disturbance 292.81 Phencyclidine intoxication delirium (143) 292.xx Phencyclidine induced psychotic disorder (338) .11 With delusions I .12 With hallucinations I 292.84 Phencyclidine induced mood disorder I (405) 292.89 Phencyclidine induced anxiety disorder I (479) 292.9 Phencyclidine related disorder NOS (283) SEDATIVE, HYPNOTIC, OR ANXIOLYTIC RELATED DISORDERS (284) Sedative, hypnotic, or anxiolytic use disorders (285) 304.60 Sedative, hypnotic, or anxiolytic dependence a,b,c (285) 305.90 Sedative, hypnotic, or anxiolytic abuse (286) Sedative, hypnotic, or anxiolytic induced disorders (286) 292.89 Sedative, hypnotic, or anxiolytic intoxication (286) 292.0 Sedative, hypnotic, or anxiolytic withdrawal (287) specify if : with perceptual disturbance
292.81 292.81 292.82 292.83 292.xx 292.84 292.89 292.89 292.89 292.9
Sedative, hypnotic, or anxiolytic intoxication delirium (143) Sedative, hypnotic, or anxiolytic withdrawal delirium (143) Sedative, hypnotic, or anxiolytic induced persisting dementia (168) Sedative, hypnotic, or anxiolytic induced persisting amnestic disorder (177) Sedative, hypnotic, or anxiolytic induced psychotic disorder (338) With delusions I,W .11 With hallucinations I,W .12 Sedative, hypnotic, or anxiolytic induced mood disorder I,W (405) Sedative, hypnotic, or anxiolytic induced anxiety disorder W (479) Sedative, hypnotic, or anxiolytic induced sexual dysfunction I (562) Sedative, hypnotic, or anxiolytic induced sleep disorder I,W (655) Sedative, hypnotic, or anxiolytic related disorder NOS (283)
POLYSUBSTANCE RELATED DISORDER (293) Note There are coded on Axis II 304.80 Polysubstance dependence a,b,c (293) OTHER ( OR UNKNOWN) SUBSTANCE RELATED DISORDERS (294) Other (or unknown) substance use disorders (295) 304.60 Other (or unknown) substance dependence a,b,c (192) 305.90 Other (or unknown) substance abuse (198) Other (or unknown) substance induced disorders (295)
292.89
Other (or unknown) substance intoxication (199) specify if : with perceptual disturbance
292.0 292.81 292.82 292.83 292.xx 292.84 292.89 292.89 292.89 292.9
Other (or unknown) substance withdrawal (201) Other (or unknown) substance delirium (143) Other (or unknown) substance induced persisting dementia (168) Other (or unknown) substance induced persisting amnestic disorder (177) Other (or unknown) substance induced psychotic disorder (338) With delusions I,W .11 With hallucinations I,W .12 Other (or unknown) substance induced mood disorder I,W (405) Other (or unknown) substance induced anxiety disorder I,W (479) Other (or unknown) substance induced sexual dysfunction I (562) Other (or unknown) substance induced sleep disorder I,W (655) Other (or unknown) substance related disorder NOS (223)
Schizophrenia and Other Psycotic Disorder (297) 295.xx
Schizophrenia (298)
The following classification of longitudinal course apply to all sub types of schizophrenia Episodic with interepisode residual symptoms (specify if : prominent negative symptoms) / Episodic with no interepisode residual symptoms Continuous (specify if : prominent negative symptoms) Single episode in partial remission (specify if : prominent negative symptoms) / Single episode in full remission Other or unspecified pattern .30 paranoid type (313) .10 disorganized type (314) .20 catatonic type (315) .90 undifferentiated type (316) .60 residual type (316)
295.40
Schizopheniform disorder (317)
specify if : without good prognostic features / with good prognostic features
295.70
Schizoaffective disorder (319) specify if : bipolar type/depressive type
297.1
Delusional disorder (323) specify if : erotomaniac type / grandiose type / jealous type / persecutory type / somatic type / mixed type / unspecified type
298.8
Brief psychotic disorder (329) specify if : with marked stressor / without marked stressor/ with postpartum onset
297.3 293.xx -.-
Shared psychotic disorder (332) Psychotic disorder due to …(indicated the general medical condition) .81 With delutions .82 With hallucinations Substance induced psychotic disorder (refer to substance related disorders for substance specific codes) (338) specify if : with onset during intoxication / with onset during withdrawal
298.9
Psychotic disorder NOS (343)
Mood Disorder (345) DEPRESSIVE DISORDER (369) 296.xx Major depressive disorder (369) .2x Single episode a,b,c,d,e,f .3x Recurrent a,b,c,d,e,f,g,h 300.4 Dysthymic disorder (376) Specify if : early onset / late onset. Specify with atypical features
311
Depressive disorder NOS (381)
BIPOLAR DISORDER (382) 296.xx Bipolar I depressive (382) .0x Single manic episode a,c,f specify if m: mixed .40 Most recent episode hypomanic g,h,i .4x Most recent episode manic a,cf,g,h,i .6x Most recent episode mixed a,cf,g,h,i .5x Most recent episode depressed a,b,c,d,e,f,g,h,i .7 Most recent episode unspecified g,h,i 296.89 Bipolar II depressive a,b,c,d,e,f,g,h (392) Specify if : (current or most recent episodes) hipyomanic / depressed
301.13 296.80 293.83
Cyclothymic disorder (398) Bipolar disorder NOS (400) Mood disorder due to ….(indicate the general medical condition) (401) Specify type with depressive features / with major depressive-like episode / with manic features / with mixed features
-.-
Substance induced mood disorder (refer to substance related disorder for substances specific codes) (405) Specify type with depressive features / with manic features / with mixed features specify if : with onset during intoxication / with onset during withdrawal
296.90
Mood disorder NOS (410)
Anxiety Disorder (429)
300.01 300.21 300.22 300.29
Panic disorder without agoraphobia (433) Panic disorder with agoraphobia (433) Agoraphobia without history of panic disorder (411) Specific phobia (443) Specify type : animal type / natural environment type / blood injection injury type / situasional type / other type
300.23
Social phobia (450) Specify type : generalized
300.3
Obsessive compulsive disorder (456) specify if : with poor insight
309.81
Posttraumatic stress disorder (463) Specify if : acute / chronic Specify if : with delayed onset
308.3 300.02 293.84
Acute stress disorder (469) Generalized anxiety disorder (469) Anxiety disorder due to ….(indicate the general medical condition) Specify if : with generalized anxiety / with panic attack / with obsessive compulsive symptoms
-.-
Substance induced anxiety disorder (refer to substance related disorder for substances specific codes) (479) Specify if : with generalized anxiety / with panic attack / with obsessive compulsive symptoms / with phobia symptoms specify if : with onset during intoxication / with onset during withdrawal
300.00
Anxiety disorder NOS (484)
Somatoform Disorder (485) 300.81 300.82 300.11
Somatization disorder (486) Undifferentiated somatoform disorder (490) Conversion disorder (492) Specify type : with motor symptoms or deficit / with sensory symptoms or deficit / with seizure or convulsion / with mixed presentation
307.xx 80 89
Pain disorder (498) Associated with psychological factor Associated with both psychological factor and a general medical condition Specify if : acute / chronic
300.7
Hypochondriasis (504) specify if : with poor insight
300.7 300.82
Body dysmorphic disorder (507) Somatoform disorder NOS (484)
Factitious Disorders (513)
300.xx .16 .19 .19 300.19
Factitious disorder (513) With predominantly psychological sign and symptoms With predominantly physical sign and symptoms With combined psychological and physical sign and symptoms Factitious disorder NOS (517)
Dissociative Disorders (519) 300.12 300.13 300.14 307.6 300.15
Dissociative disorder (520) Dissociative fugue(523) Dissociative identity disorder (526) Depersonalization disorder (530) Dissociative disorder NOS (532)
Sexual and Gender identity Disorders (535) SEXUAL DYSFUNCTION (535) Sexual desire disorder (539) 302.71 Hypoactive sexual desire disorder (539) 302.79 Sexual aversion disorder (541) Sexual arousal disorder (543) 302.72 Female sexual arousal disorder (543) 302.72 Male erectile disorder (543) Orgasmic disorder (547) 302.73 Female orgasmic disorder (547) 302.74 Male orgasmic disorder (550) 302.75 Premature ejaculation (552) Sexual pain disorder (554) 302.76 Dyspareunia (not due to a general medical condition) (554) 306.51 Viginismus (not due to a general medical condition) (556)
Sexual dysfunction due to a general medical condition (558)
625.58 608.89 607.84 625.0 608.89 625.8 608.89 -.-
Female hypoactive sexual desire disorder due to.. (indicate the general medical condition) (558) Male hypoactive sexual desire disorder due to.. (indicate the general medical condition) (558) Male erectile disorder due to.. (indicate the general medical condition) (558) Female dyspareunia due to.. (indicate the general medical condition) (558) Male dyspareunia due to.. (indicate the general medical condition) (558) Other female sexual dysfunction due to.. (indicate the general medical condition) (558) Other male sexual dysfunction due to.. (indicate the general medical condition) (558) Substance induced Sexual dysfunction (refer to substance related disorder for substances specific codes) (562) Specify if : with impaired desire / with impaired arousal / with impaired orgasm / with sexual pain specify if : with onset during intoxication
302.70
Sexual dysfunction NOS (565)
PARAPHILAS (566) 302.4 Exhibisionism (569) 302.81 Fetishism (569) 302.89 Frotteurism (570) 302.2 Phedophilia (571) Specify if : sexual attracted to males / sexual attracted to females / sexual attracted to both Specify if : limited to incest Specify type : exclusive type / nonexclusive type
302.83 302.84 302.3
Sexual masochism (572) Sexual sadism (573) Transfertic fetishism (574) Specify if : with gender dysphoria
302.82 302.9
Voyeurism (575) Paraphilia NOS (576)
GENDER IDENTITY DISORDER (576) 302.xx Gender identity disorder (576) .6 In children .85 In adolescence or adult Specify if : sexual attracted to males / sexual attracted to females / sexual attracted to both / sexual attracted to neither
302.6 302.9
Gender identity disorder NOS (576) Sexual identity disorder NOS (576)
Eating Disorders (583)
307.1
Anorexia nervosa (583) Specify type : restricting type, binge-eating / purging type
307.51
Bulimia nervosa (589) Specify type : purging type / nonpurging type
307.50
Eating disorder NOS (594)
Sleep Disorders (597) PRIMARY SLEEP DISORDER (598) Dyssomnia (598) 307.42 Primary insomnia (599) 307.44 Primary hypersomnia 347 Narcolepsy (609) 782.59 Breathing related sleep disorder (615) 307.45 Circadian rhytm sleep disorder (622) Specify type : delayed sleep phase type / jet lag type / shift work type / unspecified type
307.47
Dyssomnia NOS (629)
Parasomnia (630) 307.47 Nightmare disorder (631) 307.46 Sleep terror disorder (634) 307.46 Sleep walking disorder (639) 307.47 Parasomnia NOS (644) SLEEP DISORDER RELATED TO ANOTHER MENTAL DISORDER (645) 307.42 Insomnia related to.. (indicate the Axis I or Axis II disorder) (645) 307.44 Hypersomnia related to.. (indicate the Axis I or Axis II disorder) (645) OTHER SLEEP DISORDERS (651) 780.xx Sleep disorder due to.. (indicate the general medical condition) (651) .52 Insomnia type .54 Hypersomnia type .59 Parasomnia type .59 Mixed type -.Substance induced sleep disorder (refer to substance related disorder for substances specific codes) (655) Specify type : Insomnia type / Hypersomnia type / Parasomnia type / Mixed type specify if : with onset during intoxication / with onset during withdrawal
Impulse control Disorder Not Elsewhere Classified (663)
312.34 312.32 312.33 312.31 312.39 312.30
Intermittent explosive disorder (663) Kleptomania (667) Pyromania (669) Pathological gambling (671) Trichotilomania (674) Impulse control disorder NOS (677)
Adjustment Disorders (679) 309.xx .0 .24 .28 .3 .4 .9
Adjustment disorder (679) With depressed mood With anxiety With mixed depressed mood and anxiety With disturbance of conduct With mixed disturbance of emotions and conduct Unspecified Specify if : acute / chronic
Personality Disorder (685) 301.0 301.20 301.22 301.7 301.83 301.30 301.81 301.82 301.6 301.4 301.9
Paranoid personality disorder (690) Schizoid personality disorder (694) Schizotipal personality disorder (697) Antisocial personality disorder (701) Borderline personality disorder (706) Histrionic personality disorder (711) Narcisstic personality disorder (714) Avoidant personality disorder (718) Dependent personality disorder (721) Obsessive compulsive personality disorder (725) Personality disorder NOS (729
Other Conditions That May Be A Focus of Clinical Attention (731)
PSYCHOLOGICAL FACTORS AFFECTING MEDICAL CONDITION (731) 316 ..(specified psychological factor)affecting …(indicate the general medical condition) (731) Choose named based on nature of factors Mental disorder affecting medical condition Psychological symptoms affecting medical condition Personality traits or coping style affecting medical condition Maladaptive health behaviors affecting medical condition Stress related physiological response affecting medical condition Other or unspecified psychological factors affecting medical condition MEDICATION INDUCED MOVEMENT DISORDERS (734) Note There are coded on Axis II 332.1 Neuroleptic induced parkinsonism (735) 333.92 Neuroleptic malignant syndrom (735) 333.7 Neuroleptic induced acute dystenia (735) 333.99 Neuroleptic induced acute akathisia (735) 333.82 Neuroleptic induced tardive diskinesia (736) 333.1 Neuroleptic induced postural tremor (736) 333.90 Medication induced movement disorder NOS (736) OTHER MEDICATION INDUCED ISORDERS (736) 995.2 Adverse effects of medication NOS (736) RELATIONAL PROBLEMS V61.9 Relational problems related to a mental disorder or a general medical condition (737) V61.20 Parent child relational problem (737) V61.10 Partner relational problem (737) V61.8 Sibling relational problem (737) V62.81 Relational problem NOS (737)
PROBLEM RELATED TO ABUSE OR NEGLECT (738) V61021 Physical abuse of child (738)
(code 995.54 if focus of attention is on victim)
V61.21
Sexual abuse of child (738) (code 995.53 if focus of attention is on victim)
V61.21
Neglect of child (738) (code 995.52 if focus of attention is on victim)
-.-
Physical abuse of adult (738) (code 995.54 if focus of attention is on victim)
V61.12 V62.83
(if by partner) (if by person other than partner) (code 995.81 if focus of attention is on victim)
-.V61.12 V62.83
Sexual abuse of adult (738) (if by partner) (if by person other than partner) (code 995.83 if focus of attention is on victim)
ADITIONAL CONDITIONS THAT MAY BE A FOCUS OF CLINICAL ATTENTION (739) V15.81 Noncompliance with treatment (739) V665.2 Malingering (739) V71.01 Adult antisocial behavior (740) V62.89 Child or adolescence antisocial behavior (740) 780.9 Borderline intellectual functioning (740) Note : this is code on Axis II
V62.82 V62.3 V62.2 313.82 V62.89 V62.4 V62.89
Age related cognitive decline (740) Academic problems (741) Occupational problems (741) Identity problems (741) Religious or spiritual problems (741) Acculturation problems (741) Phase of life problems (742)
Additional Codes (743) 300.9 V71.09 799.9 V71.09 799.9
Unspecified mental disorder (nonpsychotic) (743) No diagnosis or condition on Axis I (743) Diagnosis or condition deffered on Axis I (743) No diagnosis on Axis II (743) Diagnosis deffered on Axis II (743)
Multiaxial system
Axis I Axis II Axis III Axis IV Axis V
Clinical disorder Other conditions that may be a focus of clinical attention Personality disorder Mental retardation General medical conditions Psychosocial and environmental problems Global assessment of functioning
KRITERIA DIAGNOSTIK DSM-IV-TR diambil dari Kaplan & Sadock’s Pocket Handbook of CLINICAL PSYCHIATRY 4th ed
Delirium karena kondisi medis umum A.
Disturbance of consciousness (ie, reduced clarity of awareness of the environment) with reduced ability to focus, sustain, or shift attention. Gangguan kesadaran (penurunan tingkat kewaspadaan terhadap keadaan sekitar) disertai penurunan kemampuan memusatkan,mempertahankan atau mengalihkan perhatian. B. A change in cognition (eg, memory deficit, disorientation, language disturbance, perceptual disturbance) or the development of perceptual disturbance that is not better accounted for by a preexisting, established, or evolving demensia. Perubahan kemampuan kognitif (spt penurunan daya ingat,disorientasi,gangguan berbahasa dan persepsi) atau pembentukan gangguan persepsi yang bukan ok sebelumnya ada,menetap atu merupakan dementia. C. The disturbance develops over a short period (usually hours to days) and tends to fluctuate during the course of the day. Gangguan ini terjadi dalam waktu yang singkat (biasanya dlm beberapa jam atau hari)dan cenderung berubah-ubah sepanjang hari. D. There is evidence from the history, physical examination, or laboratory findings that the disturbance is caused by the direct physiologic consequence of a general medical condition. Adanya bukti dari riwayat,pemeriksaan fisik atau temuan laboratories yg menunjukan behwa gangguan ini adalah konsekuensi fisiologis drari kondisi medis umum. From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
Delirium karena intoksikasi zat
A.
B.
C.
D.
Disturbance of consciousness (ie, reduced clarity of awareness of the environment) occurs, with reduced ability to focus, sustain, or shift attention. Gangguan kesadaran (penurunan tingkat kewaspadaan terhadap keadaan sekitar) disertai penurunan kemampuan memusatkan,mempertahankan atau mengalihkan perhatian. A change in cognition (eg, memory deficit, disorientation, language disturbance, perceptual disturbance) occurs that is not better accounted for by a preexisting, established, or evolving demensia. Perubahan kemampuan kognitif (spt penurunan daya ingat,disorientasi,gangguan berbahasa dan persepsi) atau pembentukan gangguan persepsi yang bukan ok sebelumnya ada,menetap atu merupakan dementia. The disturbance develops over a short period (usually hours to days) and tends to fluctuate during the course of the day. Gangguan ini terjadi dalam waktu yang singkat (biasanya dlm beberapa jam atau hari) dan cenderung berubah-ubah sepanjang hari. There is evidence from the history, physical examination, or laboratory findings of either (1) or (2): 1. The symptoms in criteria A and B developed during substance intoxication 2. Medication use is etiologically related to the disturbance. Adanya bukti dari riwayat,pemeriksaan fisik atau temuan laboratories antara (1) atau (2): 1.Gejala-gejala pada criteria A dan B terjadi selama intoksikasi zat. 2.Obat medikasi berkaitan secara etiologis dengan gangguan ini.
From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
Dementia karena kondisi medis umum
A.
B.
C.
D.
The development of multiple cognitive deficits manifested by both 1. Memory impairment (impaired ability to learn new information or to recall previously learned information) 2. One (or more) of the following cognitive disturbances : a. aphasia (language disturbance) b. apraxia (impaired ability to carry out motor activities despite intact motor function) c. agnosia (failure to recognize or identify ojects despite intact sensory function) d. disturbance in executive functioning (i.e., planning, organizing, sequencing, abstracting) Terjadinya berbagai deficit kognitif yg bermanifestasi sebagai berikut: 1. Penurunan memori (penurunan kemampuan mempelajari informasi baru atau mengingat informasi yang pernah dipelajari). 2. Satu atau lebih dari gangguan kognitif berikut: a. Aphasia. b. Apraxia. c. Agnosia. d. Gangguan dalam pengambilan keputusan (perencanaan,pengorganisasian,kesinambungan, abstraksi). The cognitive deficits in criteria A1 and A2 each cause significant impairment in social or occupational functioning and represent a significant decline from a previous level of function Defisit. Kognitif pada criteria A1 dan A2 menyebabkan penderitaan yang bermakna pada fungsi2 sosial dan pekerjaan serta menunjukan penurunan yang berarti dari keaadan sebelumnya. There is evidence from the history, physical examination or laboratory findings that the disturbance is the direct physiologic consequence of a general medical condition other than Alzheimer’s disease or cerebrovascular disease (e.g. HIV infection, traumatic brain injury, Parkinson’s disease, Huntington’s disease, Pick’s disease, Creutzfeldt-Jakob disease, normal-pressure hydrocephalus, hypothyroidism, brain tumor or vitamin B12 deficiency) Adanya bukti2 dari riwayat,pemeriksaan fisik atau temuan laboratoris yang menunjukan bahwa gangguan ini adalah konsekuensi langsung dari suatu kondisi medis umum selain penyakit Alzheimer atau serebrovaskuler (mis. Infeksi HIV,trauma serebral,penyakit2 Parkinson,Huntington,Pick,Creutzfeldt-Jakob,Hidrosefalus tekanan normal,Hipotiroidism,tumor otak atau defisiensi vitamin B12). The deficits do not occur exclusively during the course of delirium Deficit-defisit ini terutama tidak terjadi selama adanya delirium.
Code based on presence or absence of a clinically significant behavioral disturbance: Without behavioral disturbance : if the cognitive disturbance is not accompanied by any clinically significant behavioral disturbance Without behavioral disturbance : if the cognitive disturbance is accompanied by a clinically significant behavioral disturbance (e.g., wandering, agitation) Kode berdasarkan ada tidaknya ggn perilaku y bermakna klinis: Tanpa gangguan perilaku: jika gangguan kognitif tidak disertai oleh gangguan perilaku yang bermakna klinis. Dengan gangguan perilaku: jika gangguan kognitif disertai oleh gangguan perilaku yang bermakna klinis. Coding note : Also code the general medical condition on Axis III (e.g., HIV infection, head injury, Parkinson’s disease, Huntington’s disease, Pick’s disease, CreutzfeldtJakob disease. Catatan: Pada axis III tuliskan penyakit penyebab.
Dementia tipe Alzheimer A. The Development of Multiple cognitive deficits manifested by both Terjadinya berbagai deficit kognitif yg bermanifestasi sebagai berikut: 2. Penurunan memori (penurunan kemampuan mempelajari informasi baru atau mengingat informasi yang pernah dipelajari). 3. Satu atau lebih dari gangguan kognitif berikut: a. Aphasia. b. Apraxia. c. Agnosia. d. Gangguan dalam pengambilan keputusan (perencanaan,pengorganisasian,kesinambungan,abstraksi). B.
The cognitive deficits in criteria A1 and A2 each cause significant impairment in social or occupational functioning and represent a significant decline from a previous level of functioning. Defisit. Kognitif pada
criteria A1 dan A2 menyebabkan penderitaan yang bermakna pada fungsi2 sosial dan pekerjaan serta menunjukan penurunan yang berarti dari keaadan sebelumnya. C.
The course is characterized by gradual onset and continuing cognitive decline. Perjalanan penyakit ditandai dengan onset
yang bertahap dan penurunan kognitif berlanjut D.
The cognitive deficits in criteria A1 and A2 are not due to any of the following :
(1) other central nervous system conditions that cause progressive deficits in memory and cognition (e.g., cerebrovascular disease, Parkinson’s disease, Humington’s disease, subdural hematoma, normal-pressure hydrocephalus, brain tumor) (1) systemic conditions that are known to cause dementia (e.g.,hypothyroidism, vitamin B12 or folic acid deficiency, niacin deficiency, hypercalcemia, neurosyphilis, HIV infection) (2) substance-induced conditions.
Defisit. Kognitif pada criteria A1 dan A2 tidak disebabkan oleh: (1)Kondisi-kondisi sistim saraf pusat lainnya yang menyebabkan deficit progresif memori dan kognitif (mis. Penyakit serebrovaskuler,Parkinson,Huntington,Pick,hematoma subdural,Hidrosefalus tekanan normal,tumor otak). (2)Kondisi-kondis sistemik yang diketahui menyebabkan dementia (mis. Hipotiroidism,defisiensi vitamin ab12 atu asam folat,niacin,hiperkalsemia,neurosifilis,infeksi HIV). (3)Kondisi-kondisi yang diinduksi zat. E. The deficits do not occur exclusively during the course of a delirium. Deficitdefisit ini terutama tidak terjadi selama adanya delirium. F. The disturbance is not better accounted for by axis disorder (e.g., major depressive disorder, schizophrenia). Gangguan ini bukan disebabkan oleh gangguan axis I lainnya (mis.Gangguan Deprsif Mayor,Schizophrenia). Code based on presence or absence of a clinically significant behavioral disturbance : Without behavioral disturbance : if the cognitive disturbance is not accompanied by any clinically significant behavioral disturbance. With behavioral disturbance : if the cognitive disturbance is accompanied by a clinically significant behavioral disturbance (e.g., wandering).
Kode berdasarkan ada tidaknya ggn perilaku yg bermakna klinis: Tanpa gangguan perilaku: jika gangguan kognitif tidak disertai oleh gangguan perilaku yang bermakna klinis. Dengan gangguan perilaku: jika gangguan kognitif disertai oleh gangguan perilaku yang bermakna klinis (mis. suka jalan2) Specify subtype : With early onset : if onset is at age 65 years or below With late onset : if onset is after age 65 years
Tentukan subtype: Onset dini: jika muncul sebelum usia 65 tahun. Onset lambat: : jika muncul sesudah usia 65 tahun. Coding note : Also code the general medical condition on Axis III (e.g., HIV infection, head injury, Parkinson’s disease, Huntington’s disease, Pick’s disease, CreutzfeldtJakob disease Catatan: Tuliskan juga penyakit Alzheimer pada axis III.
From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
Amnesia karena kondisi medis umum A. The development of memory impairment as manifested by impairment in the ability to learn new information or the inability to recall previously learned information. Terjadinya
gangguan memori yang bermanifestasi sebagai gangguan kemampuan mempelajari informasi baru atau ketidakmampuan mengingat informasi yang pernah dipelajari. B. The memory disturbance causes significant impairment in social or occupational functioning and represents a significant decline from a previous level of functioning.Gangguan
memori menyebabkan penderitaan yang bermakna pada fungsi2 sosial dan pekerjaan serta menunjukan penurunan yang berarti dari keaadan sebelumnya. C. The memory disturbance does not occur exclusively during the course of a delirium or a dementia.Gangguan memori ini tidak hanya terjadi bersamaan dengan
delirium atau dementia. D. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct physiologic consequence of a general medical condition (including physical trauma).Adanya bukti2 dari riwayat,pemeriksaan fisik atau
temuan laboratoris yang menunjukan bahwa gangguan ini adalah konsekuensi fisiologis langsung dari suatu kondisi medis umum (termasuk trauma fisik).
Specify if : Transient : if memory impairment lasts for 1 month or less Chronic : if memory impairment lasts for more than 1 month
Tentukan jika: Transient: jika gangguan memori berlangsung selama 1 bulan atau kurang. Kronis: jika gangguan memori berlangsung lebih dari 1
bulan lamanya. Coding note : include the name of the general medical condition on Axis I (e.g., amnestic disorder due to head trauma); also code the general medical condition on Axis III.
Catatan: Masukan nama kondisi medis umum pada axis I (mis.Gangguan Amnesia ok TraumaCapitis) dan cantumkan itu pada axis III. From American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders text revision, 4th ed. Washington DC : American Psychiatric Association. Copyright 2000. with permission.
GGN MOOD DISEBABKAN KONDIS MEDIS UMUM A. Ggn mood yg menonjol dan menetap mendominasi gambaran klinis dan di karakterisir oleh 1 atau kedua hal berikut: 1. adanya mood depresi atau penrunan nyata minat atau kesenangan pada hampir atau semua aktifitas. 2. adanya mood yg elevasi, expansif atau irritable. B. Adanya bukti berdasarkan riwayat, pemeriksaan fisik atau temuan2 laboratoris bhw ggn ini adalah konsekunsi fisilogis lsg dari suatu kondis medis umum. C. Ggn ini tdk dpt digolongkan sebagai ggn mental lainnya (spt. Ggn Penyesuaian dgn mod depresi sbg respons thd beban menderita suatu kondis medis umum). D. Ggn ini tdk hanya terjadi dlm perjalanan suatu Delirium. E. Gejala2 diatas menyebabkan penderitaan atau hambatan yg bermakna klinis dlm bidang2 sosial, okupasional, atau fungsional penting lainnya. Tentukan tpenya: Dgn gambaran depresif: diwarnai mood depresi tetapi tdk memenuhi kriteria penuh episode Depresi Mayor. Dgn episode mirip Depresi Mayor: memenuhi kriteria penuh kecuali poin D dari Episode Depresi Mayor Dgn gambara Mania: jika diwarnai mood2 elevasi, euforia atau irritable. Dgn gambaran Campuran: jika gejala2 Depresi dan Mania ada tetapi tdk satupun yg menonjol.
DSM-IV-TR Diagnostic Criteria for Psychotic Dissorder due to a general medical condition A. Halusinasi2 atau waham2nya menonjol. B. Adanya bukti dari riwayat,pemeriksaan fisik atau temuan laboratories yg menunjukan behwa gangguan ini adalah konsekuensi fisiologis langsung dari suatu kondisi medis umum.
C. Gangguan ini tidak dapat dijelalaskan oleh gangguan mental lainnya. D. Gangguan ini tidak terjadi selama perjalanan suatu delirium. Kode berdasarkan gejala2 predominan: Dgn waham2 : jika gambaran wahamnya menonjol. Dgn halusinasi2 : jika halusinasinya yang menonjol. Cat. pengkodean: tuliskan nama dari kondisi medis umum. Pada axis I mis. Gangguan Psikotik ok Neoplasma ganas paru dgn waham; juga tuliskan nama kondisi medis umumnya pd axis III. Jika wahm yg ada sbg bagian dari Demntia vaskuler maka tunjkan sesuai dgn subtipe, mis. Demntia Vaskuler dgn waham. From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz
Diagnostic Criteria for Substance Dependence ( Alcohol and Other Substances) A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occuring at any time in the same 12-month period: Suatu pola pengguanaan zat yang maladaptif mengarah pada gangguan atau penderitaan yng bermakna klinis, bermanifestasi sebagai 3 (tiga) atau lebih hal-hal berikut yang terjadi pada tiap saat dalam periode 12 bulan: 1. tolerance, as defined by either of the following: a. a need for markedly increased amounts of the substance to achieve intoxication or desired effect b. markedly diminished effect with continued use of the same amount of the substance toleransi yang didefinisikan sbb: a. peningkatan nyata jumlah kebutuhan zat untuk mendapatkan efek yang didamba atau mencapai intoksikasi. b. Penurunan efek yang nyata dengan penggunaan kontinyu jumlah yang sama dari zat. 2. withdrawal, as manifested by either of the following: a. the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets from withdrawal from the specific substances)
b.
the same (or a closely related) substance is taken relieve or avoid withdrawal symptoms putus zat, bermanifestasi sebagai salah satu dari: a. sindroma withdrwal khas untuk zat penyebab ( criteria A dan B dari gejala withdrawal zat dimaksud). b. zat yanga sama atau sejenis digunakan untuk menghilangkan atau menghindari gejala-gejala withdrawal. 3. The substance is often taken in larger amounts or over a larger paeriod than was intended Zat yng dimaksud sering digunakan dalam jumlah yang besar atau lewat dari batas waktu pemakaiannya. 4. there is a persistent desire or unsuccesful efforts to cut down or control substance use adanya hasrat menetap atau ketidakberhasilan mengurangi atau mengendalikan pemakaian zat. 5. a great deal of time is spent in activities necessary to obtain the substance (e.g. visiting multiple doctors or driving distances), use the substance (e.g. chainsmoking), or recover from its effects Adanya aktifitas yang menyita waktu untuk kebutuhan mendapatkan zat (mis.mendatangi berbagai dokter atau sampai melakukan perjalan jauh), untuk menggunakan zat (merokok tiada sela) atau untuk pulih dari efek2nya. 6. Important social, occupational, or recreational activities are given up or reduced because of substance use Kegiatan-kegiatan soial yang penting,pekerjaan atau rekreasi dilalaikan atau dikurangi karena penggunaan zat. 7. the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g. current cocaine use despiterecognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption). penggunaan zat tetap berlanjut meskipun mengetahui bahwa problem2 fisik dan fisiologis menetap atau berulang disebabkan oleh penggunaan zat (mis.sementara menggunakan kokain meskipun mengetahui itu menginduksi depresi atau tetap meneguk-alkohol- meskipun mengetahui hal itu memperburuk ulcus gaster). Specify if: With physiologic dependence; evidence of tolerance or withdrawal (i.e., either item 1 or 2 is present) Without physiologic dependence; no evidence of tolerance or withdrawal (i.e., neither item 1 or 2 is present Tentukan jika: Dengan ketergantungan fisiologis: terbukti adanya toleransi atau putus zat (adanya item 1 atau 2).
Tanpa ketergantungan fisiologis: tidak terbukti adanya toleransi atau putus zat zat (tidaka adanya item 1 atau 2).. Course specifiers. Early full remission Early partial reemission Sustained full remission Sustained partial remission On against therapy In a controlled environment Tentukan perlangsunganya: Remisi dini penuh Pemisi dini parsial Remisi penuh menetap Remisi parsial menetap Dalam terapi agonis Dalam lingkungan yang diatur From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission DSM-IV-TR Diagnostic Criteria for Substance Abuse (Alcohol and Other Substances) A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occuring within a 12-month period Suatu pola pengguanaan zat yang maladaptif mengarah pada gangguan atau penderitaan yng bermakna klinis, bermanifestasi sebagai 1 (satu) atau lebih hal-hal berikut yang terjadi dalam periode 12 bulan: (1) recurrent substance use resulting in failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household) penggunaan berulang zat menyebabkan kegagalan memenuhi tugas utama ditempat kerja,sekolah atau dirumah (mis. berulangkali bolos hasil kerja yang buruk karena penggunaan zat, bolos,diganjar atu dikeluarkan dari sekolah karena penggunaan zat,mengabaikan anak atau anggota keluarga (2)recurrent substance use in situations in which it is physically hazardous (e.g., driving on automobile or operating a machine when impaired by substance use berulangkali menggunakn zat dalm situasi yang membahayakan fisik (mis.mengemudikan kendaraan atau mengoperasikan mesin saat terganggu oleh pemakaiannya)
(3)recurrent substance-related legal problems (e.g., arrest for substance-related disorderly conduct) berulangkali berurusan dengan hukum karena penggunaan zat (ditangkap karena ulah berkaitan dengan penggunaannya). (4)continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights) meneruskan penggunaan zat meskipun tetap atau berulang memiliki problem sosial atau interpersonal disebabkan atau kambuhnya efek2 dari zat (mis.berdebat dengan pasangan tentang akibat intoksikasi,berkaelahi). B.
The symptoms have never met the criteria for substance dependence for the class of substance. Gejala-gejalanya tidak memenuhi kriteria ketergantungan zat yang digunakan.
DSM-IV-TR Diagnostic Criteria for Substance Intoxication A. Development of a reversible substance-specific syndrome due to recent ingestion of (or exposure to) a substance. Note: different substances may produce similar or identical syndrome Terjadinya sindroma reversible zat spesifik karena barusan
menelannya atau terpapar olehnya.cat. zat yang berbeda dapat memberi sindroma yang mirip atau sama. B. Clinically significant maladaptive behavioral or psychological changes that are due to the effect of the substance on the central nervous system (e.g. belligerence, mood lability, cognitive impairment, impaired judgment, impaired social or occupational function), and develop during or shortly other use of the substance Tingkah laku maladaptif
yang bermakna secara klinis atau perobahan psikologis karena efek dari zat terhadap sitim saraf pusat (mis. keadaan siap tempur,labilitas mood,gangguan kognitif, penilaian,sosial dan fungsi pekerjaan) yang terjadi segera setelah penggunaan zat. C. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder Gejala-gejalanya tidak karena kondisi medis umum ataupun gangguan mental lainnya.
DSM-IV-TR Diagnostic Criteria for Substance withdrawal A.
The development of a substance-specific syndrome due to the cessation of (or reduction in) substance use that has been heavy and prolonged Terjadinya sindroma zat
spesifik karena penghentian mendadak (atau pengurangan) penggunaan zat yang lama dan berat. B.
The substance-specific syndrome causes clinically significant distress or impairment in social, occupational, or other important areas of function Sindroma zat spesifik
diatas menyebabkan penderitaan yang bermakna secara klinis
atau gangguan dalam hal sosial,pekerjaan atau area fungsifungsi penting lainnya C.
The symptoms are not due to a general medical conditions and are not better accounted for by another mental disorder Gejala-gejalanya tidak karena kondisi
medis umum ataupun gangguan mental lainnya
DSM-IV-TR- Diagnostic Criteria for opioid Intoxification A. Recent use of an opioid.Barusan menggunakan Opioid. B. Clinically significant maladaptive behavioral of psycological change (e.g.,initial euphoria followed by apathy, dysphoria, psycomotor agitation or retardation, impaired judgement, or impaire social or impair occupation functioning) that developed during or shorty after opioid use.Tingkah laku maladaptif yang bermakna secara klinis atau perubahan psikologis (mis. mulanya euforia disusul apatis,disforia,agitasi atau retardasi psikomotor,gangguan penilaian atau fungsi sosial atau pekerjaan) yang terjadi selama atau segera setelah pemakaian opioid. C. Pupil constriction or pupilary dilation due to anoxia from severe overdose) and one (or more) of the following: 1. drowsiness or coma. 2. slureed speech. 3. impairment of attention or memory. Kostriksi pupil (atau dilatasi ok anoxia akibat overdosis) disertai satu atau lebih tanda2 berikut yang terjadi selama atau segera setelah pemakaian opioid. yang terjadi selama atau segera setelah pemakaian opioid. 1. drowsiness atau coma. 2. bicara spt orang mabuk 3. gangguan perhatian dan memori. D. The symptom are not due to general medical condition and are not better accounted for by another mental disorder.Gejala-gejalanya tidak karena kondisi medis umum ataupun gangguan mental lainnya. Specify it : with perceptual disturbances. Tentukan jika disertai gangguan persepsi.
DSM-IV-TR kriteria diagnosis Putus Zat Opioid A. Either of the following: 1. cessation of (or reduction) opioid use that have been heavy prolonged (seveeral weeks or longer). 2. administration of an opioid antagonist after a period of opioid use. Salah satu dari berikut ini: 1. penghentian mendadak (atau reduksi) penggunaan yang berat dan lama (beberapa minggu atau lebih) 2. pemberian antagonis opioid setelah suatu periode penggunaan opioid. B. Three or more following, developing within minute to several days after criteria A : 1. Disphoric mood. 2. Nausea and vomitting. 3. Muscle aches. 4. Lacrimation and rhinorea. 5. Pupillary erection, pillorecction or sweating. 6. Diarrhea. 7. Yawning. 8. Fever. 9. Insomnia. Tiga atau lebih hal-hal berikut terjadi dalam hitungan menit sampai beberapa hari setelah kriteria A: 1. mood disforik. 2. nausea atau vomitus 3. nyeri otot. 4. lakrimasi atau rhinorrhea. 5. midriasis,piloerction atau persipirasi. 6. diare. 7. sering menguap. 8. febris. 9. insomnia. C. The symptoms in criteria B cause clinically sigificant distres or impairment in social, occupational or other important areas of functioning.Gejala-gejala kriteria B diatas menyebabkan penderitaan yang bermakna secara klinis atau gangguan dalam hal sosial,pekerjaan atau area fungsi-fungsi penting lainnya D. The symptoms are not due to general medical condition and are not better encounted by another mental disorder.Gejala-gejalanya tidak karena kondisi medis umum ataupun gangguan mental lainnya.
DSM-IV-TR Diagnostik Criteria for Amphetamine Intoxication A. Recent use of amphetamine or a related substance
(e.g.,
methylphenidate)Barusan menggunakan amfetamin atau zat sejenis (mis. methylphenidate). B. Clinically significant maladaptive behavioral or psycological changes (e.g., euforia or affective blunting; changes in sociability; hypervigilance; interpersonal sensitivity; anxiety; tension, or anger; stereotyped behaviour; impaired judgment; impaired social or occupational fungtioning) that developed during, or shortly after use of amphetamin or related substance Tingkah laku maladaptif yang bermakna secara klinis atau perubahan psikologis (mis. euforia atau afek tumpul,perubahan kemampuan sosial,sensitifitas interpersonal,hiperwaspada, anxietas, ketegangan atau gusar ,perilaku sterotipik, psikomotor,gangguan penilaian atau fungsi sosial atau pekerjaan) yang terjadi selama atau segera setelah pemakaian amfetamin dan sejenisnya. C. Two (or more) of the following developing during or shorty after use of amphetamin or related substance 1. Tachycardia or bradycardia 2. pupilary dilatation 3. elevated or lowered blood presure 4. Perpiration or chill 5. Nausea or vomiting 6. Evidence of wight loss 7. Psycomotor agitation or retardation 8. muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias 9. Confusion, seizures, dyskinesias, dystonias, or coma Adanya dua atau lebih tanda-tanda berikut ) yang terjadi selama atau segera setelah pemakaian amfetamin dan sejenisnya: 1. taki- atau bradikardi 2. midriasis. 3. tekanan darah meningkat atau turun. 4. persipirasi atau menggigil. 5. nausea atau vomitus. 6. penurunan berat badan 7. agitasi atau retardasi psikomotor 8. kelemahan otot,depresi respirasi,nyeri dada atau aritmia 9. kebingungan,kejang,diskinesia, distonia atau koma. D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder.Gejala-gejalanya tidak karena kondisi medis umum ataupun gangguan mental lainnya.
Spcify if: With perceptual disturbances
Tentukan jika: dgn ggn persepsi DSM-IV-TR Diagnostik Criteria for Amphetamine Withdrawal A. Cessation of (or reduction in) amphetamin (or related substance) use that has been heavy and prolonged Penghentian mendadak (atau pengurangan) dari pengguanaan amfetamin (atau sejenisnya) yang berat dan lama B. Dysphoric mood and two (or more) of following physiologic changes, developing within a few hous to several days after Criterion A: 1. Fatigue 2. Vivid, unpleasant dreams 3. imsomnia or hypersomnia 4. increase appetite 5. Psycomotor retardation or agitation Mood disforik dan 2 atua lebih perubahan fisiologis berikut terjadi dlm beberapa jam atau hari setelah kriteria A: 1. keletihan 2. mimpi2 tak menyenangkan yg terasa hidup 3. insomnia atau hipersomnia 4. nafsu makan meningkat 5. retardasi atu agitasi psikomotor C. The symptoms in Criterion B cause clinically significant distress or impairement in social, occupational, or other important areas of functioning.Gejala-gejala kriteria B diatas menyebabkan penderitaan yang bermakna secara klinis atau gangguan dalam hal sosial,pekerjaan atau area fungsi-fungsi penting lainnya D. The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder.Gejala-gejalanya tidak karena kondisi medis umum ataupun gangguan mental lainnya.
GGN MOOD DIINDUKSI ZAT A. Ggn mood yg menonjol dan menetap mendominasi gambaran klinis dan di karakterisir oleh 1 atau kedua hal berikut: 1. adanya mood depresi atau penrunan nyata minat atau kesenangan pada hampir atau semua aktifitas.
2.
adanya mood yg elevasi, expansif atau
irritable. Adanya bukti berdasarkan riwayat, pemeriksaan fisik atau temuan2 laboratoris: 1. gejala2 pd kriteria A selama atau dlm sebulan setelah intoksikasi atau putus zat. 2. penggunaan medikasi berhubungan etiologis dgn ggn ini. C. Ggn ini tdk dpt digolongkan sbg ggn mood yg tdk diinduksi zat dgn pembuktian sbb: geja2 mendahului sebelum onset penggunaan zat (atau medikasi); gejala2 menetap utk wkt yg jelas (mis. 1 bulan) sesudah berhentinya putus zat akut atau intoksikasi berat atau berlebihan dari yg diduga dgn jumlah atau lamanya pemakaian zat; atau adanya bukti keberadaan ggn mood yg bukan diinduksi zat (mis. Ada riwayat episode Depresi Mayor rekuren). D. Ggn ini tdk hanya terjadi dlm perjalanan suatu Delirium. E. Gejala2 diatas menyebabkan penderitaan atau hambatan yg bermakna klinis dlm bidang2 sosial, okupasional, atau fungsional penting lainnya. B.
Cat: diagnosa sebaiknya dibuat meskipun ada dignosa Intoksikasi atau Putus Zat ketika gejal2 mood muuncul berlebihan dibanding biasanya dgn intoksikasi atau putus zat dan ketika gejala2 cukup berat utk menjadi perhatian klinis tersendiri. Tentukan tipe: Dgn gambaran depresif: diwarnai mood depresi tetapi tdk memenuhi kriteria penuh episode Depresi Mayor. Dgn episode mirip Depresi Mayor: memenuhi kriteria penuh kecuali poin D dari Episode Depresi Mayor Dgn gambara Mania: jika diwarnai mood2 elevasi, euforia atau irritable. Dgn gambaran Campuran: jika gejala2 Depresi dan Mania ada tetapi tdk satupun yg menonjol. Tentukan jika: Dgn onset sewaktu intoksikasi: jika memenuhi kriteria intoksikasi zat dan gejala2 terjadi selama sindroma intoksikasi. Dgn onset sewaktu putus zat: jika memenuhi kriteria putus zat dan gejala2 terjadi selama atau segera sesudah sindroma putus zat.
DSM-IV TR: GANGGUAN PSIKOTIK YG DIINDUKSI ZAT A. Halusinasi2 atau waham2nya menonjol.Cat.: jangan masukan halusinasi jika oranya mempunyai tilikan bhw dia dipengaruhi zat. B. Adanya bukti dari riwayat,pemeriksaan fisik atau temuan laboratories yg menunjukan (1) atau (2): C. Gangguan ini tidak dpt dijelaskan oleh gangguan psikotik yg tidak diiduksi zat yg dibuktikan dgn gejala2 sudah ada sebelum menggunakan zat (atau medikasi), menetap dlm jangka waktu tertentu setelah berhentinya putus zat akut atau intoksikasi berat, atau timbulnya berlebihan dibanding jumlah atau durasi pemakaian zat, atau adanya bukti lain yg menunjukan suatu gangguan psikotik lepas yang dinduksi oleh bukan zat. D. Gangguan ini tidak terjadi selama perjalanan suatu delirium. Cat.: Diagnosis ini sebaiknya dibuat sebagai ganti Intoksikasi Zat atau Putus Zat hanya ketika gejala2nya berlebihan dari ke2 gangguan ini dan ketika cukup berat untuk menghasilkan perhatian klinis. Kode (zat spesifik) menginduksi gangguan psikotik:292.11 Inhalan, dgn waham; 292.12 Inhalan, dgn halusinasi; 292.11 Opioid, dgn waham; 292.12 Opioid, dgn halusinasi; 292.11 Phencyclidine (sejenisnya), dgn waham; 292.12 Phencyclidine (sejenisnya), dgn halusinasi; 291.5 Alkohol,dgn waham; 291.3 Alkohol,dgn halusinasi; 292.11 Amfetamin (sejenisnya), dgn waham; 292.12 Amfetamin (sejenisnya), dgn halusinasi; 292.11 Kanabis, dgn waham; 292.12 Kanabis, dgn halusinasi; 292.11 Kokain, dgn waham;292.12 Kokain, dgn halusinasi; 292.11 Halisinogen dgn waham; 292.12 Halusinogen dgn halusinasi; 292.11 Sedatif,Hipnotik atau Anxiolitik, dgn waham; 292.12 Sedatif,Hipnotik atau Anxiolitik, dgn halusinasi; 292.11 Zat lain, dgn waham; 292.12 Zat lain, dgn halusinasi. Tentukan jika: Dgn onst sewaktu intoksikasi: jika kriteria intoksikasi zat terpenuhi dan gejala2nya terjadi bersamaan. Dgn onset sewaktu putus zat: jika kriteria putus zat terpenuhi dan gejala2nya terjadi bersamaan, segera sesudahnya.
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DSM-IV-TR Diagnostic Criteria for Schizophrenia Disorder A. Characteristic symptoms: two or more of the following, each presnt for a significant portion of time during a month period (or les if successfull treated) Gejala-gejala yang khas : 2 atau lebih dari gejala berikut yang bermakna dalam periode 1 bulan (atau kurang jika berhasil diterapi): 1. delusions 2. hallucinations 3. disorganized speech (e.g frequent derailment or incohorentia) 4. grossly disorganized or catatonic behaviour 5. negative symptoms (i.e affective falttening, alogia, or avolition) 1. waham. 2. halusinasi. 3. pembicaraan yang janggal (mis. Sering derailment atau incohorensia). 4. perilaku janggal atau katatonik 5. adanya gejala negatif (spt afek datar,alogia,abulia). Note: only one criterion A symptom is required if delusions are bizzare or hallucinations consist of voice keeping up of a running comentary on the person’s behaviour or thoughts or two or more voices conversing each other. Cat. : Hanya satu dari kriteria A yang diperlukan jika waham-nya janggal atau jika halusinasinya berupa suara yang terus menerus mengomentari tingkah laku atau pikiran yang bersangkutan atau berisi 2 (atau lebih) suara-suara yang saling bercakap-cakap. B. Social / occupational dysfunction: for a significant portion of the time since the onset of the disturbance, one or more major area of functioning, such as work, interpersonal relations, or self care, are markedly below the level achieved prior to the onset (or when the onset is in the childhood or adolescence, failure to achieved expected level of interpersonal, academic or occupational achievement)Disfungsi sosial atau pekerjaan: 1 atau lebih dari area fungsional utama menunjukkan penurunan nyata di bawah tingkat yang dicapai sebelum onset dalam suatu rentang waktu yang bermakna sejak onset gangguan seperti pekerjaan, hubungan interpersonal atau perawatan diri (atau bila onset pada masa anak-anak atau remaja terdapat kegagalan pencapaian tingkat interpersonal, akademik atau okupasional lainnya) . C. Duration: contnuous sign of the disturbance persist at least for 6 months.This 6 months periode must include at 1 month of symptoms (or les if successfull treated) that are meet criterion A (i.e active phase symptoms) and may include prodormal and residual symptoms.During these prodormal and residual symptoms, the signs of the disturbance may be manifested by only negative symptoms or 2 or more symptoms list in criterion A present in attenuated form (e.g odd beliefs, unusual perceptual experiences) Durasi: tanda-tanda gangguan terus berlanjut dan menetap sedikitnya 6 bulan. Periode 6 bulan ini meliputi 1 bulan gejala-gejala fase aktif yang memenuhi kriteria A (atau kurang bila
berhasil diterapi) dan dapat juga mencakup fase prodromal atau residual. Selama berlangsung. fase prodormal atau residual ini, tanda-tanda gangguan dapat bermanifestasi hanya sebagai gejalagejala negatif saja atau lebih dariatau=2 dari gejala-gejala dalam kriteria A dalam bentuk yang lebih ringan (seperti kepercayaan – kepercayaan ganjil, pengalaman perseptual yang tidak biasa). D. Schizoaffective and mood dissorde exclusion: Schizoaffective and mood dissorder with psychotic features have been rule out because of either (1) no major depressive, manic or mixed episodes have occured concurently with the active phase symptoms, or (2) if mood episode have occured during the active phase symptoms ,their total duration has beeen relative to the duration of the active and residual peroiods. Penyingkiran skizofektif dan gangguan mood: Gangguan skizoafektif dan mood dengan gambaran psikotik dikesampingkan karena : (1) tidak ada episode depresi, mania atau campuran keduanya yang terjadi bersamaan dengan gejala-gelala fase aktif, (2) jika episode mood terjadi intra fase aktif maka perlangsungannya relatif singkat dibanding periode fase aktif dan residual. E. Substances/general medical conditions exclusion: the disturbance is not due to the direct physiologic effects of a substance (e.g., a drug abuse, a medication) or a general medical condition. Penyingkiran kondisi medis dan zat: Gangguan ini bukan disebabkan oleh efek fisiologis langsung dari suatu zat (seperti obat-obatan medikasi atau yang disalah gunakan) atau oleh suatu kondisi medis umum. F. Relationship to a pervasive developmental dissorder: if there is a history of Autistic dissorde or another pervasive developmental disorder, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations are also present for at least 1 month (or les if successfull treated). Hubungan dengan suatu gangguan perkembangan pervasif: Jika terdapat riwayat autistik atau gangguan pervasif lainnya maka tambahan diagnosa skizofernia hanya dibuat bila juga terdapat delusi atau halusinasi yang menonjol dalam waktu sedikitnya 1 bulan (atau kurang jika berhasil diterapi). Classification of longitudinal course (can be applied only after at least 1 year has elapsed since the initial onset of active phase symptoms Klasifikasi berdasarkan perjalanannya (longitudinal;hanya dipakai setelah minimal 1 tahun berlalu semenjak onset dari gejala-gejala fase aktif pertama): Episodik dengan gejala-gejala residual interepisode (episode ditandai dengan keadaan kekambuhan dari gejala-gejala psikosis) juga tentukan jika disertai gejala-gejala negatif yang menonjol. Episodik tanpa gejala-gejala residual interepisode.
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Kontinyu (gejala-gejala psikosis jelas ada sepanjang periode observasi) juga tentukan jika disertai gejala-gejala negatif yang menonjol. Episode tunggal dengan remisi parsial; juga tentukan jika disertai gejala-gejala negatif yang menonjol. Episode tunggal dengan remisi penuh Pola lainnya atau yang tidak ditentukan.
From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission Tipe PARANOID Suatu tipe skizofrenia yg memenuhi kriteria: A. Preokupasi dgn 1 atau lebih waham atau sering berhalusinasi auditorik. B. Gejala2 berikut tidak menonjol: pembicaraan atau perilaku yang janggal atau katatonik atau afek datar atau inappropriate. Tipe KACAU (DISORGANIZED) Suatu tipe skizofrenia yg memenuhi kriteria: A. Semua gejala berikut menonjol: 1. pembicaraan yang janggal. 2. perilaku yang janggal. 3. afek datar atau inappropriate. B. Kriteria tipe katatonik tidak terpenuhi. Tipe KATATONIK Suatu tipe skizofrenia dimana gambaran klinisnya didominasi ole 2 ataulebih hal2 berikut: 1. imobilitas motorik yg dibuktikan dgn catalepsy (termasuk waxy flexibility) atau stupor. 2. aktfitas2 motorik yg berlebihan (yg tampak tak bertujuan dan tidak dipengaruhi oleh stimuli external). 3. negativisme yg nyata (yg tampaknya penolakan tanpa motif thd semua perintah atau mempertahankan suatu postur kaku melawan usaha untuk menggerakannya) atau mutisme. 4. gerakan spontan yg aneh spt melakukan postur tertentu (berlagak spontan yg inappropriate atau postur ganjil),gerakan stereotipik,menojolnya manerisme atau menyerigai. 5. echolalia atau echopraxia. Tipe tak tergolongkan Suatu tipe skizofrenia yg memenuhi kriteria A tapi tidak
memenuhi kriteria tipe Paranoid,Kacau atau katatonik. Tipe RESIDUAL Suatu tipe skizofrenia yg memenuhi kriteria: A. tidak aadanya penonjolan waham2, halusinasi2, pembicaraan yang janggal, perilaku janggal atau katatonik. B. Adanya bukti perlangsunan gangguan spt yang ditunjukan olehgejala2 negatif dlm kriteria A skizofrenia dlm bentuk yg lebih lemah (keyakinan2 aneh,pengalaman2 persepsi yg tidak biasanya). .
DSM-IV-TR Diagnostic Criteria for Schizophreniform Disorder A.
Criteria A, D, and E of schizophrenia are met.Kriteria a,d dan e dari skizofrenia terpenuhi.
B.
An episode of the disorder (including prodormal, active, and residual phases) lasts at least 1 month but less rhan 6 months. (Whenthe diagnosis must be made without waiting for recovery. It should be qualified as “provisional”).Episode gangguan (termasuk fase prodormal,aktif dan residual) berlangsung sedikitnya 1 bulan tapi kurang dari 6 bulan (ketika diagnosis harus dibuat tanpa menunggu pemulihan maka seharusnya dikwalifikasikan sebagai “sementara”).
Specify if: Without good prognostic features With good progostic features: as evidenced by two (or more) of the following: 1. onset of prominent psychotic symptoms within 4 weeks of teh first noticeable change in usual behavior or functioning 2. confusion or perplexity at the heidht of teh psychotic episode 3. good premorbid social and occupational functioning 4. absence of blunted or flat affectmenonjol adanya Tentukan jika: Tanpa gambaran prognosis yang baik. Dengan gambaran prognosis yang baik yang dibuktikandengan samaatau lebihdari 2 hal berikut: 1. onset gejala-gejala psikotik yang menonjol dalam 4 minggu sejak diperhatikan kali pertama adanya perubahan dari perilaku atau fungsi biasanya. 2. kebingungan atau kekacauan dalam episode psikotik. 3. fungsi sosial dan pekerjaan premorbid berlangsung bagus.
4. tidak ada afek tumpul atau datar.
DSM-IV-TR Diagnostic Criteria for Schizoaffective Disorder A.
An uninterrupted period of illness during witch, at some time, there is either a major depressive episode, a manic episode, or a mixed episode concurrent with symptoms that meet criterion A for schizophrenia.Note: The major depressive episode must include criterion A1: depressed mood.Suatu periode gangguan tak terputus dimana suatu saat didalamnya terdapat episode depresif mayor, mania atau campuran bersamaan dengan gejala-gejala yang memenuhi kriteria A pada skizofrenia.Catatan: harus ada mood depresif pada Episode depresi mayor.
B.
During the same period of illness, there have been delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms.Selama periode yang sama dari penyakit tanpa adanya gejala2 mood yang menonjol terdapat waham-waham atau halusinasi2 sedikitnya selama 2 minggu.
C.
Symptoms that meet criteria for a mood episode are present sor a substantialportion of the total duration of the active and residual periods of the illness.Adanya gejala-gejala yang memenuhi kriteria episode gangguan mood dalam porsi yang bermakan dari total durasi fase aktif dan residual penyakit.
D.
The disturbance is not due to the direct physiologic effects of a substance (e.g., a drug abuse, a medication) or a general medical condition.Gangguan ini bukan disebabkan oleh efek fisiologis langsung dari suatu zat (seperti obat-obatan medikasi atau yang disalah gunakan) atau oleh suatu kondisi medis umum.
Specify type: Bipolar type: If the disturbance includes a manic or a mixed episode (or a manic or mixed episode and major depressive episodes) Depressive type: If the disturbance only includes major depressive episodes Tentukan tipenya: Tipe bipolar: jika gangguan ini termasuk episode mania dan depresi mayor atau campuran. Tpe depresif: juka hanya terdapat episode depresif mayor.
DSM-IV-TR Diagnostic Criteria for Delusional Disorder A. Nonbizarre delusions (i.e., involving situations that occur in real life, such as being followed, poisoned, infected, loved at a distance, or deceived by spouse or lover, or having a disease) of at least 1 month’s duration. Waham2 tidak janggal yang sedikitnya berlangsung selama 1 bulan (mis. tentang situasi2 yg terjadidalam kehidupan nyata spt (merasa) sedang dikuntit,diracun,ditulari penyakit,dicintai dari jauh,ditipu oleh pasangan atau kekasih atau menderita suatu penyakit). B. Criterion A for schizophrenia has never been met. Note: Tactile and olfactory hallucinations may be present in dilusional disorder if they are related to the delutional theme. Kriteria A Skizofrenia tidak terpenuhi.Cat. halusinasi taktil dan penghiduan mungkin ada sesuai dengan tema waham2. C. Apart from the impact of the delusion (s) or its ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre. Lepas dari dampak waham2 atau yg terkait dgn itu, fungsi2 tidak nyata terganggu dan perilaku jelas tidak ganjil atau janggal. D. If mood episodes have occured concurrently with delusions, their total duration has been brief relative to the duration of the delusional periods. Jika ada gangguan episode mood bersamaandgn waham maka terjadi relatif singkat dibanding durasi episode waham. E. The disturbance is not due to the direct physiologic effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. Gangguan ini bukan disebabkan oleh efek fisiologis langsung dari suatu zat (seperti obat-obatan medikasi atau yang disalah gunakan) atau oleh suatu kondisi medis umum. Specify type (the following types are assigned based on the predominant delusional theme): Erotomanic type: delusion that another person, usualy of higher status, is in love with the individual Grandiose type: delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person Jealous type: delusions that the individual’s sexual partner is unfaithful Persecutory type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way Somatic type: delusions that the person have some physical defect or general medical condition
Mixed type: delusions characteristic of more then one of the above types, but no one theme predominates Unspecified type Tentukan tipe (berdasarkan tema yng menonjol dari wahamnya): Tipe Erotomania: waham tentang dirinya dicintai oleh seseorang dgn status sosial lebih tinggi. Tipe kebesaran: waham tentang harga diri yg meningkat,kekusasaan,berpengetahuan Tipe cemburu Tpe persekutorik Tipe somatik Tipe campuran Tipe tidak ditentukan
DSM-IV-TR Diagnostic Criteria for Brief Psychotic Dissorder A.
Presence of one (or more) of the following symptoms: 1. delusions 2. hallucinations 3. disorganized speech (e.g., frequent derailment or incoherence) Note: Do not include a symptom if it is a culturally sanctioned response pattern. Adanya 1 ataulebih gejala-gejala berikut: 1. waham. 2. halusinasi. 3. pembicaraan yang janggal (mis. sering derailment atau incohorensia). Cat.: jangan masukaan gejala apabila diakui sbg respons pola budaya.
B.
Duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning. Durasi episode gangguan sedikitnya 1 hari sampai kurangdari 1 bulan dan dapat kembali penuh berfungsi seperti keadaan premorbid.
C.
The disturbance is not better accounted for by a mood disorder with psychotic features, schizoaffective disorder, or schizophrenia and is not due to the direct physiologic effects of a substance (e.g., a drug abuse, a medication) or a general medical condition. Gangguan ini tidak memenuhi kriteria gangguan mood dgn gambaran psikotik,skizoafektif,atau skizofrenia dan tidak disebabkan ole efek fisiologis darizat (medikasi,penyalahgunaan obat) atau kondisi medis umum.
Specify if: With marked stressor(s) (brief reactive psychosis): If symptoms occur shortly after and apparently in response to events that, singly or together, would be markedly stressful to almost anyone in similar circumstances in the person’s culture Without marked stressor(s): If psychotic symptoms do not occur shortly after and apparently in response to events that, singly or together, would be markedly stressful to almost anyone in similar circumstances in the person’s culture With postpartum onset: If onset within 4 weeks postpartum Tentukan jika: Dgn stresor(-stresor) nyata – brief reactive psychosis: jika gejala2 terjadi tampaknya segera setelah atau respons thd kejadian tunggal atau berganda yang akan menyebabkan stres berat pd hampir kebanyakan orang disitu dan kebiasaan yang sama. Tanpa stresor(-stresor) nyata: jika gejala2 psikotik tidat terjadi segera atau sbg respons thd kejadian tunggal atau berganda yang akan menyebabkan stres berat pd hampir kebanyakan orang disitu dan kebiasaan yang sama. Onset postpartum: jika onsetnya dalam 4 minggu pospartum. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz DSM-IV-TR Diagnostic Criteria for Major Depressive Episode DSM-IV-TR Diagnostic Criteria for Major Depressive Episode A. Five (or more) of the following symptoms have been present during the same 2 week period and represent a change from previous functioning: at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure Note: Do not include symptomsthat are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations. Adanya 5 ataulebih gejala2 berikut yg telah berlangsung dalam 2 minggu yg sama dan menunjukan perubahan dari fungsi2 sebelumnya dimana salah satunya adalah mood depresif atau kehilangan minat atau rasa senang.Cat. jangan memasukan gejala2 yg jelas ok kondisi medis umum atau waham dan atau halusinasi tidak serasi mood 1) Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears fearful). Note : in children and adolescents, can be irritable mood.Mood depresi berlangsung sepanjang hari pada hampir setiap hari sebagaimana dikeluhkan secara subjektif (merasa sedih atau hampa) atau diamati orang lain (terlihat berlinangan airmata).Cat pada anak dan remaja tampil sebagai mood irritable.
2) Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others) Kehilangan minat atau kesenangan yg nyata pd semua atu hampir semua aktifitas sepanjang hari hampir setiap hari (sebagaimana yang dirasakan atau diamati org lain thd ybs). 3) Significant weight loss when not dieting or weight gain (e.g., a change of more than 5 % of body weight in a month), or decrease or increase in appetite nearly every day. Note : in children, consider failure to make expected weight gains Penurunan berat badan yang bermakna tanpa diet atau peningkatannya ( perubahan berat badan lebihdari 5% sebulannya) atau adnay peningkatan atau penurunan nafsu makan.Cat. pada anak terjadi kegagalan mencapai berat badan yang diharapkan. 4) Insomnia or hypersomnia nearly every day Insomnia atau hipersomnia pada hampir setiap harinya. 5) Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down) agitasi atau retardasi psikomotor pada hampir tiap hari (yg dpt diamati orang lain bukan hanya perasaan subjektif restlessness atau lamban). 6) Fatigue or loss of energy nearly every day Fatigue atau kehilangan tenaga pada hampir setiap harinya. 7) Feelings or worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merelt self-reproach or guilt about being sick) perasaan tidak berharga atau rasa bersalah berlebihan atau inappropriate (yg mgk sebagai waham) pada hampir setiap harinya.(bukan hanya menyesali atau merasa berbeban dgn keadaanya). 8) Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) Kehilangan kemampuan berpikir atau berkonsentrasi atau membuat keputusan pada hampir setiap harinya (sebagaimana yang dirasakan atau diamati org lain thd ybs). 9) Recurrent thoughts of death (not just fear or dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide Pikiran berulang ttg kematian ( bukan hanya perasaan takut mati), bunuh diri tanpa perencanaan atau usaha bunuh diri atau adanya rencana spesifik mengakhiri hidup. B. The symptoms do not meet criteria for a mixed episode.Gejala2 tdk memenuhi kriteri episode campuran. C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning Gejala2 menyebabkab penderitaaan yg bermakna klinis atau hambatan sosial,pekerjaan atau area penting kehidupan lainnya.
D. The symptoms are not due to the direct physiologic effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism) Gejala2 tidak disebabkan oleh efek fisiologis langsung dari zat (medikasi,penyalahgunaan obat) atau kondisi medis umum (mis, hipotiroid). E. The symptoms are not better accounted for by bereavement (i.e., after the loss of a loved one), or the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, sucidal ideation, psychotic symptoms, or psychomotor retardatioin. Gejala2 tidak termasuk: keadaan dukacita (mis. kematian seseorang yg dicintai), atau menetap lebihdari 2 bulan, atau dikarakterisir oleh gangguan fungsional yan nyata,preokupasi ttg pikiran tdk berharga,ide bunuh diri,gejala2 psikotik aatau retardasi psikomotor. From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission GGN DEPRESI MAYOR, EPISODE TUNGGAL A. Adanya Episode Depresi Mayor tunggal. B. Episode Depresi Mayor yg ada tdk dpt digolongkan sbg ggn Skizoafektif dan tdk bertumpang tindih dgn Skizofrenia, Skizofreniform, ggn Waham atau Psikotik YTT. C. Tidak pernah ada episode Mania,Hipomania atau Campuran.Cat.: penyingkiran ggn2 ini tdk bisa diterapkan apabila merupakan induksi dari zat atau medikasi atau ok efek fisiologis lsg suatu kondisi medis umum. Jika criteria episode Depresi Mayor terpenuhi maka tentukangambaran klinisnya saat ini: Ringan, sedang atau berat dgn atau tanpa gambaran psikotik. Kronis. Dgn gambaran katatonik. Dgn gambaran melankolis Dgn gambaran atipik Dgn onset postpatum Jika
tidak maka tentukan juga gambarannya: Dlm remisi parsial atau penuh Kronis Dgn gambaran katatonik. Dgn gambaran melankolis Dgn gambaran atipik
Dgn onset postpatum
GGN DEPRESI MAYOR, REKUREN A. Adanya 2 atau lebih Episode Depresi Mayor..Cata: kalau dianggap sbg episode yg berbeda maka harus ada interval 2 bulan berturut yg tdk memenuhi kriteria Episode Depresi Mayor.. B. Episode Depresi Mayor yg ada tdk dpt digolongkan sbg ggn Skizoafektif dan tdk bertumpang tindih dgn Skizofrenia, Skizofreniform, ggn Waham atau Psikotik YTT. C. Tidak pernah ada episode Mania,Hipomania atau Campuran.Cat.: penyingkiran ggn2 ini tdk bisa diterapkan apabila merupakan induksi dari zat atau medikasi atau ok efek fisiologis lsg suatu kondisi medis umum. Jika kriteria episode Depresi Mayor terpenuhi maka tentukangambaran klinisnya saat ini: Ringan, sedang atau berat dgn atau tanpa gambaran psikotik. Kronis. Dgn gambaran katatonik. Dgn gambaran melankolis Dgn gambaran atipik Dgn onset postpatum Jika tidak maka tentukan juga gambarannya: Dlm remisi parsial atau penuh Kronis Dgn gambaran katatonik. Dgn gambaran melankolis Dgn gambaran atipik Dgn onset postpatum Tentukan: Penentu perjalanan longitudinal. Polanya mengikuti musim
Kriteria penentu tkt keparahan/psikotik/remisi dari Episode Depresi Mayor: Ringan: adanya bbrp gejala diagnostik yg menyebabkan hambatan minor pd fungi2 okupasional, aktifits2 sosisl atau hub dgn sesama.
Sedang: gejala dan hambatan yg ada berada diantara ”ringan” dan ”berat”. Berat tanpa gambaran psikotik: adanya sejumlah gejala diagnostik (lebih dari ringan dan sedang) dimana nyata menggangu fungi2 okupasional, aktifits2 sosisl atau hub dgn sesama. Berat dgn gambaran psikotik: terdapat waham atau halusinasi, jika memungkinkan tentukan: -gambaran psikotik sesuai mood: waham dan halusinasi (2) yg menetap bertema khas depresi ttg ketidak mampuan, rasa bersalah, penyakit, kematian, nihilistik atu berhak menerima hukuman. -gambaran psikotik tidak sesuai mood: adnay waham2 persekutorik, sisip pikir, siar pikir, atau dikendalikan. Dlm remisi parsial: kriteria penuh Episode Depresi Mayor tidak terpenuhi atau adanya periode tanpa gejala2 khas sedikitnya 2 bulan sesudah Episode Depresi Mayor terakhir (jika bertumpang tindih dgn ggn Distimia maka diagnosis ini yg ditegakan saat kriteria penuh Episode Depresi Mayor tidak terpenuhi). Dlm remisi penuh: tidak ada gejala dantanda bermakna Episode Depresi Mayor dlm 2 bulan terakhir. YTT
DSM-IV-TR Diagnostic criteria for melancholic features specified Specify if: With melancholic features (can be applied the current or most recent major depressive episode in major depressive disorder and to a major depressive episode in bipolar I or bipolar II disorder only if it is the most recent type of mood episode) Gambaran melankolik dapat diterapkan pd episode Depresif Mayor terakhir atau kini dari ggn Depresif Mayor dan episode Depresif Mayor dlm ggn BipolarI atau II jika hal in adalah tipe tersering dari episode mood. A. Either of the following, occurring during the most severe period of the current episode : 1) Loss of pleasure in all, or almost all, activities 2) Lack of reactivity to usually pleasureable stimuli (does not feel much better, even temporarily, when something good happens) Salah satu dibawah ini terjadi selama periode terparah episode kini: 1. tiada kesenangan pd hamper atau semua aktifitas
2. kehilangan reaksi pd stimuli yg biasanya menyenangkan (tidak merasa lebih baik meskipun sementara terjadi sesuatu yg bagus) B. Three (or more) of the following: 1) Distinct quality of depressed mood (i.e., the depressed mood is experienced as distinctly different from the kind of feeling experienced after the death of a loved one) 2) Depression regulary worse in the morning 3) Early morning awakening (at least 2 hours before usual time of awakening) 4) Marked psychomotor retardation or agitation 5) Significant anorexia or weight loss 6) Excessive or inappropriate guilt Adanya 3 atau lebih hal2 berikut: 1. kwalitas mood depresi tertentu ( mood depresi dirasakan khas berbeda disbanding dgn meninggalnya seseorang yg dicintai) 2. depresi secara berulang terjadi pagi hari 3. terbagun lebih awal (sekurang2nya 2 jam dari jam bangun biasanya) 4. retardasi atau agitasi psikomotor yg nyata 5. anorexia atau kehilangan bb yg bermakna 6. rasa bersalah berlebihan atau tidak sewajarnya
DSM-IV-TR Diagnostic criteria for atypical features specified Specify if: With atypical features (can be applied when these features predominate during the most recent 2 weeks of a current major depressive episode in major depressive disorder or bipolar I or bipolar II disorder when a current major depressive episode is the most recent type of mood episode, or when these features predominate during the most recent 2 years of dysthymic disorder; if the major depressive episode is not current, it applies if the feature predominates during any 2-week period) Gambaran atipik dapat diterapkan ketika hal ini menonjol selama 2 minggu terakhir pd episode Depresif Mayor sekarang dari ggn Depresif Mayor atau BipolarI atau II ketika episode Depresif Mayor terakhir adalah yg menonjol, atau ketika gambaran ini mendominasi ggn Distimia 2 tahun terakhir; jika episode Depresif Mayor tidak sedang terjadi,tetap diterapkan jika hal ini mendominasi selama 2 minggu. A. Mood reactivity (i.e., mood brightens is response to actual or potential positive events) Reaktivasi mood (mood menjadi cerah dgnberspons pd kejadian2 aktual atau potensial positif) B. Two (or more) of the following feature: 1) Significant weight gain or increase in appetite
2) Hipersomnia 3) Leaden paralysis (i.e., heavy, leaden feeling in arms or legs) 4) Long-standing pattern of interpersonal rejection sensitivity (not limited to episode of mood disturbance) that results in significant social or occupational impairment 2 atau lebih gambaran berikut: 1. bertambahnya bb yg nyata atau meningkatnya nafsu makan 2. hipersomnia 3. paralisa timah (yaitu tangan dan kaki terasa berat seprti timah) 4. pola berkepanjangan kepekaan penolakan antarpersonal C. Criteria are not met for with melancholic features or with catatonic features during the same episode.Tidak memenuhi criteria gambaran melankolis atau katatonik selama episode yg sama. DSM-IV-TR Diagnostic criteria for catatonic features specified Kriteria penentu gambaran Katatonik Dapat dipakai utk episode2 Depresi Mayor,Mania atau Campuran, ggn Bipolar I, ggn Bipolar II yg berlangsung.Gambaran klinis didominasi setidaknya oleh 2 hal berikut: 1. imobilitas motorik spt catalepsy ( termasuk flexibilitas cerea) atau stupor. 2. aktifitas motorik berlebihan (yg tidak bertujuan dan tdk dipengaruhi stimulus eksternal). 3. negativisme berat (resistensi tak bermotif pd semua perintah atau mempertahankan postur kaku pd tiap usaha utk menggerakannya) atau mutisme. 4. keanehan gerakn voluter dgn membuat postur ttt (asumsi spontan dari postur2 tdk sesuai atau janggal), gerakn2 stereotipik, manerisma atau menyeringai yg nyata. 5. adanya echolalia atau echopraxia
DSM-IV-TR criteria for Manic Episode
A.
A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary). Adanya periode nyata dari mood2 elevasi,expansif atau irritable yg abnormal dan menetap sedikitnya 1 minggu ( atau lebih singkat dimana harus rawat inap).
B.
During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree: Selama periode kekacauan mood diatas terdapat 3 gejala menetap ( ataulebih atau 4 jika moodnya hanya irritable) dan pada derajat yg bermakna dari: 1) Infiated self-esteem or grandiosity rasa harga diri meningkat atau kebesaran. 2) Decreased need for sleep (e.g., feels rested after only 3 hours sleep) kebutuhan tidur berkurang (mis. merasa telah berisitirahat walaupun hanya tidur 3 jam). 3) More talkative than usual or pressure to keep talking lebih aktif bicara dari biasanya atau dorongan kuat bicara terus-menerus. 4) Flight of ideas or subjective experience that thoughts are racing lompat gagasan atau pikiran dirasakan seperti berpacu. 5) Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli) disatraktibilitas ( perhatian terlalu mudah berpindah ke stimuli external yg tidak penting atau berkaitan). 6) Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation peningkatan intensitas aktifitas yg bertujuan (apakah disekolah, tempat kerja, lingkungan sosial, atau aktifitas sexual) atau agitasi psikomotor 7) Excessive involvement in pleasureable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees , sexual indiscretions, or foolish business investments) keterlibatan berlebihab dlm aktifitas2 yg menyenangkan dimana berpotensi menimbulkan konsekuensi yg menyakitkan (mis. kesenangan tak tertahankan utk berbelanja, perilaku sexual yg takabur, atau penanaman modal tanpa perhitungan)
C.
The symptoms do not meet criteria for a mixed episode. Gejala2 diatas tidak memenuhi kriteri episode campuran.
D.
The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevebt harm to self or other, or there are psychotic features. Gangguan mood ini mampu merusak fungsi2 pekerjaan atau aktifitas2 sosial dgn sesama, atau dibutuhkan awat inap utk mencegah tindakan membahayakan diri sendir atau orang lain, atau adanya gambaran psikotik.
E.
i. The symptoms are not due to the direct physiologic effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism). Gejala2 tidak disebabkan oleh efek fisiologis langsung dari zat (medikasi,penyalahgunaan obat, atau terapi lainnya) atau kondisi medis umum (mis, hipertiroid).
Note : Maniclike episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count to ward a diagnosis of bipolar I disorder. Cat.: Episode mirip mania yg jelas2 disebabkan terapi somatis antidepresan (obat,ECT, terapi cahaya) tidak dimasukaan sbg Gangguan Bipolar I. C. From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission.
Kriteria penentu tkt keparahan/psikotik/remisi dari Episode Mania: Ringan: gejala minimal Episode Mania terpenuhi. Sedang: adanya peningkatan tajam aktifitas2 atau ggn penilaian Berat tanpa gambaran psikotik: perlu adanya pengawasan kontinyu utk mencegah tindakan membahayakan diri sendir atau sesama. Berat dgn gambaran psikotik:, jika memungkinkan tentukan: -gambaran psikotik sesuai mood: adanya waham atau halusinasi yg bertema khas mania spt peningkatan harga diri,kekuatan, pengetahuan, identitas, atau punya hub khusus dgn dewa atau org terkenal. - gambaran psikotik tidak sesuai mood: adanya waham atau halusinasi yg bertema tdk khas mania waham2 persekutorik, sisip pikir, atau dikendalikan.
Dlm remisi parsial: kriteria penuh Episode Mania tdk terpenuhi atau adanya periode tanpa gejala2 khas sedikitnya 2 bulan sesudah Episode Mania terakhir . Dlm remisi penuh: tdk ada gejala2 atau tanda2 khas sedikitnya 2 bulan sesudah Episode Mania terakhir . YTT
DSM-IV-TR Criteria for Hypomanic Episode D. A distinct period of persistently elevated, expansive, or irritable mood, lasting throughtout 4 days, that is clearly different from the usual nondepressed mood. Adanya periode nyata dari mood2 elevasi,expansif atau irritable yg abnormal dan menetap sedikitnya 4 hari yg mana jelas berbeda dgn mood non-depresi lazimnya. E. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree Selama periode kekacauan mood diatas terdapat 3 gejala memnetap (ataulebih atau 4 jika moodnya hanya irritable) dan pada derajat yg bermakna dari: : 1. Infiated self-esteem or grandiosity rasa harga diri meningkat atau kebesaran. 2. Decreased need for sleep (e.g., feels rested after only 3 hours of sleep) kebutuhan tidur berkurang (mis. merasa telah berisitirahat walaupun hanya tidur 3 jam). 3. More talkative than usual or pressure to keep talking lebih aktif bicara dari biasanya atau dorongan kuat bicara terus-menerus. 4. Flight of ideas or subjective experience that thoughts are racing lompat gagasan atau pikiran dirasakan seperti berpacu. 5. Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli) disatraktibilitas ( perhatian terlalu mudah berpindah ke stimuli external yg tidak penting atau berkaitan). 6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation peningkatan intensitas aktifitas yg bertujuan (apakah disekolah, tempat kerja, lingkungan sosial, atau aktifitas sexual) atau agitasi psikomotor 7. Excessive involvement in pleasureable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees ,
sexual indiscretions, or foolish business investments) keterlibatan berlebihab dlm aktifitas2 yg menyenangkan dimana berpotensi menimbulkan konsekuensi yg menyakitkan (mis. kesenangan tak tertahankan utk berbelanja, perilaku sexual yg takabur, atau penanaman modal tanpa perhitungan) C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic. Episode dimaksud berhubungan dgn nyatanya perubahan fungsi2 yg tidak sesuai dgn ybs ketika tidak adanya gejala. D. The disturbance in mood and the change in functioning are observable by others. Gangguan mood dan perubahan2 fungsi diatas dapat diamati sesama. E. The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features. Episodenya tidak cukup kuat merusak fungsi2 pekerjaan atau aktifitas2 sosial dgn sesama, atau dibutuhkan awat inap, atau adanya gambaran psikotik. F. The symptoms are not due to the direct physiologic effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism) Gejala2 tidak disebabkan oleh efek fisiologis langsung dari zat (medikasi,penyalahgunaan obat, atau terapi lainnya) atau kondisi medis umum (mis, hipertiroid).
DSM-IV-TR Diagnostik criteria for Dysthymik disorder A. Depressed mood for most of the day,for more days than not,as indicated elther by subjective account or observation by other. For at least 2 years. Note: in children and adolescents,mood can be iritble and duration must be at least 1 year. Berlangsungnya mood depresif hampir sepanjang dan setiap hari yg dikeluhkan ybs atau diamati sesama selama sedikitnya 2 tahun.Cat.: pada anak2 dan remaja mood dapat irrritable dgn durasi sedikitnya 1 tahun. B. Presence,while depressed,of trwo (or more) of the following: 1) poor appetite or overeating 2) insomnis or hypersomnia
3) low energy or fatigue 4) low self-esteem 5) poor concentration or difficulty making decisions 6) feelings of hopelessness Terdapatnya 2 ataulebih hal2 berikut: 1. nafsu makan buruk atau makan berlebihan 2. insomnia atau hipersomnia 3. loyo atau letih 4. rendah diri 5. konsentrasi buruk atau sulit membuat keputusan 6. perasaan putus asa C. During the 2-yearperiod (1 year for children or adolescents) of the disturbance, the person has never been without the symptoms in criteria A and B for more than 2 months at a time.Tidak pernah bebas gejala2 kriteria A dan B lebih dari 2 bulan selama periode 2 tahun pertama gangguan (1 tahun untuk anak2 dan remaja). D. No mayor depressive episode has been present during the firs 2 years of the disturbance (1 year for children and adolescents);l,e., the disturbance is not better accounted for by chronik mayor depressive disorder, or mayor depressive episode provided there was a full remission (no significant sign or symptoms for 2 months) before development of the dysthymic disorder, in adation, after the initial 2 years (1 year in children or adolescents) of dysthymic disorder, there may be superimposed episodes of major depressive episode.Tidak pernah terdapat episode Depresi Mayor selama periode 2 tahun pertama gangguan (1 tahun untuk anak2 dan remaja) dan tidak dapat digolongkan sebagai Ggn Depresi Mayor kronis atau Ggn Depresi Mayor dlm remisi parsial.Cat.: dapat didahului episode Depresi Mayor dgn remisi penuh (bebas gejala selama 2 bulan) sebelum terjadinya ggn Distimia atau mgk tumpang tindih dgn episode depresi mayor dimana kedua diagnosa dapat diberikan. E. There has never been a manic episode, a mixed episode, or a hypomanic episode, and criteria have never been met for cyclothymic disorder.Tidak pernah ada episode mania,campuran atau hipomania dan tidakmemenuhi kriteria siklotimia F. The disturbance does not accur exclusively during the course of a chronic psychotic disorder , such as schizophrenia or delusional disorder. Gangguan ini tidak terjadi dalam perjalanan ggn psikotik kronis spt skizofrenia atau ggn waham. G. The symptoms are not due to the direct physiologic effects of a substance (e,g.m., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidsm). Gejala2 tidak disebabkan oleh efek fisiologis langsung dari zat (medikasi,penyalahgunaan obat) atau kondisi medis umum (mis, hipotiroid). H. The symptoms cause clinically significant distress or impairment in social,occupational, or other important areas of functioning. Gejala2 diatas
menyebabkan penderitaan dan hambatan bermakna klinis dlm fungsi sosial,pekerjaan atau area fungsional penting lainnya. Specify if: Early onset : if onset is before age 21 years Late onset : if onset is age 21 years or older Specity ( for most recent 2 years of dysthymic disorder): With atypical features Tentukan jika: Onset dini: jika dialami sebelum usia 21 tahun. Onset tertunda: jika dialami sesudah usia 21 tahun. Tentukan jika (pd 2 tahun terakhir dari ggn distimia):Dgn gambaran atipik From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission.
.
DSM-IV-TR Diagnostic criteria for cyclothymic disorder A. For at least 2 years. The presence of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode. Note: in children and adolescents, the duration must be at least 1 year. Sering munculnya periode gejala2 hipomania dan depresi yg tidak memnuhi kriteria episode depresi mayor sedikitnya selama 2 tahun. Cat.: pada anak2 dan remaja durasi sedikitnya 1 tahun. B. During the above 2 year period (1 year in children and adolescents), the person has not been without the symptoms in criterion A for more than 2 months at a time. Selama periode 2 tahun diatas (pada anak2 dan remaja durasi sedikitnya 1 tahun), ybs tidak pernah bebas dari gejala2 kriteria A lebihdari 2 bulan. C. No major depressive episode, manic episode, or mixed episodes has been present during the first 2 years of the disturbance. Tidak pernah ada episode dpresi mayor, mania, atau campuran pada 2 tahun pertama ggn Note After the initial 2 years (1 year in children and adolescent) of cyclothymic disorder, there may be superimposed manic or mixed episodes ( in Which case both bipolar I disorder and cyclothymic disorder may be diagnosed) or major depressive episodes (in which case both bipolar II disorder and cyclothymic, disorder may be diagnosed). D. The symptoms in criterion A are not better accounted for by schizoaffective disorder and are not superimposed on schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified. Gejala2 kriteria A
tidak dapat digolongkan sebagai skizoafektif dan bertumpang tindih dgn ggn skizofrenia, skizofreniform, waham atau psikotik tak tertentukan. E. The symptoms are not due to the direct physiologic effect of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism). Gejala tidak disebabkan oleh efek fisiologis langsung dari zat (medikasi,penyalahgunaan obat) atau kondisi medis umum (mis, hipertiroid). F. The symptoms cause clinical significant distress or impairment in social, occupational , or other important areas of functioning. Gejala2 diatas menyebabkan penderitaan dan hambatan bermakna klinis dlm fungsi sosial,pekerjaan atau area fungsional penting lainnya. From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission.
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DSM-IV-TR Diagnostic Criteria for Panic Attack Note: A panic attack is not a codeable disorder. Code the specific diagnosis in which the panic attack occurs (e.g., panic disorder with agoraphobia) Cat.: Serangan panik bukanlah gangguan berkode tersendiri, tentukan diagnosis dimana panik terjadi ( mis.Agoraphobia dgn panik). . A discrete period of intense fear or discomfort, in wich four (or more) of the following symptoms developed abruptty and reached a peak within 10 minutes.Adanya suatu periode ketakutan mencekam atau tidak nyaman yg khas dimana gejala2 berikut terjadi mendadak dan memuncak dlm 10 menit: (1) palpitations, pounding heart, or accelerated heart rate palpitasi, jantung berdebar keras, atau berpacu. (2) sweating berkeringat (3) trembling or shaking gamang atu gemetaran (4) sensations of shortness of breath or smothering rasa napas memendek atau dibekap (5) feeling of choking rasa tercekik
(6) chest pain or discomfort nyeri atau atau tidak nyamannya dada (7) nausea or abdominal distress nausea atau gangguan perut (8) feeling dizzy, unsteady, lightheaded, or faint pusing, bergoyang, pening atau berkunang-kunang (9) derealization (feelings of unreality) or depersonalization (being detached from oneself) derealisasi atu depersonalisasi (10) fear of losing control or going crazy ketakutan lepas kendali atai menjadi sinting (11) fear of dying ketakutan menghadapi maut (12) paresthesias (numbness or tingling sensations) paresthesia (13) chills or hot flushes menggigil atau wajah memanas
From American Psychiatry Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatry Association, Copyright 2000, with permission.
DSM-IV-TR kriteria diagnostik Agoraphobia Note: Agoraphobia is not acodeable diaorder.Code the specific disorder in which Agoraphobia occurs (e.g 300.21 Panic disorder with Agoraphobia) Cat.: Agoraphobia bukanlah gangguan berkode tersendiri, tentukan diagnosis dimana ggn ini terjadi ( mis.Agoraphobia dgn panik atau tanpa riwayat panik). A. Anxiety about being in places or stuations from which escape might be diffucult (or embarrassing) or in which help might not be available in the even unexpected or situationally predisposed Panic attack or panic like symptoms. Agoraphobia fears typically involve characteristic clusters of situations that include being outside the home alone, being in a crowd or standing in a line, being on bridge and traveling in abus, train or automobile.Note: Consider the specific Phobia if the avoidance is limited to one or a few only a specific situations, or Social phobia if the avoidance limited to the social situations. Anxietas berada di tempat atau situasi dimana menyelamatkan diri mgk sulit (atu memalukan) atau tiada pertolongan pada saat terjadi serangan atau mirip panik yg tak terduga atau situasional.Agoraphobia khas terjadi pd sekelompok situasi ketika sendirian diluar rumah, ditengah keramaian atau antrian, diatas jembatan, bepergian dgn bis, kereta api atau mobil.Cat.: pertimbangkan diagnosis fobia spesifik jika penghindaran hanya pada 1 atau beberapa situsi spesifik, atau Phobia Social bila terbatas pd situasi2 sosial.
B. The situations are avoided (e.g travel is restricted) or else are endured with marked distress or with anxiety having Panic Attack or panic like symptoms or require the presence of acompanion. Situasi2 diatas dihindari ( membatasi perjalanan) atau terpaksa dijalani dgn berbeban atu dgn kecemasan akan mengalami serangan panik (atau mirip) atau membutuhkan teman pendamping. C. The anxiety or phobic avoidance is not better accounted for by another mental disoerder such as Social Phobia, specific phobia, Obssesive-Compulsive disorder, Posttraumatic Stress disorder, Separation Anxiety disorder. Penghindaran kecemasan dan situasi fobik tidak dapat digolongkan sbg ggn mental lainnya spt Phobia Sosial, phobia spesifik, OCD, PTSD, atau ggn Kecemasan Perpisahan.
DSM-IV-TR Diagnostic Criteria for Generalized Anxiety Disorder A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for a least 6 months, about a number of events or activities (such as work or school performance.Kecemasan dan kekhawatiran berlebihan ( harap-harap cemaans) pd berbagai kejadian atau kegiatan (spt disekolah, tempat kerja) yg berlangsung lebihdari 6 bulan. B. The person finds it difficult to control the worry.Ybs menyadari tidak dapat mengendalikan kekhawatiran diatas. C. The anxiety and worry are associated with three (or more) of the following six simptoms (with at least some simptoms present for more days than not for the past 6 months. Note: Only one item is required in children. Kecemasan dan kekhawatiran berhubungan dgn 3 atau lebih dari 6 gejala berikut yg berlangsung lebihdari 6 bulan.Cat.: hanya 1 saja untuk diagnosa pd anak2. 1. restlessness or feeling keyed up or on edge gelisah, merasa tegang atau campuran keduanya 2. being easily fatigued gampang merasa letih 3. difficulty concentrating or mind going blank sukar berkonsentrasi atau pikiran kosong 4. irritability irritable (mudah marah) 5. muscle tension ketegangan otot
6.
sleep disturbances (difficulty falling or staying asleep, or restles, unsatisfying sleep) ) gangguan tidur (sulit tertidur atau mempertahankannya, terasa kurang atau tidak puas)
D. The focus of the anxiety and worry is not confined to features of on Axis I disorder, for example, the anxiety or worry is not about having a panic attack (as in panic disorder), being embarassed in public (as in social phobia), being contaminated (as in obssesive-compulsive disorder), being away from home or close relatives (as in separations anxiety disorder), gaining weight (as in anorexia nervosa), having multiple physical complaints (as in somatization disorder), or having a serious illness (as in hypochondriasis), and the anxiety and worry do not occur exclusively during posttraumatic stress disorder.) Inti kecemasan dan kekhawatiran berlebihan ini mengambang, tidak jelas spt gambaran gangguan axis I.Contohnya kecemasan dan kekhawatiran bukan tentang akan mengalami serangan panik (ggn panik), akan dipermalukan dimuka umum ( phobia sosial), tercemar (OCD), jauh dari rumah atau saudara dekat (ggn cemas perpisahan), menjadi gemuk (anorexia nervosa), mengalami berbagai ggn somatis (ggn somatisasi), memiiliki suatu penyakit serius (hipokondriasis) dan tidak terjadi hanya selama ggn cemas pasca trauma. E. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas or functioning.Kecemasan, kekhawatiran atau gejala2 fisik diatas menyebabkan penderitaan dan hambatan bermakna klinis dlm fungsi sosial,pekerjaan atau area fungsional penting lainnya. F. The disturbance is not due to the direct physiologic effects of a substance (e.g., a drug of abuse, a medication ) or a general medical condition(e.g.,hyperthyroidism) and does not occur excusively during a mood disorder, a psychotic disorder, or a pervasive development disorder.Gangguan ini tidak disebabkan oleh efek fisiologis langsung dari zat (medikasi,penyalahgunaan obat, atau terapi lainnya) atau kondisi medis umum (mis, hipertiroid) dan tidak terjadi hanya selama ggn mood, psikotik atu suatu ggn perkembangan pervasif.
DSM-IV-TR Diagnostic Criteria for Specific Phobia A. Marked and persistent fear that is excessive or unreasonable, cued by the presence or the anticipation of a specific object or situation (e.g., flying, heights, animals, receiving and injection, seeing blood). Ketakutan menetap dan nyata yg berlebihan atau tidak masuk akal terhadap atu antisipasi objek spesifik atau situasi (spt penerbangan, ketinggian,hewan, saat disuntik, melihat darah) B. Exposure to the phobic stimulus almost invariably provokes an immediate anxiety respons, which may take the form of a situationally predisposed panic attack. Note: in children, the anxiety may be expressed by crying, tantrums,
C. D. E.
F. G.
freezing or clinging. Ketika terpapar pd stimulus phobik hampir selalu mencetus kecemasan mendadak yg dapat menjadi serangan panik berkaitan dgn hal itu.Cat. pd anak-anak, kecemasan ditunjukan dgn menangis, mengamuk, mematung, atau memeluk (seseorang). The person recognizes that the fear is excessive or unreasonable. Note: in children, this feature may be absent. Ybs menyadari ketakutan ini berlebihan atau tidak masuk akal.Pada anak hal ini tidak ada. The phobic situation(s) is avoided or else is endured with intense anxiety or distress Situasi2 phobik dihindari atau dijalani dgn kecemasan kuat atau penderitaan. The avoidance, anxious anticipation, or distress in the feared situation(s) interferes significantly with the person’s normal routine, occupational (or academic) functioning, or social activitles or relatianships, or there is maeked distress about having the pobhia. Penghindaran, kecemasan antisipatif, atau penderitaan pada situasi2 yg ditakutkan menganggu secara bermakna pd rutinitas normal ybs,pekerjaan (atau akademik) atau aktifitas sosial atau hubungan lainnya atau adanya penderitaan yg nyata ttg phobianya. In individuals under age 18 years, in the duration is eat least 6 months. Jika berusia kurang dari 18 tahun maka durasinya minimal 6 bulan. The anxiety, panic attacks, or phobic avoidance associated with the specific object or situations is not better accounted for by another mental disorder, such as obssesive-compulsive disorder (e.g., fear of dirt in someone with an obssesion about contamination), posttraumatic stress disorder (e.g., avoidance of stimuli associated with a severe stressor), separation anxiety disorder (e.g., avoidance of school), social phobia (e.g., avoidance of social situations because of fear of embarassment ), panic disorder with agoraphobia, or agoraphobia without history of panic disorder. Kecemasan, serangan panik, penghindaran objek atau situasi spesifik tidak dapat dikategorikan pd ggn mental lainnya spt OCD,PTSD, Kecemasan perpisahan, Phobia sosial, panik dgn agoraphobia atau agora phobia tanpa riwayat panik.
Specity type: Animal type Natural environment type (e.g., heights, storms, water) Blood-injection-injury type Situational type (e.g., airplanes, elevators,enclosed places) Other type (e.g., phobic avoidance of situations that may lead to choking, vomiting, or contracting an illness; in children,avoidance of loud sound or costumed characters ) Tentukan tipe: 1. hewan ttt
2. 3. 4. 5.
lingkungan alami (ketinggian, badai, air) luka suntikan situsional (pesawat, elevator, tempat tertuutp) lainnya (penghindaran phobik dpt menimbulkan rasa tercekik,muntah, penyakit; pd anak sbg penhindaran suara keras atau tokoh berkostum)
From American Psychiatry Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatry Association, Copyright 2000, with permission.
DSM-IV-TR Diagnostic Criteria for Social Phobia
A.A marked an persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to posible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embrassing. Note: In children, there must be evidence of the capacity for age approppriate social relationships with familiar people and the anxiety must occur in peer settings, not just in interactions with adults. Ketakutan yg nyata dan menetap dari 1 atau lebih situasi atau penampilan dimana ybs terpapar dgn orang2 yg tidak dikenal atau merasa ditelanjangi oleh org lain.Ketakutan2 individu yaitu dia akan bertingkah (atau menunjukan gejala ansietas) yg akan dihina atau dipermalukan.Cat. pd anaka2. harus ada bukti2 kapasitas hubungan social yg sesuai dgn org yg dikenal dan ansietasnya harus terjadi dlm konteks kelompok anak seumurnya bukan hanya dgn orang dewasa. B.Exposure to the feared social situation almost invariably provokes anxiety, which may take the form of a situasionally bound or situasionally predisposed panic attack. Note: In children, the anxiety may be expressed by crying, tantums, freezing, or shrinking from social situations with unfamiliar people. Ansietas hampir selalu tercetus ketika terpapar dgn stuasi2 sosial terkait yg ditakutkan yg mgk saja merupakan predisposisi terhadap serangan panic.Cat. pd anak2, ansietas mgk ditunjukan lewat menangis, meledak kemarahannya, kaku terdiam, atau menjauhkan diri dari situasi2 dgn orang2 tak dikenalnya. C.The person recognizes that the fear is excessive or unreasonable. Note: In children, this feature may be absent. Ketakutan mana disadari ybs sbg berlebihan atau tidak beralasan. Cat. pd anak2, gambaran ini mgk tidak ada. D. The feared social or performance situations are avoided or else are endured with intense anxiety or distress.
Situasi2 sosial atau penampilan yg ditakuti dihindarinya atau dijalani dgn ansietas yg kuat atau menderita karenanya. E. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person's normal routine,occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia. Penghindaran, kecemasan antisipatif atau penderitaan dlm situasi2 sosial atau penampilan yg ditakuti menginterfensi secara bermakna dlm rutinitas noramal, fungsi okupasi (akademik) atau hubungan2 adan aktifitas social pasien atau adnya penderitaan yg nyata ok mengalami fobia ini. F. In individuals under age 18 years, the duration is at least 6 months. Pada individu berusia <18 tahun,durasi sedikitnya 6 bulan. G. The fear or avoidance is not due to the direct physiologic effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition and is not better accounted for by another mental disorder (e.g., panic disorder with or without agoraphobia, separation anxiety disorder, body dysmorphic disorder,a pervasive developmental disorder, or schizoid personality disorder). Ketakutan atau penghindaran tidak disebabkan efek fisilogis lsg dari zat (drug abuse, medikasi) atau suatu kondis medis umum dan tidak dpt digolongkan pd ggn mental lainnya (mis. Ggn Panik dgn/tanpa Agorafobia,Cemas Perpisahan,Dismorfik,Perkembangan Pervasif,Kepribadian Schizoid) H. If a general medical condition or another mental disorder is present, the fear in Criteterion A is unrelated to it (e.g., the fear is not of stuttering, trembling in Parkinson's disease, or exhibiting abnormal eating behavior in anorexia nervosa or bulimia nervosa). Jika terdapat suatu kondis medis umum atau ggn mental lainnya maka hal ini tdk berhungan dgn ketakutan pd kriteria A (cth. Ketakutan pd gagap, kegentaran pd Parkinson atau menunjukan perilaku makan abnormal pd Anorexia atau Bulimia Nervosa) Specify if: Generalized: If the faer include most social situations (also consider the additional diagnosis of avoidant personality disorder). Tentuka jika: Menyeluruh: jika ketakutan terjadi pd semua situasi2 sosial (pertimbangkan juga diagnosis tambahan Ggn Kepribadian Menghindar ) From American Psychiatry Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatry Association, Copyright 2000, with permission.
DSM-IV-TR Diagnostic Criteria for Obsessive-Compulsive Disorder A.
Other obsession or compulsions: Obsesi2 atau kompulsi2 lainnya: Obsession as defined by (1), (2), (3), and (4): Obsesi yg didefinisikan pada 1.2.3.4: (1). Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress Pikiran2 berulang dan menetap, dorongan2 atau khayalan yg dialami dalam waktu ttt selama gangguan ini sebagai sesuatu yg tak diundang dan tidak sesuai yg menyebabkan ansietas nyata ataupun penderitaan (2). The thoughts, impulses, or images are not simply excessive worries about real-life problems Pikiran2, dorongan2 atau khayalan2 diatas bukanlah hanya kekhawatiran berlebihan ttg problema2 kehidupan sehari2 (3). the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action Ybs berusaha utk mengabaikan atau menekan pikiran2, dorongan2 atau khayalan diatas atau menetralkannya dgn bbrp pikiranatau tindakan lain (4). the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without, as in thought insertion) Ybs menyadari pikiran2, dorongan2 atau khayalan2 obsesional diatas adalah produk pikirannya (bukan berasal dari luar seperti pd sisip pikir) Compulsions as defined by (1) and (2): Kompulsi2 seperti yg didefinisikan 1,2: (1). repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating, words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly Perilaku2 repetitif (spt mencuci tangan, mengatur, mengecek) atau kegiatan2 mental (spt sembahyang, menghitung, mengulang-ulang kata2 dalam hati ) dimana ybs merasa dikendalikan utk melakukannya sbg respons thd suatu obsesi atau sesuai aturan2 yg harus diterapkan (2). the behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive Perilaku atau kegiatan mental ini ditujukan utk mencega atau mengurangi penderitaan atau mencegah bbrp kejadian atau situasi yg amat mengakhawatirkan; meskipun demikian perilaku atau kegiatan mental ini tdk berhubugnan dgn cara2 realistik dgn
apa yg dimaksudkan yaitu utk menetralkan atau mencegah atau jelas2 berlebihan. B. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children. Pd suatu titik dlm perjalanan ggn ini, ybs menyadari bhw obsesi2 atau kompolsi2 diatas adalah berlebihan atau tidak beralasan.Cat. criteria ini tidak utk anak2 C. The obsessions or compulsions cause marked distress, are time consuming (take more than I hour a day), or significantly interfere with the person’s normal routine, occupational (or academic) functioning, or usual social activities or relationships. Obsesi2 atau kompolsi2 diatas meyebabkan penderitaan yg nyata, membuang2 waktu (makan waktu >1 jam/hari) atau menginterfensi secara bermakna dlm rutinitas normal, fungsi okupasi (akademik) atau aktifitas2 social pasien yg biasanya. D. If another Axis 1 disorder is present, the content of the obsessions or compulsions is not restricted to it (e.g., preoccupation with food in the presence of an eating disorder, hair pulling in the presence of trichochotillomania, concern with appearance in the presence of body dysmorphic disorder, preoccupation with drugs in the presence of a substance use disorder, preoccupation with having a serious illness in the presence of hypochondriasis, preoccupations with sexual urges or fantasies in the presence of a paraphilia, or gullty ruminations in the presence of major depressive disorder). Jiak terdapat juga ggn axis I lainnya, isi dari obsesi2 atau kompulsi2 tidak terbatas padanya (mis. preokupasi dgn makanan dlm Ggn makan, mencabut2 rambut pd Trikotilomania, mempwerhatikan penampilan pd Ggn Dismorfik, preokupasi dgn Napza dlm Ggn Pengguanaan Zat, preokupasi mengalami suatu peyakit serius dlm Hipokondriasis, preokupasi dgn hasrat atau fantasi sexual dlm Parafilia, atau ruminasi dgn perasaan bersalah pd Ggn Depresif Mayor) A. The disturbance is not caused by the direct physiologic effect of a substance (e.g., a drug of abuse, a medication) or a general medical condition. Gangguan ini tidak disebabkan efek fisilogis lsg dari zat (drug abuse, medikasi) atau suatu kondis medis umum Specify if: With poor insight: if, for most of the time during the current episode, the person does not recognize that the obsessions and compulsions are excessive or unreasonable Tentukan jika: dgn tilikan buruk: jika pd hampir selama episode terakhir, ybs tdk menyadari obsesi2 dan kompulsi diatas adalah diatas berlebihan atau tidak beralasan From American Psichiatric Association, Diagnostic and Statistical Manual of Mental Disorder, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, With permission.
DSM-IV-TR Diagnostic Criteria for Posttraumatic Stress Disorder A. The person has been exposed to a traumatic event in which both of the following were present: Ybs selama ini terpapar dgn kejadian traumatis dimana terdapat kedua hal berikut: (1). the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others Ybs mengalami, menyaksikan atau dihadapkan dgn suatu kejadian atau lebih yg meyangkut kematian atau ancaman kematian atau luka serius atau suatu ancaman thd keutuhan fisik dirinya atau orang lain (2). the person’s response involved fear, helplessness, or horror. Note: in children, this may be expressed instead by disorganized or agitated behavior. Respons2 ybs melibatkan ketakutan, ketidakberdayaan atau horor.cat pd anak2 hal in mgk diekspresikan dgn perilaku kacau atau agitasi. B. The traumatic event is persistently reexperienced in one (or more) of the following ways.Kejadian traumatis ini dialami berulang, menetap, dalam 1> cara2 berikut: (1). recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: in young children, repetitive play may occur in which themes or aspects of the trauma are expressed. Perulangan dan kenangan2 kejadian yg bersifat intrusive dan menderitakan termasuk bayangan2, pikiran2, atau persepsi2nya.Cat. permainan repetitif dpt terjadi dimana tema2 atau aspek2 dari trauma diekspresikan (2). Recurrent distressing dreams of the event. Note: in children, there may be frightening dreams without recognizable content. Berulangnya mimpi2 menderitakan dari kejadian itu.Cat. pd anak2 mgk ada mimpi2 menakutkan tanpa diketahui isinya (3). Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: in young children, trauma-specific reenactment may occur. Berperangai atau merasakan seakan2 kejadian traumatis itu kembali terjadi (termasuk perasan meghidupkan kembali pengalaman, ilusi2, halusinasi2 dan episode2 disosiatif pengingatan kembali baik yg terjdi wkt terjaga atau ketika mabuk).Cat. pd anak usia sekolah dasar dpt terjadi permainan berulang khas trauma.
(4). Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event Mengalami penderitaan psikologis yg meningkat saat terpapar dgn kata atau kode internal atau eksternal yg menyimbolkan atau menyrupai suatu aspek dari kejadian trumatis tsb (5). Physiologic reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event Terjadi reaktifitas fisiologis saat terpapar dgn kata atau kode internal atau eksternal yg menyimbolkan atau menyrupai suatu aspek dari kejadian trumatis tsb C. Persistent avoldance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following Penghindaran menetap stimuli yg berkaitan dgn trauma dan mematirasakan daya berespons umum (tidak ada sebelum trauma) sebagaimana yg ditunjukan ole 3 atau > hal2 berikut: (1). efforts to avoid thoughts, feelings, or conversations associated with the trauma Berusaha menghindari pikiran2, perasaan2 atau percakapan2 yg berkaitan dgn trauma (2). efforts to avoid activities, places, or people that arouse recollections of the trauma Berusaha menghindari aktifitas2, tempat2, atau orang2 yg membangkitkan kenangan2 dari trauma (3). inability to recall an important aspect of the trauma Ketidakmampuan mengingat kembali suatu aspek penting dari trauma (4). markedly diminished interest or participations in significant activities Penurunan nyata ketertarikan atau keikutsertaaan dalam aktifitas yg bermakna (5). feeling of detachment or estrangement from others Perasan terpisah atau terasing dari sesama (6). restricted range of effect (e.g., unable to have loving feelings) Rentang afek yg menyempit (mis. tidak dapat memiliki perasaan menyayangi) (7). sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span) Perasaan ttg masa depan yg terputus2 (mis. tdk mengharapka memiliki karir, perkawinan, anak2 atau usia hidup normal) D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following.Gejala2 menetap dari peningkatan kewaspadaan (tidak ada sebelum trauma) spt yg ditunjukan oleh 2 atau lebih hal2 berikut: (1). difficulty falling or staying asleep Kesulitan tertidur atau mempertahankannya. (2). irritability or outburst of anger
Gampang atau marah meledak2 (3). difficulty concentrating Kesulitan berkonsentrasi (4). Hypervigilance Kewaspadaan berlebihan (5). exaggerated startle response Respons kaget berlebihan E. Duration of the disturbance (symptoms in criteria B,C, and D) is more than 1 month. Durasi ggn (gejala2 kriteria B,C,D) > 1 bulan B. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Ggn ini menyebabkan penderitaan yg bermakna klinis atau hambatan dlm area social, okupasional atau area fungsional penting lainnya. Specify if: Acute: if symptoms last less than 3 month Chronic: if symptoms last 3 months or more Tentukan jika: Akut: jika gejala2 berlangsung <3 bulan Kronik: jika gejala2 berlangsung 3 bulan atau lebih Specify if: With delayed onset: if symptoms begin at least 6 months after the stressor Tentukan jika: dgn onset tertunda yaitu jika gejala2 muncul sedikitnya 6 bulan setelah stresor
From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder, text revision, 4th ed. Washington, DC; American Psychiatric Association, Copyright 2000, with permissi
zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz DSM-IV-TR Diagnostic criterio for Somatization Disorder A. A history of many physical complaints beginning before age 30 years that occur over a period of several years and result in treatment being sought or significant impairment in social, occupational, or other important areas of functioning.
Adanya riwayat keluhan-keluhan fisik yang dimulai sebelum usia 30 tahun yang berlangsung dalam periode beberapa tahun dan mencari-cari penyembuhannya atau terjadi hambatan bermakna dalam fungsi-fungsi sosial, pekerjaan, atau area penting lainnya. B. Each of the following criteria must have been met, with individual symptoms occurring at any time during the course of the disturbance Setiap kriteria berikut selama ini harus terpenuhi dimana gejala-gejala individu terjadi pada suatu waktu dalam perjalanan gangguan: 1. Four pain symptoms ; a history of pain related to at least four different sites or functions ( e. g., head, abdomen, back, joints, extremities, chest, rectum, during menstruation, during sexual intercourse, or during urination ). 4 gejala nyeri: riwayat nyeri pada minimal 4 tempat atau fungsional (misalnya kepala, perut, punggung, sendi, ekstremitas, dada, rektum, sewaktu coitus atau miksi). 2. Two gastrointestinal symptoms : a history of at least two gastrointestinal symptoms other than pain (e. g., nausea, bloating, vomiting other than during pregnancy, diarrhea, or intolerance of several different foods ). 2 gejala-gejala gastrointestinal: riwayat sedikitnya 2 gejala gastrointestinal selain nyeri (misalnya nausea, meteorismus, vomitus diluar kehamilan, diare, intoleransi beberapa jenis makanan). 3. One sexual symptom : a history of at least one sexual or reproductive symptom other than pain ( e. g., sexual indifference, erectile or ejaculatory dysfunction, irregular menses, excessive menstrual bleeding, vomiting throughout pregnancy ). 1 gejala sexual: riwayat sedikitnya ada 1 gejala sexual atau …… reproduksi selain nyeri (misalnya indiferen sexual, disfungsi ereksi atau ejakulasi, haid irregular, hipermenorrhea, vomitus sepanjang masa kehamilan). 4. One pseudoneurologic symptom : a history of at least one symptom or deficit suggesting a neurologic condition not limited to pain ( conversion symptoms such as impaired coordination or balance, paralysis or localized weakness, difficulty swallowing or lump in throat, aphonia, urinary retention, hallucinations, loss of touch or pain sensation, double vision, blindness, deafness, seizures ; dissociative symptoms such as amnesia ; or loss of consciousness other than fainting ). 1 gejala pseudoneurologis: riwayat sedikitnya 1 gejala atau deficit yang mengarah pada suatu kondisi neurologis yang tidak hanya nyeri (gejala-gejala konversi seperti gangguan koordinasi atau keseimbangan, paralisa atau kelemahan lokal, sukar menelan atau terasa adanya massa di tenggorok, aphonia, retensi urinae, halusinasi, kehilangan sensasi nyeri dan raba, visus ganda, kebutaan, tuli, kejang; gejala-gejala disosiatif seperti amnesia; kehilangan kesadaran selain pingsan).
C. Either (1) or (2) Adanya 1 atau 2: 1. After appropiate investigation, each of the symptoms in Criterian B cannot be fully explained by a known general medical condition or the direct effects of a substance ( e. g., a drug of abuse, a medication ). Setelah penelitian yang sesuai; gejala-gejala pada kriteria B tidak dapat dijelaskan berdasarkan kondisi medis umum yang dikenal atau efek langsung dari zat (penyalahgunaan obat atau medikasi) 2. When there is a related general medical condition, the physical complaints or resulting social or occupational impairment are in excess of what would be expected from the history, physical examination, or laboratory findings. Ketika ada kaitan dengan suatu kondisi medis umum, keluhan-keluhan fisik atau hambatan sosial atau pekerjaan adalah berlebihan berdasarkan riwayat, pemeriksaan fisik atau temuan-temuan laboratorium. D. The symptoms are not intentionally feigned or produced ( as in factitious disorder or malingering ). Gejala2 tidak (dimaksudkan) dibuat-buat atau disengaja (seperti pada gangguan buatan atau malingering).
DSM -IV-TR diagnoctic Criteria for Conversuoin Disorder A. One or more symptoms or deficit affecting voluntary motor or sensory function that suggest to neurogical or other general medical condition. 1 atau lebih gejala atau defisit pada fungsi motorik volunter atau sensoris yang mencerminkan gangguan neurologis atau kondisi medis umum lain. B. Psychological factors are judged to be associated with the symptom or deficit because the initiation oe exacerbation of the symptom or deficit in preceded by conflicts or other stressor. Faktor psikologis ditenggarai berhubungan dengan gejala atau defisit oleh karena permulaan atau eksaserbasinya didahului konflik atau streso lainnyar. C. The symptom or deficit is not intentionally produced or feigned ( as in factitious disorder or malingering). Gejala-gejala atau defisit-defisit tidak dimaksudkan demikian atau dibuat-buat (seperti pada gangguan buatan atau malingering).
D. The symptom or deficit cannot, after appropriate investigation, be fully explained by a general medical condition, or by the direct effects of a culturally sanctioned behaviour or experience. Sebuah penelitian yang sesuai, gejala atau defisit tidak dapat dijelaskan sebagai suatu kondisi medis umum atau efek langsung zat, atau sebagai budaya lokal atau pengalaman. E. The symptom or deficit causes clinically significant distress or impairment in social, occupational or other important areas of functioning or warrants medical evaluation. Gejala dan defisit menyebabkan penderitaan klinis atau hambatan nyata dalam fungsi-fungsi sosial, pekerjaan atau area penting lainnya atau dapat surat evaluasi status kesehatan..
F.The symptom or deficit is not limited to pain or sexual dysfunction, does not occur exclusively during the course of somatization disorder, and is not better accounted for by another mental disorder. Gejala dan defisit tidak terbatas pada nyeri atau disfungsi sexual, tidak terjadi dalam perjalanan gangguan somatisasi dan bukanjenis gangguan mental lainnya.
Spesify type of symptom or deficit : With motor symptom or deficit With sensory symptom or deficit With seizures or convulsions With mixed presentation . Tentukan tipe gejala dan defisit: a. dengan gejala atau defisit motorik b. dengan gejala atau defisit sensoris c. dengan kejang atau konvulsi d. tampil campuran
DSM -IV-TR diagnoctic Criteria for Pain Disorder A. Pain in one or more anatomic sites is the predominat focus of the clinical presentation and is of sufficient severity to warrant clinical attention. Nyeri pada 1 atau lebih distribusi anatomis adalah fokus yang menonjol dari gambaran klinis yang cukup parah sehingga diperhatikan secara klinis. B. The pain causes clinically significant distress or impairment in social, occupational, or other important area of functioning. Nyeri tersebut menyebabkan penderitaan atau gangguan yang bermakna klinis di area sosial, pekerjaan, atau area penting lainnya.
C. Psychological factors are judged to have an important role in the onset , severity, exacerbation, or maintenance of the pain. Faktor psikologis ditenggarai berperan penting dalam onset, keparahan, eksaserbasi atau menetapnya nyeri. D. The symptom or deficit is not intentionally produced or feigned ( as in factitious disorder or malingering). Gejala-gejala atau defisit tidakdimaksudkan demikian atau berpura-pura (seperti pada gangguan buatan atau malingering). E. The pain is not better accounted for by a mood , anxiety, or psychotic disorder and does not meet criteria for dyspareunia. Nyeri tidak dapat dikategorikan sebagai gangguan mood, anxietas atau psikotik dan tidak memenuhi kriteria dispareuni. Code as follows : Pain disorder associated with psychological factors : psychological factors are judge to have the major role in the onset , severity, exacerbation, or maintenance of the pain. ( If a general medical condition is present , it does not have a major role in the onset , severity, exacerbation, or maintenance of the pain). This type of pain disorder is not diagnosed if criteria are also met for somatization disorder.Pengkodean: Gangguan nyeri terkait faktor psikologis: faktor-faktor psikologis ditenggarai berperan penting dalam onset, keparahan, eksaserbasi atau menetapnya nyeri (jika terdapat suatu kondisi medis umum maka hal itu bukan utama). Tipe gangguan nyeri ini tidak didiagnosa jika memenuhi kriteria gangguan somatisasi. Specify if : Acute : duration of less than 6 months Chronic :duration of 6 months or longer Pain disorder associatedwith both psychological factors and a general medical condition : both psychological factors and a general medical condition are judged to have important roles in the onset, severity, exacerbation, or maintenance of the pain. The associated general medical condition or anatomic site of the pain. The associated general medical condition or anatomic site of the pain is coded on axis III. Tentukan jika: - Akut: durasinya kurang dari 6 bulan - Kronik: durasinya > 6 bulan Gangguan nyeri terkait faktor-faktor psikologis dan kondisi medis umum: keduanya ditenggarai berperan penting pada onset, keparahan, eksaserbasi atau kambuhannya nyeri..Kondisi medis umumdam lokasi anatomisnya
dimasukan pada axis III Specify if : Acute :duration of less than 6 months Chronic :duration of 6 months or longer. Tentukan jika: - Akut: durasinya kurang dari 6 bulan - Kronik: durasinya > 6 bulan
DSM-IV-TR diagnoctic Criteria for Hypochomdriosis A. Preoccupation with fears of having, or the idea thatb one has, a serious disease based on the person’s misinterpretation of boidly symptoms. Preokupasi dengan ketakutan bahwa yang bersangkutan mempunyai atau adanya idea tentang penyakit serius berdasarkan misinterpretasi ybs dengan gejala-gejala tubuhnya. B. The preoccupation persists despite appropriate medical evaluation and reassurance. Preokupasi ini menetap meskipun adanya evaluasi medis yang memadai disertai penjelasan utk meyakinkannya. C. The belief in Criterian A is not of delusional intensity ( as in delusional disorder, somatic type ) and is not restricted to a circumscribed concern about apperance ( as in body dysmorphic disorder ). Keyakinan pada A tidak setingkat waham (seperti pada gangguan waham tipe somatis) dan tidak hanya pada kepedulian tentang penampilan (seperti pada gangguan dismorfik). D. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Preokupasi ini menyebabkan penderitaan yang bermakna klinis atau di area-area sosial, okupasional, dan yang penting lainnya. E. The duration of the disturbance is at least 6 months. Durasi gangguan sedikitnya 6 bulan. F. The preoccupation is not better accounted for by generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, a major depressive episode, separation anxiety, or another somatoform disorder. Preokupasi tidak dapat digolongkan sebagai gangguan cemas menyeluruh, OCD, panik, depresif mayor, cemas perpisahan atau gangguan somatoform lainnya.
Specify if : With poor insight : if, for most of the time during the current episode, the person does not recognized that the concern about having a serious illness is excessive or unreasoneable. Tentukan jika: dengan tilikan buruk maka pada sepanjang waktu, terutama kini, yang bersangkutan tidak menyadari bhw keprihatinan mampunyai suatu penyakit serius adalah berlebihan atau tidak beralasan.
DSM-IV-TR diagnoctic Criteria for Body Dismorphic Disorder A.
Preoccupation with an imagined defect in appearance. If a slight physical anomaly is present, the person’s concern is markedly excessive. Preokupasi dengan defek imajinasi pada penampilan. Jika terdapat anomali fisik yang ringan maka kepeduliannya thd hal itu sangat berlebihan. B. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important area of functioning. Preokupasi ini menyebabkan penderitaan yang bermakna klinis atau di area-area sosial, okupasional, dan yang penting lainnya. C. The preoccupation is not better accounted for by another mental disorder ( e. g., dissatisfaction with body shape and size in anorexia nervosa ). Preokupasi ini tidak dapat digolongkan pada gangguan mental lainnya (mis. ketidakpuasan dgn bentuk dan ukuran tubuh seperti pada Anorexia nervosa).
DSM-IV-TR Diagnostic Criteria for Undifferentiated Somatoform Disorder A. One or more physical complaints (e.g., fatigue, loss of appetite, gastrointestinal or urinary complaints). Adanya 1 atau lebih keluhan fisik (seperti keletihan, hilang nafsu makan, keluhan saluran cerna dan kencing) B. Either (1) or (2): (1) Other appropriate investigation, the symptoms cannot be fully explained by a known general medical condition or the direct effects of a substance (e.g., a drug of abuse, a medication).
(2) When there is arelated general medical condition, the physical complaints or resulting social or occupational impairment is in excess of what would be expected from the history, physical examination, or laboratory findings. Adanya (1) atau (2):
C.
D. E.
F.
1. Setelah penyelidikan yg sesuai, gejala-gejala tidak dapat dijelaskan sebagai suatu kondisi medis umum atau sebagai suatu efek langsung zat (drug abuse, medikasi). 2. Ketika ada keterkaitan dengan gangguan kondisi medis umum maka keluhan-keluhan fisiknya atau fungsi sosial atau okupasi terganggu berlebihan berdasarkan riwayat, pemeriksaan fisik atau temuan laboratoris yg ada. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Gejala-gejala diatas menyebabkan penderitaan dengan hambatan bermakna klinis dalam fungsi sosial, okupasi atau area penting lainnya.. The duration of the disturbance is at least 6 months. Durasi sedikitnya 6 bulan The disturbance is not better accounted for by another mental disorder (e.g., another somatoform disorder, sexual dysfunction, mood disorder, anxiety disorder, sleep disorder, or psychotic disorder). Gangguan ini tidak dapat dikategorikan sebagai gangguan mental lainnya (misalnya gangguan somatoform lainnya, disfungsi sexual, gangguan mood, anxietas, atau psikotik). The symptom is not intentionally produced or feigned as in factitious disorder or malingering. Gejala-gejala tidak dimaksudkan demikian atau berpura-pura seperti pada gangguan buatan atau malingering.
DSM-IV-TR Diagnostic Criteria for Somatoform Disorder Not Otherwise Specified
This category includes disorders with somatoform symptoms that do not meet the criteria for any spesific somatoform disorder. Examples include: Kategori ini termasuk gangguan2 dgn gejala2 somatoform yg tidak sesuai dgn kriteria ggn somatoform spesifik,contohnya: 1. Pseudocyesis: a false belief of being pregnant that is associated with objective signs of pregnancy, which may include abdominal enlargement although the umbilicus does not become everted, reduced menstrual flow, amenorrhea, subjective sensation of fetal movement, nausea, breast enlargement and secretions, and labor pains at the expected date of delivery. Endocrine changes may be present, but the syndrome cannot be explained by a general medical condition that causes endocrine changes (e.g., a hormone-secreting tumor).Pseudocyesis: suatu keyakinan palsu menjadi hamil dikaitkan dgn tanda2 kehamilan diantaranya pembesaran perut meskipun umbilicus tidak eversi, tidak terlambatnya haid, ammenorrhea, merasa ada gerakan janin, nausea, pembesaran ammae dan adanya sekresi serta nyeri partus pada waktunya. 2. A disoreder involving nonpsychotic hypochondriacal symptoms of less than 6 months duration.Gangguan tentang gejala hipokondriasis nonpsikotik yg berlangsung sedikitnya 6 bulan 3. A disorder involving unexplained physical complaints (e.g., fatigue or body weakness) of less than 6 months duration that are not due to another mental disorder.Gangguan dgn keluhan2 fisik yg tdk dpt dijelaskan (spt keletihan atau kelemahan tubuh) yg berlangsung sedikitnya 6 bulandan bukan dikarenakan ggn mental lainnya .
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DSM-IV-TR Diagnostic Criteria for Dissociative Amnesia A. The predominant disturbance is one or more episodes of inability to recall important personal information, usually of traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness. Ggn menonjol pd ketidakmampuan mengingat kembali informasi penting pribadi
yg terjadi 1 kali atau lebih episode, biasanya ada riwayat traumatis atau kejadian sgt berat, yg terlalu luas dijelaskan dgn kelupaan biasa. B. The disturbance does not occur exclusively during the course of dissociative identity disorder, dissociative fugue, posttraumatic stress disorder, or somatization disorder and is not due to direct physiologic effects of a substance (e.g., a drug of abuse, a medication) or a neurologic or other general medical condition (e.g., amnestic disorder due to head trauma). Ggn ini tdk hanya terjadi selama perjalanan ggn2 Disosiatif Idntitas atau Fugue, Stres Pasca Trauma, Stres Akut, Somatisasi dan bukan krn efek fisiologis lsg suatu zat (penyalahgunaan obat, medikasi) atau kondisi neurologis atau medis umum lainnya (mis. Ggn Amnesia ok Trauma Capitis). C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Gejala2 diatas menyebabkan penderitaan atau hambatan yg bermakna klinis dlm bidang2 sosial, okupasional, atau fungsional penting lainnya.
DSM-IV-TR Diagnostic Criteria for Dissociative Fugue A. The predominant disturbance is sudden, unexpected travel away from home or one’s customary place of work, with inability to recall one’s past. Gangguan utama terjadi tiba-tiba, meninggalkan rumah atau tempat seseorang biasa bekerja, dengan ketidakmampuan untuk mengingat masa lalu. B. Confusion about personal identity or assumption of a new identity (partial or complete). Bingung dengan identitasnya atau mengira identitas baru (sebagian atau seluruhnya) C. The disturbance does not occur exclusively during the course of dissociative identity disorder and is not due to direct physiologic effects of a substance (e.g., a drug of abuse, a medication) or other general medical condition (e.g., temporal lobe epilepsy). Gangguan semata-mata tidak timbul selama terjadinya disosiasi kekacauan identitas dan tidak ok efek fisiologis langsung dari substansi (drug abuse, medikasi) atau kondisi medik umum (mis. Epilepsi lobus temporalis) D. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Gejala-gejala menyebabkan distress yang penting secara klinik atau kerusakkan sosial, masalah pekerjaan, atau daerah yang berhubungan dengan fungsi lainnya.
DSM-IV-TR Diagnostic criteria for Dissociative Identity Disorder A. THE PRESENCE OF TWO OR MORE DISTICNT IDENTITIES OR PERSONALITY STATES (EACH WITH ITS OWN RELATIVELY ENDURING PATTERN OF PERCEIVING,RELATING TO, AND THINKING ABOUT THE ENVIRONMENT AND SELF).TERDAPATANYA 2 ATAU LEBIH IDENTITAS BERBEDA ATAU STATUS KEPRIBADIAN (MASING2 RELATIS MEMILIKI POLA PERSEPSI, HUBUNGAN DGN, DAN PEMIKIRAN TTG DIRI SENDIRI DAN LINGKUNGAN). B. AT LEAST TWO OF THESE IDENTITIES OR PERSONALITY STATES RECURENTLY TAKE CONTROL OF THE PERSON’S BEHAVIOR. SETIDAKNYA 2 IDENTITAS BERBEDA ATAU STATUS KEPRIBADIAN DIATAS BERULANGKALI MENGENDALIKAN PERILAKU YBS. C. INABILITY TO RECALL IMPORTANT PERSONAL INFORMATION THAT IS TOO EXTENSIVE TO BE EXPLAINED BY ORDINARY FORGETFULNESS. KETIDAKMAMPUAN MENGINGAT KEMBALI INFORMASI PENTING PRIBADI YG TERLALU LUAS DIJELASKAN DGN KELUPAAN BIASA D. THE DISTURBANCES IS NOT DUE TO THE DIRECT PHYSIOLOGIC EFFECTS OF A SUBSTANCE (E.G., BLACKOUTS OR CHAOTIC BEHAVIOR DURING ALCOHOL INTOXICATION) OR A GENERAL MEDICAL CONDITION (E.G., COMPLEX PARTIAL SEIZURES). GGN INI TDK DISEBABKAN OLEH EFEK FISIOLOGIS LSG SUATU ZAT (SPT KEHILANGAN INGATAN ATAU KEKACAUAN PERILAKU SEWAKTU INTOKSIKASI ALKOHOL) ATAU KONDIS MEDIS UMUM (MIS. KEJANG KOMPLEKS-PARSIAL). NOTE: IN CHILDREN THE SYMPTOMS ARE NOT ATTRIBUTABLE TO IMAGINARY PLAYMATES OR OTHER FANTASY PLAY. CAT.: PADA ANAK2 GEJALANYA BUKAN TEMAN BERMAIN KHAYALAN ATAU PERMAINAN FANTASI LAINNYA.
DSM IV-TR Diagnostic Criteria for Depersonalization Disorder A. Persisant or recurrent experiences of feeling detached from, and as if one is an outside of, one’s mental processes or body (e.g., feeling like one is in a dream). Adanya pengalaman berulang atau menetap ybs meras terlepas dari proses mental atau tubuhnya seakan dari luar mengamati tubuhnya (mis.merasa spt dlm mimpi). B. During the personalization experience, reality testing remains intact. Tes realitas tetap utuh selama pengalaman personalisasi. C. The depersonalization causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Depersonalisasi diatas menyebabkan penderitaan atau hambatan yg bermakna klinis dlm bidang2 sosial, okupasional, atau fungsional penting lainnya The depersonalization experience does not occur exclusively during the course of another mental disorder, and is not due to the direct physiologic effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy). Pengalaman Depersonalisasi ini tdk hanya terjadi selama perjalanan ggn2 mental lainnya spt Skizofrenia, Panik, Stres Akut, atau disosiatif lainnya dan tdk disebabkan oleh efek fisiologis lsg suatu zat (penyalahgunaan obat, medikasi) atau kondisi medis umum lainnya (mis. Epilepsi Lobus Temporalis).
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DSM-IV-TR Diagnostic criteria for Female Sexual Arousal disorder (bangkitan gairah sexual ??) A. Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication swelling response of sexual excitement. Adanya ketidakmampuan menetap atau berulang mencapai atau mempertahankan aktifitas seksual sampai lengkap yaitu adanya rspons lubrikasi dari ransangan seksual. B. The disturbance causes marked distress or interpersonal difficulty. Ggn ini menyebabkan penderitaan nyata atau adanya kesulitan hubungan antarpersonal. C. The sexual dysfunction is not better accounted for by another Axis I disorder (except another sexual dysfunction) and is not due exclusively to the direct
physiologic effects of a substance (e.g, a drug of abuse, a medication) or a general medical condition. Disfungsi seksual ini tdk dpt digolongkan pd ggn axis I lainnya(kecuali disfungsi seksual lainnya) dan tdk hanya disebabkan oleh efek fisiologis lsg suatu zat (penyalahgunaan obat, medikasi) atau kondisi medis umum. Specify type : Lifelong type Acquired type Generalized type Situational type Due to psychological factors Due to combined factors Tentukan Tipe: Seumur hidup Didapat General Situsional Disebabkan faktor2 psikologis Kombinasi faktor2
DSM-IV-TR Diagnostic criteria for Female Orgasmic disorder A.
B. C.
Persistent or recurrent delay in, or absense of, orgasm following a normal sexual excitement phase. Women exhibit wide variability in the type or intensity of stimulation that triggers orgasm. The diagnosis of female orgasmic disorder should be based on the clinician's judgement that the woman's orgasmic capacity is less than would be reasonable for her age, sexual experience, and the adequacy of sexual stimulation she receives. Tertundanya atau tidak adanya orgasme setelah fase peransangan normal yg terjadi menetap atau berulang.Wanita menunjukan variasi yg luas dlm tipe atau stimulasi yg mencetus orgasme.Diagnosa berdasrkan penilaian klinikus bahwa kapasitas orgasmenya kurang dari yg diharapka berdasarkan umur, pengalaman seksual dan adekuatnya stimulasi seksual yg diterimanya. The disturbance causes marked distress or interpersonal difficulty. Ggn ini menyebabkan penderitaan nyata atau adanya kesulitan hubungan antarpersonal. The orgasmic dysfunction is not better accounted for by another Axis I disorder (except another sexual dysfunction) and is not due exclusively to the direct physiologic effects of a substance (e.g. a drug of abuse, a medication) or a general medical condition. Disfungsi orgasmik tdk dpt digolongkan pd ggn axis I lainnya(kecuali disfungsi seksual lainnya) dan tdk hanya
disebabkan oleh efek fisiologis lsg suatu zat (penyalahgunaan obat, medikasi) atau kondisi medis umum. Specify type: Lifelong type Acquired type Generalized type Situational type Due to psychological factors Due to combined factors. Tentukan Tipe: Seumur hidup Didapat General Situsional Disebabkan faktor2 psikologis Kombinasi faktor2 GGN ORGASME PADA WANITA
DSM-IV-TR Diagnostic Criteria for Male Erectile Disorder A. Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate erection. Adanya ketidakmampuan menetap atau berulang mencapai atau mempertahankan aktifitas seksual sampai lengkap yaitu ereksi adekuat. B. The disturbance causes marked distress or interpersonal difficulty. Ggn ini menyebabkan penderitaan nyata atau adanya kesulitan hubungan antarpersonal. C. The erectile dysfunction is not better accounted for by another Axis I disorder (other than a sexual dysfunction) and is not due exclusively to the direct physiologic efects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. Disfungsi ereksi tdk dpt digolongkan pd ggn axis I lainnya(selain disfungsi seksual lainnya) dan tdk hanya disebabkan oleh efek fisiologis lsg suatu zat (penyalahgunaan obat, medikasi) atau kondisi medis umum. Specify type: Lifelong type
Acquired type Generalized type Situasional type Due to psychological factors Due to combined factors Tentukan Tipe: Seumur hidup Didapat General Situsional Disebabkan faktor2 psikologis Kombinasi faktor2 From American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed.Washington, DC: American Psychiatric Association, Copyright 2000, with permission.
DSM-IV-TR Diagnostic Criteria for Gender Identify Disorder A. A strong and persistent cross-gender identification (not rarely a desire for any perceived cultural advantages of being the other sex). In children, the disturbance is manifested by four (or more) of the following Identifikasi diri yg kuat dan menetap pd kelamin berbeda (bukan hanya hasrat yg diterima budaya lokal menjadi kelamin berbeda).Pd anak2 ggn ini tampil sbg 4 atau lebih hal2 berikut: 1.
Repeatedly stated desire to be, or insistence that she or she is, the other sex mengungkapkan hasrat berulang2 atau memaksakan dirinya adalah jenis kelaminyg berbeda.dari kelamin lainnya. 2. In boys, preferences for cross-dressing or stimulating female attire; in girls, insistence on wearing only stereotypical masculine clothing pd anak laki-laki, adanya kesukaan memakai atau seakan2 memakai baju perempuan; pd anak perempuan, dia bersikeras memakai hanya pakaian stereotipik maskulin. 3. Strong and persistent preferences for cross-sex roles and makebelieve play or persistent fantasizes of being the other sex kesukaan yg kuat dan menetap berperan sbg kelamin lainnya dan permainan rekaannya atau fantasi menetap menjadi kelamin lainnya. 4. Intense desire to participate in the stereotypical games and pastimes of the other sex hasrat yg kuat utk ikutserta dlm permainan2 stereotipik atau pengisia waktu luang dari
kelamin berbeda. 5. Strong preference for playmates of the other sex hasrat yg kuat menjadi teman bermain kelamin lainnya. In adolescent and adults, the disturbance is manifested by symptoms such as a states desires to be the other sex, frequent passing as the other sex, desire to live or be treated as the other sex, of the conviction that he or she has the typical feelings and reactions of the other sex. Pada kelompok remaja dan dewasa, ggn berwujud sbg gejala2 hasrat pasti menjadi kelamin lain, sering menyamar sbg kelamin lainnya, berkehendak hidup atau diperlakukan sbg kelamin lainnya, atau adanya keyakinan bahwa ybs mempunyai perasaan tipikal dan reaksi2 kelamin lainnya. B. Persistent discomfort with his other sex or sense inappropriateness in gender role of that sex. Ketidaknyamanan menetap dgn kelaminnya atau rasa tdk cocok dgn peran gender kelaminnya. In children, the disturbance is manifested by any of the following; in boys, assertion that his penis or testes are disgusting or will disappear, assertion that it would be better not to have a penis, or aversion toward a rough and tumble play and rejection of male stereotypical toys, games and activities; in girls, rejection of urinating in a sitting position, assertion that she does no want to grow breast or menstruate, or marked aversion toward normative feminine clothing. Pada anak2, ggn ini tampil sbg: salah satu dari berikut ini; anak laki-laki: menyatakan bhw penisnya menjijikan atau akan menghilang atau lebih baik tidak memilikinya, membenci permainan kasar, adu jotos dan menolak mainan2, permainan dan aktifitas stereotipik laki-laki; anak perempuan: menolak kencing posisi jongkok,menyatakan bhw dia memiliki atau akan bertumbuh penis bukan payudara, tdk akan mengalami haid atau kebencian nyata thd pakaian2 wanita. In adolescents and adults, the disturbance is manifested by symptoms such as preoccupation with getting rid of primary and secondary sex characteristic (e.g., request for hormones, surgery, or other procedures to physically alter sexual characteristic to stimulate the other sex) or believe that she or he was born the wrong sex. Pada kelompok remaja dan dewasa, ditunjukan dgn gejala2 spt preokupasi dgn tdk mempunyai tanda sekunder kelaminnya (spt permintaan terapi hormon, bedah atau prosedur lain yg merubah ciri seks dan atau stimulasi ciri2 kelamin lainnya) atau percaya bhw dia dilahirkan dgn jenis kelamin yg salah. C. The disturbance is not concurrent with a physical intersex condition Ggn ini tdk bersamaan dgn suatu kondis fisik interseks. D. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning Gangguan diatas menyebabkan penderitaan atau hambatan yg bermakna klinis dlm bidang2 sosial, okupasional, atau fungsional penting lainnya.
code as on current age: • Gender identity disorder in children • Gender identity disorder in adolescent and adults Pengkodean berdasarkan usia saat berlangsung: Ggn Identitas Gender masa kanak Ggn Identitas Gender masa remaja dan dewasa Specify if (for sexually mature individuals) : • Sexually attracted to males • Sexually attracted to females • Sexually attracted to both • Sexually attracted to neither Tentukan jika (pd individu dewas secar seksual): Tertarik secara seksual pd laki-laki Tertarik secara seksual pd wanita Tertarik secara seksual pd laki-laki dan wanita Tidak tertarik secara seksual pd laki-laki ataupun wanita
Parafilia Gangguan
Definisi
Kondisi Umum
Eksibisionis
Menunjukkan alat kelaminnya kepada umum, jarang pada wanita
Ingin mengejutkan wanita, reaksinya mengatakan bahwa penis intak
Fetisime
Rangsangan seksual dengan benda yang tidak sesuai (sepatu, rambut, pakaian) Meremas jenis kelamin perempuan untuk mendapatkan
Lebih banyak pada pria, sering diikuti dengan perasaan bersalah
Penatalaksana an Psikoterapi, kondisi aversif, wanita harus menolak pria yang demikian, atau telepon polisi Psikoterapi internal, kondisi aversif, implasi (masturbasi dengan benda tersebut)
Terjadi pada keramaian, jarang, bukan pria yang agresif
Psikoterapi internal, kondisi aversif, terapi kelompok, medikasi
Froterisme
kenikmatan Pedofilia
Suka melakukan aktivitas seksual pada anak dibawah umur 13 tahun lebih ke parafilia
Masosisme Seksual
Keinginan seksual dengan cara dipaksa, diperkosa
Sadisme seksual
Fetisistem transfetik
Voyeurisme
95% heteroseksual, 5% homoseksual. Beresiko akan terjadi gejala ber-ulang 1012% anak telah terganggu jiwanya pada usia 18 tahun
atlantandrogeni k Memindahkan pasien pada ruang perawatan terapi kelompok, psikoterapi internal dan medikasi atlantaondragen ik Psikoterapi internal, terapi kelompok
Berusaha melawan perasaan bersalah, ingin dihukum Keinginan sek- Lebih banyak Psikoterapi, sual dengan pada laki-laki kondisi aversif memberi tekanan mental dan fisik Perubahan Lebih banyak Psikoterapi pakaian digunakan internal dalam stimulasi heterosekual. Lebih sering pada laki-laki yang menggunakan pakaian perempuan. Tidak pusing pada keinginan untuk merubah jenis kelamin Kenikmatan Masturbasi Psikoterapi seksual dengan biasanya internal, kondisi cara melihat dilakukan pada aversif aktivitas keadaan ini. seksual orang Biasanya lain (contohnya ditahan karena koitus atau mengintip dan orang yang mengendaptelanjang) bisa endap
Parafilia (parafilia ekskretori)
Zoofilia
saja terjadi pada wanita tapi paling banyak terjadi pada pria. Variasi lainnya melalui pembicaraan erotik lain Buang air (kaprolalia), atau urin (urofilia) pada pasangannya atau suara mendesah Berhubungan badan dengan binatang
Targanggunya Psikoterapi fase anal pada internal perkembangann ya dan klismafilia (enema)
Lebih sering Modifikasi pada daerah prilaku, pedesaan psikoterapi internal. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz DSM-IV-TR Diagnostic Criteria for Anorexia Nervosa
A. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintance of body weight less than 85% of that expected; or failure to make expected weight gain during perlod of growth, leading to body weight less than 85% of that expected).Penolakan mempertahankan BB normal atau diatas BB minimal sesuai dgn umur dan tinggi badan (kehilangan BB dipertahankan <85% berat yg diharapkan atau gagal mencapai BB yg sesuai selama masa pertumbuhan sehingga hanya <85% dari BB yg diharapkan) B. Intense fear of gaining weight or becoming fat, even though underweight.Ketakuatan yg kuat bertambahnya BB atau menjadi gemuk meskipun BB <standar. C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.Terjadi gangguan dlm cara pandang ybs ttg berat badannya atau bentuk tubuh, pengaruh tidak wajar dari BB atau bentuk badan berdasarkan penilaian sendiri atau menyangkal keseriusan kurangnya BB sekarang ini. D. In postmenarcheal females, amenorrhea (i.e., the absence of at least three consecutive menstrual cycles). A woman is considered to have amenorrhea if her periods occur only following hormone (e.g., estrogen) administration.Pd wanita2 postmenarche terdapat amenorrhea (tidak adan sedikitnya 3 kali berturut siklus menstruasi).Seorang wanita dianggap mengalami amenorrhea jika setelah pemberian hormone (mis.estrogen)
Specify type Tentukan tipe: Restricting type: during the current episode of anorexia nervosa, the person has not regularly engaged in binge-eating or purging behavior (i.e., self induced vomiting or the misuse of laxatives, diuretics, or enemas) Tipe terbatas: selama episode terakhir Anorexia Nervosa, ybs tidak reguler melakukan Binge eating etau perilaku mengosongkan perut (mis. Meransang sendiri utk muntah, pemakaian salah laxantia,diuretic atau enema) Binge-eating/purging type: during the current episode of anorexia nervosa, the person have regularly engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives, diuretics, or enemas) Tipe Binge eating / Mengosongkan perut: selama episode terakhir Anorexia Nervosa, ybs reguler melakukan Binge eating etau perilaku mengosongkan perut (mis. meransang sendiri utk muntah, pemakaian salah laxantia,diuretic atau enema) From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission.
DSM-IV-TR Diagnostic Criteria for Bulimia Nervosa A. Recurrent episodes for binge eating. An episode of binge eating is characterized by both of the following Adanya episode berulang binge eating yg dikarakterisir oleh kedua hal berikut: (1)eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances makan secara periodik (mis.tiap 2 jam) sejumlah makanan yg jumlahnya jelas melebihi kebanyakan orang melakukannya dlm periode itu dan suasana yg serupa. (2)a sense of lack of control over eating during the episode (e.g., feeling that one cannot stop eating or control what or how much one is eating) adanya perasaan kehilangan kendali makan berlebihan selama episode tsb (ybs merasa tdk dpt berhenti makan atau mengendalikan apa dan banyaknya yg dimakannya) B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. Perilaku kompensasi tidak sesuai yg
berulang dgn maksud mencegah kenaikan BB spt meransang sendiri utk muntah, pemakaian salah laxantia,diuretic enema atau medikasi lainnya, berpuasa atau olahraga berlebihan C. The binge eating and inappropriate compensatory behaviors both occur , on average, at least twice a week for 3 months. Binge eating dan perilaku kompensasi tidak sesuai diatas rata2 dilakukan 2 kali seminggu dalam 3 bulan. D. Self-evaluation is unduly influenced by body shape and weight. Penilaian sendiri dipengaruhi secara tidak wajar oleh bentuk dan berat badan E. The disturbance does not occur exclusively during episodes of anorexia nervosa. Gangguan ini tidak hanya terjadi selama episode Anorexia Nervosa Specify type Tentukan tipe: Purging type : during the current episode of bulimia nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas Tipe pengosong perut: selama episode terakhir bulimia nervosa, ybs reguler melakukan meransang sendiri utk muntah, pemakaian salah laxantia,diuretic atau enema Nonpurging type : during the current episode of bulimia nervosa, the person has used other inappropriate compensatory behavior, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas Tipe bukan pengosong perut: selama episode terakhir bulimia nervosa, ybs melakukan perilaku kompensasi tidak sesuai lainnya spt berpuasa atau olahraga berlebihan tetapi tidak regular meransang sendiri utk muntah, pemakaian salah laxantia,diuretic atau enema From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission. DSM-IV-TR Research Criteria for Binge-Eating Disorder
(MAKAN GAYA
MABUK ??????) A. Recurrent episode of binge eating. An episode of binge eating is characterized by both of the following Adanya episode berulang binge eating dimana satu episodenya dikarakterisir oleh kedua hal berikut: 1. eating, in a discrete periode of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances. makan secara periodik (mis.tiap 2 jam) sejumlah makanan yg jumlahnya jelas melebihi kebanyakan orang melakukannya dlm periode itu dan suasana yg serupa 2. a sense of lack of control over eating during the episod (e.g., a feeling that one
cannot stop eating or control what or how much one is eating). adanya perasaan kehilangan kendali makan berlebihan selama episode tsb (ybs merasa tdk dpt berhenti makan atau mengendalikan apa dan banyaknya yg dimakannya) B. The binge eating episodes are associated with three (or more) of the following episode2 binge eating berhubungan dgn 3 atau lebih hal berikut: 1. eating much more rapidly than normal Makan lebih cepat disbanding normalnya 2. eating until feeling uncomfortably full Makan sampai merasa penuh dan tidak nyaman 3. eating large amounts of food when not feeling physically hungry Memakan banyak makanan ketika tidak lapar secara fisik 4. eating alone because of being embarrassed by how much one is eating. Makan sendirian karena merasa malu dgn betapa banyak yg dimakannya 5. feeling disgusted with oneself, depressed, or very guilty after overeating Merasa jijik dgn diri sendir, tertekan atau sangat bersalah setelah makan berlebihan C. Marked distress regarding binge eating is present. Penderitaan yg nyata dgn adanya binge eating D. The binge eating occurs, on averages, at least 2 days a week for 6 months. Binge eating rata2 terjadi sedikitnya 2 hari dalam seminggu selama 6 bulan Note: The method of determining frequency differs from that use for bulimia nervosa; future research should address whether the preferred method of setting a frequency threshold is counting the number of days on which binges occur or counting the number of episodes of binge eating. F. The binge eating is not associated with the regular use of innappriate compensatory behaviors (e.g., purging, execissive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa. Binge eating tidak terkait dgn perilaku regular kompensasi tidak sesuai (mengosongkan perut, olahraga berlebihan) dantidak hanya terkadi selama perjalanan Anorexia Nervosa atau Bulimia nervosa From American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz
GANGGUAN PERILAKU EKSPLOSIF-INTERMITEN
A. Several discrete episodes of failure to resist aggressive impulses that result in serious assaultive acts or destruction of property Adanya bbrp episode dari kegagalan menahan impuls agresif yg mengakibatkan serangan serius thd org lain atau perusakan barang2. B. The degree of aggressiveness expressed during the episodes is grossly out of proportion to any precipitating psychososcial stressors. Derajat keagresifan yg terjadi selama episode jelas melampaui proposi thd stressor psikososial pencetusnya. C. The aggressive episodes are not better accounted for by another mental disoreder (e.g antisocial personality disorder, borderline personality disorder, a psychotic disorder, a manic episode, conduct disorder, or attention deficit/hyperactivity disorder) and not due exclusively to the direct physiologic effects of a substance (e.g. a drug of abuse, a medication) or a general medical condition (e.g head trauma, Alzheimer’s disease). Episode agresig diatas tidak dpt digolonggkan sbg ggn mental lainnya (spt ggn kepribadian antisocial,kepribadian ambang, psikotik, episode mania, perilaku (conduct) atau ADHD) dan bukan ok efek fisiologis langsung zat ( drug abuse,medikasi) atau suatu kondis medis umum (trauma capitis, peny Alzheimer) KLEPTOMANIA A. Recurrent failure to resist impulses to steal objects that are not needed for personal use or to their monetary value. Adanya kegagalan berulang menahan impuls utk mencuri benda yg tdk dibutuhkan ybs atau harganya. B. Increasing sense of tension immediately before commiting the theft Peningkatan perasaan ketegangan sesaat sebelum melakukan pencurian. C. Pleasure, gratification, or relief at the time commiting the theft Adanya perasaan senang, puas atau lega saat melakukan pencurian. D. The stealing not commited to express anger or vengeance and it is not in response to delusion or hallucination Pencurian tdk dilakukan sbg ungkapan kemarahan, balas dendam dan bukan sbg respons dari suatu waham atau halusinasi. E. The stealing is not better accounted for by conduct disorder, a manic episode, or antisocial personality Pencurian dimaksud tidak dapat digolonggkan sbg ggn kelakuan (conduct), episode mania atau kepribadian antisosial. PIROMANIA A. Deliberate and purposefull fire setting on more than one occasion Pembakaran yg disengaja atau direncanakan pada 1 ataulebih kesempatan. B. Tension or affective arousal before the act Adanya perasaan tegang atau meningkatnya afek sebelum pembakaran.
C. Fascination with, interst in, curiousity about aor attraction to fire and its situational contexts (e.g parapehernalia,uses, consequences) Keterpikatan , ketertarikan, keingintahuan atau kesukaan dgn api dan situsasi yg ditimbulkannya ( paraphernalia,penggunaan, konsekuensi2nya). D. Pleasure, gratification, or relief when settings fire or when witnessing or participation in their aftermath Adanya perasaan senang, puas atau lega saat melakukan pembakaran, menyaksikannya, atau membantu sesudah kebakaran. E. The fire setting is not done for monetary gain, as in expression of sociopolitical ideology, to conceal criminal activity, to express anger or vengeance, to improve one’s living circumstances,in response to delusion or hallucination, or as a result of impaired judgment (e.g dementia, mental retardation, substance intoxication) Pembakaran tdk dilakukan utk mendapatkan uang, penyataan ideology sosiopolitik, menyembunyikan tindakan criminal, mengskspresikan kemarahan atau dendam, pembuktian kehidupan seseorang, sbg respons thd waham atau halusinasi atau sbg hasil ggn penilaian (spt dementia, retardasi mental, intoksikasi zat). F. The fire setting is not better accounted for by conduct disorder, a manic episode, or antisocial personality Pembakaran ini tdk dpt digolongkan sbg ggn perilaku (conduct), episode mania, atau ggn kepribadian antisosial.
TRIKOTILOMANIA A. Recurrent pulling of one’s hair resulting in noticeable hair lossPencabutan berulang rambut sendiri sehingga tampak nyata area kehilangan rambut. B. An increasing sense of tension immediately before pulling out the hair or when attempting to resist the behaviour Adanya peningkatan rasa tegang sesaat sebelum mencabut rambut atau ketika mencoba menahan perilaku ini. C. Pleasure, gratification, or relief when pulling out the hair Adanya perasaan senang, puas atau lega saat mencabut rambut. D. The disturbance is not better accounted for by another mental disorder and is not due to a general medical condition. Gangguan ini tidak dpt digolonggkan sbg ggn mental lainnya atau disebabkan kondis medis umum (spt kondisi dermatologis). E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning Gangguan ini menyebabkan penderitaan yg bermakna klinis atau hambatan social, pekerjaaan, atau pd area fungsi2 penting lainnya.
DSM-IV-TR Diagnstic Criteria for Adjustment Disorder (GANGGUAN PENYESUAIAN ??????) A. The development of emotional or behavioural symptoms in response to an identifiable stressor(s) occurring within 3 month of the onset of stressor(s) Terjadinya gejala2 emosional atau perilaku sbg respons thd stressor(2) yg diketahui dan berkembang dalsam 3 bulan sejak oset stressor(2). B. These symptoms or behaviours are clically significant as evidenced by either of the following Gejala2 atau perilaku2 diatas bermakna secara klinis yg dibuktikan oleh salah 1 hal berikut: 1. marked distress that is exess of would be expected from exposure to the stressor penderitaan yg dialami melebihi dari apa yg diduga jika terpapar stressor(2) tsb. 2. significant impairment in social or occupational (academic) functioning adanya hambatan bermakna dlm fungsi2 sosial atau pekerjaan (akademik). C. The stress related disturbance does not meet the criteria for another axis I disorder and is not merely an exacerbation of a preexisting axis I or axis II disorder Gangguan terkait stress ini tidak memenuhiriteria ggn spesifik axis I lainnya dan bukanlah eksaserbasi ggn2 axis I dan II yg sudah ada sebelumnya. D. The symptoms do not represent bereavement Gejala2 diatas bukanlah keadaan berduka. E. Once the stressor (or its consequences) has terminated,the symptoms do not persist for more than additional 6 months Ketika stresor(2) atau konsekuensinya berakhir, gejala2 diatas tidak menetap dalam 6 bulan kedepan. Spicify if: acute if the disturbance lasts less than 6 months chronic if the disturbance lasts for 6 months or longer Adjusment disorder are coded base on the subtype, which is selected for the predominant symptoms.The specifis stressor(s) can be specified in axis IV: with depressed mood with anxiety with mixed anxiety and depressed mood with disturbance of conduct with mixed disturbance of emotions and conduct unspecified Tentukan jika: Akut: jika ggn berlangsung kd 6 bulan. Kronis: jika ggn berlangsung ld 6 bulan. Ggn Penyesuaian dikode berdasarkan subtipe yg ditentukan oleh ejala2 predominan.stresor(2)nya disebutkan pd axis IV:
Dgn mood depresi Dgn anxietas Campuran anxietas dan mood depresi Dgn ggn perilaku (conduct) Campuran ggn emosi dan perilaku Taktertentukan
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DSM-IV-TR Diagnostic Criteria for Psychological Factors Affecting Medical Condition A. A general medical condition (coded on axis III) is present Teradapat suatu kondisi medis umum (dikode pd axis III) B. Psychological factors adversely affect the general medical condition in one of the following ways Faktor2 psikologis mempengaruhi kondisi medis umum dalam salah satu cara berikut: 1. The factors have influenced the course of the general medical condition as shown by a close temporal association between the psychological factors and the development or exacerbation of, or delayed recovery from, the general medical condition. Faktor2 telah mempengaruhi perjalanan dari kondisi medis umum yg ditunjukan dgn hubungan temporal yg kuat antara faktor2 psikologis dan terjadinya atau eksaserbasi, atau keterlambatan pemulihan kondisi medis umum 2. The factors interfere with the treatment of the general medical condition. Faktor2 mengintervensi perawatan dari kondisi medis umum 3. The factors constitute additional health risks for the individual Faktor2 memberi tambahan resiko2 kesehatan pada ybs 4. Stress – related physiologic responses precipitet or exacerbate symptoms of a general medical condition. Respons2 fisiologis terkait stress mempresitasi atau meneksaserbasi kondisi medis umum Choose name based on the nature of the psychological factors: if more than one factors is present indicate the most prominent: Pemilihan nama berdasarkan sifat faktor2 psikologis, jika lebih dari satu maka indikasikan yg plg menonjol Mental disorder affecting medical condition ( e.g. , a.n Axis I disorder such as major depresseve disorder delaying recovery from a myocardial infraction ) Gangguan mental mempengaruhi kondis medis (mis. ggn pd axis I adalah ggn Depresif Mayor memperlambat pemulihan Miokard Infark) Psychological symptomps affecting medical condition ( e.g., depressive symptomps delaying recovery from surgery, anxiety, exacerbating asthma )
Gejala2 psikologis mempengaruhi kondis medis (mis. gejala2 depresif memperlambat pemulihan pembedahan, ansietas mengeksaserbasi Asthma ) Personality traits or coping style affecting medical condition ( e.g., pathological denial of the need for surgery in a patient with cancer, hostile, pressured behavior contributing to cardiovascular disease ). Tipe kepribadian atau cara koping mempengaruhi kondis medis (mis. penyangkalan patologis thd perlunya pembedahan pasiendgn kanker, sikap bermusuhan atau perilaku meledak2 berkontribusi pd penyakit kardiovaskuler) Maladaptive health behaviours affecting medical condition ( e.g., lack of exercise, unsafe sex, overeating ). Perilaku2 sehat maladaptif mempengaruhi kondis medis (mis. tidak berolahraga, hubungan sex tidak aman, makan berlebihan) Stress – related physiologic response affecting general medical condition ( e.g., stress – related exacerbation of ulcer hypertension, arhytmia, or tension headache) Repons fisiologis terkait stress mempengaruhi kondis medis umum (mis. stress terkait dgn eksaserbasi ulkus hipertensi,aritmia atau tension headache) Other or unspecifiedpsychological factors affecting medical condition ( e.g., interpersonal, cultural or religius factors ) Faktor psikologis lain atau tak tertentukan mempengaruhi kondis medis (mis. faktor2 antarpersonal, budaya atau religius) From American Psychiatri Association \. Diagnostic and Statitical Manual of Mental Disorders, text revision 4 th ed. Washington, DC: American Psychiatri Association, Copyright 2000, with permission.
DSM-IV-TR Diagnostic Criteria for Paranoid Personality Disorder A. A pervasive distrust and suspiciousness of others such that their motives
are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following Adanya ketidakpercayaan dan
kecurigaan yang mendalam (pervasive) thd sesame dimana motivasi mrk diinterpretasi sbg bermaksud jahat.Hal ini bermula sejak awal masa dewasa dalam berbagai konteks spt yg ditunjukan oleh 4 hal al berikut ini: 1. suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her mencurigai sesama tanpa dasar kuat bhw mrk (sementara) mengeksploitasi, membahayakan atau menipu ybs. 2. is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates terpreokupasi dgn keraguan tak terbantahkan ttg kesetiaan atau kepercayaan dari teman2 atau orang2 dekatnya. 3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her engaan
mempercayai sesama ok adanya ketakutan tak beralasan bhw informasinya akan digunakan sbg balas dendam pada ybs. 4.
reads hidden demeaning or threatening meanings into benign remarks or
membaca hal tersembunyi yg merendahkan dirinya atau mengancam dari ucapan atau kejadian biasa saja events
5.
persistently bears grudges, that is, is unforgiving of insults, injuries, or slights
mendendam scr persisten, tak termaafkan thd perkataan menghina, merendahkan atau luka2 6.
perceives attacks on his or her character or reputation that are not apparent
menanggapi serangan tak berarti dr sesama thd karakter atau reputasinya dgn lsg marah atau membalasnya. to others and is quick to react angrily or to counterattack
7.
has recurrent suspicions, without justification, regarding fidelity of spouse or
menanggapi serangan tak berarti dr sesama thd karakter atau reputasinya dgn lsg marah atau membalasnya. sexual partner
B.
Does not occur exclusively during the course of schizophrenia, a mood disorder with psychotic features, or another psychotic disorder, and is not due to the direct physiologic effects of a general medical condition. Hal2 diatas tidak hanya
terjadi dlm perjalanan Skizofrenia, ggn mood dgn gambaran psikotik atau ggn psikotik lainnya dan bukan ok efek2 fisiologis lsg suatu kondisi medis umum. Note: If criteria are met prior to the onset of schizophrenia, add “ premorbid, ” for example, “paranoid personality disorder (premorbid).”
Catatan: jika criteria diatas terpenuhi seb onset Skizofrenia maka tambahkan “premorbid”, contohnya Gggn Kepribadian Paranoid (premorbid). From American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
GANGUAN KEPRIBADIAN PARANOID 1. menanggapi serangan tak berarti dr sesama thd karakter atau reputasinya dgn lsg marah atau membalasnya. DSM-IV-TR Diagnostic Criteria For Schizoid Personality Disorder A pervasive pattern of detachment from social relationships and a restricted range A. of supression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following Adanya suatu pola pervasif pemutusan dgn hub2 sosial
dan supresi rentang emosi dlm hub antarpersonal. Hal ini bermula sejak awal masa dewasa dalam berbagai konteks spt yg ditunjukan oleh 4 hal al berikut ini: 1.
neither desires nor enjoys close relationships, including being part of a family tiada gairah atau menikmati hub2 akrab termasuk pd
aggota keluarga. 2.
almost always chooses solitary activities
hampir selalu memilih
aktifitas soliter. 3.
4. 5.
6. 7.
has little, if any, interest in having sexual experiences with another person
sedikit sekali, jika ada, tertarik pd pengalaman2 sexual dgn orang lain. takes pleasure in few, if any, activities menyenangi, jika ada, pada sedikit aktfitas lacks close friends or confidants other than first-degree relatives tdk mempunya teman akrab atau curahan hati diluar keluaraga inti. appears indifferent to the praise or criticism of others tampak indiferen thd pujian atau kritik dari sesama shows
emotional
coldness,
menunjukan kebekuan pendatan afek. B.
detachment,
emosi,
or
flattened
berdiri
affectivity
sendiri
atau
Does not occur exclusively during the course of schizophrenia, a mood disorder with psychotic features, another psychotic disorder, or a pervasive developmental disorder and is a not due to the direct physiologic effects of a general medical condition. Hal2
diatas tidak hanya terjadi dlm perjalanan Skizofrenia, ggn mood dgn gambaran psikotik, ggn psikotik lainnya atau suatu ggn perkembangan pervasive dan bukan ok efek2 fisiologis lsg suatu kondisi medis umum. Note: If criteria are met prior to the onset of schizophrenia, add “ premorbid, ” for example, “schizoid personality disorder (premorbid).”
Catatan: jika criteria diatas terpenuhi seb onset Skizofrenia maka tambahkan “premorbid”, contohnya Gggn Kepribadian Skizoid (premorbid). From American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
GANGGUAN KEPRIBADIAN SKIZOID
Table 19-3
DSM-IV-TR Diagnostic Criteria for Schizotypal Personality Disorder A. A pervasive pattern of social and interpersonal deficits marked by acute discomfort with and reduced capacity for close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following Adanya suatu pola pervasive defisit hub2 sosial dan antarpersonal yg ditandai oleh ketidaknyamanan akut dan menurunnya kapasitas thd hub2 dekat, distorsi kognitif dan persepsi serta perilaku eksentrik. Hal ini bermula sejak awal masa dewasa dalam berbagai konteks spt yg ditunjukan oleh 5 hal al berikut ini: 1. 2.
3. 4.
5. 6. 7. 8. 9.
ideas of reference (excluding delusions of reference) adnya ide2 rujukan (bukan waham rujukan). add beliefs or magical thinking that influences behavior and is inconsistent with sub cultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or “sixth sense” in children and adolescents, bizarre fantasies or preoccupations) adanya kepercayaan aneh atau pikiran magis yg mempengaruhi perilaku dan tidak sesuai dgn norma2 subkultur (mis. hal takhyul, percaya pd tenung, telepati, atau indra keenam; pd anka dan remaja adanya fantasi2 ganjil dan preokupasi2). unusual perceptual experiences, including bodily illusions pengalaman2 persepsi tidak biasanya termasuk ilusi2 ttg tubuh. odd thinking and speech (e.g. vague, circumstantial, metaphoric, overelaborate, or stereotyped) pemikiran dan pembicaraan yg aneh (mis. tdk berinti, sirkumtansial, metaforik, melebih-lebihkan atau stereotipik). suspiciousness or paranoid ideation kecurigaan atau ide paranoid. inappropriate or constricted affect afek tidak sesuai atau menyempit. behavior of appearance that is ood, eccentric, or peculiar penampilan yg aneh, eksentrik, ganjil. lack of close friends of confidants other than first-degree relatives tdk mempunya teman akrab atau curahan hati diluar keluaraga inti. excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self adanya kecemasan social berlebihan yg tdk berkurang dgn situasi
kekeluargaan dan cenderung berrkaitan dgn ketakutan paranoid lebih dari penilaian negative thd diri sendiri.
B.
Does not occur exclusively during the course of schizophrenia, a mood disorder with psychotic features, another psychotic disorder, or a pervasive developmental disorder Hal2 diatas tidak hanya terjadi dlm perjalanan Skizofrenia, ggn mood dgn gambaran psikotik, ggn psikotik lainnya atau suatu ggn perkembangan pervasive.
Note: If criteria are met prior to the onset of schizophrenia, add “ premorbid, ” for example”, schizotypal personality disorder (premorbid). Catatan: jika criteria diatas terpenuhi seb onset Skizofrenia maka tambahkan “premorbid”, contohnya Gggn Kepribadian Skizotipal (premorbid). ”From American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, text revision, 4 th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
DSM-IV-TR Diagnostic Criteria for Antisocial Personality Disorder A. There is a pervasive pattern of disregard for and violation of the rights of others ccurring since age 15 years as indicated by three (or more) of the following Adanya suatu pola pervasif meremehkan dan pelanggaran hak2 sesama yg terjadi semnjak usia 15 tahun yg ditunjukan oleh 3 tau lebih hal2 berikut ini: (1) failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest kegagalan mengikuti norma2 sosial dan tidak menghargai perilaku taat hukum yg ditandai dgn berulangkali melakukannya dan dihukum karenanya (2) deceitfulness, as indicated by repeated lying, us of all cases, or conning others for personal profit pr pleasure suka menipu spt yg ditunjukan dgn berulang kali berbohong, memanfaatkan atau mengadu domba sesama utk keuntungan atau kesenangan diri sendiri (3) impulsivity or failure to plan ahead bersifat impulsif atau gagal membuat rencana kedepan
(4) irritability and aggressiveness, as indicated by repeated physical fight or ossauits bersifat iritabel dan agresif yg ditunjukan dgn berulang kali berkelahi atu menyerang secara tiba2 (5) reckless disregard for safety of self or others tidak peduli pd keselamatan diri sendiri dan orang lain (6) consistent irresponsibility as indicated by repeated failure to sustain consistent work behavior or honor financial obligations selalu tdk bertanggung jawab yg ditunjukan dgn berulang kali gagal melanjutkan perilaku bekerja menetap atau pekrjaan yg menghasilkan uang. (7) lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another tiada rasa penyesalan yg ditunjukan dgn sikap indeferen atau rasionalisasi tindakannya melukai, melecehkan atumencuri dari sesama B. The individual is at least age 18 years. Ybs minimal berusia 18 tahun C. There is evidence of conduct disorder with onset before age 15 years. Ada bukti2 ggn kepatuhan perilaku yg terjadi seb usia 15 tahun D. The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode. Kejadian perilaku antisosial tidak hanya terjadi selama perjalanan Skizofrenia atau suatu Episode Mania From American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
Table 19-5 DSM-IV-TR Diagnostic Criteria for Borderline Personality Disorder A pervasive pattern of instability of interpersonal relationships, self-image, and affects and marked impulsivity beginning by early adulthood and present in a variety of context, as indicated by five (or more) of the following Suatu pola pervasif ketidakstabilan hubungan2 antarpersonal, gambaran diri dan afek2 serta sifat impulsif yg jelas dimulai semenjak usia dewasa muda dan muncul dlm berbagai konteks spt yg
ditunjukan oleh 5 atau lebih hal2 berikut ini: : (1) frantic efforts to avoid real or imagined abandonment (Note: Do not include suicidal or self- mutilating behavior, covered in Criterion 5) adanya usaha2 penuh kegelisahan utk menghindari keadaan ditinggalkan bak nyata maupunyg dibayangkan (2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation suatu pola hubungan antarpersonal yg tdk stabil dan kuat dikarakterisir oleh berganti2nya antara idealisasi ekstrim dan devaluasi (3) identity disturbance: markedly and persistently unstable self-image or sense of self ggn identitas: gambaran diri atau perasaan yg tidak stabil, jelas dan menetap (4) impulsivity in at least two areas that are potentially self damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating) (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5) impulsif dlm sedikitnya 2 are yg berpotensi membahayakan diri sendiri (mis. berfoya2, hubungan sex, penyalahgunaan zat, ceroboh berkendaraan, binge eating).Cat. tdk termasuk perilaku bunuh diri atau mutilasi diri pd kriteria 5 (5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior perilaku berulang utk bunuh diri, sikap atau mengancam akan melakkukannya atau perilaku mutilasi diri (6) affective instability due to marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days) ketidakstabilan afektif disebabkan mood reaktif yg nyata (mis. disforia episodi yg kuat, iritabilitas atau ansietas yg biasanya berlangsung bbrp jam dan kadang2 saja sampai beberapa hari) (7) chronic feelings of emptiness perasaan2 hampa yg berlangsung kronis (8)inappropriate, intense anger or difficulty controlling anger (e.g., frequentdisplays of temper constant anger,
recurrent physical fights) amarah yg tidak sesuai atau kesulitan mengendalikannya (mis. sering meledak kemarahannya, marah terus2an, berulang kali adu jotos) (9)transient, stress-related paranoid ideation or severe dissociative symptoms ide2 paranoid terkait stres atau gejala2 disosiatif berat yg berlangsung sementara From American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, text revision, 4 th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
Table 19-6 DSM-IV-TR Diagnostic Criteria for Histrionic Personality Disorder A pervasive pattern of excessive emotionality and attention seeking, beginning by earlyadulthood and present in a variety of contexts, as indicated by five (or more) of the following Suatu pola pervasif tingkat emosional dan mencari2 perhatian yg berlebihan yg dimulai semenjak usia dewasa muda dan muncul dlm berbagai konteks spt yg ditunjukan oleh 5 atau lebih hal2 berikut ini: (1) is uncomfortable in situations in which he or she is not the center of attention merasa tdk nyaman dlm situasi2 dimana ybs bukan sbg pusat perhatian (2) interaction with others is often characterized by inappropriate sexually seductive or provocative behavior interaksi dgn sesama sering dikarakterisir oleh perilaku menggoda secara seksual atau bersifat menghasut (3) displays rapidly shifting and shallow expression of emotions menampilkan ekspresi emosi yg cepat berubah dan dangkal (4) consistently uses physical appearance to draw attention to self selalu memanfaatkan penampilan fisik untuk menarik perhatian (5) has a style of speech that is excessively impressionistic and lacking in detail gaya bertutur yg terlalu mengesankan dan kehilangan rinciannya (6) shows self –dramatization, theatricality, and
exaggerated expression of emotion menunjukan perilaku dramatisasi, teaterikal dan ekspresi emosi yg berlebihan (7) is suggestible, that is, easily influenced by others or circumstances gampang dipengaruhi spt mudah terpengaruh orang lain atau lingkungan (8) considers relationships to be more intimate than they actually are mengangap hubungan2 sbg lebih akrab dari yg sebenarnya From American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
Table 19-7 DSM-IV-TR Diagnostic Criteria for Narcissistic Personality Disorder A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of context, as indicated by five (or more) of the following Suatu pola pervasif ttg kebesaran (dlm fantasi dan perilaku), membutuhkan penghormatan dan ketiadaan empati yg dimulai semenjak usia dewasa muda dan muncul dlm berbagai konteks spt yg ditunjukan oleh 5 atau lebih hal2 berikut ini: (1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements) mempunyai perasaan kebesaran ttg pentingnya ybs (mis. melebih-lebihkan pencapaian dan talenta2nya, mengahrapkan dipandang superior tanpa adanya pencapaian2 yg setara) (2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love terpreokupasi dgn fantasi2 ttg kesuksesan2 tak terkira, kekuasaan, kepintaran, kecantikan atau cinta ideal (3) believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions) ybs percaya dia itu khusus,unik dan hanya dapat dipahami atau berteman dgn kelompok khusus atau kalangan kelas
atas (atau lembaga2) (4) requires excessive admiration membutuhkan penghormatan berlebihan (5) has a sense of entitlement, that is, unreasonable expectations for a specially favorable treatment or automatic compliance with his or her expectation merasa mempunyai hak khusus hal mana berupa harapan2 tak beralasan utk mendapat perlakuan istimewa atau kepatuhan otomatis thd kehendak2nya (6) is inter personality exploitative, that is, takes advantage of others to a achieve his or her own ends bersifat mengeksploitasi antarpersonal yg mengambil keuntungan dari sesama utk mencapai tujuannya (7) lacks empathy: is unwilling to recognize or identify with the feellings and needs of others hampa empati dimana ybs tdk berkemauan menyadari atau mengenali perasaan2 dan kebutuhanorang lain (8) is often envious of others or believes that others are envious of him or her sering irihati atau percaya bhw orang lain iri terhadapnya (9) shows arrogant, naughty behavior or attitudes menunjukan sikap mau menang sendiri, perilaku atau sikap nakal From American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
DSM-IV-TR Diagnostic Criteria for Obsessive-Compulsive Personality Disorder A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, of the expense of flexibility, openness, and efficiency,beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following Suatu pola pervasif preokupasi dgn keteraturan, kesempurnaan, pengendalian mental dan antarpersonal yg mengikis habis fleksibilitas dan keterbukaan, dan keefisienan yg dimulai semenjak usia dewasa muda dan muncul dlm berbagai konteks spt yg ditunjukan oleh 4 atau lebih hal2 berikut ini: (1) is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
terpreokupasi dgn hal2 rinci, aturan2, urutan2, perintah, pengorganisasian atau jadwal2 sampai sluas2nya dimana tiitk penting dari aktifitas menjadi hilang (2) shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met) menunjukan perfeksinisme yg mengganggu penyelesaian tugas (mis. tidak dapat menyelesaikan proyek ok standarisasi yg ketat berlebihan dari ybs tidak terpenuhi) (3) is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity) mengabdi berlebihan pd pekerjaan dan usaha menghasilkan sampai menyingkirkan kegiatan menyenangkan dan persahatan (tidak termasuk bila memenuhi kebutuhan ekonomi) (4) is over conscientious, scrupulous, and inflexible about matters of morality, ethics or values (not accounted for by cultural or religious identification) merasa bertanggung jawab berlebihan, sgt seksama dan kaku ttg moralitas, etika2 atau norma2 (tidak termasuk tanda pengenal budaya atau agama) (5) is unable to discard worn-out or worthless objects even when they have no sentimental value tidak mampu membuang barang2 rusak atau tidak berharga meskipun tidak mempunyai nilai sentimental (6) is reluctant to delegate tasks or work with others unless they submit to exactly his or her way of doings things keberatan mendelegasikan tugas2 atau pekerjaa kpd org lain kecuali kalau mereka mereka megikuti tepat sama dgn caranya (7) adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophies mengadopsi gaya kikir thd diri sendiri dan sesama; uang dipandang sbg sesuatu yg hrs disimpan antisipasi malapetaka (8) shows rigidity and stubbornness menunjukan kekakuan dan keras kepala From American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
DSM-IV-TR Diagnostic Criteria for Avoidant Personality Disorder A pervasive pattern of social inhibition, feeling of inadequacy and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of context, as indicated by four (or more) of the following Suatu pola pervasif hambatan sosiial, perasaan ketidakmampuan dan sgt sensitif thd penilaian negatif yg dimulai semenjak usia dewasa muda dan muncul dlm berbagai konteks spt yg ditunjukan oleh 4 atau lebih hal2 berikut ini: (1)avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection.menghindari aktifitas2 okupasional dimana terjadi kontak bermakna antarpersonal karena ketakutan akan kritikan, tidak adanya pengakuan atau penolakan (2)is unwilling to get involved with people unless certain of being liked. tidak berkeinginan terlibat dgn banyak org jika ybs tidak secra pasti diterima disitu (3)shows restraint within intimate relationships because of the fear of being shamed or ridiculed menunjukan pengekangan diri dlm hubungan2 akrab karena ketakutan dipermalukan atau dicemooh (4)is preoccupied with being criticized or rejected in social situations terpreokupasi dgn akan dikritik atau ditolak dlm situasi2 sosial (5)is inhibited in new interpersonal situations because of feeling of inadequacy. Terhambat dlm situasi2 antarpersonal baru ok perasaan tidak berdaya (6)views self as socially inept, personally unappealing, or inferior to others memandang dirinya sebagai suatu keganjilan sosial, pribadi yg tdk menarik atau lebih rendah dari sesama (7)is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrasing keengganan yg tdk biasanya utk mengambil resiko2 personal atau masuk dlm aktifitas2 baru manapun krn hal2 itu dpt mempermalukan ybs American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
DSM-IV-TR Diagnostic Criteria for Dependent Personality Disorder A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts as indicated by five (or more) of the following Suatu kebutuhan pervasif dan berlebihan utk diurus yg mengarah pd perilaku penurut dan bergantung erat dan adanya ketakutan perpisahan yg dimulai semenjak usia dewasa muda dan muncul dlm berbagai konteks spt yg ditunjukan oleh 4 atau lebih hal2 berikut ini : (1)has difficulty making everyday decisions without on excessive amount of advice and reassurance from others memiliki kesulitan membuat keputsan2 sehari2 tanpa saran dan penentraman dlm jml berlebihan dari orang lain (2)needs others to assume responsibility for most major areas of his or her live membutuhkan orang lain utk mengambil tanggung jawab pd kebanyakan hal penting kehidupan ybs (3)has difficulty expressing disagreement with others because of fear of loss of support or approval (Note: Do not include realistic fears of retribution) mempunyai kesulitan dlm mengekspresikan ketidaksetujuan dgn orang lain krn ketakutan akan kehilangan pengakuan atau dukungan (cat. Tdk termasuk ketakutan realistik akan hukuman setimpal) (4)has difficulty initiating project or doing things on his or her own (because of lack of self-confidence in judgment or abilities rather than a lack of motivation or energy) mempunyai kesulitan dlm memulai proyek atau melakukan sesuatu atas kehendak sendiri ( karena ketiadaan sikap percaya diri dlm penilaian atau kemampuan daripada ketiadaan motivasi atau energi) (5)goes to excessive lengths to obtain nurturance and support from others to the point of volunteering to do things that are unpleasant terlalu berlebihan usahanya
utk mendapatkan pengasuhan dan dukungan dari org lain sampai pd kerelaanmelakukan hal2 yg tidak menyenangkan (6)feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or her self merasa tdk nyaman atau tdk berdaya ketika sendirian ok ketakutan berlebihan akantidak mampu merawat dirinya (7)urgently seeks another relationships as a source of care and support when a close relationships ends dgn segera mencari2 hubungan2 lain sbg sumber pengasuhan atau dukungan ketika suatu hubungan dekat berakhir (8)is unrealistically preoccupied with fears of being left to take care of himself or herself terpreokupasi tidak realistis dgn ketaktan akan ditinggalakan utk mengurus diri sendiri American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
DSM-IV-TR Research Criteria for Passive-Aggressive Personality Disorder A. A pervasive pattern of negativistic attitudes and passive resistance to demands for adequate performance, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following Suatu pola pervasif sikap negativistik dan perlawanan pasif thd pemenuhan keinginan utk penampilan yg memadai yg dimulai semenjak usia dewasa muda dan muncul dlm berbagai konteks spt yg ditunjukan oleh 5 atau lebih hal2 berikut ini : (1)passively resists fulfilling routine social and occupational tasks melawan secara pasif utk memenuhi tugas rutin sosial dan okupasional (2)complains of being misunderstood and unappreciated by others mengeluh selama ini disalah mengerti dan tidak dihargai sesama (3)is sullen and argumentative menjengkelkan dan suka bersilat lidah (4)unreasonably criticizes and scorns authority mengkritik tanpa alasan dan membenci yg berwenang (5)expresses envy and resentment toward those apparently more fortunate mengekspresikan kecemburuan dan sakita hati thd mereka yg nampaknya lebih beruntung
(6)voices exaggerated and persistent complaints of personal misfortune menyuarakan keluhan2 yg berlebihan dan menetap ttg ketidakberuntungannya (7)alternates between hostile defiance and contrition berubah2 antara sikap penentangan sengit dan penyesalan B. Does not occur exclusively during major depressive episodes and is not better accounted for by dysthymic disorder Tidak hanya terjadi selama Episode2 Depresif Mayor dan tidak dapat digolongkan sbg Ggn Distimia American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
DSM-IV-TR Diagnostic Criteria for Depressive Personality Disorder A. A pervasive pattern of depressive cognitions and behaviors beginning by early adulthood and present in variety of contexts, as indicated by five (or more) of the following Suatu pola pervasif pikiran2 dan perilaku2 depresif dimulai semenjak usia dewasa muda dan muncul dlm berbagai konteks spt yg ditunjukan oleh 5 atau lebih hal2 berikut ini: (1)usual moods dominated by dejection, gloominess, cheerlessness, joylessness, unhappiness mood selalu didominasi kemurungan, kemuraman, tiada keceriaan atu kesukaan atau kegembiraan (2) self-concept centers around beliefs of inadequacy, worthlessness, and low self-esteem konsep diri berpusat pd keyakinan ttg ketidakmampuan, ketakberhagaan dan rendah diri (3) is critical, blaming, and derogatory toward self kritis, menyalahkan dan mencemooh diri sendiri (4) is brooding and given to worry suka termenung dan khawatir (5)is negativistic, critical, and judgmental toward others berpendangan negativistik, kritis, dan meghakimi sesama (6)is pessimistic pesimistik (7) is prone to feeling guilty or remorseful rentan thd perasaan bersalah atau penyesalan yg dalam B. Does not occur exclusively during major depressive episodes and is not better accounted for by dysthymic disorder Tidak hanya terjadi selama Episode2 Depresif Mayor dan tidak dapat digolongkan sbg Ggn Distimia
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th ed. Washington, DC: American Psychiatric Association, Copyright 2000, with permission
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DSM-IV-TR Diagnostic Criteria for Reading Disorder A. Reading achievement, as measured by individually administered standardized test reading accuracy or comprehension, is substantially below that expected given the person’s chronologic age, measured intelligence, and age-appropriate education.Kemampuan membaca yg diukur berdasarkan tes ketepatan dan komprehensif membaca terstandar yg diberikan pd ybs adalah kurang(dibawah) secara bermakna disbanding dgn yg diharapkan berdasarkan usia, tkt intelegensia dan pendidikannya. B. The disturbance in criterion A significantly interferes with academic achievement or activities of daily living that require reading skills.Ggn yg digambarkan criteria A secara bermakna mengganggu pencapaian akademik atau aktifitas sehari2 yg membutuhkan kemampuan membaca. C. If a sensory deficit is present, the reading difficulties are in excess of those usually associated with it.Jika ada deficit sensoris maka kesulitan2 membaca melebihi keadaan2 yg biasanya terjadi. Coding note : if a general medical (e.g. neurologic) condition or sensory deficit is present, code the condition on axis III.Cat. pengkodean: jika terdapat suatu kondisi medis ummum atau defist sensoris maka dikode pd axis III.
DSM-IV-TR Diagnostic Criteria For Mathematic Disorder A. Mathematical ability, as measured by individually administered standardized tesis, is substantially below that expected given the person’s chronologic age, measured intelligence, and age-appropriate education.Kemampuan matematis yg diukur berdasarkan tes standar individual yg diberikan pd ybs adalah kurang(dibawah) secara bermakna dibanding dgn yg diharapkan berdasarkan usia, tingkat intelegensia dan pendidikannya. A. The disturbance in criterion A significantly interfes with academic achievement
or activities of daily living that require mathematical ability. .Ggn yg digambarkan criteria A secara bermakna mengganggu pencapaian akademik atau aktifitas sehari2 yg membutuhkan kemampuan matematis. B. If a sensory deficit is present, the difficulties in mathematical ability are in excess of those usually associated with it Jika ada deficit sensoris maka kesulitan2 matematis melebihi keadaan2 yg biasanya terjadi. Coding note: if a general medical (e.g., neurologist) condition or sensory deficit is present, code the condition on axis III. Cat. pengkodean: jika terdapat suatu kondisi medis ummum atau defist sensoris maka dikode pd axis III.
DSM-IV-TR
Diagnostic
Criteria
for
Disorder
of
Written
Expression
(KETRAMPILAM MENULIS ???) A. Writing skills, as measured by individually administered standardized test (or functional assessment of writing skills), are substantially below those expected given the person’s chronologic age, measured intelligence, and age-appropriate education. Ketrampilan menulis yg diukur berdasarkan tes standar individual (atau pegukuran ketrampilan fungsional menulis)yg diberikan pd ybs adalah kurang(dibawah) secara bermakna dibanding dgn yg diharapkan berdasarkan usia, tingkat intelegensia dan pendidikannya. B. The disturbance in criterion A significantly interferes with academic achievement or activities of daily living that require the composition of written texts (e.g., writing grammatically correct sentences and organized paragraphs). Ggn yg digambarkan criteria A secara bermakna mengganggu pencapaian akademik atau aktifitas sehari2 yg membutuhkan komposis tulisan tangan (mis.penulisan kalimat benar secara tatabahasa dan paragraph yg teratur). C. If sensory deficit is present, the difficulties in writing skills are in excess of those usually associated with it. Jika ada deficit sensoris maka kesulitan2 matematis melebihi keadaan2 yg biasanya terjadi. Coding note: If a general medical (e.g., Neurologic) condition or sensory deficit is present, code the condition on Axis III. Cat. pengkodean: jika terdapat suatu kondisi medis ummum atau defist sensoris maka dikode pd axis III.
DSM-IV-TR Diagnostic criteria for Developmental Coordination Disorder (GGN PERKEMBANGAN KOORDINASI GERAKAN ?????) A. Performance in daily activities that require motor coordination is substantially below that expected given the person’s chronologic age and measured intelligence. This may be manifested by marked delays in achieving motor milestones (e.g. walking, crawling, sitting) dropping things, “clumsiness”, poor performance in sports, or poor handwriting.Penampilan dlm aktifitas sehari2 yg membutuhkan koordinasi motorik adalah kurang(dibawah) secara bermakna dibanding dgn yg diharapkan berdasarkan usia, tingkat intelegensia dan pendidikannya. B. The disturbance in Criterion A significantly interferes with academic achievement or activities of daily living. Ggn yg digambarkan criteria A secara bermakna mengganggu pencapaian akademik atau aktifitas dal kehidupan sehari2. C. The disturbance is not due to a general medical condition (e.g. cerebral palsy, hemiplegia or muscular dystrophy) and does not meet criteria for a pervasive developmental disorder.Gangguan ini tidak disebabkan oleh suatu kondisi medis umum (mis. Cerebral Palsy, Hemiplegia atau Distrofi Muskuler) D. If mental retardation is present, the motor difficulties are in excess of those usually associated with it.Jika bersamman dgn Retardasi Mentalmak kesulitan2 motorik melebihi keadaan2 yg biasanya terjadi. Coding note: if a general medical (e.g., neurologic) condition or sensory deficit is present, code the condition on Axis III. Cat. pengkodean: jika terdapat suatu kondisi medis ummum atau defist sensoris maka dikode pd axis III.
DSM-IV-TR Diagnostic Criteria for Expressive Language Disorder (KECAKAPAN BERBAHASA ????) A. The scores obtained from standardized individually administered measures of expressive language development are substantially below those obtained from standardized measures of both nonverbal intellectual capacity and receptive language development.The disturbance may be manifest clinically by symptoms that includes having a markedly limited vocabulary, making errors in tense, or having difficulty recalling words or producing sentences with developmentally appropriate length or complexity.Nilai2 yg diperoleh berdasarkan yg diukur berdasarkan ukuran standar individual yg diberikan pd ybs adalah kurang(dibawah) secara bermakna dibanding dgn ukuran standar kapasitas intelektual nonverbal dan perkembangan bahasa reseptif.Gangguan ini mgk tampil secara klinis sbg gejala2 kurang memiliki kosa kata yg nyata,
B.
C. D.
membuat kesalahan2 dalam kalimat menurut waktu terjadinyatenses, atau kesulitan mengingat kembali kata2 atau pembuatan kalimat2 yg panjang dan rumit sesuai tahap perkembangannya. The difficulties with expressive language interfere with academic or occupational achievement or with social communication.Kesulitan2 berbahasa ekkspresif mengganggu pencapaian akademik atau okupasional atau dlm komunikasi sosial. Criteria are not met for mixed receptive-expressive language disorder or a pervasive developmental disorder.Kriteria2 tidak memenuhi Ggn Berbahasa campuran resptif-ekspresif. If mental retardation, a speech-motor or sensory deficit, or environmental deprivation is present, the language difficulties are in excess of those usually associated with these problems. Jika bersamaman dgn Retardasi Mental, deficit sensorik atau motorik berbicara maka kesulitan2 berbahasa melebihi keadaan2 yg biasanya terjadi
Diagnostic Criteria for Mixed Receptive-expressive language Disorder (Campuaran penerimaan dan pengungkapan bahas ???) A. The scores obtained from battery of standardized individually administered measures of both receptive and expressive language development are substantially below those obtained from standardized at measures of nonverbal intellectual capacity.Symptoms include those for expressive language disorder as well as difficulty understanding words, sentences, or specific types of words, such as spatial terms. .Nilai2 yg diperoleh berdasarkan seperangakat ukuran standar individual yg diberikan pd ybs adalah kurang(dibawah) secara bermakna dibanding dgn ukuran standar kapasitas intelektual nonverbal.Gejala2nya seperti Gangguan Berbahasa Ekspresif ditambah kesulitan mengerti kata2, kalimat2 atau kata2 tertentu demikian juga dgn kalimat menurut waktu terjadinya-tenses,. B. The difficulties with receptive and expressive language significantly interfere with academic or occupational achievement or with social communication. Kesulitan2 berbahasa reseptif dan ekspresif mengganggu secara bermakana pencapaian akademik atau okupasional atau dlm komunikasi sosial. C. Criteria are not met for pervasive developmental disorder.Tidak memenuhi criteria Gangguan Perkembangan Pervasif. D. If mental retardation, a speech-motor or sensory deficit, or environmental deprivation is present, the language difficulties are in excess of those usually associated with these problems. Jika bersamaman dgn Retardasi Mental, deficit sensorik atau motorik berbicara atau kekurangan lingkungannya maka kesulitan2 diatas melebihi keadaan2 yg
biasanya terjadi.
Diagnostic Criteria for Phonologic Disorder A. Failure to use developmentally expected speech sounds that are appropriate for age and dialect (e. g. errors in sound production, use, representation, or organization such as, but not limited to substitutions of one sound for another [use of/t/for target/k/sound] for omissions of sounds such as final consonants).Adanya kegagalan memnggunakan suara/bunyi berbicara yg setara dgn perkembangan sesuai usia dan dialek (mis. kesalahan menghasilkan bunyi, pemakaian, pemunculannya atau pengaturannya tdk hanya terbatas pd kesalahan substitusi suatu bunyi dgn lain utk melampauinya spt pd konsonan diakhir kata(/t/ dlm /target/ berbunyi /k/)). B. The difficulties in speech sound production interfere with academic or occupational achievement or with social communication. Kesulitan2 menghasilkan bunyi dlm berbicara mengganggu pencapaian akademik atau okupasional atau dlm komunikasi sosial. C. If mental retardation, a speech-motor or sensory deficit, or environmental deprivation is present, the speech difficulties are in excess of those usually associated with this problems. Jika bersamaman dgn Retardasi Mental, deficit sensorik atau motorik berbicara atau kekurangan lingkungannya maka kesulitan2 diatas melebihi keadaan2 yg biasanya terjadi.
DSM-V-TR Diagnostic Criteria or Stuttering A. Disturbances in the normal fluency and time patterning of speech (inappropriate for the individual’s age), characterized by frequent occurrences of one or more of the following Gangguan dalam kelancaran normal dan pola waktu dalam berbicara (tdk sesuai dgn umur ybs) yg dikarakterisir seringnya terjadi hal2 berikut: 1. Sound and syllable repetitions Perulangan bunyi dan suku kata. 2. Sound prolongations Pemanjangan bunyi. 3. Interjections Adanya kata2 seru. 4. Broken words (e. g. pauses within a word) Kata2 yg diucapkan tiba2 terhenti ditengahnya. 5. Available or silent blocking (filled or unfilled pauses in speech) Ada atau hilangnya hambatan
(masuk dan tidaknya penghentian semntara dlm berbicara) 6. Circumlocutions (word substitution to avoid problematic words) Berbelit2 (substitusi kata utk menghindari kata2 menyulitkan) 7. Words produced with an excess of physical tension Kata2 dihasilakan dgn ketegangan fisik berlebihan 8. Monosyllabic whole-word repetitions (e. g. “I-I-I-I see him”) Pengulangan seluruh kata monosilabik (mis. “I-I-I-I-I-I see him”) B. The disturbances in fluency interferes wit academic or occupational achievement or with social communication Kesulitan2 kelancaran dlm berbicara mengganggu pencapaian akademik atau okupasional atau dlm komunikasi sosial. C. If a speech-motor or sensory deficit is present, the speech difficulties are in excess of those usually associated with the problems. Jika bersamaman dgn defisit sensorik atau motorik berbicara kesulitan2 diatas melebihi keadaan2 yg biasanya terjadi.
DSM-IV-TR Diagnostic Criteria for Autistic Disorder A. A total for six (or more) items from (1), (2), and (3), with at least two from (1) and one each from (2) and (3).Terdapat total 6 item dari (1), (2), (3) dimana sedikitnya 2 item dari poin (1) dan 1 dari poin (2) dan (3). 1. Qualitative impairment in social interaction, as manifested by at least two of the following Hambatan kwlitatif dlm interaksi2 sosial yg bermanifestasi sedikitnya dlm 2 hal berikut: a. Marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction.Hambatan nyata dlm menngunakan berbagai perilaku nonverbal spt tatapan mmata ke mata, ekspresi wajah, postur2 tubuh dan gestures untuk mengatur interaksi social. b. Failure to develop peer relationship appropriate to developmental level Gagal membangun hubungan dgn teman sebaya sesuai dgn tkt perkembangan. c. A lack of spontaneous seeking to share enjoyment, interest, or achievements with other people (e. g. by showing, bringing, or pointing out subject of interest) Ketiadaan spontanitas membagi kegembiraan, minat, atau keberhasila2 pencapaiannya dgn sesame (mis. memamerkan, membawa kesana-kemari atau menunjuk pd sesuatu yg menarik)
d. Lack of social or emotional reciprocity.Kehampaan timbale-balik social dan emosional. 2. Qualitative impairments in communication as manifested by at least one of the following Hambatan2 kwalitatif dlm berkomukasi yg bermanifestasi sedikitnya dlm 1 hal berikut: : a. Deficit in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gestures or mime) Defisit atau sama sekali tidak ada perkembangan bahasa bicara (tdk disertai suatu usaha kompensasi lewat cara2 alternatif spt gestures gerakan tanpa ekspresi). b. In individual with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others Pada mereka yg mampu berbicara terdapat hambatan nyata dlm kemampuan memulai atau mempertahankan percakapan dgn orang lain. c. Stereotyped and repetitive use of language or idiosyncratic language Memakai bahasa stereotipik atau repetitive atau bahasa idiosinkrasi. d. Lack of varied, spontaneous make-believe play or social imitative play appropriate to development level tidak adanya variasi permainan, spontan karangan sendiri atau ditiru dari lingkungan social yg sesuai dgn tkt perkembangan. 3. Restricted repetitive and stereotyped patterns of behavior, interest, and activities, as manifested by at least one of the following Pola2 perilaku repetitive yg terbatas dan stereotipik dari perilaku, minat2 dan aktifitas2 spt yg ditunjukan sedikitnya oleh 1 hal berikut: a. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus menunjukan preokupasi dgn 1 atau lebih pola2 minat stereotipik dan terbatas yg abnormal baik dlm intensitas atau pemusatannya. b. Apparently inflexible adherence to specific, nonfunctional routines or rituals tampak adanya kepatuhan kaku pd ritual2 atau rutinitas spesifik dan nonfungsional c. Stereotyped and repetitive motor mannerism (e. g. hand or finger flapping or twisting, or complex whole-body movements) manreisme motorik yg stereotipik dan repetitif (mis. melambai2kan atau memutar2 telapak tangan atau jari atau gerakan2 rumit seluruh tubuh) d. Persistent preoccupation with parts of objects Preokupasi menetap dgn bagian2 dari benda. B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years Fungsional yg terlambat atau abnormal dlm sedikitnya 1 dari area2 berikut yg dimulai sebelum usia 3 tahun:
(1)Social interaction, (2) language as used in social communication, or (3) symbolic at imaginative play. (1) interaksi social, (2) bahas yg dipakai dlm komunikasi social atau (3) simbol2 dlm permeinan imajinasi. C. The disturbance is not better accounted for by Rett’s disorder or childhood disintegrative disorder.Gangguan ini tidak dpt digolongkan sbg ggn Rett atau Gangguan Disintegratif Masa Kanak.
DSM-IV-TR Diagnostic Criteria for Childhood Disintegrative Disorder A. Apparently normal development for at least the first 2 years after birth or manifested by the presence of age-appropriate verbal and nonverbal communication, social relationship, play, and adaptive behavior.Tampaknya berkembang normal sedikitnya 2 tahun dari kelahirannya atau ditunjukan oleh komunikasi verbal dan nonverbal, hubungan2 sosial, bermain dan perilaku adaptif yg sesuai dgn usia. B. Clinically significant loss of previously acquired skills (before age 10 years) in at least two of the following areas Kehilangan yg bermakna klinis dari ketrampilan2 yg diterima (sebelum usia 10 tahun) sedikitnya dlm 2 area berikut: 1. Expressive or receptive language Bahasa ekspresif atau reseptif 2. Social skills or adaptive behavior Perilaku social atau adaptif 3. Bowel or bladder control Pengendalian defekasi atau miksi 4. Play Bermain 5. Motor skills Ketrampiulan2 motorik C. Abnormalities of functioning in at least one of the following areas Keabnormalan2 fungsional sedikitnya dlm 1 area berikut: 1. Qualitative impairment in social interaction (e. g. impairment in nonverbal behavior, failure to develop peer relationships, lack of social or emotional reciprocity) Hambatan kwalitatif dlm interaksi social (mis. hambatan dlm perilaku nonverbal, gagal menjalin hubungan dgn teman sebaya, ketiadaan timbale balik social atau emotional) 2. Qualitative impairments in communication (e. g. delay or lack of spoken language, inability to initiate or sustain a conversation, stereotyped and repetitive use of language, lack of varied make-believe play) Hambatan kwalitatif dlm berkomunikasi (mis. terlambat atau tdk dpt bertutur, ketidakmampuan memulai atau mempertahankan percakapan, menggunakan bahasa stereotipik dan repetitive, ketiadaan variasi permainan khayalan). 3. Restrictive, repetitive, and stereotyped patterns of behavior,
interests, and activities, including motor stereotypes and mannerisms Pola2 repetitif yg terbatas dan stereotipik dari perilaku, minat2 dan aktifitas2 termasuk stereotipik dan manerisme motorik. D. The disturbance is not better accounted for by another specific pervasive developmental disorder or by schizophrenia Gangguan ini tidak dpt digolongkan sbg ggn perkembangan pervasif spesifik atau Skizofrenia
DSM-IV-TR Diagnostic Criteria for Attention Deficit/Hyperactivity Disorder A. Either (1) or (2) Adanya salah asatu dari (1) atau (2): 1. Six (or more) of the following symptoms of inattention have persist for at least six months to a degree that is maladaptive and inconsistent with developmental level 6 (enam) atau lebih dari gejala2 kurang perhatian (inattention) berikut telah menetap sedikitnya 6 bulan sampai pd taraf maladaptif dan tidak konsisten dgn tingkat perkembangan: Inattention Inatensi a. Often falls to give close attention to details or makes careless mistakes in schoolwork, work, or other activities Sering tdk dpt memusatkan perhatian pada hal2 rinci atau membuat kesembronoan dlm tugas sekolah, pekerjaan atau aktifitas2 lainnya. b. Often has difficulty sustaining attention in tasks or play activities Sering sulit mempertahankan perhatian pd tugas2 dan kegiatan2 permainan. c. Often does not seem to listen when spoken to directly Sering tampak tidak menyimak ketika bercakap2 lansung. d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not oppositional behavior or failure to understand instructions) Sering tidak dapat mengikuti alur intruksi2 dan gagal menyelesaikan tugas sekolah, pekerjaan sehari2 atau tugas2 di tempat kerja (bukan perilaku menentang atau kegagalan emahami instryksi2) e. Often has difficulty organizing tasks and activities Sering kesulitan mengelola tugas2 dan kegiatan2 f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework) Sering menghindar, tdk menyukai atau enggan terlibat dlm tugas2 yg membutuhkan ketahanan kerja mental ( spt
tugas sekolah atau pekerjaaan rumah) g. Often loses things necessary for tasks of activities (e. g. toys, school assignments, nails, books, or tools) Sering kehilangan barang2 yg diperlukabn utk tugas2 atau kegiatan2 (mis. mainan, tugas2 sekolah, jepitan2, buku2 atau alat2) h. Is often easily distracted by extraneous stimuli Sering mudah teralih perhatian dgn stimuli agak menonjol i. Is often forgetful in daily activities Sering lupa dlm kegiatan sehari2 2. Six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level 6 (enam) atau lebih dari gejala2 hiperaktif-impulsif berikut telah menetap sedikitnya 6 bulan sampai pd taraf maladaptif dan tidak konsisten dgn tingkat perkembangan:: Hyperactivity Hiperaktifitas a. Often fidgets with hands or feel or squirms in seat Sering mengerakgerakan tangan atau merasa spt itu atau menggeliat-geliat di tempat duduk b. Often leaves seat in classroom or in other situations in which remaining seated is expected Sering meninggalkan tempat duduk ruang kelas atau situasi lainnya dimana diharapkan tetap di tempat duduk c. Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adult, may be limited to subjective feelings of restlessness) Sering berlarian kesana-kemari atau memnjat-manjat pada situasi yg tidak sesuai (pd remaja atau dewasa mgk hanya terbatas pd perasaan tak bias diam) d. Often has difficulty playing or engaging in leisure activities quietly Sering kesulitan untuk tenang dlm permainan atau aktifitas santai e. Is often “on the go” or often acts as if “driven by a motor” Sering sudah beranjak atau berlaku seakan dikendalikan sbuah motor f. Often talks excessively Sering banyak bicara Impulsivity Impulsifitas g. Often blurts out answers before questions have been completed Sering jawaban terlontar sebelum pertanyaan selesai h. Often has difficulty awaiting turn Sering kesulitan menunggu giliran i. Often interrupt or intrudes on others (e. g. butts in to conversations or games) Sering menyela atau nimbrung ketengah2 orang lain (mis. meneruduk masuk ketengah percakapan atau permainan). B. Some hyperactive-impulsive or inattentive symptoms that caused impairment
were present before age 7 years. Same impairment from the symptoms is present in two or more setting (e. g. of school (or work) and at home) Beberapa gejala hiperaktifitas-impulsifitas atau inatensi yg menyebabkan hambatan sudah ada sebelum usia 7 tahun C. There must be clear evidence or clinically significant impairment in social, academic, or occupational functioning Harus ada bukti jelas atau hambatan bermakna klinis dlm fungsi2 sosial, akademik atau okupasional D. The symptoms do not occur exclusively during a course of a pervasive developmental disorder, schizophrenia or other psychotic disorder and are not better accounted for by another mental disorder (e. g. mood disorder, anxiety disorder, dissociative disorder, or a personality disorder) Gejala2 tidak hanya terjadi selama perjalanan suatu ggn perkembangan pervasive, Skizofrenia atau ggn psikotik dan tidak dpt digolonggkan sbg ggn mental lainnya (mis. ggn mood, ansietas, disosiatif atau ggn kepribadian) Code based on type Kode berdasarkan tipe: Attention deficit/hyperactivity disorder, combined type: if both criteria A1 and A2 are met for the past six months Gangguan Defisit Perhatian/Hiperaktifitas, tipe kombinasi: jika kedua kriteri A(1) dan A (2) terpenuhi dalm 6 bulan terakhir Attention deficit/hyperactivity disorder, predominantly inattentive typed: if criterion A1 is met but criterion A2 is not met for the past six months Gangguan Defisit Perhatian/Hiperaktifitas, tipe inatensi menonjol: jika kriteria A(1) terpenuhi tetapi A (2) tdk terpenuhi dalm 6 bulan terakhir Attention deficit/hyperactivity disorder, predominantly hyperactiveimpulsive type: if criterion A1 is not met but criterion A2 is met for the past six months Gangguan Defisit Perhatian/Hiperaktifitas, tipe hiperaktif-impulsif menonjol: jika kriteria A(1) tidak terpenuhi tetapi A (2) terpenuhi dalm 6 bulan terakhir Coding note: for individuals (especially adolescents and adults) who currently have symptoms that no longer meet full criteria “in partial remission” should be specified.Catatan: pd individu2 (khususnya remaja dan dewasa) yg sekarang mempunyai gejala2 yg tdk lagi memenuhi kriteria penuh maka sebaiknya ditentukan sbg “dlm remisi parsial”
DSM IV-TR Diagnostic Criteria for Oppositional Defiant Disorder (PERILAKU MENENTANG ?????)
A. A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present suatu pola perilaku negativistic, bermusuhan dan menentang yg berlangsung sedikitnya 6 bulan dimana selama itu terdapat 4 atau lebih hal2 berikut: (1) often loses temper sering meledak kemarahannya (2) often argues with adults sering adu mulut dgn org dewasa (3) often actively defies or refuse to comply with adults request or rule sering secara aktif membantah atau menolak mengikuti permintaan atau aturan orang deawasa (4) often deliberately annoys people sering dgn sengaja menjengkelkan sesama (5) often blames others for his or her mistakes or misbehavior sering menyalahkan sesama atas kesalahan atau tingkah laku buruknya (6) is often touchy or easily annoyed by others sering tersinggung atau mudah dibuat jengkel oleh org lain (7) is often angry and resentful sering marah dan kesal (8) is often spiteful or vindictive sering mendendam atau mendengki Note: Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.Cattatan: suatu criteria dipertimbangkan hanya jika perilaku tsb lebih sering terjadi disbanding yg diamati ada pd individu2 dari usia setara atau tingkat perkembangan B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.Gangguan perilaku menyebabkan hambatan yg bermakna klinis dlm fungsi2 sosisal, akademis atau okupasional C. The behaviors do not occur exclusively during the course of a psychotic or mood disorder.Perilaku2 diatas tdk hanya terjadi selama perjalanan suatu ggn psikotik atau mood. D. Criteria are not met for conduct disorder, and if the individual is age 18 years or older, criteria are not met for antisocial personality disorder.Kriteria2 tdk memenuhi Gangguan Perilaku ()conduct) dan jika ybs berusia 18 tahun atau lebih maka tdk memnuhi criteria ggn Kepribadian Antisosial.
DSM-IV-TR
Diagnostic
PERILAKU ??????????)
Criteria
for
Conduct
Disorder
(KEPATUHAN
A. A repetitive and persistent pattern of behavior in which the basic right of others or major. age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months, with at least one criterion present in the past 6 months Suatu poal perilaku repetitive dan menetap dimana hak2 dasar sesama atau norma2 atau aturan2 sosial utama sesuai usia usia dilanggar yg bermanifestasi lwt 3 atau lebih criteria berikut dlm 12 bulan terakhir dimana sedikitnya 1 kriteria terpenuhi dlm 6 bulan terakhir: Aggression to people and animals.Agresi thd org lain atau hewan: (1)often bullies, threatens, or intimidates others sering menggunakan kekuatan fisiknya utk memaksa, mengancam atau mengintimidasi sesama (2)often initiates physical fights sering memulai adu jotos. (3)has use a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken, bottle, knife, gun) sudah pernah menggunakan senjata yg dpt menyebabkan cedera fisik serius orang lain (mis. pemukul baseball, batubata, botol pecah, pisau, pistol) (4)has been physically cruel to people selama ini bersikap bengis terhadap sesama (5)has been physically cruel to animals selama ini bersikap bengis terhadap hewan2 (6)has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery) pernah mencuri saat konfrontasi dgn korban (mis. membodohi sesame, menjambret, merampas, perampokan bersenjata) (7)has forced someone into sexual activity pernah memaksa seseorang dlm aktifitas seksual Destruction of property Perusakan Barang2 (8)has deliberately engaged in fire setting with the intention of causing serious damage pernah dgn sengaja melakukan pembakaran dgn maksud menyebabkan kerusakan serius (9)has deliberately destroyed others property (other than by fire setting) pernah dgn sengaja menghancurkan barang2 orang lain (selain pembakaran) Deceitfulness or theft Penipuan atau pencurian (10) has broken into someone else’s house building or car pernah masuk paksa kerumah, bangunan atau mobil seseorang (11) often lies to obtain goods or favors or to avoid obligations (I e., “cons” others) sering berbohong utk mendapatkan barang atau hal yg diinginkan atau utk mnghindari
kewajiban2 (mis. dgn mengadu domba sesama) (12) has stolen items of nontrivial value without confronting a victim (e. g., shoplifting, but without breaking and entering; forgery) pernah mencuri barang tidak berhargatanpa konfrontasi dgm korban Serious violations of rules Pelanggaran serius aturan2 (13) often stays out at night despite parental prohibitions, beginning before age 13 years sering tidak dirumah malam hari meskipun ada larangan orangtua yg dimulai sebelum usia 13 tahun (14) has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period) pernah melarikan diri dari rumah berhari2 sedikitnya 2 kali ketika tinggal dirumah orangtua atau pengasuh (atau sekali tanpa kembali dalm waktu yg panjang) (15) is often truant from school, beginning before age 13 years sering membolos dari sekolah yg dimulai sebelum usia 13 tahun B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning. Gangguan perilaku menyebabkan hambatan yg bermakna klinis dlm fungsi2 sosisal, akademis atau okupasional C. If the individual is age 18 years or older, criteria are not met for antisocial personality disorder. Jika ybs berusia 18 tahun atau lebih maka tdk memenuhi criteria ggn Kepribadian Antisosial. specify type based on age an onset Tentukan tipe berdasrkan usia onset: Childhood-onset type: onset of at least one criterion characteristic of conduct disorder prior to age 10 years.Tipe onset masa kanak: onset ssedikitnya 1 kriteria khas Ggn Conduct sebelum usia 10 tahun Adolescent-onset type: absence of any criteria characteristic of conduct disorder prior to age 10 years.Tipe onset masa remaja: tidak ada criteria khas Ggn Conduct sebelum usia 10 tahun Unspecified type: age of onset is not known Tipe taktertentukan: usia onset tdk diketahui Specify severity Tentukan keparahannya: Mild: few if any conduct problems in excess of those required to make the diagnosis and conduct problems cause any minor harm to others.Ringan: ada sedikit masalah conduct yg berlebihan sbg dasar diagnosis dan hanya menyebabkan beberapa bahaya kecil terhadap sesama
Moderate: number of conduct problems and effect on others are intermediate between “mild and severe” Sedang: jumlah problem conduct dan akibatnya thd sesame berada diantara “ ringan dan berat” Severe: many conduct problems in excess of those required to make the diagnosis or conduct problems cause considerable harm to others.Berat: banyak masalah conduct yg berlebihan sbg dasar diagnosis atau hal ini menyebabkan bahaya besar bagi sesame.
DSM-IV-TR Diagnostic Criteria for Encopresis A. Repeated passage of feces into inappropriate places (e.g., clothing or floor) whether involuntary or intentional.Defekasi berulang bukan pada tempat yang sesuai (mis. dicelana atau lantai) B. At least one such event to month for at least 3 months Terjadi sedikitnya sekali ebualn dalam 3 bulan terakhir. C. Chronologic age is at least 4 years (or equivalent developmental level).Usia kronologis sekurang2nya 4 tahun (atau sebanding dgn tkt perkembangan) D. The behavior is not due exclusively to the direct physiologic effects of substance (e.g., laxatives) or a general medical condition except through a mechanism involving constipation.Perilaku ini tdk hanya disebabkan oleh efek fisilogis langsung zat (laksansia) atau oleh suatu kondisi medis umum kecuali yg disetai konstipasi. Code of follows Pengkodean: With constipation and overflow incontinence Dgn konstipasi dan inkontinensia berlebihan Without constipation and overflow incontinence Tanpa konstipasi dan inkontinensia berlebihan
DSM-IV-TR Diagnostic Criteria for Enuresis
A. Repeated voiding of urine into bed or clothes (whether involuntary or intentional) Berulang2 kencing di tempat tidur atau celana (apakah tdk dpt dikontrol atau dimaksudkan demikian) B. The behavior is clinically significant as manifested by either a frequency of twice a week for at least 3 consecutive month or the presence of clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning.Perilaku ini bermakna klinis yg dimanifestasikan baik dgn frekuensinya 2 kali seminggu dlm 3 bulan berturut atau adanya penderitaan bermakna klinis atau hambatan dalam fungsi social, akademis ()okupasional) atau area penting lainnya C. Chronologic age is at least 5 years (or equivalent developmental level). Usia kronologis sekurang2nya 5 tahun (atau sebanding dgn tkt perkembangan) D. The behavior is not due exclusively to the direct physiologic effects of substance (e.g., diuretic) or a general medical condition (e.g., diabetes, spina bifida, or seizure disorder). Perilaku ini tdk hanya disebabkan oleh efek fisiologis langsung zat (diuretik) atau oleh suatu kondisi medis umum (mis. Diabetes, Spina Bifida atau ggn kejang). Specify type Tentukan tipe: Nocturnal only Nokturnal saja Diurnal only Diurnal saja Nocturnal and diurnal Nokturnal dan Diurnal
DSM-IV-TR Diagnostic Criteria for Separation Anxiety Disorder A. Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached, as evidenced by three (or more) of the following Berkembangnya ansietas yg tidak sesuai dan berlebihan tentang jauh darirumah atau orang2 yg dekat dgn individu yg dibuktikan dgn 3 atau lebih hal berikutaa: (1) recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated berulang kali tertekan berlebihan ketika terjadi jauh dari rumah atau figur2 dekat utama atau berupa antisipasi (2) persistent and excessive worry about losing, or about possible harm befalling, major attachment figures kekhawatiran berlebihan dan menetap ttg kehilangan atau kemungkinan kemalangan menimpa figur2 dekat utama (3) persistent and excessive worry that an untoward event will lead to separation from a major attachment figure (e.g., getting lost or being kidnapped) kekhawatiran berlebihan dan menetap bahwa
ada kejadian malang yg akan memisahkannya dari figur2 dekat utama (mis. hilang atau diculik) (4) persistent reluctance or refusal to go to school or elsewhere because of fear of separation kengganan atau penolakan menetap utk kesekolah atau tempat lain karean ketakutan akan perpisahan (5) persistent and excessive fear or reluctance to be alone or without major attachment figures at home or without significant adults in other settings ketakuatan menetap dan berlebihan atau kengganan ditinggal sendiri atau tanpa figur2 dekat utama dirumah atau tanpa orang yg dikenal dalam suasana lain (6) persistent reluctance or refusal to go to sleep without being near a major attachment figure or to sleep away from home keengganan menetap atau penolakan utk tidur sendiri tanpa disamping figur2 dekat utama atau tidur bukan dirumahnya (7) repeated nightmares involving the theme of separation mengalami mimpi buruk berulang yg bertema perpisahan (8) repeated complaints of physical symptoms (such as headaches, stomachaches, nausea, or vomiting) when separation from major attachment figures occurs or is anticipated keluhan2 berulang dari gejala2 fisik (spt sakit kepala, nyeri perut, mual atau muntah) ketika terjadi perpisahan dgn figur2 dekat utama atau berupa antisipasi B. The duration of the disturbance is at least 4 week Durasi ggn ini sedikitnya 4 minggu. C. The onset is before 18 years Onsetnya sebelum usia 18 tahun D. The disturbance causes clinically significant distress or impairment in social academic (occupational), or other important areas of functioning .Gangguan ini menyebabkan penderitaan yg bermakna klinis atau hambatan dlm fungsi2 sosisal, akademis (okupasional) atau area penting lainnya E. The disturbance does not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or other psychotic disorder, and in adolescents and adult, is not better accounted for by panic disorder with agoraphobia.Gangguan ini tidak hanya terjadi selama perjalanan suatu ggn perkembangan pervasive, Skizofrenia atau ggn psikotik lainnya dan tidak dapat digolongkan (pd remaja dan dewasa) sbg Ggn Panik dgn Agorafobia Specify if Tentukan jika: Early onset: if onset occurs before age 6 years Onset Dini: jika onset terjadi sebelum usia 6 tahun
DSM-IV-TR Diagnostic Criteria for Selective Mutism
(A) Consistent failure to speak in specific social situations (in which there is an expectation for speaking, e.g., at school) despite speaking in other situations.Kegagalan berbicara konsisten dlm situasi2 sosisl tertentu (dimana diharapkan berbicara mis. disekolah) (B) The disturbance interferes with educational or occupational achievement or with social communication Gangguan ini mengganggu pencapaian pendidikan atau okupasional atau dalm komukasi social. (C) The duration of the disturbance is at least 1 month (not limited to the first month of school).Durasi ggn sedikitnya 1 bulan. (D) The failure to speak is not due to a lock of knowledge of, or comfort with, the spoken language required in the social situation.Kegagalan berbicara tidak disebabkan oleh tiadanya pengetahuan atau nyaman dgn bahasa ucapan yg dibutuhkan dlm situasi sosial (E) The disturbance is not better accounted for by a communication disorder (e.g., stuttering) and does not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or other psychotic disorder Gangguan ini tdk dpt digolongkan sbg ggn berkomunikasi (mis. Gagap) dan tdk hanya terjadi selama perjalanan suatu ggn perkembangan pervasive, Skizofrenia atau ggn psikotik lainnya.
DSM – IV – TR Diagnostic Criteria for Stereotypic Movements Disorder
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Repetitive, seemingly driven, and nonfunctional motor behavior (e.g., hand shaking or waving, body rocking, head banging, mouthing of objects, self-biting, picking at skin or bodily orifices, bitting own body).Perilaku motorik repetitive yg tampaknya dikendalikan dan nonfungsional (mis. gerakan jabat tangan atau melambai, gerakan dansa, membentur2kan kepala, mengunyah2 sesuatu, memukul2 diri sendiri, mengorek2 kulit atau lubang2 tubuh, menggigit2 diri sendiri). The behavior markedly interferes with normal activities or results in self-inflicted bodily injury that requires medical treatment (or would result in a injury if preventive measures were not used).Perilaku ini nyata mengganggu aktifitas normal atau menyebabkan luka2 tubuh sendiri yg membutuhkan perawatan medis. If mental retardation is present, the stereotypic or self-injurious behavior is of sufficient severity to become a focus of treatment.Jika bersamaan dgn Retardasi Mental maka perilaku stereotipik atau melukai diri sendiri adalah cukup parah utk menjadi focus perawatan. The behavior is not better accounted for by a compulsion (as in obsessive-compulsive disorder), a tic (as in tic disorder), a stereotypic that is part of a pervasive developmental disorder, or hair pulling (as in trichotillomania).Perilaku ini tidak dpt digolongkan sbg kompulsi (spt dlm Ggn Obsesi-Kompulsif), tic (ggn tic), bagian dari suatu ggn perkembangan pervasive atau mencabut2 rambut (Trikotilomania) The behavior is not due to the direct physiologic effects of a substances or a general medical condition.Perilaku ini tidak disebabkan oleh efek lsg suatu zat atau suatu kondis medis umum. The behavior persists for 4 weeks or longer.Perilaku ini memetap selama 4 minggu atau lebih
Specify if Tentukan jika: With self-injurious behaviour : If the behavior results in bodily damage that requires specific treatment (or that would result in bodily damage if protective measures were not used) Dengan Perilaku melukai diri: jika perilaku menyebabkan kerusakan badan yg membutuhkan erawatan tertentu.
DSM – IV – TR Diagnostic Criteria for Mental Retardation A.
Significantly subaverage intellectual functioning: On IQ of approximately 70 or below on an individually administered IQ test (for infants, a clinical judgment of significant subaverage of intellectual functioning).Fungsi2 intelektual jelas dibawah rata2.Pada tes pemeriksaan IQ didapatkan rata2 70 atau kurang (pada bayi berdsarkan penilaian klinis dari fungsi2 intelektual rata2). B. Concurrent deficits or impairments in present adaptive functioning (i.e., the person’s effectiveness in meeting the standards expected for his or her age by his or her cultural group) in at least two of the following areas : communication, self-care, home living, social/interpersonal skills, use of community resources, self-direction, functional academic skills, work, leisure, health, and safety.Defisit2 dan hambatan pd fungsi2 adaptif saat ini (kefektifan ybs thd standar2 yg diharapkan berdasarkan kelompok usia atau budaya) setidaknya pada 2 area berikut: komunikasi, perawatan diri, keseharian, ketrampilan social/antarpersonal, pemanfaatan fasilitas publik, pengarahan diri, ketrampilan fungsional akademik, pekerjaan, kesenangan, kesehatan dan keselamatan. C. The onset is before age 18 years.Onsetnya sebelum usia 18 tahun. Code based on degree of severity reflecting level of intellectual impairment : Mild mental retardation : IQ level 50 – 55 to approximately 70 Moderate mental retardation : IQ level 35 – 40 to 50 – 55 Severe mental retardation : IQ level 20 – 25 to 35 – 40 Profound mental retardation : IQ level below 20 or 25 Mental retardation severity unspecified: When there is strong presumption of mental retardation but the person’s intelligence is untestable by standard tests. Penkodean berdasarkan derajat keparahan hambatan intelektual: Ringan: IQ 50 – 55 sampai 70 Sedang: IQ 35 – 40 sampai 50 – 55 Berat: IQ 20-25 sampai 35-40 Sangat Berat: IQ kurang dari 25 Taktertentukan: ada dugaan kuat RM tetapi belum dilakukan tes standar
