Schizophrenia Or Other Primary Psychotic Disorders – Definitions & ICD 11 Codes


Definition of Schizophrenia Or Other Primary Psychotic Disorders: Schizophrenia and other primary psychotic disorders are characterised by significant impairments in reality testing and alterations in behaviour manifest in positive symptoms such as persistent delusions, persistent hallucinations, disorganised thinking (typically manifest as disorganised speech), grossly disorganised behaviour, and experiences of passivity and control, negative symptoms such as blunted or flat affect and avolition, and psychomotor disturbances. The symptoms occur with sufficient frequency and intensity to deviate from expected cultural or subcultural norms. These symptoms do not arise as a feature of another mental and behavioural disorder (e.g., a mood disorder, delirium, or a disorder due to substance use). The categories in this grouping should not be used to classify the expression of ideas, beliefs, or behaviours that are culturally sanctioned.

Coded Elsewhere:


Schizophrenia

Definition of Schizophrenia: Schizophrenia is characterised by disturbances in multiple mental modalities, including thinking (e.g., delusions, disorganisation in the form of thought), perception (e.g., hallucinations), self-experience (e.g., the experience that one’s feelings, impulses, thoughts, or behaviour are under the control of an external force), cognition (e.g., impaired attention, verbal memory, and social cognition), volition (e.g., loss of motivation), affect (e.g., blunted emotional expression), and behaviour (e.g., behaviour that appears bizarre or purposeless, unpredictable or inappropriate emotional responses that interfere with the organisation of behaviour). Psychomotor disturbances, including catatonia, may be present. Persistent delusions, persistent hallucinations, thought disorder, and experiences of influence, passivity, or control are considered core symptoms. Symptoms must have persisted for at least one month in order for a diagnosis of schizophrenia to be assigned. The symptoms are not a manifestation of another health condition (e.g., a brain tumour) and are not due to the effect of a substance or medication on the central nervous system (e.g., corticosteroids), including withdrawal (e.g., alcohol withdrawal).

ICD 11 Code For Schizophrenia

  6A20  Schizophrenia

Exclusions:

  • Schizotypal disorder (6A22)
  • schizophrenic reaction (6A22)
  • Acute and transient psychotic disorder (6A23)

6A20.0 Schizophrenia first episode

Definition of Schizophrenia first episode: Schizophrenia, first episode should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizophrenia (including duration) but who have never before experienced an episode during which diagnostic requirements for Schizophrenia were met.

6A20.00 Schizophrenia first episode currently symptomatic

Definition of Schizophrenia first episode currently symptomatic: All definitional requirements for Schizophrenia, first episode in terms of symptoms and duration are currently met, or have been met within the past one month.

6A20.01 Schizophrenia first episode in partial remission

Definition of Schizophrenia first episode in partial remission: All definitional requirements for Schizophrenia, first episode in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.

6A20.02 Schizophrenia first episode in full remission

Definition of Schizophrenia first episode in full remission: All definitional requirements for Schizophrenia, first episode in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remission may have occurred in response to medication or other treatment.

6A20.0Z Schizophrenia first episode unspecified

6A20.1 Schizophrenia multiple episodes

Definition of Schizophrenia multiple episodes: Schizophrenia, multiple episode should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizophrenia and who have also previously experienced episodes during which diagnostic requirements were met, with substantial remission of symptoms between episodes. Some attenuated symptoms may remain during periods of remission, and remissions may have occurred in response to medication or other treatment.

6A20.10 Schizophrenia multiple episodes currently symptomatic

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

6A20.11 Schizophrenia multiple episodes in partial remission

Definition of Schizophrenia multiple episodes in partial remission: All definitional requirements for Schizophrenia, multiple episodes in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.

6A20.12 Schizophrenia multiple episodes in full remission

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

6A20.1Z Schizophrenia multiple episodes unspecified

6A20.2 Schizophrenia continuous

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

6A20.20 Schizophrenia continuous currently symptomatic

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

6A20.21 Schizophrenia continuous in partial remission

Definition of Schizophrenia continuous in partial remission: All definitional requirements for Schizophrenia, continuous in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.

6A20.22 Schizophrenia continuous in full remission

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

6A20.2Z Schizophrenia continuous unspecified

6A20.Y Other specified episode of schizophrenia

6A20.Z Schizophrenia episode unspecified

Schizoaffective disorder

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

ICD 11 Code For Schizoaffective disorder

  6A21  Schizoaffective disorder

6A21.0 Schizoaffective disorder first episode

Definition of Schizoaffective disorder first episode: Schizoaffective disorder, first episode should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizoaffective disorder (including duration) but who have never before experienced an episode during which diagnostic requirements for Schizoaffective disorder or Schizophrenia were met.

6A21.00 Schizoaffective disorder first episode currently symptomatic

Definition of Schizoaffective disorder first episode currently symptomatic: All definitional requirements for Schizoaffective disorder, first episode in terms of symptoms and duration are currently met, or have been met within the past one month.

6A21.01 Schizoaffective disorder first episode in partial remission

Definition of Schizoaffective disorder first episode in partial remission: All definitional requirements for Schizoaffective disorder, first episode in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.

6A21.02 Schizoaffective disorder first episode in full remission

Definition of Schizoaffective disorder first episode in full remission: All definitional requirements for Schizoaffective disorder, first episode in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remission may have occurred in response to medication or other treatment.

6A21.0Z Schizoaffective disorder first episode unspecified

6A21.1 Schizoaffective disorder multiple episodes

Definition of Schizoaffective disorder multiple episodes: Schizoaffective disorder, multiple episodes should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizoaffective disorder and who have also previously experienced episodes during which diagnostic requirements for Schizoaffective disorder or Schizophrenia were met, with substantial remission of symptoms between episodes. Some attenuated symptoms may remain during period of remission, and remissions may have occurred in response to medication or other treatment.

6A21.10 Schizoaffective disorder multiple episodes currently symptomatic

Definition of Schizoaffective disorder multiple episodes currently symptomatic: All definitional requirements for Schizoaffective disorder, multiple episodes in terms of symptoms and duration are currently met, or have been met within the past one month.

6A21.11 Schizoaffective disorder multiple episodes in partial remission

Definition of Schizoaffective disorder multiple episodes in partial remission: All definitional requirements for Schizoaffective disorder, multiple episodes in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.

6A21.12 Schizoaffective disorder multiple episodes in full remission

Definition of Schizoaffective disorder multiple episodes in full remission: All definitional requirements for Schizoaffective disorder, multiple episodes in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remission may have occurred in response to medication or other treatment.

6A21.1Z Schizoaffective disorder multiple episodes unspecified

6A21.2 Schizoaffective disorder continuous

Definition of Schizoaffective disorder continuous: Symptoms fulfilling all definitional requirements of Schizoaffective disorder have been present for almost all of the illness course over a period of at least one year, with periods of subthreshold symptoms being very brief relative to the overall course.

6A21.20 Schizoaffective disorder continuous currently symptomatic

Definition of Schizoaffective disorder continuous currently symptomatic: All definitional requirements for Schizoaffective disorder, continuous in terms of symptoms and duration are currently met, or have been met within the past one month.

6A21.21 Schizoaffective disorder continuous in partial remission

Definition of Schizoaffective disorder continuous in partial remission: All definitional requirements for Schizoaffective disorder, continuous in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.

6A21.22 Schizoaffective disorder continuous in full remission

Definition of Schizoaffective disorder continuous in full remission: All definitional requirements for Schizoaffective disorder, continuous in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remission may have occurred in response to medication or other treatment.

6A21.2Z Schizoaffective disorder continuous unspecified

6A21.Y Other specified schizoaffective disorder

6A21.Z Schizoaffective disorder unspecified

Schizotypal disorder

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

ICD 11 Code For Schizotypal disorder

  6A22  Schizotypal disorder

Inclusions:

Exclusions:

Acute and transient psychotic disorder

Definition of Acute and transient psychotic disorder: Acute and transient psychotic disorder is characterised by acute onset of psychotic symptoms that emerge without a prodrome and reach their maximal severity within two weeks. Symptoms may include delusions, hallucinations, disorganisation of thought processes, perplexity or confusion, and disturbances of affect and mood. Catatonia-like psychomotor disturbances may be present. Symptoms typically change rapidly, both in nature and intensity, from day to day, or even within a single day. The duration of the episode does not exceed 3 months, and most commonly lasts from a few days to 1 month. The symptoms are not a manifestation of another medical condition (e.g. a brain tumour) and are not due to the effect of a substance or medication on the central nervous system (e.g. corticosteroids), including withdrawal (e.g. alcohol withdrawal).

ICD 11 Code For Acute and transient psychotic disorder

  6A23  Acute and transient psychotic disorder

6A23.0 Acute and transient psychotic disorder first episode

Definition of Acute and transient psychotic disorder first episode: Acute and transient psychotic disorder, first episode should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for acute and transient psychotic disorder but who have never before experienced a similar episode.

6A23.00 Acute and transient psychotic disorder first episode currently symptomatic

Definition of Acute and transient psychotic disorder first episode currently symptomatic: All definitional requirements for Acute and transient psychotic disorder, first episode in terms of symptoms and duration are currently met, or have been met within the past one month.

6A23.01 Acute and transient psychotic disorder first episode in partial remission

Definition of Acute and transient psychotic disorder first episode in partial remission: All definitional requirements for Acute and transient psychotic disorder, first episode in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.

6A23.02 Acute and transient psychotic disorder first episode in full remission

Definition of Acute and transient psychotic disorder first episode in full remission: All definitional requirements for Acute and transient psychotic disorder, first episode in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remission may have occurred in response to medication or other treatment.

6A23.0Z Acute and transient psychotic disorder first episode unspecified

6A23.1 Acute and transient psychotic disorder multiple episodes

Definition of Acute and transient psychotic disorder multiple episodes: Acute and transient psychotic disorder, multiple episodes should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for acute and transient psychotic disorder and who have experienced similar episodes in the past.

6A23.10 Acute and transient psychotic disorder multiple episodes currently symptomatic

Definition of Acute and transient psychotic disorder multiple episodes currently symptomatic: All definitional requirements for Acute and transient psychotic disorder, multiple episodes in terms of symptoms and duration are currently met, or have been met within the past one month.

6A23.11 Acute and transient psychotic disorder multiple episodes in partial remission

Definition of Acute and transient psychotic disorder multiple episodes in partial remission: All definitional requirements for Acute and transient psychotic disorder, multiple episodes in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.

6A23.12 Acute and transient psychotic disorder multiple episodes in full remission

Definition of Acute and transient psychotic disorder multiple episodes in full remission: All definitional requirements for Acute and transient psychotic disorder, multiple episodes in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remission may have occurred in response to medication or other treatment.

6A23.1Z Acute and transient psychotic disorder multiple episodes unspecified

6A23.Y Other specified acute and transient psychotic disorder

6A23.Z Acute and transient psychotic disorder unspecified

Delusional disorder

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

ICD 11 Code For Delusional disorder

  6A24  Delusional disorder

6A24.0 Delusional disorder currently symptomatic

Definition of Delusional disorder currently symptomatic: All definitional requirements for Delusional disorder in terms of symptoms and duration are currently met, or have been met within the past one month.

6A24.1 Delusional disorder in partial remission

Definition of Delusional disorder in partial remission: All definitional requirements for Delusional disorder in terms of symptoms and duration were previously met. Symptoms have ameliorated such that the diagnostic requirements for the disorder have not been met for at least one month, but some clinically significant symptoms remain, which may or may not be associated with functional impairment. The partial remission may have occurred in response to medication or other treatment.

6A24.2 Delusional disorder in full remission

Definition of Delusional disorder in full remission: All definitional requirements for Delusional disorder in terms of symptoms and duration were previously met. Symptoms have ameliorated such that no significant symptoms remain. The remission may have occurred in response to medication or other treatment.

6A24.Z Delusional disorder unspecified

Symptomatic manifestations of primary psychotic disorders

Definition of Symptomatic manifestations of primary psychotic disorders: These categories may be used to characterize the current clinical presentation in individuals diagnosed with Schizophrenia or another primary psychotic disorder, and should not be used in individuals without such a diagnosis. Multiple categories may be applied. Symptoms attributable to the direct pathophysiological consequences of a health condition or injury not classified under Mental, behavioural or neurodevelopmental disorders (e.g., a brain tumour or traumatic brain injury), or to the direct effects of a substance or medication on the central nervous system, including withdrawal effects, should not be considered as examples of the respective types of symptoms.

ICD 11 Codes For Symptomatic manifestations of primary psychotic disorders

  6A25  Symptomatic manifestations of primary psychotic disorders

Coding Note:

  • These categories should never be used in primary coding. The codes are provided for use as supplementary or additional codes when it is desired to identify the presence of these symptoms in primary psychotic disorders.

6A25.0 Positive symptoms in primary psychotic disorders

Definition of Positive symptoms in primary psychotic disorders: Positive symptoms in primary psychotic disorders include persistent delusions, persistent hallucinations (most commonly verbal auditory hallucinations), disorganised thinking (formal thought disorder such as loose associations, thought derailment, or incoherence), grossly disorganised behaviour (behaviour that appears bizarre, purposeless and not goal-directed) and experiences of passivity and control (the experience that one’s feelings, impulses, or thoughts are under the control of an external force). The rating should be made based on the severity of positive symptoms during the past week.

Coding Note:

  • Code also the causing condition

6A25.1 Negative symptoms in primary psychotic disorders

Definition of Negative symptoms in primary psychotic disorders: Negative symptoms in primary psychotic disorders include constricted, blunted, or flat affect, alogia or paucity of speech, avolition (general lack of drive, or lack of motivation to pursue meaningful goals), asociality (reduced or absent engagement with others and interest in social interaction) and anhedonia (inability to experience pleasure from normally pleasurable activities). To be considered negative psychotic symptoms, relevant symptoms should not be entirely attributable to antipsychotic drug treatment, a depressive disorder, or an under-stimulating environment, and should not be a direct consequence of a positive symptom (e.g., persecutory delusions causing a person to become socially isolated due to fear of harm). The rating should be made based on the severity of negative symptoms during the past week.

Coding Note:

  • Code also the causing condition

6A25.2 Depressive mood symptoms in primary psychotic disorders

Definition of Depressive mood symptoms in primary psychotic disorders: Depressive mood symptoms in primary psychotic disorders refer to depressed mood as reported by the individual (feeling down, sad) or manifested as a sign (e.g. tearful, defeated appearance). If only non-mood symptoms of a depressive episode are present (e.g., anhedonia, psychomotor slowing), this descriptor should not be used. This descriptor may be used whether or not depressive symptoms meet the diagnostic requirements of a separately diagnosed Depressive disorder. The rating should be made based on the severity of depressive mood symptoms during the past week.

Coding Note:

  • Code also the causing condition

6A25.3 Manic mood symptoms in primary psychotic disorders

Definition of Manic mood symptoms in primary psychotic disorders: Manic mood symptoms in primary psychotic disorders refer to elevated, euphoric, irritable, or expansive mood states, including rapid changes among different mood states (i.e., mood lability). It also includes increased subjective experience of energy, which may be accompanied by increased goal-directed activity. The severity of associated non-mood symptoms of a Manic or Hypomanic Episode (e.g., decreased need for sleep, distractibility) should not be considered in making a rating. Increased non-goal-directed psychomotor activity should be considered as part of the rating of the ‘psychomotor symptoms in primary psychotic disorders’ rather than here. This descriptor may be used whether or not the manic symptoms meet the diagnostic requirements of a separately diagnosed bipolar disorder. The rating should be made based on the severity of manic mood symptoms during the past week.

Coding Note:

  • Code also the causing condition

6A25.4 Psychomotor symptoms in primary psychotic disorders

Definition of Psychomotor symptoms in primary psychotic disorders: Psychomotor symptoms in primary psychotic disorders include psychomotor agitation or excessive motor activity, usually manifested by purposeless behaviours such as fidgeting, shifting, fiddling, inability to sit or stand still, wringing of the hands, psychomotor retardation, or a visible generalised slowing of movements and speech, and catatonic symptoms such as excitement, posturing, waxy flexibility, negativism, mutism, or stupor. The rating should be made based on the severity of psychomotor symptoms during the past week.

Coding Note:

  • Code also the causing condition

6A25.5 Cognitive symptoms in primary psychotic disorders

Definition of Cognitive symptoms in primary psychotic disorders: Cognitive symptoms in primary psychotic disorders refer to cognitive impairment in any of the following domains: speed of processing, attention/concentration, orientation, judgment, abstraction, verbal or visual learning, and working memory. The cognitive impairment is not attributable to a neurodevelopmental disorder, a delirium or other neurocognitive disorder, or the direct effects of a substance or medication on the central nervous system, including withdrawal effects. Ideally, use of this category should be based on the results of locally validated, standardized neuropsychological assessments, although such measures may not be available in all settings. The rating should be made based on the severity of cognitive symptoms during the past week.

Coding Note:

  • Code also the causing condition

Exclusions:

Other specified primary psychotic disorder

ICD 11 Code For Other specified primary psychotic disorder

  6A2Y  Other specified primary psychotic disorder

Schizophrenia or other primary psychotic disorders unspecified

ICD 11 Code For Schizophrenia or other primary psychotic disorders unspecified

  6A2Z  Schizophrenia or other primary psychotic disorders unspecified

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