02 - Relationship problems and maltreatment as fac

Relationship problems and maltreatment as factors influencing health status or health services

709 Relationship problems and maltreatment Relationship problems and maltreatment as factors influencing health status or contact with health services Categories for relationship problems and maltreatment from Chapter 24 on factors influencing health status or contact with health services are used when the purpose is to record one of three types of clinically significant relationship phenomena. These are: • to document a pattern of clinically significant relationship conflict with an intimate partner, parent or other caregiver; • to document a history over the individual’s lifetime of maltreatment independent of a specific injury or other harm, which may refer to ongoing maltreatment or to past episodes – such as a history of child abuse – that are relevant to the individual’s health status or encounters with the health system; or • to document a possible episode of maltreatment that is currently under clinical investigation. QE51.0 Relationship problems and maltreatment P Relationship distress with spouse or partner Relationship distress with spouse or partner is defined as substantial and sustained dissatisfaction with a spouse or intimate partner associated with significant disturbance in functioning. This diagnosis can be assigned to one or both parties in a dyad, depending on the context of the evaluation or treatment. Caregiver–child relationship problem Caregiver–child relationship problem is defined as substantial and sustained dissatisfaction within a caregiver–child relationship, including a parental relationship, associated with significant disturbance in functioning. This diagnosis can be assigned to one or both parties in a dyad, depending on the context of the evaluation or treatment. QE52.0 Available categories for history of maltreatment in Chapter 24 are: History of spouse or partner violence QE51.10 History of spouse or partner violence, physical QE51.11 History of spouse or partner violence, psychological QE51.12 History of spouse or partner violence, sexual QE51.13 History of spouse or partner violence, neglect. These diagnoses can be used to indicate ongoing or past episodes of maltreatment by a spouse or partner when the focus of the evaluation is not related to a specific injury or death. If the history of maltreatment is not related to a spouse or partner relationship, categories from QE82 Personal history of maltreatment should be used instead. QE51.1 Available categories for intimate partner or caregiver–child relationship distress or conflict in Chapter 24 are:

Clinical Descriptions and Diagnostic Requirements for ICD-11 Mental, Behavioural or Neurodevelopmental Disorders Available categories for examination or observation for suspected maltreatment in Chapter 24 are: Relationship problems and maltreatment | Personal history of maltreatment Personal history of maltreatment QE82.0 Personal history of physical abuse QE82.1 Personal history of sexual abuse QE82.2 Personal history of psychological abuse QE82.3 Personal history of neglect QE82.Y Other specified personal history of maltreatment QE82.Z Personal history of maltreatment, unspecified. These diagnoses can be used to indicate ongoing or past episodes of maltreatment by someone other than a spouse or partner (e.g. a parent, another relative, a stranger), when the focus of the evaluation is not related to a specific injury or death. If the history of maltreatment is related to a spouse or partner relationship, categories from QE51.1 History of spouse or partner violence should be used instead. The time in life (e.g. child under 5 years, adolescent, late geriatric) can be indicated using postcoordinated extension codes. QE82 Examination or observation for suspected maltreatment QA04.50 Examination or observation for suspected physical maltreatment QA04.51 Examination or observation for suspected sexual maltreatment QA04.52 Examination or observation for suspected psychological maltreatment QA04.53 Examination or observation for suspected neglect or abandonment QA04.5Y Other specified examination or observation for suspected maltreatment QA04.5Z Examination or observation for suspected maltreatment, unspecified. QA04.5 If maltreatment is confirmed based on the examination or observation, the diagnosis should generally be changed to one of the maltreatment categories in Chapter 24, if the evaluation is in relation to a specific injury, or otherwise to the applicable history or spouse or partner violence or personal history of maltreatment category in Chapter 24. In some circumstances, categories from Chapter 23 and Chapter 24 can be used together – for example, when there is an established history of maltreatment, and an injury resulting from that maltreatment is the focus of a current episode of care. However, examination or observation codes in Chapter 24 would typically not be assigned together with maltreatment categories from Chapter 23 explaining the cause of a specific injury.