226 - 6E21 Mental and behavioural disorders associa

6E21 Mental and behavioural disorders associated ...

Clinical Descriptions and Diagnostic Requirements for ICD-11 Mental, Behavioural or Neurodevelopmental Disorders Mental and behavioural disorders associated with pregnancy, childbirth or the puerperium, with psychotic symptoms Essential (required) features • Onset of a syndrome involving significant mental and behavioural features occurring during pregnancy or the puerperium (i.e. up to about 6 weeks following delivery) is required for diagnosis. • The syndrome includes psychotic symptoms (i.e. delusions, hallucinations or other psychotic symptoms). Depressive and/or manic mood symptoms are also typically present. • The symptoms are not a manifestation of another medical condition (e.g. a brain tumour), and are not due to the effects of a substance or medication on the central nervous system (e.g. benzodiazepines), including withdrawal effects (e.g. from stimulants). • The disturbance results in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. If functioning is maintained, it is only through significant additional effort. Note: this diagnosis may be assigned regardless of whether biological factors related to pregnancy, childbirth or the puerperium are known to be etiologically related to the syndrome. If the symptoms meet the diagnostic requirements for a specific mental disorder (e.g. a mood disorder, schizophrenia or another primary psychotic disorder), that diagnosis should also be assigned. If the symptoms do not meet the diagnostic requirements for a specific mental disorder, the presentation can be described using codes from the section on mental or behavioural symptoms, signs or clinical findings (p. 677). Additional clinical features • Psychotic symptoms in mental and behavioural disorders associated with pregnancy, childbirth or the puerperium most commonly occur in the context of a depressive, manic or mixed mood episode, in which case a diagnosis of single episode depressive disorder, recurrent depressive disorder or bipolar type I disorder should also be assigned. • Additional symptoms may include confusion and disorientation, sleep disturbance, excessive energy and agitation, obsessions and compulsions, paranoid ideation and attempts to harm oneself or the baby. Mental and behavioural disorders associated with pregnancy, childbirth or the puerperium 6E21