For the diagnosis of

personality disorders Personality disorders (PD) are a class of mental health conditions characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the culture. T ...

, diagnostic frameworks such as the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM) and the ''

International Classification of Diseases The International Classification of Diseases (ICD) is a globally used medical classification that is used in epidemiology, health management and clinical diagnosis. The ICD is maintained by the World Health Organization (WHO), which is the dir ...

'' (ICD) have residual diagnostic categories for diagnosis of conditions which do not align well with specific PD diagnoses. The

DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the '' Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiat ...

defines two personality disorder diagnoses, namely Other specified personality disorder and Unspecified personality disorder, along with '' Personality change due to another medical condition'' under ''Other personality disorders.'' The

ICD-10 ICD-10 is the 10th revision of the International Classification of Diseases (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social cir ...

also contains similar categories, namely, Other specific personality disorder and Personality disorder, unspecified. Additionally, in the ''Alternative DSM-5 Model for Personality Disorders'', the DSM-5 introduced the diagnosis Personality disorder - trait specified (PD-TS) as an alternative to let clinicians define the presentation in detail, in terms of "impairment of personality functioning" and "pathological personality traits". Personality disorder not otherwise specified (PD-NOS) was a

subclinical Asymptomatic (or clinically silent) is an adjective categorising the medical conditions (i.e., injuries or diseases) that patients carry but without experiencing their symptoms, despite an explicit diagnosis (e.g., a positive medical test). P ...

diagnostic classification for some

DSM-IV The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a com ...

Axis II

personality disorder Personality disorders (PD) are a class of mental health conditions characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the culture. ...

s not listed in DSM-IV. The DSM-5 transitioned from NOS diagnoses to ''other specified'' and ''unspecified'' in order to "enhance diagnostic specificity". The diagnoses in the DSM-5 are not direct equivalents to PD-NOS.

Diagnosis types

In all cases of non-specific diagnoses it is a requirement that the person meet the general criteria for personality disorders.

Other specified & Other specific

The ICD-10 defines the diagnosis ''Other specific personality disorder'' () for personality disorders that don't have a separate code. This diagnosis allows the following type specifiers: "eccentric", " haltlose", " immature", "

narcissistic Narcissism is a self-centered personality style characterized as having an excessive preoccupation with oneself and one's own needs, often at the expense of others. Narcissism, named after the Greek mythological figure ''Narcissus'', has evolv ...

", "

passive-aggressive Passive-aggressive behavior is characterized by a pattern of passive hostility and an avoidance of direct communication. Inaction where some action is socially customary is a typical passive-aggressive strategy (showing up late for functions, s ...

", and "psychoneurotic". The DSM-5 contains the similarly named diagnosis ''Other Specified Personality Disorder'' (301.89; F60.89), which is used when recording the presence of personality disorder along with the reasons for the condition not being classified as one of the specific personality disorders.

Unspecified

The ICD-10 contains ''Personality disorder, unspecified'' () for general personality disorder diagnoses. The DSM-5 diagnosis of ''Unspecified Personality Disorder'' (301.9; F60.9) is, according to the DSM-5, used when a patient presents with personality disorder symptoms that cause distress or impairment, but the clinician either chooses not to indicate the specific reason these criteria are not met for any one disorder, or there isn’t enough information available to make a more precise diagnosis.

Not otherwise specified

This diagnosis was part of the

DSM-IV-TR The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a c ...

, and could be assigned when no other personality disorder in the DSM fit the patient's symptoms.

Diagnostic and Statistical Manual of Mental Disorders The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a com ...

Fourth edition Text Revision (DSM-IV-TR)

American Psychiatric Association The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 39,200 members who are in ...

(2000) This diagnosis is not included in subsequent (DSM-5 and

DSM-5-TR The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomy (general), taxonomic and diagnostic tool published by the ...

) editions of the DSM. The DSM-IV-TR excluded four personality disorders, but this diagnosis may be used instead. The four excluded personality disorders are: *

Sadistic personality disorder Sadistic personality disorder is an obsolete term for a proposed personality disorder defined by a pervasive pattern of sadistic and cruel behavior. People who fitted this diagnosis were thought to have a desire to control others and to have a ...

* Self-defeating personality disorder * Depressive personality disorder * Passive–aggressive personality disorder

Severity unspecified

ICD-11 The ICD-11 is the eleventh revision of the International Classification of Diseases (ICD). It replaces the ICD-10 as the global standard for recording health information and causes of death. The ICD is developed and annually updated by the World H ...

uses general diagnoses with specifiers to fully describe a condition. The unspecified PD diagnosis in the ICD-11 is ''Personality disorder, severity unspecified'' ().

Epidemiology

The National Comorbidity Survey Replication estimated the prevalence of PD-NOS in the general population at around 1.6% (0.3-2.9%). Comorbidity measures indicated a strong association with

antisocial personality disorder Antisocial personality disorder (ASPD) is a personality disorder defined by a chronic pattern of behavior that disregards the rights and well-being of others. People with ASPD often exhibit behavior that conflicts with social norms, leading to ...

(and generally Cluster B), moderate association with obsessive-compulsive personality disorder, and strong negative association with schizoid and

dependent personality disorder Dependent personality disorder (DPD) is a personality disorder characterized by a pervasive psychological dependence on other people. This personality disorder is a long-term condition in which people depend on others to meet their emotional ...

s. A 2004 meta-analysis estimated the prevalence of PD-NOS in patient samples between 8-13%. In structured interview studies it is the third most common diagnosis given, in unstructured studies it is the single most frequent diagnosis. Half the studies did not give further definition for the diagnosis, and those that did used "mixed" most often. In another study, out of 1760 psychotherapy referrals, 21.6% was diagnosed exclusively with PD-NOS. In terms of severity, patients with PD-NOS fell between a formal personality disorder diagnosis and no personality disorder. Patients who received PD-NOS as an additional diagnosis to their formal personality disorder diagnosis had the most severe problems.

Notes

References

External links

{{ICD-10 personality disorders Personality disorders