Paranoia ICD-10 vs. DSM-5
The ICD-10-CM (the International Classification of Diseases, Tenth Revision, Clinical Modification) and the Diagnostic and Statistical Manual of Mental Illnesses, Fifth Edition (DSM-5), both classify mental health conditions, but each one serves a different purpose. While the two manuals contain a significant amount of overlapping information, they also have many differences and are used for different reasons.
To understand more about the ICD-10 and DSM-5, we’ll look at how each of these manuals approaches paranoia as a symptom of paranoid personality disorder.
What is the ICD-10?
The International Classification of Diseases (ICD) is a diagnostic tool that classifies and monitors causes of death and injuries. It was designed to promote international compatibility in collecting and reporting health data.
What is in the ICD-10?
The ICD-10 contains descriptions of all known diseases and injuries. Each one is detailed with diagnostic characteristics and is assigned a unique identifier to code data on clinical records and mortality data on death certificates. The classifications consist of four alpha-numeric characters, where the first number designates a chapter in the ICD, and the others specify different classification axes. For example, the ICD-10-CM diagnosis code for paranoid personality disorder is F60.0.
Who manages the ICD-10?
The ICD-11, a revision of the ICD 10, took effect in 2022. Some changes include making many of the secondary clinical categories into new subchapters, removing some categories altogether, and adding new subcategories. The WHO also published a manual in 2024 to support health professionals in identifying and diagnosing mental, behavioral, and neurodevelopmental disorders.
What is the DSM-5?
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or DSM-5, is a reference book that categorizes mental health and brain-related conditions and disorders. It’s written, reviewed, and updated by the American Psychiatric Association. The Fifth Edition was released in 2013, but a revised edition called the DSM-5-TR (Text Revision) was released in 2022.
What is the purpose of the DSM-5?
The DSM's primary purpose is to help clinicians diagnose mental health and brain-related conditions. It gives mental health providers highly detailed definitions of these conditions, including symptoms and diagnostic criteria. This reference manual also organizes these conditions into groups, making it easier for providers to distinguish between them.
ICD-10 vs DSM-5
The ICD has been around longer than the DSM, and while the two do have many things that overlap, they serve two different purposes. The ICD-10 and subsequent ICD-11 assign codes to use for reimbursement, claims, billing, and data tracking, while the DSM-5 provides professionals with specific diagnostic criteria to classify and diagnose mental health conditions. They generally agree when terms are out-of-date or should no longer be used. For example, neither the DSM nor the ICD contains paranoid schizophrenia as a diagnosis.
Another difference between the two is that the DSM-5 covers only mental health and brain-related conditions, while the ICD-10 covers mental disorders as well as physical health conditions. For this reason, it does not go into as much detail about mental health conditions as the DSM does.
Do the ICD-10 and DSM-5 contain the same information?
The DSM and ICD were developed and maintained by separate entities, so they have some differences. The DSM covers more mental health conditions and is more detailed than the ICD. Some diagnoses that appear in the DSM do not appear in the ICD or have a direct correlation with a condition in the ICD. However, in most cases, the diagnoses and criteria are similar.
Paranoia, psychotic symptoms, and the diagnosis code in the ICD-10
Paranoia in the ICD-10 is not a separate disorder but a symptom of a variety of mental disorders. As mentioned above, paranoid personality disorder (PPD) is classified under ICD-10-CM code F60.0. The ICD-10 classifies mental, behavioral, and neurodevelopmental disorders and requires that any personality disorder also meet the criteria for generalized anxiety disorder.
Symptoms of paranoid personality disorder for diagnosis code F60.0 in the ICD-10
In the ICD-10-CM code, PPD is categorized by having the following symptoms:
- Excessive sensitivity to setbacks
- Unforgiveness of insults
- Suspiciousness and a tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous
- Recurrent suspicions, without justification, regarding the sexual fidelity of the spouse or sexual partner
- Combative and tenacious sense of personal rights
People with PPD may also experience excessive self-importance and excessive self-reference, and this diagnosis can also include expansive paranoid personality disorder, fanatic personality disorder, querulant personality disorder, and sensitive paranoid personality disorder.
Paranoia and psychotic symptoms in the DSM-5
In the DSM-5, PPD has similar diagnostic criteria to the paranoid personality ICD-10 criteria. In the DSM-5, for a diagnosis of PPD, patients must have a persistent distrust and suspiciousness of others as well as four or more of the following symptoms:
- “1. Suspects, without sufficient basis, that others are exploiting, harming, or
- deceiving him or her.
- 2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of
- friends or associates.
- 3. Is reluctant to confide in others because of unwarranted fear that the
- information will be used maliciously against him or her.
- 4. Reads hidden demeaning or threatening meanings into benign remarks or
- events.
- 5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
- 6. Perceives attacks on his or her character or reputation that are not apparent
- to others and is quick to react angrily or to counterattack.
- 7. Has recurrent suspicions, without justification, regarding fidelity of spouse or
sexual partner.”
These criteria overlap with the ICD-10 symptoms, but there are some differences. The DSM-5 is generally more expansive and specific, but the criteria cover the same types of symptoms.
Psychotic disorder and other diagnoses
There are other terms that appear in the ICD-10 and DSM-5 relating to paranoia, like paranoid psychosis, which the ICD also refers to as alcoholic psychosis, or induced psychotic disorder, which results from substance use, or delusional disorder.
Treatment for paranoid personality disorder
While the ICD and DSM list diagnostic criteria for many conditions, they do not typically recommend treatment. Treatment for PPD and other conditions that cause paranoia varies depending on the cause. Treatment generally involves talk therapy, during which individuals can work with a mental health professional to improve coping skills, self-esteem, communication, and trust.
Online therapy for those with paranoid personality disorder or a psychotic disorder
If you’re interested in working with a therapist but paranoia or psychotic symptoms make it difficult to attend in-person therapy, you might consider online treatment. When you sign up with an online therapy platform, you can work with a licensed mental health professional from the comfort of home at a time that works for your schedule. Most people who sign up are matched with a therapist in as little as 48 hours, and you can change therapists at any time until you find one who is the right fit for you.
How effective is online therapy for paranoia or psychotic symptoms?
Research shows that online therapy can be effective at treating multiple types of mental health conditions that may be common among people with PPD, such as anxiety and depression. One study published in 2017 found that online cognitive behavioral therapy was effective for generalized anxiety disorder, social anxiety, depression, and bipolar disorder, the latter of which may cause psychotic symptoms (those with such symptoms may also be prescribed medication by a psychiatrist). Also, a licensed online therapist may be able to answer questions about paranoia ICD-10 and DSM-5 criteria.
Takeaway
PPD can cause significant problems with trust, which can make it difficult to get effective treatment. Online therapy can help those with PPD work through co-occurring disorders, like anxiety and depression. Take the first step toward getting support with paranoid thoughts and contact BetterHelp today.
- Previous Article
- Next Article