Gender minorities such as transgender and gender non-conforming individuals experience gender dysphoria.

Populations at Risk of Gender Dysphoria

- Since the advent in the 1950s of medical treatment that aimed to change the body 
more in accordance with gender identity, gender dysphoria has been the clinical target 
for gender affirmative care.
- The clinical rationale with medical treatment has been to alleviate gender dysphoria by changing the body to be more in accordance with gender identity. For children, this medical treatment model includes the possibility of puberty suppression and hormonal 
treatment after age 16. 
- Furthermore, the number of teenagers seeking medical treatment for gender incongruence/gender dysphoria has been increasing each year since 2013 in the Western world.
- Identifying as transgender does not automatically imply a need for medical treatment or meeting the diagnostic criteria for gender dysphoria.

Treatment of Gender Dysphoria

- Gender dysphoria emerged as the new diagnosis, replacing transsexualism/gender 
identity disorder in the Diagnostic and Statistical Manual of Mental Disorders (5th Edition). 
- The International Classification of Diseases 11th Revision (ICD11) diagnosis of gender incongruence refers to the same mismatch as gender dysphoria.

History of Gender Dysphoria

Gender Dysphoria is characterized by the subjectively experienced distress that arises from the mismatch between gender identity, or internally felt sense of gender, and assigned sex at birth.

Arizona State University

Also called psychological disorders, these are disorders rooted in mental thought patterns that impair the person's functioning, with specific disorders having their own disgnostic criteria. 

Mental Disorders/Mental Illnesses

Section II of the DSM-5-TR covers the bulk of the manual by including the descriptive text and criteria for each diagnosis. This section also references relevant context and research for the diagnoses and other conditions, medication-related adverse effects and -induced disorders, and corresponding ICD-10 codes. This section is broken down into the following chapters: 

-	Neurodevelopmental Disorders
-	Schizophrenia Spectrum and Other Psychotic Disorders
-	Bipolar and Related Disorders
-	Depressive Disorders
-	Anxiety Disorders
-	Obsessive-Compulsive and Related Disorders
-	Trauma- and Stressor-Related Disorders
-	Dissociative Disorders
-	Somatic Symptom and Related Disorders
-	Feeding and Eating Disorders
-	Elimination Disorders
-	Sleep-Wake Disorders
-	Sexual Dysfunctions
-	Gender Dysphoria 
-	Disruptive, Impulse-Control, and Conduct Disorders
-	Substance-Related and Addictive Disorders
-	Neurocognitive Disorders
-	Personality Disorders
-	Paraphilic Disorder
-	Other Mental Disorders and Additional Codes
-	Medication-Induced Movement Disorders and Other Adverse Effects of Medication
-	Other Conditions that May Be a Focus of Clinical Attention


[DSM-5-TR] Section II: Diagnostic Criteria and Codes

Dysphoria is an abnormally augmented sad mood.

Dysphoria

Jessen, R. S., Haraldsen, I., & Stänicke, E. (2021). Navigating in the dark: Meta-synthesis of subjective experiences of gender dysphoria amongst transgender and gender non-conforming youth. Social Science & Medicine, 281, 114094. https://doi.org/10.1016/j.socscimed.2021.114094

Navigating in the Dark: Meta-Synthesis of Subjective Experiences of Gender Dysphoria Amongst Transgender and Gender Non-Conforming Youth

- Anxiety disorders
- Mood disorders 
- Psychotic disorders
- Personality disorders
- Eating disorders
- Sleep disorders
- Addiction
- Adjustment disorders

Categories of mental disorders/mental illnesses

Psychopathology is a term with a dual meaning. It refers to the scientific study of psychological disorders, which includes investigating their symptoms, etiology (causes), and potential treatments. Concurrently, the term can also describe the manifestation of a psychological disorder itself, meaning the abnormal thoughts, feelings, and behaviors that indicate its presence.

Psychopathology

Characteristics associated with a lower likelihood of developing a mental illness/disorder.
- Biophysical 
- Psychological 
- Social 
- Spiritual 

Protective Factors

Various health and life outcomes of mental disorders/mental illnesses. 

Mental Disorders/Mental Illnesses Outcomes

Anxiety Sensitivity (AS) describes the fear of anxiety-related symptoms that are often accompanied by hyperarousal, pain, stomach distress, and racing thoughts. Individuals experience physical and social fears alongside concerns for mental capability.

Anxiety Sensitivity

In this study, researchers collected data on healthy eating barriers which impact individuals suffering from mental illness. They found that participant's barriers towards a healthy lifestyle were modifiable and suggested helpful intervention techniques. 

Healthy Eating in Persons with Serious Mental Illnesses: Understanding and Barriers

The cause of comorbid Anxiety and Depression is debated within the scientific community. Adolescents experience comorbidity of Anxiety and Depression at rates ranging from 15.9%-61.9%.  

Comorbidity of Anxiety and Depression in Youth

Gender Dysphoria

An emerging field which seeks to identify which dietary components are truly important for mental health, including in psychiatric disease, as well as to whom,
under which circumstances and at which specific dosages these nutritional interventions have preventative and therapeutic efficacy.

Nutrition Psychiatry

Factors that predispose adults and children to develop a mental disorder
- Biological 
- Psychological 
- Social 
- Spiritual 
- Cultural

Risk Factors for Developing a Mental Disorder

Neurological disorders are a specific type of disorder that occurs as a result of injury or trauma to the brain or central nervous system, consisting of the spinal cord and the connected nerves. Neurological disorders can impair movement and speech to various degrees, depending on the intensity and the specific type of neurological disorder. Neurological disorders can also occur as a result of genetic abnormalities and infections. Specific neurological disorders include cerebral palsy, ADD, and conversion disorder.

Neurological Disorders

References for Neurological Disorders

The term of psychiatric survivor comes from the c/s/x movement and is meant to position individuals as survivors of the psychiatric system and psychiatric industrial complex.

Psychiatric Survivor

Ex-patient was used as a term starting in the 1970s by individuals in the growing ex-patients movement. The term was used at the time because of how madness and mad as derogatory terms were not yet reclaimed. It was used as an identity to indicate individuals who have previously been 
patients in asylums or other mental health systems.

Ex-patient

The term psychiatric consumer originated at the 1985 Alternatives Conference and was chosen to represent individuals who receive care from mental health and psychiatric services. It was chosen in part because it was meant to signify that patients have, or ideally should have, a choice of services and treatment.

Psychiatric Consumer

Disorder Class: Disruptive, Impulse-Control, and Conduct Disorders

A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of three (or more) of the following criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months:
1. Aggression to people and  animals
2. Destruction of property
3. Deceitfulness or theft
4. Serious violations of rules
 
The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
 
If the individual is age 18 years or older, criteria are not met for Antisocial Personality Disorder
 
Specify age onset:  Individuals show at least one symptom characteristic of conduct disorder prior to age 10 years

[DSM-5] Conduct Disorder Criteria

Borderline Personality Disorder (BPD) is primarily defined by a pervasive pattern of instability across interpersonal relationships, self-image, and mood, combined with significant impulsivity. Individuals with this disorder often experience intense emotions and may engage in frantic behaviors to manage their profound fear of abandonment.

Borderline Personality Disorder

A personality disorder is defined by a pervasive and inflexible personality style that significantly deviates from cultural norms, causing problems for the individual and for others. This pattern typically emerges during adolescence or early adulthood and leads to significant distress or functional impairment.

Personality Disorders

Neurodevelopmental disorders are a class of conditions typically identified in childhood, characterized by developmental impairments across personal, social, academic, and intellectual domains. Key examples within this category include attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder.

Neurodevelopmental Disorders

Feeding and Eating Disorders are characterized by persistent changes to eating or eating-related behaviors that result in altered consumption or absorption of food, significantly impairing an individual’s physical health and/or psychosocial functioning. 

Feeding and Eating Disorders

Neurocognitive Disorders are a group of disorders characterized by the primary clinical deficit of the individual being in cognitive functioning that is acquired, not developmental. These disorders have a strongly recognized and researched disease etiology to them making them a unique intersection between psychiatry and pathology. 

Neurocognitive Disorders

Substance-Related and Addictive Disorders are characterized by abusing the activation of the brain reward system through certain behaviors or the use of pharmacological substances. This often results in a sense of increased pleasure, or a “high”, encouraging reinforcement of behaviors and actions that are detrimental to or neglectful of daily activities. Due to insufficient research, repetitive behaviors that have been coined as behavioral addictions (e.g., sex addiction, exercise addiction, or shopping addiction) are excluded from this chapter.

Substance-Related and Addictive Disorders

According to the DSM-5, Depressive Disorders constitute a primary category of mood disorders characterized by depression as their central feature. This group of disorders is recognized by the presence of sad, empty, or irritable moods, along with associated somatic and cognitive changes that significantly impair an individual's ability to function. The specific disorders within this category can vary in their duration, timing, and presumed causes.

Depressive Disorders

Sleep-Wake Disorders are defined using a multidimensional approach due to the expectations for co-existing or comorbid diagnosis in both mental and neurological health. They are largely characterized by individual’s interpretation of having dissatisfying sleep quality, timing, or amount of sleep. These complaints are often expressed alongside issues of distress or impairment during expected daytime activities. 

Sleep-Wake Disorders

Sexual Dysfunctions are characterized by clinically significant disturbances related to an individual’s ability to respond sexually or experience sexual pleasure. This requires a multidimensional approach to diagnoses by considering the biological, sociological, and psychological factors that influence the ways in which individuals experience sex. However, these disorders, do not include sexual dysfunctions that are a result of inadequate or a lack of stimulation or knowledge which may still be treated, but are not diagnosed.

Sexual Dysfunctions

Obsessive-compulsive and related disorders are a group of conditions listed in the DSM-5 that are characterized by overlapping features, specifically the presence of intrusive thoughts and/or repetitive behaviors. This diagnostic category encompasses several distinct but related conditions, including obsessive-compulsive disorder, body dysmorphic disorder, and hoarding disorder.

Obsessive-Compulsive and Related Disorders

Bipolar and Related Disorders are recognized by unusual shifts in mood, energy, activity levels, and concentration, affecting the ability to carry out day-to-day tasks. The presence of mania is a defining trait of bipolar disorder. These shifts range from periods of manic episodes (being extremely “up”, elated, irritable, or energized) and depressive episodes (being very “down”, indifferent, or hopeless).

Bipolar and Related Disorders

Elimination Disorders are characterized by inappropriate elimination of either urine or feces. These disorders are typically diagnosed in childhood or adolescence but are based on developmental age rather than chronological age.

Elimination Disorders

A node to help create and move other nodes around

TEMP Node for DSM 

Dissociative Disorders are characterized by the disruption and/or discontinuity in the integration of consciousness, memory, motor control, perception, body representation, emotion, identity, and behavior. These symptoms can be applicable to all areas of psychological functioning and are typically experienced as unbidden intrusions into one’s awareness and behavior. This coincides with a loss of continuity in the subjective experience of the individual and/or the inability to access information or to control mental functions. 

Dissociative Disorders

Anxiety disorders are characterized by features of excessive fear and anxiety, as well as related behavioral disturbances. These symptoms are often not temporary and linger beyond typical expectations. Excessiveness of these symptoms is clinician diagnosed with cultural contexts taken into consideration.

Anxiety Disorders

Paraphilic Disorders are characterized by those paraphilias that result in distress or impairment to the individual, or, for the satisfaction of the individual, entail harm, or risk of harm, themselves or to others. Simply having a paraphilia does not meet the requirements for a diagnosis of a paraphilic disorder. 

Paraphilic Disorders

Trauma- and Stressor-Related Disorders are characterized by exposure to a traumatic or stressful event. Symptoms and reactions vary for each case and while they may be understood in an anxiety- or fear-based context, individuals often instead prominently display anhedonic, dysphoric, dissociative, and/or aggressive symptoms. This variability in the display of symptoms imposes a distinction from other similar disorders, which then also requires that for one to be diagnosed with a trauma- and stressor-disorder, they specifically must have had explicit exposure to a traumatic or stressful event.

Trauma- and Stressor-Related Disorders

Disruptive, Impulse-Control, and Conduct Disorders are a group of conditions characterized by problems related to the self-control of emotions and behaviors. These disorders are distinct from other disorders with emotional or behavioral regulation due to the nature that these problems result in violations of the rights of others and/or significant conflict with societal norms or authority figures. These disorders and their presentation can greatly vary within the category, as well as between individuals. 


Disruptive, Impulse-Control, and Conduct Disorders

Schizophrenia Spectrum and Other Psychotic Disorders are recognized through abnormalities occurring within at least one of five domains. These domains include delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behavior (including catatonia), and negative symptoms.

Schizophrenia Spectrum and Other Psychotic Disorders

Somatic Symptom and Related Disorders are characterized by the presence of prominent somatic symptoms as well as the abnormal thoughts, feelings, and/or behaviors in response to the somatic symptoms. These symptoms and the response to them result in significant distress and impairment to the individual. The symptoms themselves may sometimes be less important than the way individuals will present and interpret them.

Somatic Symptom and Related Disorders

A common and disruptive type of emotional dysregulation (ED) that is thought to be innate to ADHD and not caused by trauma. It is also sometimes called hysteroid dysphoria in Europe and is characterized by intense but brief mood shifts triggered by real or perceived rejection or criticism. 

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