**§4.130 Schedule of ratings-mental disorders.**

The nomenclature employed in this portion of the rating schedule is
based upon the Diagnostic and Statistical Manual of Mental Disorders,
Fourth Edition, of the American Psychiatric Association (DSM-IV). Rating
agencies must be thoroughly familiar with this manual to properly
implement the directives in §4.125 through §4.129 and to apply the
general rating formula for mental disorders in §4.130. The schedule for
rating for mental disorders is set forth as follows:

Rating

**[schizophrenia and other psychotic disorders]{.smallcaps}**

**9201** Schizophrenia, disorganized type

**9202** Schizophrenia, catatonic type

**9203** Schizophrenia, paranoid type

**9204** Schizophrenia, undifferentiated type

**9205** Schizophrenia, residual type; other and unspecified types

**9208** Delusional disorder

**9210** Psychotic disorder, not otherwise specified (atypical
psychosis)

**9211** Schizoaffective disorder

**[delirium, dementia, and amnestic and other cognitive
disorders]{.smallcaps}**

**9300** Delirium

**9301** Dementia due to infection (HIV infection, syphilis, or other
systemic or

intracranial infections)

**9304** Dementia due to head trauma

**9305** Vascular dementia

**9310** Dementia of unknown etiology

**9312** Dementia of the Alzheimer's type

**9326** Dementia due to other neurologic or general medical conditions
(endocrine

disorders, metabolic disorders, Pick's disease, brain tumors, etc.) or
that are

substance-induced (drugs, alcohol, poisons)

**9327** Organic mental disorder, other (including personality change
due to a general

medical condition)

**[anxiety disorders]{.smallcaps}**

**9400** Generalized anxiety disorder

**9403** Specific (simple) phobia; social phobia

**9404** Obsessive compulsive disorder

**9410** Other and unspecified neurosis

**9411** Post-traumatic stress disorder

**9412** Panic disorder and/or agoraphobia

**9413** Anxiety disorder, not otherwise specified

**[dissociative disorders]{.smallcaps}**

**9416** Dissociative amnesia; dissociative fugue; dissociative identity
disorder (multiple

personality disorder)

**9417** Depersonalization disorder

**[somatoform disorders]{.smallcaps}**

**9421** Somatization disorder

**9422** Pain disorder

**9423** Undifferentiated somatoform disorder

**9424** Conversion disorder

**9425** Hypochondriasis

**[mood disorders]{.smallcaps}**

**9431** Cyclothymic disorder

**9432** Bipolar disorder

**9433** Dysthymic disorder

**9434** Major depressive disorder

**9435** Mood disorder, not otherwise specified

**[chronic adjustment disorder]{.smallcaps}**

**9440** Chronic adjustment disorder

General Rating Formula for Mental Disorders:

Total occupational and social impairment, due to such symptoms as:

gross impairment in thought processes or communication;

persistent delusions or hallucinations; grossly inappropriate

behavior; persistent danger of hurting self or others; intermittent

inability to perform activities of daily living (including maintenance

of minimal personal hygiene); disorientation to time or place; memory

loss for names of close relatives, own occupation, or own name 100

Occupational and social impairment, with deficiencies in most areas,

such as work, school, family relations, judgment, thinking, or mood,

due to such symptoms as: suicidal ideation; obsessional rituals

which interfere with routine activities; speech intermittently
illogical,

obscure, or irrelevant; near-continuous panic or depression affecting

the ability to function independently, appropriately and effectively;

impaired impulse control (such as unprovoked irritability with periods

of violence); spatial disorientation; neglect of personal appearance and

hygiene; difficulty in adapting to stressful circumstances (including

work or a worklike setting); inability to establish and maintain

effective relationships 70

Occupational and social impairment with reduced reliability and

productivity due to such symptoms as: flattened affect; circumstantial,

circumlocutory, or stereotyped speech; panic attacks more than once

a week; difficulty in understanding complex commands; impairment

of short- and long-term memory (e.g., retention of only highly learned

material, forgetting to complete tasks); impaired judgment; impaired

abstract thinking; disturbances of motivation and mood; difficulty in

establishing and maintaining effective work and social relationships 50

Occupational and social impairment with occasional decrease in work

efficiency and intermittent periods of inability to perform occupational

tasks (although generally functioning satisfactorily, with routine

behavior, self-care, and conversation normal), due to such symptoms

as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or

less often), chronic sleep impairment, mild memory loss (such as

forgetting names, directions, recent events) 30

Occupational and social impairment due to mild or transient symptoms

which decrease work efficiency and ability to perform occupational

tasks only during periods of significant stress, or; symptoms controlled

by continuous medication 10

A mental condition has been formally diagnosed, but symptoms are not

severe enough either to interfere with occupational and social

functioning or to require continuous medication 0

**[eating disorders]{.smallcaps}**

**9520** Anorexia nervosa

**9521** Bulimia nervosa

Rating Formula for Eating Disorders:

Self-induced weight loss to less than 80 percent of expected minimum

weight, with incapacitating episodes of at least six weeks total
duration

per year, and requiring hospitalization more than twice a year for

parenteral nutrition or tube feeding 100

Self-induced weight loss to less than 85 percent of expected minimum

weight with incapacitating episodes of six or more weeks total

duration per year 60

Self-induced weight loss to less than 85 percent of expected minimum

weight with incapacitating episodes of more than two but less than

six weeks total duration per year 30

Binge eating followed by self-induced vomiting or other measures to

prevent weight gain, or resistance to weight gain even when below

expected minimum weight, with diagnosis of an eating disorder and

incapacitating episodes of up to two weeks total duration per year 10

Binge eating followed by self-induced vomiting or other measures to

prevent weight gain, or resistance to weight gain even when below

expected minimum weight, with diagnosis of an eating disorder

but without incapacitating episodes 0

**Note**: An incapacitating episode is a period during which bed rest
and treatment by a physician are required. (Authority: 38 U.S.C. 1155)

\[53 FR 23, Jan. 4, 1988; 53 FR 1441, Jan. 19, 1988. Redesignated and
amended at 61 FR 52700, Oct. 8, 1996\]

**Supplement *Highlights* reference**: 19(1)

*Next Section is §4.149*

Reserved