Symptoms and complaints
Psychological

P01 FEELING ANXIOUS/NERVOUS/TENSE R45.0 incl: anxiety NOS, feeling frightened excl: anxiety disorder P74 criteria: feelings reported by the patient as an emotional or psychosocial experience not attributed to the presence of a mental disorder. A gradual transition exists from feelings that are unwelcome - but quite normal - and feelings that are so troublesome to the patient that professional help is sought P02 ACUTE STRESS REACTION F43.0,F43.2,F43.8,F43.9,F50.4 incl: adjustment disorder, culture shock, feeling stressed, grief, homesick, immediate post-traumatic stress, shock (psychic) excl: feeling depressed P03, depressive disorder P76, post-traumatic stress disorder P82 criteria: a reaction to a stressful life event or significant life change requiring a major adjustment, either as an expected response to the event or as a maladaptive response interfering with daily coping and resulting in impaired social functioning, with recovery within a limited period of time P03 FEELING DEPRESSED R45.2,R45.3 incl: feeling inadequate, lonely, unhappy, worried excl: depressive disorder P76 criteria: feelings reported by the patient as an emotional or psychological experience not attributed to the presence of a mental disorder. A gradual transition exists from feelings that are unwelcome - but quite normal - and feelings that are so troublesome to the patient that professional help is sought P04 FEELING/BEHAVINGIRRITABLE/ANGRY R45.1,R45.4,R45.5,R45.6 incl: agitation NOS, restlessness NOS excl: overactive child P21, irritability in family member Z13 criteria: feelings reported by the patient as an emotional or psychological experience not attributed to the presence of a mental disorder, or behaviour indicating irritability or anger. A gradual transition exists from feelings or behaviour that are unwelcome - but quite normal - and those that are so troublesome that professional help is sought P05 SENILITY, FEELING/BEHAVING OLD R54 incl: concern with aging, senescence criteria: feelings reported by the patient as an emotional or psychological experience not attributed to the presence of a mental disorder. A gradual transition exists from feelings that are unwelcome - but quite normal - and feelings that are so troublesome to the patient that professional help is sought P06 SLEEP DISTURBANCE F51,G47 incl: insomnia, nightmares, sleep apnoea, sleepwalking, somnolence excl: jetlag A88 criteria: sleep disturbance as a diagnosis requires that the sleeping problem forms a major complaint, which, according to both patient and doctor, is not caused by another disorder but is a condition in its own right. Insomnia requires a quantitative or qualitative deficiency of sleep which is unsatisfactory in the patients' opinion, over a considerable period of time. In hypersomnia excessive daytime sleepiness and sleep attacks exist which limit the patients' performance P07 SEXUAL DESIRE REDUCED F52.0 incl: frigidity, loss of libido excl: impotence P08, loss of sexual fulfilment P08, concern with sexual preference P09 criteria: sexual problems with regard to desire not caused by any organic disorder or disease, but a réflexion of the inability of a patient to participate in the sexual relationship s/he wants because of lack of desire, failure of genital response or function P08 SEXUAL FULFILMENT REDUCED F52.1 to F52.9 incl: non-organic impotence or dyspareunia, premature ejaculation, vaginismus of psychogenic origin excl: sexual problems with desire P07, concern with sexual preference P09, organic impotence and sexual problems Y07, vaginismus NOS X04 criteria: sexual problems with regard to fulfilment not caused by any organic disorder or disease, but a réflexion of the inability of a patient to participate in the sexual relationship s/he wants because of failure of genital response or function, or problems with sexual development P09 SEXUAL PREFERENCE CONCERN F64 to F66 excl: sexual problems with desire P07 or fulfilment P08 criteria: sexual problems with regard to preference not caused by any organic disorder or disease, but a réflexion of the inability of a patient to participate in the sexual relationship s/he wants because of problems with sexual identity, preference or orientation P10 STAMMERING, STUTTERING, TICS F95,F98.4,F98.5,F98.6 excl: tic douloureux N92 criteria: stammering and stuttering: disorder of speech characterized by frequent repetitions or prolongations of sounds, or by frequent hesitations on pauses disrupting speech P11 EATING PROBLEM IN CHILDREN F98.2,F98.3 incl: feeding problem, problem with eating behaviour of children excl: anorexia nervosa P86, eating problem in adults T05 Note: Problems with behaviour of children are particularly difficult to classify, which is illustrated by the fact that they are distributed over four chapters of ICPC. Whether or not parents present these problems to a GP will reflect their ideas about the gradual differences between normal - though maybe annoying - behaviour, and behaviour that is considered worrying or 'pathological' P12 BEDWETTING, ENURESIS F98.0 excl: due to organic disorders U04 criteria: involuntary voiding of urine by day or by night not determined to be related to any organic disorder Note: Problems with behaviour of children are particularly difficult to classify, which is illustrated by the fact that they are distributed over four chapters of ICPC. Whether or not parents present these problems to a GP will reflect their ideas about the gradual differences between normal - though maybe annoying - behaviour, and behaviour that is considered worrying or 'pathological' P13 ENCOPRESIS/BOWEL TRAINING PROBLEM F98.1 criteria: encopresis requires repeated passage of usually well formed faeces in inappropriate places, considered abnormal in relation to age, and not caused by constipation, sphincter control disorder or another disease P15 CHRONIC ALCOHOL ABUSE F10.1 to F10.9 incl: alcoholism, alcohol brain syndromes, alcohol psychosis, delirium tremens criteria: a disorder due to the use of alcohol resulting in one or more of harmful use with clinically important damage to health, dependence syndrome, withdrawal state, or psychotic disorder P16 ACUTE ALCOHOL ABUSE F10.0 incl: drunk criteria: a disorder due to the use of alcohol resulting in acute intoxication, with or without a background of chronic abuse P17 TOBACCO ABUSE F17 incl: smoking problem criteria: a disorder due to the use of tobacco resulting in one or more of acute intoxication, harmful use with clinically important damage to health, dependence syndrome, or withdrawal state consider: risk factor NOS A23 Note: Substance abuse problem Substance abuse problem definitions should take into account the considerable differences between countries and cultures. An alcohol dependent or heroin addicted patient needs medical attention, but the definitions of 'tobacco abuse' are controversial. In these cases physicians can decide to label the episode as 'tobacco abuse' without the patient's agreement, and consequently also without their willingness to agree to any medical intervention P18 MEDICATION ABUSE F13,F19,F55 incl: any prescribed drugs Note: Substance abuse problem Substance abuse problem definitions should take into account the considerable differences between countries and cultures. An alcohol dependent or heroin addicted patient needs medical attention, but some patients request and use tranquillizers, sleeping tablets, anorectics or laxatives inappropriately and for too long. In these cases physicians can decide to label the episode as 'medicine abuse' without the patient's agreement, and consequently also without their willingness to agree to any medical intervention. P19 DRUG ABUSE F11 to F16,F18,F19 incl: addiction to drugs, drug withdrawal criteria: a disorder due to the use of a dependence producing psychoactive substance, resulting in one or more of the following conditions: - acute intoxication - harmful use with clinically important damage to health - dependence syndrome - withdrawal state - psychotic disorder Note: Substance abuse problem Substance abuse problem definitions should take into account the considerable differences between countries and cultures.An alcohol dependent or heroin addicted patient needs medical attention, but the definitions of 'use of hashish' are controversial. Some patients request and use tranquillizers, sleeping tablets, anorectics or laxatives inappropriately and for too long. In these cases physicians can decide to label the episode as 'drug abuse' without the patient's agreement, and consequently also without their willingness to agree to any medical intervention. P20 MEMORY DISTURBANCE R41 incl: amnesia; disturbance of concentration; disorientation (P21) transferred to P81 P22 CHILD BEHAVIOUR SYMPTOM/COMPLAINT F91 to F94,F98.8,F98.9 incl: delayed milestones; jealousy; overactive child; speech delay; temper tantrum excl: adolescent P23; adult P80; concern about physical development T10; growth delay T10 P23 ADOLESCENT BEHAVIOUR SYMPTOM/COMPLAINT F91,F92,F94,F98.8,F98.9 incl: delinquency excl: child P22,P81; adult P80 P24 SPECIFIC LEARNING PROBLEM F80 to F83,R48 incl: dyslexia excl: attention deficit disorder P81, mental retardation P85 criteria: specific speech, language and learning problems with onset in childhood, together with an impairment of functions related to biological maturation of the central nervous system, and a steady course over time without spontaneous remissions or relapses, although the deficit may diminish as the child grows older P25 PHASE OF LIFE PROBLEM ADULT Z60.0 incl: empty nest syndrome, mid-life crisis, retirement problem excl: senility,feeling/behaving old P05; menopause X11 P27 FEAR OF MENTAL DISORDER Z71.1 incl: concern about mental disease, fear of attempting suicide excl: if patient has the disease code the disease criteria: concern or fear of mental disease in a patient without the disease or until the diagnosis is proven P28 LIMITED FUNCTION/DISABILITY Z73.6 incl: limited function/disability as a result of psychological disorders excl: low self esteem P03 Note: The COOP/WONCA Charts are suitable for documenting the patient's functional status (see Chapter 8). P29 PSYCHOLOGICAL SYMPTOM/COMPLAINT, OTHER F50.8,F50.9,F98.8,F98.9,R44,R45.7, R45.8,R46,Z64.2,Z64.3,Z73.0,Z73.1 incl: delusions, eating disorders NOS, hallucinations, multiple psychological symptoms/complaints, poor hygiene, strange behaviour, suspiciousness excl: tension headache N95