• A.A medical symptom or condition (other than a mental disorder) is present.

AND

• B.Psychological or behavioral factors adversely affect the medical condition in one of the following ways:

• 1.The factors have influenced the course of the medical condition as shown by a close temporal association between the psychological factors and the development or exacerbation of, or delayed recovery from, the medical condition.
• 2.The factors interfere with the treatment of the medical condition (e.g., poor adherence).
• 3.The factors constitute additional well-established health risks for the individual.
• 4.The factors influence the underlying pathophysiology, precipitating or exacerbating symptoms or necessitating medical attention.

AND

• C.The psychological and behavioral factors in Criterion B are not better explained by another mental disorder (e.g.,panic disorder, major depressive disorder, posttraumatic stress disorder).

Specify current severity:

• Mild: Increases medical risk (e.g., inconsistent adherence with anti-hypertension treatment).

• Moderate: Aggravates underlying medical condition (e.g., anxiety aggravating asthma).

• Severe: Results in medical hospitalization or emergency room visit.

• Extreme: Results in severe, life-threatening risk (e.g., ignoring heart attack symptoms).