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Chapter V

Habit and impulse disorders - F63


This category includes certain disorders of behaviour that are not classifiable under other categories. They are characterized by repeated acts that have no clear rational motivation, cannot be controlled, and generally harm the patient's own interests and those of other people. The patient reports that the behaviour is associated with impulses to action. The cause of these disorders is not understood and they are grouped together because of broad descriptive similarities, not because they are known to share any other important features.
    Excludes:
  • habitual excessive use of alcohol or psychoactive substances ( F10-F19 )
  • impulse and habit disorders involving sexual behaviour ( F65.- )
F63.0 Pathological gambling
The disorder consists of frequent, repeated episodes of gambling that dominate the patient's life to the detriment of social, occupational, material, and family values and commitments.
Compulsive gambling
    Excludes:
  • excessive gambling by manic patients ( F30.- )
  • gambling and betting NOS ( Z72.6 )
  • gambling in dissocial personality disorder ( F60.2 )
F63.1 Pathological fire-setting [pyromania]
Disorder characterized by multiple acts of, or attempts at, setting fire to property or other objects, without apparent motive, and by a persistent preoccupation with subjects related to fire and burning. This behaviour is often associated with feelings of increasing tension before the act, and intense excitement immediately afterwards.
    Excludes:
  • fire-setting (by)(in):
  • adult with dissocial personality disorder ( F60.2 )
  • alcohol or psychoactive substance intoxication ( F10-F19 , with common fourth character .0)
  • as the reason for observation for suspected mental disorder ( Z03.2 )
  • conduct disorders ( F91.- )
  • organic mental disorders ( F00-F09 )
  • schizophrenia ( F20.- )
F63.2 Pathological stealing [kleptomania]
Disorder characterized by repeated failure to resist impulses to steal objects that are not acquired for personal use or monetary gain. The objects may instead be discarded, given away, or hoarded. This behaviour is usually accompanied by an increasing sense of tension before, and a sense of gratification during and immediately after, the act.
    Excludes:
  • depressive disorder with stealing ( F31-F33 )
  • organic mental disorders ( F00-F09 )
  • shoplifting as the reason for observation for suspected mental disorder ( Z03.2 )
F63.3 Trichotillomania
A disorder characterized by noticeable hair-loss due to a recurrent failure to resist impulses to pull out hairs. The hair-pulling is usually preceded by mounting tension and is followed by a sense of relief or gratification. This diagnosis should not be made if there is a pre-existing inflammation of the skin, or if the hair-pulling is in response to a delusion or a hallucination.
    Excludes:
  • stereotyped movement disorder with hair-plucking ( F98.4 )
F63.8 Other habit and impulse disorders
Other kinds of persistently repeated maladaptive behaviour that are not secondary to a recognized psychiatric syndrome, and in which it appears that the patient is repeatedly failing to resist impulses to carry out the behaviour. There is a prodromal period of tension with a feeling of release at the time of the act.
Intermittent explosive disorder
F63.9 Habit and impulse disorder, unspecified


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