92 Severity and Impairment

This chapter introduces cross-cutting specifiers that change monitoring and risk. Most useful when documenting severity or course.

Purpose. Separate symptom severity from functional impairment. Capture distress and disability without conflating them.

92.1 Core Distinctions

Severity: intensity of symptoms within a domain.
Impairment: impact on function (work/school, relationships, self-care).
Distress: subjective suffering that may not match impairment.

92.2 Severity Anchors (per domain)

0: Absent / within typical range.
1: Mild; noticeable but limited impact.
2: Moderate; clear impact and persistent symptoms.
3: Severe; significant disruption and high burden.
4: Extreme; disabling or unsafe.

92.3 Functional Impairment Tiers

None: functioning intact.
Mild: some disruption, compensatory coping effective.
Moderate: substantial disruption in one or more domains.
Severe: unable to maintain key roles or self-care.

Documentation Output. Domain severity ratings (0-4). Functional impairment tier and primary areas affected. Distress level if it diverges from impairment.