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ICD-10 Learning Lab Exit Presentation Mode

Category: F90 F91 F92 F93 F94 F95 F98

F92 — Mixed disorders of conduct and emotions: facilitator sheet

Teaching objective

F92 requires both a conduct-disorder-level behavioural pattern and a co-occurring emotional disturbance severe and persistent enough to meet its own criteria (for example, a depressive episode's criteria for F92.0) — the combination, not either alone, is what this category captures.

Choose material

Worked example · Case: Conduct problems and a genuine depressive episode · Case: 'Moody lately,' or a genuine depressive episode?

Worked example

Show scenario

A 15-year-old with a well-documented year-long pattern of truancy, aggression toward peers, and repeated theft is described by his mother as 'moody lately.' On closer questioning, this turns out to mean occasional short-tempered comments when asked to do chores, with no change in sleep, appetite, interest, or energy, and no sustained low mood.

(or reveal one step at a time below)
  1. Reveal step 1

    Step 1 — Confirm the conduct-disorder component: truancy, aggression, and theft over a year is a clear, persistent F91-level pattern.

  2. Reveal step 2

    Step 2 — Check the emotional component against its own threshold: 'moody' here means brief, situational short temper, with no sustained change in mood, sleep, appetite, interest, or energy.

  3. Reveal step 3

    Step 3 — Weigh what this means: F92 requires a genuine, independently diagnosable emotional disturbance, not situational irritability described informally as 'moody.'

  4. Reveal step 4

    Conclusion — This supports F91 (conduct disorder) rather than F92, since the emotional component described does not independently meet a depressive episode's own threshold.

Comparison points

F92 is distinguished from F91 by the presence of a genuine, independently diagnosable emotional disturbance alongside the conduct pattern — brief irritability or situational upset in response to being disciplined is not sufficient. It is distinguished from a mood disorder (F30-F39) alone by the presence of a genuine, independently established conduct-disorder pattern.

Discussion prompts

(or reveal one at a time below)
  1. Prompt 1

    Explain why F92 requires both components to independently meet their own criteria.

  2. Prompt 2

    Explain why brief irritability after being disciplined is not sufficient for F92.

Summary

A conduct-disorder-level behavioural pattern together with a genuine, independently diagnosable emotional disturbance — both components required, neither implying the other.