F22.9

The ICD-10 code F22.9 designates an unspecified delusional disorder, applied when an individual has ongoing delusions that lack a defined type or distinct features. Delusions are false, firmly held beliefs not grounded in reality and not explained by cultural or religious norms.

The hallmark of this disorder is the presence of one or more delusions lasting for at least one month. Unlike other psychotic disorders, such as schizophrenia, F22.9 is not associated with prominent hallucinations, disorganized thinking, or significant cognitive impairments. The “unspecified” label means that sufficient details about the delusions are unavailable to categorize them further.

Symptoms

People with F22.9 may exhibit:

1. Persistent delusions: These can involve themes such as persecution, grandeur, jealousy, somatic issues, or other fixed beliefs.
2. Minimal impact on overall functioning: Outside the delusion, cognitive abilities and behavior may remain relatively intact.
3. Emotional responses linked to delusions: Individuals may exhibit anger, fear, or sadness directly related to the delusional content.
4. Limited insight: Patients are often unaware that their beliefs are not based on reality.

Diagnostic сriteria

To diagnose F22.9, the following criteria must typically be met:

1. Presence of delusions lasting for at least one month.
2. Absence of other significant psychotic features: Hallucinations, if present, are not prominent or directly related to the delusion.
3. No major impairment in cognitive function or communication skills.
4. Not attributable to another mental health condition: For example, schizophrenia or mood disorders with psychotic features.
5. Not caused by substance use or medical conditions.

Differentiating F22.9 from other conditions

1. Schizophrenia:
   • F22.9: Delusions are the primary feature; no prominent hallucinations or severe cognitive decline.
   • Schizophrenia: Often includes hallucinations, disorganized speech, and cognitive impairments.
2. Mood disorders with psychotic features:
   • F22.9: Delusions occur independently of mood disturbances.
   • Mood disorders: Psychotic features appear during depressive or manic episodes.
3. Substance-induced psychotic disorder:
   • F22.9: Delusions are not linked to substance use or withdrawal.
   • Substance-induced disorder: Symptoms emerge during or shortly after substance use.
4. Delirium or dementia:
   • F22.9: No significant confusion or memory loss.
   • Delirium/Dementia: Includes cognitive impairments and fluctuating levels of consciousness.

Diagnostic process

Diagnosing F22.9 involves:

1. Clinical Interviews: Exploring the nature, duration, and impact of delusions.
2. Mental Status Examination: Assessing insight, thought processes, and emotional responses.
3. Medical Evaluation: Ruling out neurological conditions, infections, or other medical causes.
4. Collateral Information: Gathering details from family or caregivers to understand the patient’s behavior.
5. Psychometric Tools: Using standardized assessments like the Positive and Negative Syndrome Scale (PANSS) to evaluate psychotic symptoms.

Treatment

1. Pharmacotherapy:
   • Antipsychotic medications, such as risperidone or olanzapine, may help reduce delusional intensity.
2. Psychotherapy:
   • Cognitive-behavioral therapy (CBT) focuses on challenging and modifying delusional beliefs.
3. Psychoeducation:
   • Educating patients and their families about the disorder to improve understanding and reduce stigma.
4. Supportive Care:
   • Encouraging adherence to treatment and maintaining social and occupational functioning.

Importance for medical workers

For medical workers, understanding F22.9 is crucial to:

• Differentiate it from other psychotic disorders.
• Recognize its subtle presentation to ensure timely intervention.
• Provide tailored treatment plans that address the specific needs of the patient.

Sources:

1. World Health Organization. (2019) International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10): F22.9 Persistent delusional disorder, unspecified. Available at: https://icd.who.int/browse10/2019/en
2. ICD10Data.com. (2025) ICD-10-CM Diagnosis Code F22: Delusional disorders. Available at: https://www.icd10data.com/ICD10CM/Codes/F01-F99/F20-F29/F22-/F22
3. Medentic. (2025) ICD-10 – F22.9: Persistent delusional disorder, unspecified. Available at: https://www.medentic.app/en/resources/icd-codes/f22-9
4. Gesund.bund.de. (2025) ICD-10 code: F22.9 Persistent delusional disorder, unspecified. Available at: https://gesund.bund.de/en/icd-code-search/f22-9
5. Wikipedia. (2024) Delusional disorder. Available at: https://en.wikipedia.org/wiki/Delusional_disorder
6. MD Clarity. (2024) Available at: https://www.mdclarity.com/icd-codes/f22
7. AAPC. (2024) ICD-10 Code for Delusional disorders- F22- Codify by AAPC. Available at: https://www.aapc.com/codes/icd-10-codes/F22
8. ICD10Data.com. (2025) ICD-10-CM Codes F22*: Delusional disorders. Available at: https://www.icd10data.com/ICD10CM/Codes/F01-F99/F20-F29/F22-