ICD-10 code for histrionic personality disorder
Living with histrionic personality disorder means navigating a complex landscape of emotions and relationships. For those experiencing this condition, everyday interactions can feel like walking a tightrope between seeking genuine connection and fearing invisibility. While the journey can be challenging, modern therapeutic approaches offer paths toward understanding and healing, helping individuals build more fulfilling relationships with themselves and others.
The ICD-10 code for histrionic personality disorder is F60.4. This diagnosis belongs to the dramatic personality disorders category (Cluster B), alongside borderline personality disorder (F60.3), narcissistic personality disorder (F60.81), and antisocial personality disorder (F60.2).
Approximately 1% of the general population experiences HPD. While HPD is diagnosed more frequently in women and people assigned female at birth, researchers recognize potential gender bias in diagnosis, with evidence suggesting that societal norms may lead to overdiagnosis in women and underdiagnosis in men. The condition typically emerges in late adolescence or early adulthood, manifesting as a persistent pattern of excessive emotionality and attention-seeking behaviors.
When to use F60.4 for histrionic personality disorder
When considering an HPD diagnosis, clinicians are called to look deeply at each person's unique pattern of experiences and behaviors. While the DSM-5-TR provides a framework of specific criteria, behind each criterion is a human being experiencing real emotional challenges. Clinicians have an ethical and compliant obligation to carefully differentiate HPD from similar presentations, ensuring each person receives care that truly resonates with their lived experience.
The patient must exhibit at least five of the following eight diagnostic criteria:
- Discomfort when not the center of attention
- Inappropriate sexually seductive or provocative behavior
- Rapidly shifting and shallow emotional expression
- Consistent use of physical appearance to draw attention
- Impressionistic and vague speech
- Self-dramatization and theatrical expression
- High suggestibility
- Viewing relationships as more intimate than they are
HPD vs. narcissistic personality disorder
While both HPD and narcissistic personality disorder involve a deep need for attention from others, the nature of this need differs in meaningful ways. A person living with HPD often seeks connection and engagement through various forms of expression, comfortable with being seen as playful or even silly if it means staying connected to others. In contrast, someone with narcissistic personality disorder specifically yearns for admiration and recognition of their perceived special qualities.
HPD vs. Borderline Personality Disorder
While both conditions involve deep emotional experiences, individuals living with borderline personality disorder often struggle with profound feelings about their self-worth, experiencing emotions with particular intensity and depth. They may carry a heavy burden of feeling inherently “bad” — a painful internal experience that differs from the relationship-focused struggles of someone with HPD, where self-esteem challenges tend to manifest more in how they seek validation from others rather than in core beliefs about themselves.
Interventions and CPT codes for histrionic personality disorder
Therapeutic intervention for HPD requires a thoughtful, multi-faceted approach. While there's no cure for HPD, many individuals who engage in treatment develop more fulfilling lives and healthier relationships.
90837: Individual psychotherapy (60 minutes)
Psychotherapy offers a healing space for individuals living with HPD to explore their experiences and discover new ways of connecting with themselves and others. While different therapeutic approaches may help — including psychodynamic therapy, which gently explores underlying emotions and patterns — the journey is unique for each person. What matters most is creating a safe, accepting environment where someone can gradually build insight and develop more fulfilling ways of relating to others.
90849: Group psychotherapy
The decision to include group therapy requires thoughtful consideration of each client's unique needs and therapeutic journey. While some clinicians have found group therapy with the patient present (CPT code 90853) beneficial for providing real-time feedback, others note that group environments may inadvertently reinforce attention-seeking patterns or intensify emotional expression. In such cases, group psychotherapy without the patient might be the best way to support the family system and garner new perspectives to inform treatment.
Supporting clients with histrionic personality disorder
The journey of treating HPD requires a delicate balance of validation and growth-oriented intervention. Healthcare providers play a crucial role in helping clients develop more adaptive ways of relating to others and building authentic self-esteem. While maintaining accurate clinical documentation is essential for insurance compliance and continuity of care, the focus must remain on supporting clients' emotional well-being and interpersonal effectiveness.
Upheal offers an innovative solution to this documentation challenge, allowing providers to focus more deeply on therapeutic work while ensuring complete and compliant clinical records. The platform's AI-powered tools handle the administrative burden, freeing clinicians to provide more attentive and effective care. Try Upheal free today to transform your practice.
