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DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS

DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS. (DSM-IV-TR) (DSM-V coming this May). What do we use it for?. Education Diagnosis Treatment Planning. Multiaxial Reporting. Assessment that focuses on several domains that may help a clinician plan treatment and predict outcomes.

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DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS

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  1. DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS (DSM-IV-TR) (DSM-V coming this May)

  2. What do we use it for? • Education • Diagnosis • Treatment Planning

  3. Multiaxial Reporting • Assessment that focuses on several domains that may help a clinician plan treatment and predict outcomes. • Provides a convenient format for organizing and communicating clinical information. • 5 Axis areas…

  4. Axis I Clinical Disorders & Other Conditions That May Be a Focus of Clinical Attention • Examples… • Substance-Related Disorders • Mood Disorders • Anxiety Disorders • Schizophrenia and Other Psychotic Disorders • Eating Disorders

  5. Axis II Personality Disorders & Mental Retardation • Examples… • Paranoid Personality Disorder • Borderline Personality Disorder • Obsessive-Compulsive Personality Disorder • Mental Retardation

  6. Axis III General Medical Conditions • Examples… • Infections & Parasitic Diseases • Immunity Disorders • Diseases of the Respiratory System • Injury and Poisoning

  7. Axis IV *Used to report problems that may affect the diagnosis, treatment, and prognosis of mental disorders. Psychosocial and Environmental Problems *These problems can develop as a consequence of a diagnosis *May be problems that should be considered in treatment plan • Problems with primary support group • Death of a family member • Disruption of family by divorce, estrangement • Parental overprotection • Birth of a sibling

  8. Axis IV, cont. • Educational problems • Illiteracy • Academic problems • Economic problems • Extreme Poverty • Professional/Job problems • Unemployment • Stressful work schedule

  9. Axis V Global Assessment of Functioning *Used to report clinician’s judgment of an individual’s level of functioning *Useful in planning treatment, measuring its impact, and predicting outcome GAS Scale

  10. Example Multiaxial Report • Axis I: 296.4 Bipolar 1 Disorder, Mixed, Severe with Psychotic Features 314.01 Attention-Deficit/Hyperactivity Disorder, Combined Type • Axis II: 799.9 Diagnosis Deferred (pending gathering of info) • Axis III: 343.9 Palsy, cerebral • Axis IV: Psycho-social stressors, early childhood abuse and neglect, academic difficulties • Axis V: 70

  11. Diagnostic Criteria • There are 2 areas of diagnostic criteria that must be met for each diagnosis in the DSM • Inclusion Criteria • “Must-have” symptoms • Length of time symptoms exhibited • Exclusion Criteria • “Cannot-have” symptoms or related diagnoses

  12. Example Diagnostic Criteria • 307.42 Primary Insomnia • Criterion A (inclusion): • Nonrestorative sleep that lasts for at least 1 month • Criterion B (inclusion): • Causes clinically significant distress or impairment in social, occupational, or other important ares of functioning • Criteria C & D (exclusion): • Does not occur exclusively during the course of another sleep disorder (C) or mental disorder (D) • Criterion E (exclusion): • Is not due to the direct physiological effects of a substance or a general medical condition

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