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Diagnostic and Statistical Manual of Mental Disorders ( DSM)

Diagnostic and Statistical Manual of Mental Disorders ( DSM). Diagnostic and Statistical Manuals. DSM-I (1952): Classified Mental Disorders as Reactions to Stressors DSM-II (1968): Influenced by Psychodynamic Theory DSM-III (1980): Development of Classification System

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Diagnostic and Statistical Manual of Mental Disorders ( DSM)

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  1. Diagnostic and Statistical Manual of Mental Disorders( DSM)

  2. Diagnostic and Statistical Manuals • DSM-I (1952): Classified Mental Disorders as Reactions to Stressors • DSM-II (1968): Influenced by Psychodynamic Theory • DSM-III (1980): Development of Classification System • DSM-IV (1994): Characterized as the “Biologic” or “Syndromal” Approach to Diagnosis • DSM-IV-TR (2000): Evidence-based text revision of DSM-IV

  3. Diagnostic and Statistical Manual of Mental Disorders To provide clear descriptions of diagnostic categories in order to enable clinicians and investigator to diagnose, communicate about, study, and treat people with various mental disorder

  4. International Classification of Disease (ICD-10) • Comprehensive classification system of medical conditions and mental disorders • Official medical and psychiatric nosology used throughout most of the world

  5. ICD-10 VS DSM-IV-TR • Both are the classification systems and fully compatible, although the wording may differ. • All of the DSM-IV-TR categories are found in ICD-10 but not all ICD categories are found in DSM-IV.

  6. 1. Mental Retardation 2. Learning Disorders 3. Motor Skills D 4. Communication D 5. Pervasive Developmental Disorders 6. Attention-Deficit and Disruptive B/H D 7. Feeding and Eating D 8. Tic D 9. Elimination D 10. Other D of infancy, Childhood, or Adolescence Disorders Usually First Diagnosed in infancy, Childhood, or Adolescence

  7. 1. Mental Retardation 정신지체 • Mild : IQ 50-55 to 70 • Moderate : IQ 35-40 to 50-55 • Severe : IQ 20-25 to 35-40 • Profound : IQ below 20 or 25

  8. 2. Learning Disorders 학습장애 • Reading (읽기 장애) • Mathematics (산술장애) • Disorders of Written Expression (쓰기 장애) • Learning Disorder NOS

  9. 3. Motor Skills D 운동기술장애 • Developmental Coordination D (발달성 근육운동 조정장애)

  10. 4. Communication D • Expressive Language D(표현성언어장애) • Mixed Receptive Expressive Language D (혼재 수용-표현성 언어장애) • Phonological D (음성학적 장애) • Stuttering (말더듬)

  11. 5. Pervasive Developmental Disorders 광범위성 발달장애 • Autistic D (자폐성장애) • Rett’s D (레트장애) • Childhood Disintegrative D (소아기 붕괴성 장애) • Asperger’s D (아스퍼거 장애)

  12. 6. Attention-Deficit and Disruptive B/H Disorders(주의력결핍 및 파괴적 행동장애) • Attention-Deficit/Hyperactivity D (주의력결핍 및 과잉행동장애) • Conduct D (품행장애) • Oppositional Defiant D (반항성장애) • Disruptive Behavior D NOS

  13. 7. Feeding and Eating D (급식 및 섭식장애) • Pica (이식증) • Rumination D (반추장애) • Feeding Disorder of Infancy or Early Childhood (유아기 또는 초기 소아기의 급식장애)

  14. 8. Tic D (틱장애) • Tourette’s D (뚜렛장애) • Chronic Motor or Vocal Tic D (만성 운동 또는 음성 틱장애) • Transient Tic D (일과성 틱장애)

  15. 9. Elimination D (배설장애) • Encopresis (유분증) • Enuresis (유뇨증)

  16. 10. Other D of infancy, Childhood, or Adolescence • Separation Anxiety D (분리불안장애) • Selective Mutism (선택적 함구증) • Reactive Attachment D (반응성 애착장애) • Stereotypic Movement D (상동증적 운동장애)

  17. Delirium, Dementia, and Amnestic and Other Cognitive Disorder섬망, 치매, 기억상실장애 및 기타 인지장애 • Delirium (섬망) • Dementia (치매) -Alzheimer’s Type -Vascular Dementia(혈관성치매) • Amnestic Disorders (기억상실장애) • Other Cognitive Disorders

  18. Mental Disorders Due to a General Medical Condition not Elsewhere Classified (다른 곳에 분류되지 않는 일반적인 의학적 상태로 인한 정신장애)

  19. Substance Related Disorders물질관련 장애 • Alcohol-related disorders • Amphetamine- • Caffeine- • Cannabis- (대마계 제제) • Cocaine- • Hallucinogen- (환각제) • Inhalant- (흡입제)

  20. Nicotine- • Opioid- (아편류) • Phencyclidine- • Senative, Hypnotic, Anxiolytic- (진정제, 수면제, 항불안제) • Polysubstance-(복합 물질관련장애) • Other Substance-

  21. Schizophrenia and Other Psychotic Disorders정신분열병과 기타 정신증적 장애 • Schizophrenia • Schizophreniform Disorder(정신분열형) • Schizoaffective Disorder(분열정동장애) • Delusional Disorder(망상장애) • Brief Psychotic Disorder(단기정신증적) • Shared Psychotic Disorder(공유정신증적)

  22. Schizophrenia (정신분열병) • paranoid type (편집형) • Disorganized (해체형) • Catatonic (긴장형) • Undifferentiated (감별 불능형) • Residual (잔류형)

  23. Mood Disorders (기분장애) • Depressive D (우울장애) • Bipolar D (양극성 장애)

  24. Anxiety Disorders (불안장애) • Panic D (공황장애) • Obsessive-Compulsive D (강박장애) • Posttraumatic Stress D (외상후스트레스) • Gereralized Anxiety D (범불안장애)

  25. Somatoform Disorders(신체형장애) • Somatization D (신체화 장애) • Conversion D (전환장애) • Pain D (통증장애) • Hypochondriasis (건강염려증) • Body Dysmorphic D (신체변형장애)

  26. Factitious Disorders (허위성장애) Dissociative Disorders (해리성 장애) • Dissociative Amnesia(해리성 기억상실) • Dissociative Fugue (해리성 둔주) • Dissociative Identity D (해리성 정체감장애) • Depersonalization D (이인성 장애)

  27. Sexual and Gender Identity D성적장애 및 성정체감 장애 • Sexual Dysfunctions(성기능부전,장애) • Sexual Desire D (성욕장애) • Sexual Arousal D (성적 흥분장애) • Orgasmic D (절정감장애) • Sexual Pain D (성교통증장애) Dyspareunia, Vaginismus(질경련증) • Sexual Dysfunction Due to a General Medical Condition(일반적 의학정상태로 인한 성기능부전)

  28. Paraphilias(변태성욕) • Exhibitionism (노출증) • Fetishism (물품음란증) • Frotteurism (마찰 도착증) • Pedophilia (소아기호증) • Sexual Masochism (성적 피학증) • Sexual Sadism (성적 가학증) • Transvestic Fetishism (복장도착적) • Voyeurism (관음증)

  29. Eating Disorders (섭식장애) • Anorexia Nervosa (신경성 식욕부진증) • Bulimia Nervosa ( 신경성 폭식증)

  30. Sleep Disorders (수면장애) Primary Sleep Disorders(원발성 수면장애) • Dyssomnias(수면 곤란증) Primary Insomnia(원발성 불변증) Primary Hypersomnia(원발성 수면과다증) Narcolepsy (수면발작, 기민형) Circadian Rhythm Sleep D(일주기리듬) • Parasomnia (수면관련장애) Nightmare(악몽), Sleep Terror(수면중경악), Sleepwalking D (수면중 보행장애)

  31. Impulse Control Disorders Not Elsewhere Classified • Intermittent Explosive D(간헐적 폭발성) • Kleptomania(병적 도벽) • Pyromania(병적 방화) • Pathological Gambling(병적 도박) • Trichotillomania(발모광)

  32. Adjustment Disorders 적응장애 • With Depressed Mood • With Anxiety • With Mixed Anxiety and Depressed Mood • With Disturbance of Conduct • With Mixed Disturbance of Emotions and Conduct • Unspecified

  33. Paranoid Schizoid Schizotypal Antisocial Borderline Histrionic Narcissistic Avoidant Dependent Obsessive-Compulsive Personality Disorders(인격장애)

  34. Other Conditions that may be a focus of clinical attention • Psychological factors affecting medical condition • Medication-induced movement disorders • Other medication-induced D • Problems related to abuse or neglect • Additional conditions that may be a focus of clinical attention

  35. Multiaxial System • Axis I: Psychiatric Diagnosis • Axis II: Personality Disorder Mental Retardation • Axis III: Medical Diagnosis • Axis IV: Psychological and Environmental Problems • Axis V: The Global Assessment of Functioning (GAF)

  36. Axis V: Global Assessment of Functioning Scale • 100-91: Superior functioning, no symptoms • 90-81: Absent or minimal symptoms, good functioning in all area • 80-71: Transient and expectable reactions to psycho social stressors • 70-61: Some mild symptoms, some difficulty in social, occupational, or school functioning

  37. Axis V: GAF Scale • 60-51: Moderate symptoms, moderate difficulty in social , occupational, or school functioning • 50-41: Serious symptoms, serious impairment in social, occupational, or school functioning • 40-31: Some impairment in reality testing or communication or major impairment in several areas-work, school, family relations, judgment, thinking or mood

  38. Axis V: GAF Scale • 30-21: Behavior is considerably influenced by delusions or hallucinations or serious impairment in communication or judgment • 20-11: Some danger of hurting self or others, or gross impairment in communication • 10-1: Persistent danger of severely hurting self or others, or serious suicidal act with • 0: Inadequate information

  39. Multiaxial Diagnostic Schema • Axis I: Delusional Disorder • Axis II: Paranoid Personality: Moderate • Axis III: Hypertension • Axis IV: Psychosocial Stressor: Extreme (death of children) • Axis V: GAF: Major Impairment in Work (40)

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