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DSM-5 questions and answers latest 2023

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DSM-5 questions and answers latest 2023What are the benefits of having the DSM Diagnosis: 1. Reduces clinical complexity 2. Treatment Guides 3. Enables communication 4. *Helps to determine benefits levels from various programs( 5. Legal relevance 6. Epidemiology What are the diagnostic issues specific to mental disorders? 1. differentiation between diagnosis. 2. No biological test for mental illnesses (subjective reporting of diagnosis) 3. Changes in the DSM over time. (what is actually a disorder) 4. Difference in Cultural factors -how people act, relate, and presentations. 5. Subjective treatments (moral judgments. Mental disorder A syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. (have to involve some type of dysfunction and reflect disability/social, occupation) ^^Just being deviant or conflict with other individual is not diagnosable. Design of the DSM 1-Polythetic Criteria Set (x number of symptoms to qualify for the diagnosis.) 2. Categories are not mutually exclusive. 3. Design to maximize clinical usefulness. Polythetic Criteria Set -for a diagnosis to be made, a person may have some but not all of the possible diagnostic criteria. Advantages of the DSM system -Creates a framework to guide research about treatment -Creates a framework that may be used to guide treatment decisions -Enables communication among providers -Increases diagnostic reliability -Clarifies process of differential diagnosis Disadvantages of the DSM Reliability 1. One underlying issue (e.g. severe childhood abuse) can lead to a very large number of diagnoses 2. May lead to labeling people in ways that undermine identity and self-esteem, and lead to seeing a disease rather than a person 3. May lead to expectations about prognosis that become self-fulfilling prophecies (e.g. individuals with schizophrenia in developing countries have substantially better outcomes than those in developed countries) -uses of antipsychotic (thought that schizophrenia must be a life long treatment. ) DSM-III merely described the disorders and did not talk about etiologies. This was a changes from DSM 1 & 2. DSM-5 version of Diagnostic and Statistical Manual of Mental Disorders set to be published in 2013; includes changes to many diagnostic categories (e.g. personality disorders) and more emphasis on severity of symptoms in diagnosis DSM Transition of 4 to 5 1. The previous 5-axis system of diagnosis was eliminated Provides information about diagnoses, but does not offer specific guidelines about treatment 2. Moves towards a more dimensional (as opposed to categorical) approach --E.g. one Autism-Spectrum Disorder as opposed to the five separate categories found in the DSM-IV-TR 3. Organized to follow the lifespan (i.e. diagnoses at the beginning of the book typically manifest early in life) 4. Addition of Disruptive Mood Regulation Disorder (this was invented to fix a mix diagnosis problem.) Resolve to stop the easy diagnosis Bi-polar no treatments purely diagnostic Criticism of the DSM-5 1. Normal problems are increasingly seen as pathology. -removal of MDD -lowering criteria for GAD -Removal of Asperger's as 2nd dx 2. Influence from pharmaceutical industry 3. Shift attention to people who could do well without while those who need help don't get it. Diagnostic with the DSM-5 1. Prototype for the diagnosis, but pt doesn't fit into the criteria. 2. Clinicians vary on whether to adhere strictly to criteria or to diagnose based on similarity to the most relevant prototype 3. Pressure to diagnose "down" avoiding stigmatism 4. Pressure to diagnose "up" -insurance or justify a higher level of care. Syndrome cluster of signs and symptoms occurring together that are characteristic of a specific disorder Many psychiatric disorders this: Major Depressive Episode symptoms constitute this Categories of DSM-5 Neurodevelopmental Disorders Schizophrenia Spectrum and Other Psychotic Disorders Bipolar and Related Disorders Depressive Disorders Anxiety disorders Obsessive-Compulsive and Related Disorders Trauma- and Stressor-Related Disorders Dissociative Disorders Somatic Symptom and Related Disorders Feeding and Eating Disorders Elimination Disorders More Categories of DSM-5 Sleep-Wake Disorders Sexual Dysfunctions Gender Dysphoria Disruptive, Impulse Control, and Conduct Disorders Substance-Related and Addictive Disorders Neurocognitive Disorders Personality Disorders Paraphilic Disorders Other Mental Disorders Medication-Induced Movement Disorders and Other Adverse Effects of Medication Other Conditions That May Be a Focus of Clinical Attention Rules for Diagnostic Precedence for DSM-5 The text of each diagnosis contains a section on differential diagnosis that highlights the features that differentiate that diagnosis from other, similar diagnoses (such as symptom duration) In some cases, the criteria are such that an individual could meet full criteria for more than one diagnosis in a section In this case, the text will typically state which diagnosis takes precedence Prevalence Point prevalence is the percentage of a population that currently has the diagnosis Lifetime prevalence is the percentage of a population that has met criteria for the diagnosis at any point in life Incidence is the rate of occurrence of new cases in a population Course usual pattern of the disorder across time) Age of onset Gradual vs. abrupt onset Episodic vs. continuous course Single episode vs. recurrent episodes Duration Progression Familial pattern Frequency of the disorder among first-degree relatives Other disorders that are more common in family members of affected individuals Differential Diagnosis Each diagnosis has a section describing how to differentiate it from other, similar diagnoses WHODAS 2.0 Replaces the Axis V Global Assessment of Functioning as the way to communicate level of impairment in functioning 36-item self administered scale of functioning in adults Six domains Cognition Mobility Self-care Getting along with people Life activities (household and school/work) Participation in society

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