10.19 Classification Of Psych Disorders

Question 1

What system is used in SA to diagnose psychiatric disorders?

Answer 1

DSM-5-TR (Diagnostic and statistical manual of mental disorders, version 5, trial revision)
Evidence based criteria

• Use ICD-11 for billing but not diagnostic purposes

Question 2

How do diagnostic criteria work?

Answer 2

• Specific (number) of symptoms, present for distinct period of time, under specific circumstances.
• EG. Diagnostic criteria for Depressive episode
  • 5/12 symptoms
  • Present for 2-week period
  • Significant distress or impairment (NB!)
  • Absence of substance / medical condition that can better explain (excessive alcohol or condition that can better explain symptoms than psych disorder)

Question 3

Diagnostic criteria and codes

Answer 3

Disorders:
- neurodevelopment
- schizophrenia spectrum and other psychotic
- bipolar and related
- depressive
- anxiety
- obsessive-compulsive and related
- trauma and stressor related

The these disorders and common symptoms

Question 4

Psychosis
DSM-V-TR: Schizophrenia-spectrum and other psychotic disorders

Answer 4

Brief Psychotic Episodes (<1 month)
- Psychosis + emotional turmoil
- < 1 month duration
- Usually due to stressor

Schizophreniform disorder
- Hallucinations/delusions/ disturbed speech/behaviour
-1-6 months duration

Schizophrenia
- Any 2: Hallucinations/delusions/ disturbed speech/behaviour/ negative Sx
- > 6 months deterioration

Delusional disorder
- delusion >6 months
- only delusional

Schizoaffective disorder
- Scz criteria + depression or mania
- > 6 months

Substance-related

Neurocogniative disorders

Question 5

Mood
DSM-V-TR

Answer 5

1. Depressive disorders
➡️Major depressive disorder
- > 2 weeks depressed or no pleasure weight loss/gain
- Tired
- Psychomotor agitation/retardation
- Worthlessness, hopelessness poor concentration
- Suicide/death
- in absence of other substance that can explain it
➡️Persistent depressive disorder
- Chronic depressed for 2 years
- No MDE
➡️Premenstrual dysphoric disorder
- 5 sx in most cycles
- 1 week before + 1 week after better
- Mood swings, irritability, depression, anxiety +
- Anhedonia, poor concentration, sleep disturb

2. Bipolar disorders
➡️BMD I: 1 or > manic episodes
- BMD II: 1 or > hypomanic episodes (short)
- Manic = euphoric/irritable + grandiosity + < sleep + talkative
+ > thoughts + >distracted + > activities + > pleasure
+ admission or significant impairment
- Hypomanic = the same but no admission or significant impairment
➡️Cyclothymia:
- 2-year period very depressed and hypomanic episodes
- No MDE of mania

Question 6

Anxiety
DSM-V-TR: Anxiety Disorders

Answer 6

Generalized Anxiety disorder
- Excessive worry most days
- >6 months,
>3/6:
1. Restless
2. Poor concentration
3. Fatigue
4. Irritability
5. Muscle tension
6. Sleep disturbance

Panic disorder
1.Panic attacks (repetitive, spontaneous, unexpected)
2. Avoidance of triggers
3. Anticipatory anxiety (scared of another attack that might come)

Agoraphobia
- Irrational fear of: places/situations where cannot escape/help not available
- associated with panic disorders

Social Anxiety disorder
- Irrational fear of negative evaluation in social situations

Specific phobias
- Irrational fear of specific objects or situations