51 - Review of DSM-5 and clinical rating scales

Question 1

DSM-5 and DSM-5, TR

• moving from ___ numerals to ___ numbers
• publication of the DSM-5, TR added further ___ and cultural factors in diagnosis
• dropped the ___ assessment due to negative separation of psychiatric and medical disorders
• reorganized to reflect disorders across a ___ based on developmental and lifespan considerations

Answer 1

• roman, arabic
• SDOH
• multi-axial
• continuum

Question 2

neurodevelopmental disorders: encompasses disorders previously considered to be ___ diagnoses
- __ disabilities and delays; communication disorders
- ___ spectrum disorders
- ADHD

Answer 2

chilhood
- intellectual
- autism

Question 3

DSM-5 did not delete any specific psychotic disorder
- relates them across spectrum of illness
- deletes schizophrenia ___

bipolar and related disorders and depressive disorders have ___ chapters
- bipolar found between schizophrenia spectrum and depressive disorder
- reflect ___ nature of bipolar disorder

Answer 3

subtypes
separate
overlapping

Question 4

separate chapters for
anxiety disorders (3)

new separate chapters for OCD, trauma, and stressor related disorders

Answer 4

• GAD
• SAD
• panic disorders

Question 5

substance related disorders

• no more “___” and “ ___”
• set criteria for all substances that only vary with symptom presentation based on type of substance used
• includes ___ disorders

Answer 5

abuse, dependence
gambling

Question 6

neurocognitive disorders (formerly known as ___ )
- categorized into ___ and ___

Answer 6

dementia
major, minor

Question 7

rating scales - depression

patient health questionnaire (PHQ-9)
- 9 questions to screen for ___ and ___ thinking
- ___ rated

Answer 7

depression
suicidal
patient

Question 8

rating scales - depression

___ depression inventory (BDI)
- 21 item, ___ rated

Answer 8

Beck
patient

Question 9

Mood Disorders Questionnaire (MDQ)

• designed to be a ___ rated ___ tool for ___ (mania and depression)
• not designed for ___ (hypomania and depression)
• 3 questions

Answer 9

• patient, screening, bipolar I
• bipolar II

Question 10

depression - research rating scales

___ Depression (HAM-D, HDRS)
- ___ rated
- validated in clinical trials, gold standared for evaluating ___ overtime

Answer 10

Hamilton
clinician
change

Question 11

depression - research rating scales

___ Depression Rating Scale (MADRS)
- validated in clinical trials, gold standard
- may be more ___ based on comparison to Beck (BDI) and to treatment effects vs HAM-D

Answer 11

Montgomery-Asberg
relevant

Question 12

bipolar disorder and GAD

___ Mania Rating Scale (YMRS)
- ___ rated by ___ report of symptoms over the past 48 hours
- used to evaluate symptoms at baseline and over time

Answer 12

Young
- clinician, patient

Question 13

bipolar disorder and GAD

Hamilton Anxiety Rating Scale (HAM-A)
- 14 item, ___ rated
- is a gold standard scale but does not always discriminate treatment effects

Answer 13

clinician

Question 14

Schizophrenia - Clinical Trails

___ and ___ Syndrome Scale (PANSS)
- Gold standard scale
- 30 item, ___ rated

Answer 14

Positive, Negative
clinician

Question 15

Schizophrenia - Clinical Trails

Brief Psychiatric Rating Scale (BPRS)
- gold standard in ___
- 18 item, ___ rated

Answer 15

clinical trials
clinician

Question 16

Movement Side Effects of Antipsychotics

Simpson-Angus (SAS)
- evaluates drug induced ___ symptoms
- 10 item, ___ rated

Answer 16

parkinsonian
clinician

Question 17

Movement Side Effects of Antipsychotics

___ Akathisia Scale (BARS)
- ___ rated
- objective observation of akathisia

Answer 17

Barnes
- clinician

Question 18

Tardive Dyskinesia/Overall Movement Side Effect Assessment

Abnormal Involuntary Movement Scale (AIMS)
- assess ___ dyskinesia
- 12 item, ___rated
- orofacial, extremity, truncal dyskinesia, global severity, patient awareness/distress

Answer 18

tardive
clinician

Question 19

Tardive Dyskinesia/Overall Movement Side Effect Assessment

Extrapyramidal Symptoms Rating Scale (ESRS)
- 45 item, ___ rated
- designed to assess ___ symptoms, akathisia, dystonia, and ___ dyskinesia in one rating scale
- very time consuming

Answer 19

• clinician
• parkinsonian, tardive

Question 20

Overalll Psychiatric Functioning Assessments

Clinical Global Impressions (CGI)
- CGI-S = ___
- CGI-I = ___
- 3 item, ___ rated
- used to assess ___ over time

Answer 20

• severity
• improvement
• observer
• change

Question 21

Overalll Psychiatric Functioning Assessments

Global Assessment of Functioning (GAF)
- ___ rated
- ___ results based on clinician evaluation and experience

Answer 21

• clinician
• variable

clinician bias, cant use stat methods, looks bad in clinical trials

Question 22

rating scales

Depression - Clinically Useful (2)

Answer 22

PHQ-9 and BDI

Question 23

rating scales

Depression - Research (2)

Answer 23

HAM-D and MADRS

Question 24

rating scales

Bipolar Disorder and Generalized Anxiety (2)

Answer 24

YMRS and HAM-A

Question 25

rating scales

Schizophrenia - Clinical Trials (2)

Answer 25

PANSS and BPRS

Question 26

rating scales

Movement Side Effects of Antipsychotics (2)

Answer 26

SAS and BARS

Question 27

rating scales

Tardive Dyskinesia/Overall Movement Side Effect Assessment (2)

Answer 27

AIMS and ESRS

Question 28

rating scales

Overalll Psychiatric Functioning Assessments (2)

Answer 28

CGI and GAF