Diagnosis of psychiatric disorders Flashcards
ICD
International Classification of Diseases
for WHO for all diseases
ICD 9 diagnostic codes used in Canada
DSM
Diagnostic and Statistical Manual for the APA
diagnosing psychiatric illness in Canada and US
Mental Status Examination components
Orientation General presentation State of consciousness Attention Speech Mood Affect Form of thought Thought content Perceptions Judgment Insight Memory Intellectual functioning
DSM IV axes
I: major psychiatric disorders
II: personality disorders, mental retardation
III: medical problems
IV: psychosocial/environmental problems (stressors)
V: global assessment of functioning
Axis I diagnoses
Must meet A criteria
with a certain numbero f other criteria
Axis II clusters
A: paranoid, schizoid, schizotypal
B: histrionic, borderline, narcissistic, antisocial
C: avoidant, dependent, obsessive-compulsive
DSM V changes
Axis I, II, III together
IV no longer present but discuss stressors
V: no longer present but assess sicidal/homicidal risk, assess symptom and diagnostic severity, assess disability using rating scales
comment on functioning
Psychiatric disorder case formulation
bio-psycho-social model and 4Ps
predisposing, precipitating, perpetuating, protective factors
Biological predisposing factors
genetic
environmental toxins
fetal alcohol
Biological precipitating factors
medical illness
substance intoxication/withdrawal
recent childbirth
Biological perpetuating factors
ongoing medical illness
chronic substance use
Biological protective factors
intelligence
Psychological predisposing factors
chaotic family of origin
alcohol
abuse
untreated mental illness
Psychological precipitating factors
marital discord
financial difficulties
death of a loved one
Psychological perpetuating factors
poor psychological mindedness
blaming
world-judging
Psychological protective factors
psychological mindedness
resilience
SOciological predisposing factors
low SES
poor access to health care
homelessness
no social supports
Sociological precipitating factors
sudden loss of supports
sudden homelessness
loss of job
marital/relationship breakdown
Sociological perpetuating factors
unemployment
single
no social supports
Sociological protective factors
good support system
feeling of contribution to society
Order of psychiatric evaluation
Collateral information Diagnostic interview MSE More collateral information Multi-axial diagnosis Formulation Physical examination The Plan
