DSM-5 Preface and Intro

Question 1

Give the complete name of the DSM. Who publishes it?

Answer 1

Diagnostic and Statistical Manual of Mental Disorders 5th edition. It was published by the American Psychiatric Association.

Question 2

What was it designed to facilitate?

Answer 2

A more reliable diagnosis of disorders.

Question 3

List three of the ways the DSM is intended to serve:

Answer 3

a. guide for organizing information that can aid in the accurate diagnosis and treatment of mental disorders.
b. Tools for clinicians
c. Reference for researchers

Question 4

1. What do the acronyms ICD and WHO stand for?

Answer 4

ICD: International Classification of Disease, WHO: World Health Organization

Question 5

List five of the enhancements incorporated into the DSM-5.

Answer 5

a. Representation of developmental issues
b. Integration of scientific findings
c. Streamlined classification of bipolar and depressive disorders
d. Section III: new disorders and features
e. Online enhancements

Question 6

Why are reliable diagnoses essential? List four reasons cited in the DSM-5.

Answer 6

a. Guiding treatment recommendations
b. Identifying prevalence for mental health service planning
c. Identifying patient groups for clinical and basic research
d. Documenting important public health information such as mortality rates

Question 7

List the four stages of the DSM-5 Revision Process.

Answer 7

a. Proposal for revisions
b. DSM-5 field trials
c. Public and Professional Review
d. Expert Review

Question 8

What four principles guided draft revisions?

Answer 8

a. DSM-5 is primarily intended to be a manual to be used by clinicians, and revisions must be feasible for routine clinical practice
b. Recommendations for revisions should be guided by research evidence
c. Where possible, continuity should be maintained with previous editions of DSM
d. No a priori constraints should be placed on the degree of change between DSM-IV and DSM-5

Question 9

Briefly summarize reasons why harmonization with the ICD-11 was thought to be important.

Answer 9

The existing 2 major classifications of mental disorders:

• hinders the collection and use of national health statistics, the design of clinical trials aimed at developing new treatments, and the consideration of global applicability of the results by international regulatory agencies.
• complicates attempts attempts to replicate scientific results across national boundaries.
• DSM-IV and ICD-10 diagnosis didn’t always agree

Question 10

What realities are described as resulting from the narrowing of diagnostic categories in the attempt to identifying homogenous patient populations for research treatment?

Answer 10

Narrow diagnostic categories that did not capture clinical reality, symptom heterogeneity within diagnostic categories that did not capture clinical reality, symptom heterogeneity within disorders, and significant sharing of symptoms across multiple disorders.

Question 11

How does DSM-5 incorporate developmental and lifespan issues into its overall organization?

Answer 11

It begins with diagnosis thought to reflect developmental processes that manifest early in life, followed by diagnoses that more commonly manifest in adolescence and young adulthood and ends with diagnoses relevant to adulthood and later life.

Question 12

List the three concepts offering greater clinical utility that replaced the culture-bound syndrome in the DSM-5.

Answer 12

a. Cultural syndrome
b. Cultural idiom of distress
c. Cultural explanation or perceived cause

Question 13

1. What two phrases have replaced NOS diagnosis in the DSM-5? Briefly describe each of these. (15) nos- not otherwise specified

Answer 13

a. Other specified disorder – allows clinicians to communicate the specific reason that the presentation does not meet the criteria for any specific category with a diagnostic class.
b. Unspecified disorder – if the clinician chooses not to specify the reason that the criteria are not met for a specific disorder, then “unspecified depressive disorder” would be diagnosed.

Question 14

What happened to Axes 3, 4, and 5 in the DSM-5? How is this information to be coded or conveyed when using the DSM-5?

Answer 14

We don’t do axes anymore at all. We still list medical conditions (axis 3) and medical disorders, we still list stressors (axis 4) but we are supposed to use ICD-10 Z codes, and for axes 5 we use the WHODAS instead of the GAF.

Question 15

Provide the definition of a mental disorder given in the DSM-5.

Answer 15

a syndrome characterized by clinically significant disturbance or a dysfunction. It is usually associated with significant distress or disability. It is not an expectable or culturally approved response to a common stressor or loss and it is not a socially deviant behavior.

Question 16

What general diagnostic criterion continues to be used in the DSM-5 to establish disorder thresholds?

Answer 16

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Question 17

What are subtypes and specifiers as the terms are used in the DSM-5?

Answer 17

Subtypes define mutually exclusive and jointly exhaustive phenomenological subgroupings withn a diagnosis and are indicated by the instruction “specify whether” in the criteria set
Specifiers are not intended to be mutually exclusive or jointly exhaustive, and as a consequence, more than one specifier may be given. They provide an opportunity to define more homogeneous subgrouping of individuals with the disorder who share certain features and to convey information that is relevant to the management of the individuals disorder.

Question 18

How are the terms Principle Diagnosis and Provisional Diagnosis used in the DSM-5?

Answer 18

Principle diagnosis -The condition established after study to be chiefly responsible for occasioning the admission of the individual.
Provisional diagnosis – can be used when there is a strong presumption that the full criteria will ultimately be met for a disorder but not enough information is available to make a firm diagnosis.