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NURS 329 Psychiatric Nursing > DSM IV, DSM 5 & SCID > Flashcards

DSM IV, DSM 5 & SCID Flashcards

Diagnostic Statistical Manual IV Structured Clinical Interview for Diagnosis

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1
Q

DSM IV

A

Diagnostic Statistical Manual IV - this is the older version., based more on consensus

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2
Q

DSM 5

A

Diagnostic Statistical Manual 5 - this is the newer version, based more on evidence and research

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3
Q

Axis I

A

Major Mental Health Disorders - such as depression, anxiety

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4
Q

Axis II

A

Personality DIsorders and Mental Retardation

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5
Q

Personality Disorders and treatment

A

not a lot of treatment we do and not a lot of getting better - there is psychotherapy but there is not a lot of treatment to address the issue

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6
Q

Axis III

A

General Medical Conditions

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7
Q

Axis IV

A

Psychosocial & Environmental Problems

  • problems that are related to mental illness
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8
Q

Axis V

A

Global Assessment of Functioning (GAF)

this is a number from 0-100 for insurance reimbursement purposes

all of us in class would be around 99

50 is the cutoff - 50 and below indicates a need for inpatient intensive care

10 or below is a serious risk for harm to self and others

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9
Q

DSM IV

A

Has 5 axis system

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10
Q

DSM-5 is non axial - what is combined ?

A

DSM-IV axes I, II, and III have been combined

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11
Q

What axis has been eliminated in DSM-5

A

Global Assessment of Functioning

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12
Q

WHODAS

A

World Health Organization Disability Assessment Schedule

This is what the DSM-5 uses instead of GAF (Global Assessment of Functioning)

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13
Q

NOS

A

not otherwise specified - would see this in old DSM IV

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14
Q

SCID

A

Structured Clinical Interview for Diagnosis

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15
Q

What is SCID ?

A

The subjective and objective process of making mental health disorder diagnoses

you are asking a barrage of questions and rating their responses and adding up numbers to see if they reach a diagnosis threshold

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16
Q

The etiology of most mental health disorders is _________

A

unknown

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17
Q

In the SCID, what is the first thing you do ?

A

Ask qualifying questions ……

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18
Q

Psychiatric diagnoses are ___________ from medical diagnoses

A

different.

Its based on how you answer questions, what you are feeling and what the clinician observes

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19
Q

past or present

A

many diagnoses make the distinction of being past or present

Alcohol dependence Present

Alcohol Dependence Past

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20
Q

If someone is diagnosed with Alcohol Dependence Present, what does this mean?

A

They have presented symptoms within the past 60 days

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21
Q

If someone is alcohol dependence past, what does this mean ?

A

The person has exhibited symptoms over 60 days ago, but not within 0-60 days

22
Q

Mood disorders

A 
Major Depressive Disorder 
Bipolar 1 Disorder (more severe than Bipolar 2)
Bipolar 2 Disorder 
Dysthymic Disorder 
Mood D/O due to a Medical Condition 
Mood D/O due to Substance Abuse
23
Q

Major Depressive Disorder

A

down and depressed most of the day, nearly every day for a two week period

lost interest or pleasure in things you usually enjoy (2 week period)

24
Q

Major Depressive Disorder

A 
Appetite - can be up or down 
Sleep - can be too much or none
Motor (restlessness or lethargic)
Feelings of Worthlessness
Inappropriate Guilt 
Concentration, Indecisiveness 
Suicidal Ideation
25
Q

Suicidal Ideation

A

best to ease into these questions

  1. Life is too hard
  2. Better off dead
  3. Thoughts of self-harm
  4. Plan
  5. Attempt
26
Q

Bipolar I

A

Have diagnosis of major depressive disorder in addition to manic episodes

27
Q

Manic Episodes

A

Has there ever been a time when you were feeling so good, so “high”, excited or hyper that other said you were not acting your normal self?
What about periods of anger, rage, that concerned others?

28
Q

what is an often misdiagnosed symptom of manic episode ?

A

Rage

29
Q

Why is it so important to distinctly identify depression and bipolar disorder ?

A

For med treatment, if you are bipolar and given an SSRI this is contraindicated, because it will trigger manic episodes.
Thats why its so important to make an accurate diagnosis

30
Q

Bipolar I , Manic Episodes

A

more severe
manic episodes last at least 1 week
issues of functioning

Inflated self-Esteem
Require less sleep?
Thoughts racing
Easily distracted
Increased goal directed activity (Work, cleaning, sexual acting out)
Impulsive spending or trips
Mixed Episodes at same time
31
Q

Bipolar II

A

periods of hypomania (not as severe)
manic episode is less than a week
there are no real issues of functioning

32
Q

Dysthymic Disorder (DSM IV)

A

renamed persistent depressive disorder (DSM 5)

During the past couple of years have you been bothered by depressed mood more days than not?
Appetite
Sleep
Energy level
Feeling down on yourself
Trouble concentrating
33
Q

Substance Abuse DIsorders - multiple categories

A 
Alcohol
Sedatives
Cannabis
Stimulants
Opioid
Cocaine
Hallucinogens/PCP
Poly Drug Abuse
34
Q

In DSM IV, for substance abuse disorders, they made the distinction between _________ and ___________

A

Abuse versus Dependence

35
Q

Abuse qualifying questions

A

Missed work or School because you were intoxicated, high or hung over (recurrent)
What about not keeping your house clean, taking proper care of your children
Drink in situations that could be considered dangerous- drive, use machines (recurrent)
Trouble with the law (recurrent)

36
Q

Dependence Qualifying Questions

A

Drank more than initially intended
Ever try to cut down or stop your drinking
Spent a lot of time drinking, being drunk or hung over
Lost interest in hobbies, friends due to drinking
Blackouts (recurrent)
Tolerance
Withdrawal

37
Q

blackouts pertaining to alcohol

A

conscious while it happened but have no memory of it

38
Q

SUD

A

Substance Use Disorder

39
Q

In DSM 5, substance ________ and substance ______________ were combined into a single disorder .

A

Abuse; dependence

40
Q

someone can have a panic attack without being diagnosed with a panic disorder. True or false

A

True

41
Q

Anxiety Disorders

A

Panic Disorders - with or without agoraphobia
Panic Attacks
Social Phobias (public speaking)
Specific Phobias (animal, environmental –heights, storms, Blood, injection types, situational (flying, bridges, elevators)
Others (choking, contacting illness, clowns, children avoidance)

42
Q

Obsessive Compulsive

A

Recurrent persistent thoughts or images causing distress

43
Q

Compulsive Behaviors

A

repetitive, hand washing, checking, mental acts, counting, touching, cleaning aimed at reducing stress or preventing some dreaded event

44
Q

PTSD

A

Sometimes things happen to people that are extremely upsetting, like being in a life threatening situation like a major disaster, very serious accident or fire, or being physically assaulted or raped, or seeing another person killed or hurt or hearing about something horrible that has happened to someone close to you.

45
Q

PTSD symptoms

A

Intense Fear, helpless, horror
Recurrent or distressing recollections
Dreams, nightmares
Feeling like the event reoccurs
Distress over any cues that remind you of the event
Physical Sx – heavy breathing, heart pounding
Avoids places or people that remind you of the event
Inability to recall certain aspects of the event
Diminished interest in activities and feelings

Difficulty Sleeping - falling asleep or staying asleep
Irritability, outbursts of anger
Difficulty concentrating
Hyper-vigilance
Exaggerated startle response
46
Q

Somatoform Disorders

A

Pain Disorder - having pain, though there is no seeming cause
Hypochondriasis - believing you have an illness when there is no evidence of it
Body Dysmorphic

47
Q

Eating Disorders

A

Anorexia Nervosa
Bulimia
Binge Eating Disorder (new in DSM 5)

48
Q

Psychotic Disorders

A

Schizophrenia

49
Q

Diagnostic criteria for Schizophrenia

A

Delusions (religious, grandiose, paranoid, somatic)
Hallucinations (auditory, visual, tactile)
Disorganized speech (e.g., frequent derailment or incoherence
Grossly disorganized or catatonic behavior
Negative symptoms, i.e., affective flattening, alogia (poverty of speech), or avolition (lack of motivation)

50
Q

Regarding schizophrenia, positive symptoms are the

A

Delusions (religious, grandiose, paranoid, somatic)
Hallucinations (auditory, visual, tactile)
Disorganized speech (e.g., frequent derailment or incoherence
Grossly disorganized or catatonic behavior

51
Q

What is Schizoaffective Disorder ?

A

A dual diagnosis of Schizophrenia with mood disorder

52
Q

Thing to note about personality disorders

A

medications generally are not very effective
these personalities are ingrained and don’t change much
these individuals often do not do well in groups as the symptoms become especially evident in groups

Long term individual therapy is the best course of action

NURS 329 Psychiatric Nursing (2 decks)

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