L20: Mental disorder classification and multiaxial evaluation

Question 1

apa itu ppdgj-III

Answer 1

• Pedoman Penggolongan dan Diagnosis
  Gangguan Jiwa di Indonesia III
• Based on ‘ICD-10 Classification of Mental
  and Behavioural Disorders’
  (International Classification of Diseases)
  & DSM-IV (Diagnosis and Statistical
  Manual of Mental Disorder

Question 2

apa itu ICD 10?

Answer 2

Grouped in 10 blocks (F0 – F9)
▪ Blocks F0 –F5 are based on hierarchy
▪ Vertical arrangement of group based on rank.
▪ A group on a higher rank / hierarchy have more
attributes than the one on the lower

Question 3

Axis 1 apa aja?

Answer 3

• Consist of Clinical Disorders & other conditions that may be a focus of clinical attention
• All mental disorders from block F0 to F9, except F6
• F6 is Personality Disorder which is classified in axis II
• Block F7, F8, & F9 are mental disorders which its
  onset start
  during childhood or adolescent
• It can be found in adult if the condition continues during the adult years
• Block F0-F6 can be manifested in children & adolescent too, if the diagnostic criteria is fulfill
• Z code : Life problems which are not fulfill diagnostic criterias but make a person seek for help or medical
  conditions that need attention or therapy

Question 4

Axis II apa aja?

Answer 4

Consist of
* Personality disorders and
* Mental Retardation

Question 5

Axis III apa aja?

Answer 5

• Physical disorder or general medical condition that is present in addition to
  the mental disorder
• The physical condition may be
• Causative
  : e.g kidney failure causing delirium
• The
  result of a mental disorder: e.g alcohol gastritis secondary to alcohol
  dependence
• Unrelated
  to the mental disorder
• When a medical condition is causative or causally related to a mental disorder
  → a mental dis due to a general medical condition is listed on Axis I & the general
  medical condition is listed on both Axis I and Axis III

Question 6

Axis IV apa aja?

Answer 6

• To code the psychosocial & environmental
  problems that contribute significantly to
  the development or exacerbation of the
  current disorder
• The evaluation of stressor:
• Based on a clinicians’ assessment of the
  stressor that an average person with similar
  sociocultural values & circumstances would
  experience from the psychosocial stressor
• Stressor:
• Positive: e.g. job promotion
• Negative: loss of a love one
• To formulate a treatment plan:
• Attempt to remove psychosocial stressor
• Psychosocial & environmental
  problems:
• Problems with primary support
  group
• Problems related to the social
  environmental
• Educational problems
• Occupational problems
• Housing problems
• Economic problems
• Problems with access to health
  care services
• Problems related to interaction
  with the legal system/ crime
• Other psychosocial &
  environmental problems
• Help the patient cope with them

Question 7

Axis V apa aja?

Answer 7

• Global assessment of functioning
  (GAF)
• Scale in which clinicians judge patients’
  overall levels of functioning during a
  particular time
• At the time of the evaluation
• Patients’ highest level of functioning for
  at least a few months during the past
  year
• 3 major area of functioning:
• Social
• Occupational
• Psychological

Question 8

GAF Scale interpretasinya?

Answer 8

91 – 100 → Fungsi superior tanpa gejala atau gangguan yang signifikan.

81 – 90 → Gejala ringan yang bersifat sementara (misalnya stres ringan) tanpa gangguan fungsi sosial atau pekerjaan yang signifikan.

71 – 80 → Gejala sementara yang dapat ditangani dengan baik (misalnya kecemasan ringan).

61 – 70 → Beberapa kesulitan dalam fungsi sosial atau pekerjaan, tetapi masih mampu berfungsi secara baik dalam keseharian.

51 – 60 → Gejala sedang seperti kesulitan sosial, pekerjaan, atau hubungan interpersonal yang cukup mengganggu.

41 – 50 → Gangguan serius dalam fungsi sosial atau pekerjaan (misalnya tidak memiliki teman atau sering berkonflik).

31 – 40 → Gangguan besar dalam berbagai aspek kehidupan (misalnya perilaku yang tidak menyesuaikan dengan norma sosial).

21 – 30 → Gangguan serius yang bisa mengarah pada ketidakmampuan dalam menjaga kebersihan diri atau komunikasi nyata terganggu.

11 – 20 → Perilaku yang sangat berbahaya, ketidakmampuan total dalam fungsi dasar sehari-hari.

1 – 10 → Risiko tinggi melukai diri sendiri atau orang lain, serta gangguan fungsi yang ekstrem.

0 → Tidak cukup informasi untuk menilai kondisi individu