Lecture 51 - DSM-5 Flashcards
DSM-5 and DSM-5, TR
- May 2013 – publication of the DSM-5 with many changes made, including moving from Roman numerals to express edition to Arabic numbers
- March 2022 – publication of the DSM-5, TR, added further SDOH and cultural factors in diagnosis
- From the Preface: “Some symptom domains, such as depression and anxiety, involve multiple diagnostic categories and may reflect common underlying vulnerabilities for a larger group of disorders. In recognition of this reality, the disorders included in the DSM-5 were reordered into a revised organizational structure meant to stimulate new clinical perspectives”.
Challenging, But Positive, Transition for Mental Health Providers
- Reorganized to reflect disorders across a continuum based on developmental and lifespan considerations
Begins with…
Neurodevelopmental disorders:
* Intellectual disabilities and delays; communication disorders
* Autism spectrum disorders: deletes the diagnosis of Asperger’s disorder
* Attention-deficit/HyperactivityDisorder
Schizophrenia Spectrum, Depression, Bipolar Disorder
- Bipolar and related disorders and Depressive disorders have separate chapters – with bipolar found between schizophrenia spectrum and depressive disorders – reflecting the overlapping nature of bipolar disorder
The Anxiety Disorders
- Anxiety Disorders – includes generalized anxiety disorder, social anxiety disorder, panic disorder
- New separate chapters for Obsessive-Compulsive and related disorders and Trauma- and Stressor-related disorders
Substance-Related Disorders
- No more “abuse” and “dependence”
- Set criteria for all substance that only vary with symptom presentation based on type of substance used: alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives/hypnotics/anxiolytics, stimulants, tobacco, other; Includes gambling disorder – other behavioral excesses have been studied, but not yet included (internet, shopping, etc…..)
2/11 criteria
We Finish Up With….
- Neurocognitive Disorders (formerly known as dementia….)
- Categorized into major and mild neurocognitive disorders
- Specifiers include type (Alzheimer’s,etc.)
Rating scales
research-focused
clinical use
Depression – Clinically Useful
- Patient Health Questionnaire (PHQ- 9): 9 questions to screen for depression and suicidal thinking; patient-rated
- Beck Depression Inventory (BDI): patient-rated
very much validated to the pts experience
Mood Disorders Questionnaire (MDQ)
patient-rated screening tool for bipolar I (mania and depression)
Depression – Research Rating Scales
- Montgomery-Asberg Depression Rating Scale (MADRS): validated in clinical trials, gold standard
- Hamilton Depression (HAM-D, HDRS): clinician-rated; gold standard for evaluating change over time
Bipolar Disorder and Generalized Anxiety
- Young Mania Rating Scale (YMRS): clinician rated by patient report of symptoms over past 48 hours (for bipolar disorder)
Hamilton Anxiety Rating Scale (HAM-A) (for anxiety)
Schizophrenia – Clinical Trials
- Positive and Negative Syndrome Scale (PANSS): Gold standard scale, clinician-rated
- Brief Psychiatric Rating Scale (BPRS): Gold standard scale in clinical trials, clinician-rated
Movement Side Effects of Antipsychotics
- Simpson-Angus (SAS): Evaluates drug-induced parkinsonian symptoms; clinician-rated
- Barnes Akathisia Scale (BARS): Clinician-rated, objective observation of akathisia
Tardive Dyskinesia/Overall Movement Side Effect Assessment
- Abnormal Involuntary Movement Scale (AIMS): Assess tardive dyskinesia, clinician-rated
- Extrapyramidal Symptoms Rating Scale (ESRS): clinician-rated; Designed to assess parkinsonian symptoms, akathisia, dystonia, and tardive dyskinesia in one rating scale
