Other Conditions That May Be a Focus of Clinical Attention Flashcards
Other Conditions That May Be a Focus of Clinical Attention
While not mental disorders, these conditions or problems may be encountered in routine clinical practice and may be coded if:
1.
2.
3.
4.
- it is a reason for the current visit.
- it helps explain the need for a test, procedure, or treatment.
- it plays a role in the initiation or exacerbation of a mental disorder.
- it constitutes a problem that should be considered in the management plan.
Other Conditions That May Be a Focus of Clinical Attention
An individual has engaged in potentially self-injurious behavior with some intent to die, either explicit or inferred from the behavior or circumstances.
Suicidal Behavior
Other Conditions That May Be a Focus of Clinical Attention
An individual has engaged in intentionally self-inflicted damage to their body that is likely to induce bleeding, bruising, or pain in the absence of suicidal intent.
Nonsuicidal Self-Injury
Other Conditions That May Be a Focus of Clinical Attention
Nonaccidental physical injury to a child. Injury is considered ___________, regardless of intent to hurt. Excludes reasonable, non-injurious discipline.
Child Physical Abuse
abuse
Other Conditions That May Be a Focus of Clinical Attention
Acts involving children that are intended to provide __________ __________________ to a parent, caregiver, or other individual who has responsibility for the child.
Child Sexual Abuse
sexual gratification
Other Conditions That May Be a Focus of Clinical Attention
Confirmed or suspected egregious acts or omissions by parent(s) or caregiver(s) that deprives child of needs and (potentially) results in physical or psychological harm to a child.
Child Neglect
Other Conditions That May Be a Focus of Clinical Attention
Nonaccidental verbal or symbolic acts by parent(s) or caregiver(s) that (potentially) result in significant _______________ harm to a child, excluding physical or sexual abuse.
Child Psychological Abuse
psychological
Other Conditions That May Be a Focus of Clinical Attention
Nonaccidental acts of force that (potentially) result in _____________ harm to, or significant fear in, an intimate partner, excluding self-defense.
Spouse or Partner Violence, Physical
physical
Other Conditions That May Be a Focus of Clinical Attention
The use of physical or psychological coercion to compel a partner to engage in completed or uncompleted ____________ ________ against their will, or if they cannot consent.
Spouse or Partner Violence, Sexual
sexual acts
Includes completed or uncompleted sexual acts.
Other Conditions That May Be a Focus of Clinical Attention
Any egregious act or omission that deprives a dependent partner of basic needs and (potentially) results in physical or psychological harm.
Spouse or Partner Neglect
Potentially results in physical or psychological harm.
Other Conditions That May Be a Focus of Clinical Attention
Nonaccidental verbal or symbolic acts that (potentially) result in significant harm to a partner.
Spouse or Partner Abuse, Psychological
Other Conditions That May Be a Focus of Clinical Attention
Acts of physical, sexual, or emotional maltreatment between adults are the focus of clinical treatment.
Adult Abuse by Non-Spouse or Non-Partner
Other Conditions That May Be a Focus of Clinical Attention
Impaired functioning in behavioral, cognitive, or affective domains is associated with the quality of the parent-child relationship. Consideration should be given to developmental and cultural contexts.
Parent-Child Relational Problems
Other Conditions That May Be a Focus of Clinical Attention
A pattern of interaction between siblings is associated with significant impairment in individual or family functioning, or with the development of symptoms affecting the course, prognosis, or treatment of mental or physical health.
Sibling Relational Problem
Other Conditions That May Be a Focus of Clinical Attention
The quality of an intimate relationship affects the course, prognosis, or treatment of mental or physical health or distress is associated with impaired functioning in behavioral, cognitive, or affective domains.
Relationship Distress with Spouse or Intimate Partner
Other Conditions That May Be a Focus of Clinical Attention
Includes Upbringing Away from Parents,
Child Affected by Parental Relationship Distress,
Disruption of Family by Separation or Divorce, and
High Expressed Emotion Level Within Family
Problems Related to the Family Environment
Other Conditions That May Be a Focus of Clinical Attention
Includes illiteracy or low-level literacy; lack of access to schooling, unavailable or unattainable; problems with academic performance or underachievement; discord with teachers, school staff, or other students; problems related to inadequate teaching; and other related problems.
Educational Problems
Other Conditions That May Be a Focus of Clinical Attention
Includes problems related to current military deployment status; unemployment; recent change of job; threat of job loss; stressful work schedule; uncertainty about career choices; sexual harassment on the job; other discord with boss, supervisor, co-workers, or others; uncongenial or hostile work environments; other physical or mental strain related to work; sexual harassment; or any other related problems.
Occupational Problems
Other Conditions That May Be a Focus of Clinical Attention
The primary nighttime residence is a homeless shelter, a warming shelter, a domestic violence shelter, a motel, or in a temporary or transitional living situation.
Sheltered Homelessness
Other Conditions That May Be a Focus of Clinical Attention
Residing in a place not meant for human habitation, such as a public space, a building not intended for residential use, a car, a cave, a cardboard box, or other ad hoc housing situation.
Unsheltered Homelessness
Other Conditions That May Be a Focus of Clinical Attention
Examples include a lack of heat or electricity, infestation by insects or rodents, inadequate plumbing and toilet facilities, overcrowding, lack of adequate sleeping space, and excessive noise.
Consider cultural norms.
Inadequate Housing
Other Conditions That May Be a Focus of Clinical Attention
3 Other Housing Problems Categories
- Discord with Neighbor, Lodger, or Landlord
- Problem Related to Living in a Residential Institution (not related to a change in living situation)
- Other Housing Problem
Other Conditions That May Be a Focus of Clinical Attention
Areas to consider include lack of adequate food or safe drinking water, extreme poverty, low income, insufficient social or health insurance or welfare support, or other related problems.
Economic Problems
Other Conditions That May Be a Focus of Clinical Attention
Includes Problem Related to Living Alone, Acculturation Difficulty, Social Exclusion or Rejection, Target of (Perceived Adverse Discrimination or Persecution, and other related problems.
Problems Related to the Social Environment
Other Conditions That May Be a Focus of Clinical Attention
Areas to be considered include conviction in criminal proceedings, imprisonment or other incarceration, problems related to release from prison, and problems related to other legal circumstances.
Problems Related to Interaction with the Legal System
Other Conditions That May Be a Focus of Clinical Attention
Includes Problem Related to Lifestyle, Problems Related to Unwanted Pregnancy; Problems Related to Multiparity (multiple pregnancies, births, or children); Discord with Social Service Provider, Including Probation Officer, Case Manager, or Social Services Worker.
Problems Related to Other Psychosocial, Personal, and Environmental Circumstances
Other Conditions That May Be a Focus of Clinical Attention
Unavailability or Inaccessibility of Health Care Facilities or Other Helping Agencies
Problems Related to Access to Medical and Other Health Care
Other Conditions That May Be a Focus of Clinical Attention
Personal History of Psychological Trauma or Military Deployment
Circumstances of Personal History
Other Conditions That May Be a Focus of Clinical Attention
Includes Genetic Counseling, Sex Counseling, Dietary Counseling, and Other Counseling or Consultation
Other Health Service Encounters for Counseling and Medical Advice
Other Conditions That May Be a Focus of Clinical Attention
A desire to walk about that is associated with a mental disorder and leads to significant clinical management or safety concerns. Code mental disorder first.
Wandering Associated with a Mental Disorder
Other Conditions That May Be a Focus of Clinical Attention
A normal reaction to the death of a loved one. Culture is considered when evaluating duration and expression of symptoms. Major Depressive Episode and Prolonged Grief Disorder should be ruled out.
Uncomplicated Bereavement
Other Conditions That May Be a Focus of Clinical Attention
Problems associated with adjustments to life-cycle transitions.
Phase of Life Problem
Other Conditions That May Be a Focus of Clinical Attention
Distressing experiences that involve loss or questioning of faith, problems associated with conversion to a new faith, or questioning of spiritual values not necessarily related to an organized church or religion.
Religious or Spiritual Problem
Other Conditions That May Be a Focus of Clinical Attention
Antisocial behavior of adults that is not attributable to a mental disorder that may include behaviors of some professional thieves, racketeers, or dealers in illegal substances.
Adult Antisocial Behavior
Other Conditions That May Be a Focus of Clinical Attention
Non-patterned antisocial behavior of children or adolescents that is not attributable to a mental disorder.
Child or Adolescent Antisocial Behavior
Other Conditions That May Be a Focus of Clinical Attention
Nonadherence to an important aspect of treatment for mental disorder or another medical condition for reasons such as discomfort resulting from treatment, expense personal value judgements or religious or cultural beliefs, age-related debility, or the presence of a mental disorder.
Nonadherence to Medical Treatment
Other Conditions That May Be a Focus of Clinical Attention
The focus of clinical attention is the client’s weight.
Overweight or Obesity
Other Conditions That May Be a Focus of Clinical Attention
The intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives such as avoiding military duty, avoiding work, obtaining financial compensation, evading criminal prosecution, or obtaining drugs. May represent adaptive behaviors. Not Factitious Disorder which lacks external motivators. Not Functional Neurological Symptoms Disorder or other symptom-related mental disorder.
Malingering
Should be strongly considered when a client is referred by an attorney; marked discrepancy between claims and objective findings or observations; lack of cooperation during diagnostic evaluation or treatment; presence of antisocial personality disorder.
Other Conditions That May Be a Focus of Clinical Attention
An objectively identified decline in cognitive functioning consequent to the aging process that is within normal limits. Not better explained by specific mental disorder or neurological condition.
Age-Related Cognitive Decline
Other Conditions That May Be a Focus of Clinical Attention
Not mild Intellectual Developmental disorder, but difficulties in intellectual and adaptive functions that are the focus of clinical attention.
Borderline Intellectual Functioning
