DSM V: Review of Commonly Seen Diagnosis Found in the Inpatient Mental Health Setting Joyce Salzer Centracare Health, Salzerj@Centracare.Com

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2014 DSM V: Review of Commonly Seen Diagnosis Found in the Inpatient Mental Health Setting Joyce Salzer CentraCare Health, [email protected]

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Recommended Citation Salzer, Joyce, "DSM V: Review of Commonly Seen Diagnosis Found in the Inpatient Mental Health Setting" (2014). Nursing Posters. 27. https://digitalcommons.centracare.com/nursing_posters/27

This Book is brought to you for free and open access by the Posters and Scholarly Works at DigitalCommons@CentraCare Health. It has been accepted for inclusion in Nursing Posters by an authorized administrator of DigitalCommons@CentraCare Health. For more information, please contact [email protected]. DSM V Review of Commonly Seen Diagnosis Found in the Inpatient Mental Health Setting Presented by: Joyce Salzer, RN-BC

Objectives

• Increased awareness of where to find some of the most commonly seen diagnosis within the DSM V. • Knowledge of some of the changes that have been made in diagnostic classification.

Classifications

Neurodevelopmental Disorders Bipolar and Related Disorders Depressive Disorders

 Intellectual Disabilities  Often experienced as dystonic with exception of Bipolar I Disorder (most recent episode manic) which is quite often  Depressive disorders are extremely dystonic. There is often severe  Communication Disorders in resistance and syntonic. impairment in functioning. There is noted correlation to drug use - Stuttering  Bipolar I Disorder with alcohol, amphetamines, cocaine. There is a powerful  Autism Spectrum Disorder . Psychotic driven manic episodes marked by grandiosity correlation to suicide. . Often seen as a syntonic condition during childhood but may develop . Disabling depressive episodes  Disruptive Mood Dysregulation Disorder into a dystonic condition during adolescents. Moderate correlation to . Often viewed as syntonic - This disorderrequires identification of one or more of the suicide due to social isolation and a sense of “being different”. These . Significant risk for accidental death “Pathogenic Care Realms” individuals often are victimized by bullying. There is significant . Lower rate and risk for suicide  Major Depressive Disorder, Single Episode correlation to alcohol use and cannabis.  Bipolar II Disorder  Major Depressive Disorder, Recurrent . There has been a tightening of criteria. Diagnostic severity of 2 or 3 Most extreme vulnerability to complete suicide – watch for hypomanic condition with irritable mood.  Persistent Depressive Disorder (Dysthymia has been eliminated) must be observed across time and circumstances. . Cyclothymic Disorder  Premenstrual Dysphoric Disorder . Individuals with a well-established DSM IV diagnosis of; Autism - Two years of hypomanic episodes and depressive symptoms that does not meet major depression  Mixed Anxiety/Depression Disorder Disorder, Asperger’s Disorder, or Pervasive Developmental Disorder criteria. - Applied when the client exhibits at least NOS, PDD-NOS will be given the Diagnosis of “Autism Spectrum - No correlation to suicide three of the symptoms of major Disorder in the DSM V. - Often seen as having “mood swings” depression. - Focus is based on deficits seen in relationships, communication and . Substance/Medication Induced Bipolar and Related Disorders - Applied when the client exhibits at least social interaction. . Bipolar and Related Disorder Due to Another Medical Condition three of the symptoms of Generalized Anxiety - Autism Spectrum Disorder (Asperger’s) must have a severity index Disorder. score of a 2 or 3 to be considered a mental disorder. Those - Major correlate to cannabis and alcohol use. individuals previously given a mental disorder diagnosis of - Major correlate to suicide thoughts Asperger’s which score a mild impairment on the severity index  Substance Induced scale may now loose services previously rendered and insurance  Medical Conditions coverage based on the change in diagnosis. Trauma and Stress Related Disorders  Attention Deficit/Hyperactivity Disorder (New Classification in the DSM V)  Specific Learning Disorder - Dyslexia  Reactive Attachment Disorder*  Motor Disorders Personality Disorders - Tourette’s - Symptoms displayed before the age of six. - Tic’s - Severity index of 2 or 3 across time and circumstances  Other Specified Neurodevelopmental Disorders must be met for diagnosis.  With the elimination of Axis II the goal of this diagnosis is to evaluate the impact of these behaviors on the efficacy of treatment. The goal is not to - Fetal Alcoholism will no longer be found in the DSM V, but will now be  Disinhibited Social Engagement Disorder* identified in this category. diagnose but how will this affect the treatment relationship. The goal is  Posttraumatic Stress Disorder “Describing without Diagnosis.”  Acute Stress Disorder*  Cluster A Personality Disorders  Adjustment Disorders - Paranoid  Other Specified Trauma - and Specified – Related Disorders - Schizoid - Schizotypal  Unspecified Trauma – and Stressor –Related Disorders Merging traits of the Schizoid Personality: * Behaviors found in these 3 diagnosis, (Reactive Attachment Disorder , Disinhibited Social Engagement Disorder,  Confused boundaries between self and others Schizophrenia Spectrum and Other Posttraumatic Stress Disorder in Children,) are often consequence of inconsistent nurturing in these “Five  Difficulty in maintaining relationships Pathogenic Care Realms”.  Prefers to be alone Psychotic Disorders  Usually experienced as syntonic  Rarely if ever seeks treatment  Symptoms frequently will emerge between the ages of 17-24 for the male.  No correlation to drug use or suicide behavior Symptoms frequently will emerge between the ages of 32-36 for the female.  Cluster B Personality Disorders  Symptoms can consist of delusions, hallucinations, thought disorganization, Borderline Personality Markers - Antisocial catatonia, and restricted affect. - Borderline  Schizotypal Personality Disorder (This is housed in the “Personality A pervasive pattern of instability of interpersonal relationships, Disorders” ) A. Self-functioning self-image, and affects, and marked impulsivity, beginning by  Delusional Disorders Identity: Poorly developed and unstable. early adult-hood and present in a variety of contexts.  Brief Psychotic Disorder Self–direction: Instability in goals and aspirations. - Histrionic  Schizophreniform Disorder B. Interpersonal functioning - Narcissistic  Schizophrenia Empathy: Limited ability to recognize the feelings or needs of others.  Cluster C Personality Disorders Those receiving this diagnosis are of significantly high risk to complete Intimacy: Conflicted in relationships, views relationships with extreme idealization or devaluation, suspicious of - Avoidant suicide within 6 weeks of diagnosis. abandonment. - Dependent  Schizoaffective Disorder C. Pathological Personality Traits - Obsessive – Compulsive  Substance/Medication-Induced Psychotic Disorder Negative affectivity: Emotional lability  Other Personality Disorders  Psychotic Disorder Due to Another Medical Condition Disinhibition: Impulsivity  Catatonia Disorder Due to Medical Issues Antagonism: Hostility  Other Specified Schizophrenia Spectrum and Other Psychotic Disorder: - Attenuated Psychosis Syndrome - Often times this is the diagnosis that will be given in early detection of an emerging schizophrenia diagnosis. Presented at CentraCare St. Cloud Hospital by Jack Klott, MSSA, LISW, CSW, Revolutionizing Diagnosis & Treatment References Using the DSM-5, March 1, 2013. American Psychiatric Association. (2013). Desk Reference to the Diagnostic Criteria From DSM-5. Arlington, VA: Author.