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Clinical Sequelae and Functional Outcomes
Published in Mark A. Mentzer, Mild Traumatic Brain Injury, 2020
The severity of TBI is classified using the Glasgow Coma Scale (GCS), Loss of Consciousness (LOC), and post-traumatic amnesia (PTA), along with a variety of other screening tools such as ANAM (Automated Neuropsychological Assessment Metrics), the Repeatable Battery for Assessment of Neuropsychological Status, the Concussion Management Algorithm (CMA), the King-Devick concussion test (North et al., 2012; Marshall et al., 2012), the Sport Concussion Assessment Tool (SCAT3), and the Acute Concussion Evaluation (Ontario Neurotrauma Foundation, 2013; Gioia and Collins, 2006). And no single classification embraces all the features of mTBI (clinical, pathological, cellular/molecular). The severity does not directly equate to neurocognitive disorder (NCD) or the potential for rehabilitation. Many factors such as injury specifics, age, prior history, and substance abuse relate to the effects of a TBI (Relias Academy, 2020). Edition 5 of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) describes the neurocognitive sequelae following TBI. NCD encompasses the group of acquired disorders wherein the primary clinical deficit is disrupted cognitive functioning (American Psychiatric Association, 2013). DSM-5 is the standard classification of mental disorders used by mental health professionals in the United States.
Foundational Issues in Deception
Published in Harold V. Hall, Joseph G. Poirier, Detecting Malingering and Deception, 2020
Harold V. Hall, Joseph G. Poirier
International classification of diseases (ICD)-10-CM became effective in 2015 with mandatory use for billing purposes by almost all licensed mental health professionals in the United States and Canada (ICD-11 is projected to be released in 2022). DSM-5 (and future DSMs) can still be utilized for diagnosing mental disorders, but, unless the American Psychiatric Association continues to publish this significantly limited classification system, it will likely be increasingly seen as redundant and eventually phase out of existence. Meanwhile, it is permissible (and cumbersome) to use both manuals for a single forensic case, especially since the ICD lists conditions not included in DSM-5. The ICD is hardly superior to DSM. ICD-10-CM has 68,000 codes, over 600 of which are for mental conditions. This is a degree of specification that is mere labeling by committee vote and does not include empirically based commentary. There are, for example, 20 diagnostic categories for the various subtypes of child abuse and neglect. Further, American Law Institute (ALI) and modified-ALI tests of insanity (i.e., criminal responsibility), used in most state and federal jurisdictions, require a diagnosis of a mental disorder for exculpation and some other conclusions. In general, the forensic professional has no choice, but to use one or both of these limited classification systems.
Classification and diagnosis: ICD-10 and DSM-5 and their application to substance use disorders in young people
Published in Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros, Substance Misuse and Young People, 2019
The simultaneous preparation of DSM-5 and ICD-11 had provided an opportunity to achieve increased compatibility between them. Nevertheless, the delay in the publication of the latter, initially intended for 2012, created a decision point, which was to either aim for increased compatibility, or to make an independent system, and avoid the mistakes of the former. DSM-5 has been criticised as being over-inclusive and as biased towards increasing the sensitivity of psychiatric diagnoses while reducing their specificity (Frances and Nardo, 2013). This is particularly pertinent to diagnoses of substance use disorders due to the elimination of the abuse diagnoses and the introduction of a single dimension of substance use disorder. In contrast, it seems that the traditional dichotomy of dependence/harmful use is preserved in ICD-11. Nonetheless, the category of Hazardous Substance Use, in the chapter ‘Factors influencing health status or contact with health services’, does probably address some of the public health issues, especially in adolescence in which the pattern of use is often episodic and without appreciation of the potential consequences (Poznyak et al., 2018). This is defined as, ‘a pattern of psychoactive substance use that appreciably increases the risk of harmful physical or mental health consequences to the user or to others to an extent that warrants attention and advice from health professionals, and it often persists in spite of awareness of increased risk of harm to the user or others’.
Improving Pain Care Using Psychosocial Screening and Patient Education among Veterans
Published in Military Behavioral Health, 2022
The current study highlighted the potential use of two Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) tools to enhance clinical decision-making in a Veteran population. Keep in mind that the cross-cutting screening measure is brief in comparison to an amalgamation of different instruments to measure each of the twelve psychiatric domains. Furthermore, the functional disability screening is unique in that it measures functioning and disability in accordance with the International Classification of Functioning, Disability, and Health (World Health Organization (WHO), 2001). The DSM-5 measures utilized in this study could help providers document psychiatric symptoms and functional disability, aid in developing more precise treatment plans, and monitor treatment progress. Future studies should replicate the current findings using demographically matched samples and primary/secondary outcome measures when investigating the effectiveness of pain education programming.
A Crosswalk Study of DSM-IV and DSM-5 Criteria for PTSD from the DSM-5 Field Trials
Published in Psychiatry, 2022
Carol S. North, Alina M. Surís, Diana Clarke, Jayme M. Palka, Lamyaa Yousif, Darrel A. Regier
The DSM-5 Field Trials were conducted in six academic or large psychiatric treatment sites in the United States and one in Canada between December 1, 2010, and October 1, 2011. The field trials aimed to examine the clinical utility, feasibility, reliability, and validity of the proposed DSM-5 criteria (see Clarke et al., 2013) for a detailed description of the DSM-5 Field Trials methods). The DSM-IV to DSM-5 criteria crosswalk substudy for PTSD was appended to the Field Trials protocol at the Dallas Veterans Affairs (VA) Medical Center and Houston’s Michael E. DeBakey VA Medical Center sites, which were selected based on the strength of their institutions’ applications to assess PTSD diagnoses. The full Field Trials protocol, including the PTSD crosswalk component, assessment tools, and consent forms, was approved by institutional review boards of the APA and the Dallas and Houston VA medical centers, and all participants provided written informed consent as part of enrollment in the research.
Icelandic translation and reliability data on the DSM-5 version of the schedule for affective disorders and schizophrenia for school-aged children – present and lifetime version (K-SADS-PL)
Published in Nordic Journal of Psychiatry, 2020
Ólafur Þórðarson, Friðrik Már Ævarsson, Sigríður Helgadóttir, Bertrand Lauth, Inga Wessman, Steinunn Anna Sigurjónsdóttir, Orri Smárason, Harpa Hrönn Harðardóttir, Gudmundur Skarphedinsson
The 2013 publication of the DSM-5 included important changes to the classification of psychiatric disorders. Listing all of them would exceed the scope of this paper (for a more thorough account of the changes made in the DSM-5, see the report issued by the Substance Abuse and Mental Service Administration) [8]. However, several changes that may directly affect the diagnosis of psychiatric disorders in children follow here. Dysthymic disorder was renamed persistent depressive disorder (PDD) and major depessive disorder (MDD) was added as a specifier to the overruling PDD diagnosis. [8,9]. A new addition with the DSM-5, disruptive mood dysregulation disorder (DMDD), is characterized by frequent and severe outbursts of temper and chronic irritability between outbursts over a period of 12 months. This diagnosis cannot coexist with oppositional defiant disorder (ODD) [9]. Research has indicated the diagnostic frequency of ODD has diminished in favour of DMDD due to similar diagnostic criteria [8,10,11]. Major changes were also made to the autism spectrum disorder (ASD). In the DSM-5, there are no diagnostic subcategories of ASD. Diagnostic criteria also underwent significant changes. Comorbidities with other disorders (such as ADHD) are also recognized [12].