DSM-IV-TR

Diagnostic and Statistical Manual of Mental Disorders, 4th ed, Text Revision.

“Standard nomenclature of emotional illness published by the American Psychiatric Association (APA) and used by all health care practitioners. It classifies mental illness and presents guidelines and diagnostic criteria for various mental disorders.”   Psychiatric Mental Health Nursing, 6th edition, Townsend

Published in July 2000 as a update to be official in 2014. The last updated DSM-IV was in 1994.

This is the original DSM-I

My diagram of the Diagnostic and Statistical Manual shows the 5 Multi-axial system.

There are 3 Components of the DSM:

Diagnostic Classification – list of the mental disorders
Diagnostic Criteria –  description of each disorder
Descriptive Text – accompanies each disorder with descriptions under the following headings: Diagnostic Features *  Subtypes and/or Specifiers * Recording Procedures * Associated Features and Disorders * Specific Culture, Age, and Gender Features * Prevalence * Course * Familial Pattern * Differential Diagnosis

Multi-axial system

The DSM-IV organizes each psychiatric diagnosis into five levels (axes) relating to different aspects of disorder or disability:

• Axis I: Clinical disorders, including major mental disorders, and learning disorders. Common Axis I disorders include depression, anxiety disorders, bipolar disorder, ADHD, autism spectrum disorders, phobias, and schizophrenia.
• Axis II: Personality disorders and mental retardation. Common Axis II disorders include personality disorders: paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, borderline personality disorder, antisocial personality disorder, narcissistic personality disorder, histrionic personality disorder, avoidant personality disorder, dependent personality disorder, obsessive-compulsive personality disorder, and mental retardation.
• Axis III: Acute medical conditions and physical disorders. Common Axis III disorders include brain injuries and other medical/physical disorders which may aggravate existing diseases or present symptoms similar to other disorders.
• Axis IV: Psychosocial and environmental factors contributing to the disorder.
• Axis V: Global Assessment of Functioning or Children’s Global Assessment Scale for children and teens under the age of 18

Psych Sites

I’ve added a blog link category called Psych for different Psychiatric sites which may be useful during our 3rd semester. If you know of any other good ones I should add, please let me know!

DSM-5

For fellow classmates. You know how we have our charts for giving numbers to a condition to see if it fits or what heading it falls under? Such as the APGAR, Braden Scale, Glasgow coma scale. There is a recent drafting of a proposed classification for diagnostic and statistical manual of mental disorders called the DSM-5. Maybe it is really like taking our 8×5 Orem cards and coming up with the focus for our nursing diagnosis. Personally I always wondered about the classification of bipolar and schizophrenia as they are both so close together.

Anyways, the American Psychiatric Association just recently came out with this new global draft on Feb 10th 2010 to place the listed disorders in their classifications. After complete review and revision, (2 years) it will be the new taxonomy. The last published edition was six years ago in 1994. The original publication – DSM-1 was in 1952. If you want to read more go to http://www.dsm5.org/Pages/Default.aspx. You know NANDA-I just recently is going through the process of submission of new diagnosis and revisions of old ones too.

Since we are going into Psych one of these days, and this is a pretty big thing going on right now, I wanted to post it. The following links go to the APA site with the proposed classification criteria for each disorder.

As stated on their site, “Anyone can submit their suggestions and ideas to the members of the work groups through the DSM-5 Web site, by clicking the “Participate” button on the upper right hand side of this screen and registering. The proposed draft revisions to DSM-5 are posted on the Web site, and anyone can provide feedback to the work groups on these during periods of public comment.”  To put this in perspective – the final publication of the DSM-5 will be released May 2013.

 

Structural, Cross-Cutting, and General Classification Issues for DSM-5

Adjustment Disorders

Anxiety Disorders
Delirium, Dementia, Amnestic, and Other Cognitive Disorders
Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence
Dissociative Disorders
Eating Disorders
Factitious Disorders
Impulse-Control Disorders Not Elsewhere Classified
Mental Disorders Due to a General Medical Condition Not Elsewhere Classified
Mood Disorders
Other Clinical Conditions That May Be a Focus of Clinical Attention
Personality and Personality Disorders

Schizophrenia and Other Psychotic Disorders
Sexual and Gender Identity Disorders
Sleep Disorders
Somatoform Disorders
Substance-Related Disorders

 

American Psychiatric Association