265761 - PowerPoint Presentation

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DIAGNOSTIC AND STATISTICAL MANUAL Slide2

Gurpreet kaur 4232926 (17)Jasdeep kaur 4231701(19)Jasmine kaur 4232827(20)Inderveer kaur 4231899(18)Slide3

INTRODUCTIONThe Diagnostic and Statistical Manual of Mental Disorders (DSM)Often referred to as ‘psychiatry’s bible’Is published by American Psychiatric AssociationOffers standard criteria for the classification of mental disorders. It is used by clinicians, researchers, psychiatric drug regulation agencies, health insurance companies, the legal system and the policy makers together with alternatives such as ICD. Slide4

HISTORY/EVOLUTIONDSM is originated in 1840 with the need to collect statistical information of mental illness in U.S.The term ‘idiocy/insanity’ appeared in that year’s census.Forty years later, the census expanded & included these 7 categories: “mania, melancholia, monomania, paresis, dementia, dipsomania and epilepsy”.In 1917, a publication “the Statistical Manual for the Use of Institutions for the Insane

” was created by the Committee on Statistics of the American Medico-Psychological Association(now the AMERICAN PSYCHIATRIC ASSOCIATION) and the National Commission on Mental Hygiene.Slide5

….contdThe committees separated mental illness into 22 groups.The manual went through 10 editions until 1942.After several diagnostic systems, the need for a classification that can minimize confusion and help mental professionals to use common diagnostic language in communication lead the pavement for the origin of DSM-I in 1952.DSM-II (1968)DSM-III (1980)DSM-III-R (1987)DSM-IV (1994)

DSM-IV-TR (2000)Slide6

USES OF DSM

DSM is used by most Mental Health Professionals to determine & communicate patient’s diagnosis

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To categorize patients for research purposes

Hospital, clinics, insurance companies in US require a DSM diagnosis for all patients treatedSlide7

DSM is both used in Clinical settings (inpatient, outpatient, partial hospital, consultation-liaison, clinic, private practice & primary care)as well as with Community populations

.

It is also a necessary tool for collecting & communicating accurate public health statistics about the diagnosis of psychiatric disorders.Slide8

CRITICISM TO DSMReliability and Validity IssuesPrime concern with Signs & Symptoms and Non-clearance of Underlying Causes/

pathophysiology

Inappropriate Dividing lines between presence of Mental illness and Normality

Cultural Bias

Medicalization & Financial conflicts of interest

Consumers/Survivors Slide9
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DSM-5DSM-5 is the 2013 update to the American Psychiatric Association’s(APA) classification and diagnostic tool.The development of this new edition began with a conference in 1999

and proceeded with the formation of a

Task Force in 2007.

This 5

th

edition was

approved

by the Board of Trustees of APA on

December 1, 2012

and

published on May 18, 2013.

The DSM-5 is the first major edition of the manual in twenty years.Slide11

Changes from DSM-IV-TR to DSM-5http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR--to-DSM-5.pdfSlide12

NOTABLE CHANGES IN DSM-5The Roman Numerals Numbering System has been discontinued to allow for greater clarity in regard to revision numbers.Dropping Asperger syndrome as a distinct classificationLoss of subtype classifications for variant forms of SchizophreniaDropping the "bereavement exclusion" for 

depressive disorders

A revised treatment and naming of

gender identity disorder

to

gender dysphoria

and

Removing the A2 criterion for

posttraumatic stress disorder

(PTSD) because its requirement for specific emotional reactions to trauma did not apply to combat veterans and first responders with PTSD.Slide13

CRITICISM TO DSM-5According to Psychiatrist –

Allen Frances

“DSM will medicalize normality and result in a glut of unnecessary and harmful drug prescription”.

Frances lists the 10 “most potentially harmful changes” to DSM-5 :

=>Disruptive Mood Dysregulation Disorder, for temper tantrums

=>Major Depressive Disorder, includes normal grief

=>Minor Neurocognitive Disorder, for normal forgetting in old ageSlide14

…contd=> Adult Attention Deficit Disorder, encouraging psychiatric prescriptions of stimulants=> Binge Eating Disorder, for excessive eating=> Autism, defining the disorder more specifically, possibly leading to decreased rates of diagnosis and the disruption of school services=> First time drug users will be lumped in with addictsSlide15

…contd=> Behavioral Addictions, making a “mental disorder of everything we like to do a lot.”=> Generalized Anxiety Disorder, includes everyday worries=> Post-traumatic stress disorder, changes opening “the gate even further to the already existing problem of misdiagnosis of PTSD in forensic settings.”Slide16

IMPACT OF CHANGES TO DSM-5 ON PEOPLE WITH MENTAL HEALTH ISSUES“Some got Relief.., Some got Label”Some of the changes have unnecessarily “medicalized” normal human mental processes.For example; the medicalization of grief

and

Disruptive Mood Dysregulation Disorder

Some may now no longer qualify for the diagnosis they were given.

For example;

Autism

(some kids may no longer qualify for services that have previously helped them).Slide17

…contdSome disorders are disappearing, others have been created.For example; Asperger Syndrome is subsumed by Autism Spectrum Disorder(since Asperger is a mild form of the disorder, and some people with Asperger might not identify with the more wide-ranging “Autism” label. )

Mislabeling Medical Illness As Mental Disorder

Over prescription of Psychotropic MedicationsSlide18

DSM and FRAMEWORK FOR SUPPORT DEFINITION:- A Framework for Support is CMHA’s central policy regarding people with mental illness. This framework retained the integrity of the model and is now positioned within the current context of population health, health promotion, and recovery.Slide19
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STRUCTURE OF FRAMEWORKThe Framework for Support focuses on three core areas to mark the way forward. The three areas are community, knowledge, and the personal resources needed to cope with mental illness. The focus on community serves to anchor our thinking in the real process of consumers’ lives in society.It balances the service-focused bias of older policies by calling for full partnerships with consumers and families, and by recognizing the complex range of factors that shape the lives of consumers in the community.Slide21

…contdThe focus on knowledge offers a model that fully engages the wide range of knowledge that we now possess. This includes, but goes beyond, best practices and evidence-based concepts to outline a rich convergence of kinds of understanding that range from the scientific to the experiential.The focus on personal resources redefines the inner landscape of consumers from a repository of illness and symptoms to a dynamic mixture of skills and capacities.Slide22

RELATION OF FRAMEWORK WITH DSM-5Relation to Knowledge Resource base: Resource -DSM V contain a rating of the quality ant quantity of information available to support the different diagnostic systems. The advantage of such as approach is staightforward.It will inform the reader about highly variable state of knowledge with regard to various psychiatric disorders.Slide23

…contdRelation to Community Resource Base:-DSM V criteria applicable to all communities, socities, cultures, countries throughout the world to the all people having different regions, different norms, different spiritual, religious, beliefs, practices and different habits, different perception of mental health and mental illness.Slide24

…contdRelation to Person Resource Base:-Person resource base have its emphasis on well being of its clients and same DSM V have a non psychiatric setting which have objective to prevent mental disorders by early detection and early prevention. Patient self reporting and objectively observable signs and behavior culled to remove mental disorders.Slide25

DSM-5: a collection of psychiatrist views on the changes, controversies, and future directionshttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3846446/Slide26
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Services include:Client survey individual counseling.Client survey employment services.Client survey community justice services.Client survey safe bed.

Address:-6760 Morrison street, unit 2, Niagara falls. L2E6Z8Slide28
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Vidyasagar Institute of Mental Health and Neuro SciencesIt focuses on:

Mental health

Neurosciences

Rehabilitation.

Mind body center.

Allied specialties.

TrainingSlide30
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http://en.wikipedia.org/wiki/DSM-IV-TR#DSM-IV-TR_.282000.29http://en.wikipedia.org/wiki/DSM-5#Criticismhttp://psychcentral.com/blog/archives/2010/02/11/a-review-of-the-dsm-5-draft/http://www.psychiatrictimes.com/dsm-5-0/why-psychiatrists-should-sign-petition-reform-dsm-5http://www.psychologytoday.com/blog/dsm5-in-distress/201212/mislabeling-medical-illness-mental-disorder

http://www.forbes.com/sites/alicegwalton/2012/12/03/what-effect-will-changes-to-the-dsm-5-have-on-people-with-and-without-mental-health-issues/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3846446/

http://www.cmha.ca/public_policy/a-framework-for-support/#.U2uRufldWmUSlide32