Psychiatrics
Psychiatrics
Hey Guys
I'm done with psychiatry.
I started this section when I recieved my diagnose for Panic Disorder, ADHD and Tourette's at the same time. I know that's some pretty fricking bad news, but hey, I've already came over it!
And just as an encouragement for all fellow patients, life goes on, and so will you.
Some Conventions and Nomenclature
How Bad?
DSM-5
[...]
Mild Few, if any, symptoms in excess of those required to make the diagnosis are present, and symptoms result in no more than minor impairments in social or occupational functioning.
Moderate Symptoms or functional impairment between “mild” and “severe” are present.
Severe Many symptoms in excess of those required to make the diagnosis, or several symptoms that are particularly severe, are present, or the symptoms result in marked impairment in social or occupational functioning.
Neurotics
Intellectual Disability
DSM-5
Intellectual Disability (intellectual developmental disorder) is a disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains.
Diagnose
The following three criteria must be met:
- Deficits in intellectual functions, such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience, confirmed by both clinical assessment and individualized, standardized intelligence testing.
- Deficits in adaptive functioning that result in failure to meet devel opmental and sociocultural standards for personal indepen dence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, and indepen dent living, across multiple environments, such as home, school, work, and community.
- Onset of intellectual and adaptive deficits during the develop mental period.
ICD
| __.__ | (__.__) | Intellectual Disability (Intellectual Developmental Disorder) (17) |
|---|---|---|
| 317 | (F70) | Mild |
| 318 | (F71) | Moderate |
| 319 | (F72) | Severe |
| 320 | (F73) | Profound |
| 315.8 | (F88) | Global Developmental Delay (23) |
| 319 | (F79) | Unspecified Intellectual Disability (Intellectual Developmental Disorder) (23) |
Social Disorder
Diagnose
- Persistent difficulties in the acquisition and use of language across modalities (i.e., spoken, written, sign language, or other) due to deficits in comprehension or production that include the following:
Reduced vocabulary (word knowledge and use).
Limited sentence structure (ability to put words and word endings together to form sentences based on the rules of gram-
mar and morphology)
Impairments in discourse (ability to use vocabulary and connect sentences to explain or describe a topic or series of events or have a conversation). - Language abilities are substantially and quantifiably below those expected for age, resulting in functional limitations in effective communication, social participation, academic achievement, or occupational performance, individually or in any combination.
- Onset of symptoms is in the early developmental period.
- The difficulties are not attributable to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition and are not better explained by intellectual disability (intellectual developmental disorder) or global developmental
delay.
ICD
| __.__ | (__.__) | Communication Disorders (24) |
|---|---|---|
| 315.32 | (F80.2) | Language Disorder (24) |
| 315.39 | (F80.0) | Speech Sound Disorder (24) |
| 315.35 | (F80.81) | Childhood-Onset Fluency Disorder (Stuttering) (25) |
| 315.39 | (F80.89) | Social (Pragmatic) Communication Disorder (26) |
| 307.9 | (F80.9) | Unspecified Communication Disorder (27) |
Autism Spectrum Disorder
Diagnose
- Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive):
Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-andforth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers. - Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive):
Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).
Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
Hyperor hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
Specify current severity:
Severity is based on social communication impairments and restricted, repetitive patterns of behavior (see Table 2). - Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
- Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
Autism Spectrum Disorder 29 - These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.
| __.__ | (__.__) | Autism Spectrum Disorder (27) |
|---|---|---|
| 299.00 | (F84.0) | Autism Spectrum Disorder (27) |
Attention Deficient and Hyperactive Disorder
Diagnose
- A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (A) and/or (B):
A
Inattention
Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.
Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate).
Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).
Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).
Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).
Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).
Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts).
Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, re-
turning calls, paying bills, keeping appointments).
B
Hyperactivity and impulsivity Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities:
Often fidgets with or taps hands or feet or squirms in seat.
Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place).
Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless.)
Often unable to play or engage in leisure activities quietly.
Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced
by others as being restless or difficult to keep up with).
Often talks excessively.
Often blurts out an answer before a question has been
completed (e.g., completes people’s sentences; cannot
wait for turn in conversation).
Often has difficulty waiting his or her turn (e.g., while
waiting in line).
Often interrupts or intrudes on others (e.g., butts into con-
versations, games, or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing).
- Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years.
- Several inattentive or hyperactive-impulsive symptoms are present in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).
- There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.
- The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder (e.g., mood disorder, anxiety disorder, dissociative disorder, personality disorder, substance intoxication or withdrawal).
ICD
| __.__ | (__.__) | Intellectual Disability (Intellectual Developmental Disorder) (17) |
|---|---|---|
| 314.01 | (F90.2) | Combined presentation |
| 314.00 | (F90.0) | Predominantly inattentive presentation |
| 314.01 | (F90.1) | Predominantly hyperactive/impulsive presentation |
| 314.01 | (F90.8) | Other Specified ADHD (35) |
| 314.01 | (F90.9) | Unspecified ADHD |
Dylexia
| __.__ | (__.__) | Specific Learning Disorder (36) |
|---|---|---|
| 315.00 | (F81.0) | With impairment in reading (specify if with word reading accuracy, reading rate or fluency, reading comprehension) |
| 315.2 | (F81.81) | With impairment in written expression (specify if with spelling accuracy, grammar and punctuation accuracy, clarity or organization of written expression) |
| 315.1 | (F81.2) | With impairment in mathematics (specify if with number sense, memorization of arithmetic facts, accurate or fluent calculation, accurate math reasoning) |
Motor Disorder
| __.__ | (__.__) | Motor Disorders (39) |
|---|---|---|
| 315.4 | (F82) | Developmental Coordination Disorder (39) |
| 307.3 | (F98.4) | Stereotypic Movement Disorder (40) |
Tic Disorder
| __.__ | (__.__) | Tic Disorders |
|---|---|---|
| 307.23 | (F95.2) | Tourette's Disorder (41) |
| 307.22 | (F95.1) | Persistent (Chronic) Motor or Vocal Tic Disorder (41) |
| 307.21 | (F95.0) | Provisional Tic Disorder (42) |
| 307.20 | (F95.8) | Other Specified Tic Disorder (42) |
| 307.20 | (F95.9) | Unspecified Tic Disorder (42) |
Miscellaneous
| __.__ | (__.__) | Other Neurodevelopmental Disorders (43) |
|---|---|---|
| 315.8 | (F88) | Other Specified Neurodevelopmental Disorder (43) |
| 315.9 | (F89) | Unspecified Neurodevelopmental Disorder (44) |