- Last edited on April 30, 2020
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teaching:2-diagnosis [on April 25, 2020] |
teaching:2-diagnosis [on January 27, 2024] (current) psychdb [Primer] |
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| ===== Primer ===== | ===== Primer ===== | ||
| - | Diagnosing psychiatric disorders can be difficult, and below are some algorithmic approaches for learners. | + | <WRAP group> |
| - | ==== Anxiety ==== | + | <WRAP half column> |
| - | <imgcaption fig1|>{{ :anxiety:anxiety_flow_chart.png?direct&600|Diagnostic Flow Chart for Anxiety}}</imgcaption> | + | **Diagnosing psychiatric disorders** can be challenging, and below are some practical approaches for beginners. |
| + | </WRAP> | ||
| + | <WRAP half column> | ||
| + | <HTML> | ||
| + | <div id="amazon"> | ||
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| + | https://www.psychdb.com/amazon_aff/diagnosis_frances.jpg" ></a> | ||
| + | <p> | ||
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| + | <small> | ||
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| + | </small> | ||
| + | </div> | ||
| + | </HTML> | ||
| + | </WRAP> | ||
| + | </WRAP> | ||
| + | |||
| + | ===== Anxiety ===== | ||
| + | <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success"> | ||
| + | See main section: **[[anxiety:home|]]** | ||
| + | </alert> | ||
| + | <WRAP group> | ||
| + | <WRAP half column> | ||
| Is the anxiety in the background of euthymia (normal mood)? If so, then it is likely a primary anxiety disorder, such as generalized anxiety disorder. If the anxiety is in the background of a depressed mood, then depression with anxious features should override a primary anxiety disorder diagnosis. Another thing to consider is if the patient’s “anxiety” is actually heightened excitement, restlessness, and fidgeting from hypomania. In this case, bipolar II should be considered. Some other clues would be if the anxiety is very episodic in nature (i.e. – months of having no anxiety symptoms at all). | Is the anxiety in the background of euthymia (normal mood)? If so, then it is likely a primary anxiety disorder, such as generalized anxiety disorder. If the anxiety is in the background of a depressed mood, then depression with anxious features should override a primary anxiety disorder diagnosis. Another thing to consider is if the patient’s “anxiety” is actually heightened excitement, restlessness, and fidgeting from hypomania. In this case, bipolar II should be considered. Some other clues would be if the anxiety is very episodic in nature (i.e. – months of having no anxiety symptoms at all). | ||
| - | ==== Psychosis ==== | + | </WRAP> |
| - | <imgcaption fig2|>{{ psychosis:psychosis-anxiety_flow_chart.png?direct&600|Diagnostic Flow Chart for Psychosis}}</imgcaption> | + | <WRAP half column> |
| + | <imgcaption fig1|>{{ :anxiety:anxiety_flow_chart.png?direct|Diagnostic Flow Chart for Anxiety}}</imgcaption> | ||
| + | |||
| + | </WRAP> | ||
| + | </WRAP> | ||
| + | |||
| + | ===== Psychosis ===== | ||
| + | <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success"> | ||
| + | See main section: **[[psychosis:home|]]** | ||
| + | </alert> | ||
| + | <WRAP group> | ||
| + | <WRAP half column> | ||
| Is the psychosis occurring during a manic episode (mania with psychotic features)? Is the psychosis occurring in a depressive episode (depression with psychotic features)? If the psychosis only ever happens during periods of euthymia, then schizoaffective disorder should be considered. | Is the psychosis occurring during a manic episode (mania with psychotic features)? Is the psychosis occurring in a depressive episode (depression with psychotic features)? If the psychosis only ever happens during periods of euthymia, then schizoaffective disorder should be considered. | ||
| + | |||
| + | </WRAP> | ||
| + | <WRAP half column> | ||
| + | <imgcaption fig2|>{{ psychosis:psychosis-anxiety_flow_chart.png?direct|Diagnostic Flow Chart for Psychosis}}</imgcaption> | ||
| + | |||
| + | </WRAP> | ||
| + | </WRAP> | ||
| ===== Uncertainty ===== | ===== Uncertainty ===== | ||
| + | <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success"> | ||
| + | See main section: **[[teaching:cognitive-bias-misdiagnosis-overdiagnosis|]]** | ||
| + | </alert> | ||
| Be comfortable with using //Unspecified// or //Other Specified Disorder// diagnoses when you are not sure if a patient meets full criteria for a diagnosis. | Be comfortable with using //Unspecified// or //Other Specified Disorder// diagnoses when you are not sure if a patient meets full criteria for a diagnosis. | ||
| ===== Adjustment Disorder ===== | ===== Adjustment Disorder ===== | ||
| - | Don't be afraid to use adjustment disorder for patients seen in emergency settings. Not everything is a recurrence of an existing mental disorder (e.g. - recurrent major depressive episode). | + | Don't be afraid to use [[trauma-and-stressors:adjustment|adjustment disorder]] for patients seen in emergency settings. Not everything is a recurrence of an existing mental disorder (e.g. - recurrent major depressive episode). |
| ===== V Codes and Z Codes ===== | ===== V Codes and Z Codes ===== | ||
| - | <callout type="success">{{fa>arrow-circle-right?color=green}} See main article: **[[teaching:dsm-v-icd-z-codes]]**</callout> | + | <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success"> |
| - | + | See main article: **[[teaching:dsm-v-icd-z-codes]]** | |
| - | Don't be afraid to use V Codes and Z Codes! | + | </alert> |
| + | You don't always have to give a diagnosis. Don't be afraid to use V Codes and Z Codes! | ||
| ===== Resources ===== | ===== Resources ===== | ||
| - | ==== For Providers ==== | + | |
| - | * [[https://www.amazon.ca/Essentials-Psychiatric-Diagnosis-Revised-Responding/dp/1462513484|Amazon: Essentials of Psychiatric Diagnosis, Revised Edition: Responding to the Challenge of DSM-5]] | + | |
| {{tag>ax-dx}} | {{tag>ax-dx}} | ||