Transcript DSM-IV-TR in Action Powerpoint


DSM-IV-TR information on relative co-morbidity &
associated features added
DSM-5: Major changes to this section.
 A grouping of these disorders will be termed
Obsessive-Compulsive Spectrum Disorders
 Delete Agoraphobia without history of panic
disorder
 Numerous clarifications and changes to almost all
diagnoses in this category
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Social Phobia: now includes avoidant disorder
of childhood.
Specific Phobia was called Simple Phobia:
must now have marked excessive or
unreasonable fear. Based on research, now
added sub-types.
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Obsessive-Compulsive Disorder: the
definition between the obsession and
compulsion has been clarified, the obsession
causes distress and the compulsion is a way
to try to handle it.
New Name:
Anxiety and Obsessive-Compulsive Spectrum
Disorders
 Will also include trichotillomania and possible other
conditions
 Obsessions to be described as urges rather than
impulses
 Term “impulses” is problematic as how do you
distinguish them from impulse control disorders,
so will change term
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Panic Disorder With or Without
Agoraphobia: recent attacks involving at
least one month of consistent concern, the
thresholds have been changed for both.
Agoraphobia with History of Panic Disorder:
fear of being in places where escape may be
difficult.
Generalized Anxiety Disorder: now includes
over-anxious disorder.
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Post-Traumatic Stress Disorder: symptoms must last at
least one month, if more that 6 months after event
should specify delayed onset (no longer must be must
be outside of range of usual experience, often relive
situation, now has acute and chronic specified, must
cause distress).
Acute Stress Disorder: This new category was added
into the DSM-IV to address acute reactions to extreme
stress (occurring within four weeks of the stressor and
lasting from 2 days to 4 weeks). This may help predict
the development of PTSD.
The trauma experienced in acute stress disorder will
not include:
Witnessing events on television
Witnessing events through electronic media
 Will also drop the criteria that the person must
experience intense fear
 Symptoms may no longer need to involve feelings of
dissociation
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Developmental manifestations of PTSD are still being
developed.
The term 'developmental manifestation' in DSM-5 refers
to age-specific expressions of one or another criteria
that is used to make a diagnosis across age groups.
For children, inclusion of loss of a parent or other
attachment figure is being considered.
The optimal number of required symptoms for both
adults and children will be further examined with
empirical data.
 New
disorder proposed:
Hoarding Disorder
GENERIC/BRAND
DURATION OF ACTION DOSE (MG)
Librium/Temezepam
Long Acting, 15-75 mg day
Valium/Diazepam
Long Acting, 4-30 mg day
Dalmane/Flurazepam
Long Acting, 15-30 mg day
Xanax/Alprazolam
Short Acting, 0.5-1.5 mg day
Restoril/Temazepam
Short Acting, 15 - 30 mg day
Halcion/Triazolam
Short Acting, 0.125 - 0.5 mg
Serax/Clorazepate), Tranxene/Diazepam,
Klonopin/Clonazepam
The benzodiazepine is a central nervous system
depressant so do not mix it with alcohol or
significant depression can result.
Consider Buspar (Buspirone HCL) if history of
drug seeking or abuse behavior is suspected.