DSM IV-TR Review

Abstract: The DSM IV TR states all of the diagnostic criteria for every mental disorder known to the United States of America. It is divided into 3 specific sections, includes explanations for each disorder, and includes differential diagnoses for each disorder. Here we will distinguish the difference between 4 different diagnoses.
Opening thought: The DSM IV-TR is a manual that gives criteria with which to diagnose mental disorders. Here, we will talk a bit about what is found inside of this manual.

Factual paragraph #1: The DSM divides mental disorders into 3 different sections: mental disorders due to a general medical condition, substance related mental disorders, and primary mental disorders. Mental disorders due to a general medical condition are mental disorders that are directly caused or affected by a medical condition. Substance related mental disorders are disorders that stem from the use of substances, and primary mental disorders are all the rest.

Factual paragraph #2: Before diagnosing a disorder as a primary mental disorder a social worker must rule out the possibility that a client’s symptoms are caused by a general medical condition or by a substance. Only then can a person be sure that mental disorder is not due to a medical condition or use of a substance. Exclusion criteria in the DSM are criteria that speak of a mental disorder that only shows symptoms while another disorder is present. These instances cannot be diagnosed as a primary either.

Factual paragraph #3: With every disorder comes specific symptoms. Not every disorder has the same system, but some do share symptoms with other disorders. There are specific symptoms associated with certain mental disorders. Hallucinations are sensory perceptions occurring without external stimulation of the associated sensory organ. They are different from illusions, where stimuli are present but misinterpreted by the affected individual.

Factual paragraph #4: Let’s explore differential diagnosis beginning with the mood disorder. First, Major Depressive Disorder and Dysthymic Disorder differ in level of severity and persistence. More specifically, Dysthymia includes chronic depressive symptoms that occur more often than not for at least two years, while major depressive symptoms are more severe and not as long-lived. Dysthymia is less likely to include vegetative symptoms such as sleep, eating, and psychomotor disturbances.

Factual paragraph #5: A social worker must know how to distinguish between major depression and bereavement. Bereavement can include a major depressive episode, but it cannot include any of the following symptoms- feelings of guilt unrelated to preventing loved one’s death, thoughts of death other than normal, survivor feelings, morbid preoccupation with worthlessness, significant psychomotor retardation, prolonged and significant impairment in functioning, or hallucinatory experiences other than the occasional thinking that he has seen or heard the deceased person. The presence of any one of these symptoms shows the social worker that the client is suffering from at least one depressive disorder. Major depressive disorder usually is not diagnosed if the symptoms are not still there 2 years after the loss.

Factual paragraph #6: Major depressive disorder can be difficult to distinguish from a psychotic disorder if the depressed client’s symptoms include delusions, hallucinations, and catatonic features. In Major Depressive Disorder, the psychotic symptoms occur exclusively during periods of mood disturbance.

What is most interesting about this podcast? The most interesting part in this podcast was the differential diagnosis between major depressive disorder and dysthymic disorder.

What can you share with other students about this podcast? Upon listening to this podcast, I would tell students to be sure to learn the differences between similar diagnoses of mental disorders before going on with any interview.

Concluding Sentence: The Diagnostic and Statistical Manuel outlines different disorders. It is the duty of the social worker to learn the difference of differential diagnosis and be cognizant of the possibility of diagnosing anyone else as wrong.

References:

Clinical Diagnosis & the DSM-IV-TR. Association of Social Work Boards, Audio.