The DSM

Question 1

What is the definition of a mental illness?

Answer 1

Clinically significant behavioral or psychological syndrome associated with distress, disability, or increased risk of suffering, pain, death, disability, or important loss to freedom

Question 2

What are the important exclusions to mental illness?

Answer 2

1. Must not be an expected response - i.e. bereavement

2. Disturbance is not only between the individual and society (i.e. criminality, political, religious, or sexual)

Question 3

What are the three categories of mental illness?

Answer 3

1. Depressive disorders
2. Substance use disorders
3. Cognitive disorders

Question 4

What is meant by the “etiological neutrality” of the DSM?

Answer 4

DSM-5 attempted to no longer bias their pathogenesis descriptions towards psychoanalytic theory, and chooses to adopt the more neutral bio-psycho-social model, improving diagnostic standards for research

Question 5

What is one thing that is definitely not in the DSM?

Answer 5

Information regarding treatment of these diseases

Question 6

How is the DSM organized?

Answer 6

Based on development and lifespan

• > development disorders first (i.e. intellectual disability)
• > disorders of elderly last (i.e. cognitive)

Question 7

What is other specified disorder vs unspecified disorder?

Answer 7

Other specified - Allows communication of why criteria for a full diagnosis is not met (i.e. depressive disorder with insufficient symptoms)

Unspecified - physician chooses not to document which criteria are not met

Question 8

What is the usefulness of the DSM?

Answer 8

It is a “living document” for clinical utility of accurate diagnosis and subsequent treatment of patients. It is based on solid research.

Question 9

What are the criticisms of DSM?

Answer 9

1. Diagnosis rate is high -> 25% will qualify for a mental disorder. Is anyone normal? Makes it easy to prescribe medications
2. Are all diagnoses the same across cultures, races, and ethnicities?

Question 10

What model guides the interview and treatment of the patient?

Answer 10

The biopsychosocial model

Question 11

What factors full under the biological factors?

Answer 11

1. Current physical disorders / HPI
2. Prenatal history including infections and exposures, and childhood illnesses
3. GENETIC factors
4. Medications currently taking

Question 12

What factors fall under psychological factors?

Answer 12

1. Experiences throughout life (interpersonal, not health-wise which would be biological)
2. Current psychological strengths and weaknesses (i.e. resiliency)

Question 13

What factors fall under social factors?

Answer 13

1. Current family relationships and interactions (not experiences, which would be psychological factors)
2. Supports and stressors
3. Racial, religious, socioeconomic, and cultural background -> think social determinants of health

Question 14

What type of doctor treats the most mental illness?

Answer 14

PCPs