The DSM 4 Anyone got a lifeboat?

See The Pen? Write it down… Write it down…

What is it? The Diagnostic and Statistical Manual of Mental Disorders The Diagnostic and Statistical Manual of Mental Disorders Used by medical and mental health professionals to diagnose disorders of mental health, development, and social adjustment Used by medical and mental health professionals to diagnose disorders of mental health, development, and social adjustment

Where are We? Current version Current version Created by the American Psychiatric Association Created by the American Psychiatric Association Based on work of Emil Kraepelin - Late 1800s to early 1900s

How is it used Used to classify seemingly not normal development or behaviour by placing it in a disorder or disease Used to classify seemingly not normal development or behaviour by placing it in a disorder or disease You must meet a specific number of criteria to be diagnosed with a disease or disorder You must meet a specific number of criteria to be diagnosed with a disease or disorder

The 5 Axis Approach Axis I Clinical syndromes and V-Codes Axis II Developmental and Personality Disorders Axis III Physical disorders Axis IV Severity of Psychosocial Stressors Axis V Global Assessment of Functioning

New Inclusions Appendix A Controversial new disorders Appendix B Decision Trees Appendix C Glossary of Technical Terms

New Version Coming in 2012 Is it soon enough?

“Classic” ADHD? Dennis the Menace Dennis the Menace Impulsive Impulsive Lack of Consequence Lack of Consequence Unable to Maintain Focus Unable to Maintain Focus Short Term Memory Short Term Memory Difficulty Waiting Turn Difficulty Waiting Turn Interupts Interupts

Who tends to get a diagnosis? Some interesting statistics to think about… Some interesting statistics to think about… According to [neurologist Dr. Fred] Baughman, 500,000 children [in the USA] were diagnosed ADHD in 1985 and between 5 and 7 million were today. According to [neurologist Dr. Fred] Baughman, 500,000 children [in the USA] were diagnosed ADHD in 1985 and between 5 and 7 million were today. Schizophrenia affects 1% of the Canadian population. Schizophrenia affects 1% of the Canadian population.

About 1% of Canadians will experience bipolar disorder (or "manic depression"). About 1% of Canadians will experience bipolar disorder (or "manic depression").depression African Americans may be less likely to suffer from major depression and more likely to suffer from phobias African Americans may be less likely to suffer from major depression and more likely to suffer from phobias Men from Black Caribbean, Black African, and other Black groups were more likely than other groups to have been detained under the Mental Health Act Men from Black Caribbean, Black African, and other Black groups were more likely than other groups to have been detained under the Mental Health Act Men from Black CaribbeanMental Health Act 1983 Men from Black CaribbeanMental Health Act 1983

The risk of suicide in federal prisons remains "unacceptably high" The risk of suicide in federal prisons remains "unacceptably high" Government inaction puts inmates at risk: Prison watchdog By Janice Tibbetts, Canwest News Service Government inaction puts inmates at risk: Prison watchdog By Janice Tibbetts, Canwest News Service

So… What are the factors that can lead to a diagnosis?

Advantages People get help People get help Treatments are available Treatments are available Treatments very from medical, to analysis, to therapy, to counseling, to some combination Treatments very from medical, to analysis, to therapy, to counseling, to some combination Funding Funding

Disadvantages Not reliable enough Not reliable enough Assumes western culture Assumes western culture Child and adolescent are not considered enough Child and adolescent are not considered enough Too medical Too medical

But…Remember Dennis?

Can he have a…?

Assessment Based on what you know – if you had something that could be considered a “disorder”, would you want a doctor to use the DSM IV with you? Include consideration of advantages and disadvantages in your answer. Based on what you know – if you had something that could be considered a “disorder”, would you want a doctor to use the DSM IV with you? Include consideration of advantages and disadvantages in your answer. Outcomes Covered: Outcomes Covered: Identify various psychological disorders and the corresponding therapies Identify various psychological disorders and the corresponding therapies