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Psych Notes Clinical Pocket Guide.
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,IntroductionThe DSM-5 has modified previous classifications, as well as added new classifica-
tions such as Neurocognitive Disorders, Neurodevelopmental Disorders, and Trauma
and Stressor-Related Disorders, based on new scientific research and evidence-
based practice. New Disorders have also been added including Hoarding Disorder,
Binge Eating Disorder, and Disruptive Mood Dysregulation Disorder to name a few.
The Bereavement Exclusion for Major Depressive Disorder (MDD) has been eliminat-
ed. This exclusion did not allow for a diagnosis of MDD for two months after the loss
of a loved one. Now a grieving client can be diagnosed with MDD and treated for
major depression before the two-month exclusionary period is up.
The American Psychiatric Association wants to focus on and is moving toward a
better understanding of cultural factors and a cultural understanding of mental ill-
ness. It wants to focus on the patient’s understanding of the illness, the influence
of others in the family, a cultural definition of the problem, and factors affecting
coping and help seeking, using the Cultural Formulation Interview (CFI). The CFI
will be included in DSM-5’s Section III: Emerging Measures and Models.
Severity scales will prove of greater importance. Using severity scales will allow for
a way to demonstrate improvement or worsening on a continuum over time.
Severity scales will be used for evaluating disorders such as Autism Spectrum
Disorder and Gambling Disorder. Primary care professionals may screen for disor-
ders/severity using self-administered Patient Health Questionnaires (phqscreen-
ers.com) or use the many Psychiatric Rating Scales available in the Assess Tab.
Dimensional/Cross-cutting Assessments – DSM-5 aimed to focus on all symptoms
as well as symptoms that show up in many diagnoses (e.g., depression, anxiety,
anger/irritability, sleep, and substance-use issues) and is leaning away from a pure
criteria-based approach (e.g., 3 or more of the following) and single diagnosis
approach, though this is just the beginning. These Assessment Measures will be
included in DSM-5’s Section III: Emerging Measures and Models.
The APA also wanted to change the personality disorders to a “hybrid-dimensional”
approach, eliminating 4 of the 10 PDs, but decided to retain the PDs as they existed in
the DSM-IV-TR, believing such a change was too drastic and required more time and
research. The alternative DSM-5 model for personality disorders will be included in
Section III of the DSM-5. The Multiaxial System (Axes I-V) and Global Assessment of
Functioning (GAF) scale have been eliminated from the DSM-5.
Further discussion of the DSM-5 changes can be found in the Disorders/
Interventions Tab.
Dedication
PsychNotes 4e is especially dedicated to my son Jorgen David Pedersen, Jessica, and
Isaac. Special thanks to Christina Snyder; also thanks to William Welsh, Lisa Thompson,
Sam Rondinelli, Ellen Thomas, and of course Bob Martone and Julia Carp.
PsychNotes has been translated into Chinese, Portugese, Turkish, and Hungarian
languages.
, 4th Edition
Psych
Notes Clinical Pocket Guide
Darlene D. Pedersen, MSN, APRN,
PMHCNS
Purchase additional copies of this book at your
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by shopping online at www.fadavis.com or by
calling 800-323-3555 (US) or 800-665-1148 (CAN)
A Davis’s Notes Book
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Copyright © 2014 by F. A. Davis Company
All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored
in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, pho-
tocopying, recording, or otherwise, without written permission from the publisher.
Printed in China
Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1
Publisher, Nursing: Robert G. Martone
Manager, Freelance Development: William F. Welsh
Assistant Project Editor: Christina Snyder
Design and Illustration Manager: Carolyn O’Brien
As new scientific information becomes available through basic and clinical research, recom-
mended treatments and drug therapies undergo changes. The author(s) and publisher have
done everything possible to make this book accurate, up to date, and in accord with accepted
standards at the time of publication. The author(s), editors, and publisher are not responsible
for errors or omissions or for consequences from application of the book, and make no war-
ranty, expressed or implied, in regard to the contents of the book. Any practice described in this
book should be applied by the reader in accordance with professional standards of care used
in regard to the unique circumstances that may apply in each situation. The reader is advised
always to check product information (package inserts) for changes and new information
regarding dose and contraindications before administering any drug. Caution is especially
urged when using new or infrequently ordered drugs.
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