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Introduction
The
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
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A Davis’s Notes Book
Darlene D. Pedersen, MSN, APRN,
PMHCNS
F. A. Davis Company
1915 Arch Street
Philadelphia, PA 19103
www.fadavis.com
Copyright © 2014 by F. A. Davis Company
All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored
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Assistant Project Editor: Christina Snyder
Design and Illustration Manager: Carolyn O’Brien
As new scientific information becomes available through basic and clinical research, recom-
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BASICS
ASSESS DISORDERS/ DRUGS/
INTERV
LABS
DRUGS A-Z
CRISIS
GERI
TOOLS/
INDEX

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