Mental disorder

“syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning” (p. 20)

Almost half of all Americans (46.4%) will meet the criteria for a mental, emotional, or behavioral disorder sometime during their lives

The various disorders are catalogued and described in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

standard resource for clinical diagnosis in this country. The first edition of the DSM came out in 1952 and has undergone many revisions during the last 50 years.

Purposes of diagnosis

Defines categories to give structure to research

Promotes communication among professionals

Reimbursement for 3rd party payers

Provides guideline for decisions about intervention

The diagnostic categories enable social workers to help clients, and possibly also their families, learn about the nature of the person’s problems.

DSM and Social Work

Preeminence of medical profession

State licensing exams

Social Workers in MH settings

social workers should be able to recognize the symptoms of possible disorders in their clients and appropriately refer them for treatment services.

Proliferation of DSM resources

Promotes status

How could mental disorders be classified? Etiology

Continuums

Clinical Disorders

Adjustment Disorders

Primary

+Adjustment Disorders

within 3 mos of stressor once stressor and its consequences end, symptoms must not

persist longer than additional 6 mos either symptoms:

distress that markedly exceeds what would normally be expected from such a stressor

materially impaired job, academic or social functioning

309.0 w/Depressed Mood

309.24 w/Anxiety

309.28 w/Mixed anxiety and depressed mood

309.3 w/Disturbance of conduct

309.4 w/mixed disturbance of emotions and conduct

309.9 unspecified

Acute or chronic

Adjustment Disorders, cont.

+Additional codes that are primary

No diagnosis or condition V71.09

Diagnosis or condition deferred 799.9

diagnosis first for current condition

least restrictive

when uncertain “provisional”

severity criteria

hierarchical principles medical conditions and substance use disorders preempt most pervasive disorders

Guidelines

+Secondary

disorders with more of a constitutional basis

includes the personality disorders and mental retardation.

chronic conditions

If a personality disorder is the most important reason for the client’s seeking evaluation, the social worker should add the term “principal diagnosis.”

+Medical conditions

general medical conditions

source of the information should also be listed here