This book reflects the discontent of many mental health professionals with the Diagnostic and Statistical Manual-IV (DSM-IV), which has come to provide the foundation for managed care's fragmented, symptomatic treatment approaches. Some of the criticisms that the contributors note are (a) the excessive reliance of the DSM on the medical model; (b) an excessive focus on reliability at the expense of validity and a predominance of the categorical, rather than the dimensional, approach to diagnosis; (c) arbitrary cut-off points for disorders; (d) a significant problem with comorbidity; and (e) a steady proliferation of labels for the personality disorders. The contributors explore this and other criticisms of the DSM system and propose new ways of looking at diagnosis and treatment. This thought-provoking volume proposes the ultimate goal of finding a diagnostic process that can be meaningfully related to what clinicians do in their actual work with patients.
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
Designed to take the reader step-by-step through the diagnostic process for every DSM-IV category, the author clearly explains how to derive a complete, five-axis diagnosis. Each set of criteria is discussed in detail, illustrated by a vivid clinical vignette and interpreted in lucid terms. With this logical organization, the book provides a full course in diagnostic thinking, presented by a master clinician who has evaluated and treated over 15,000 patients.
The most up-to-date coverage on adult psychopathology Adult Psychopathology and Diagnosis, Fifth Edition offers comprehensive coverage of the major psychological disorders and presents a balanced integration of empirical data and diagnostic criteria to demonstrate the basis for individual diagnoses. The accessible format and case study approach provide the opportunity to understand how diagnoses are reached. Updated to reflect the rapid developments in the field of psychopathology, this Fifth Edition encompasses the most current research in the field including: A thorough introduction to the principles of the DSM-IV-TR classification system and its application in clinical practice The biological and neurological foundations of disorders and the implications of psychopharmacology in treatment Illustrative case material as well as clinical discussions addressing specific disorders, diagnostic criteria, major theories of etiology, and issues of assessment and measurement Coverage of the major diagnostic entities and problems seen in daily clinical work by those in hospitals, clinics, and private practice A new chapter on race and ethnicity by renowned expert Stanley Sue
A riveting exploration of the most difficult and important part of what doctors do, by Yale School of Medicine physician Dr. Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration for the hit Fox TV series House, M.D. "The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patients in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, ‘What is wrong with me?’ They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar place a name, to know it—on some level—restores a measure of control, independent of whether or not that diagnosis comes attached to a cure. Because, even today, a diagnosis is frequently all a good doctor has to offer." A healthy young man suddenly loses his memory—making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment—only to have their symptoms mysteriously return. A young woman lies dying in the ICU—bleeding, jaundiced, incoherent—and none of her doctors know what is killing her. In Every Patient Tells a Story, Dr. Lisa Sanders takes us bedside to witness the process of solving these and other diagnostic dilemmas, providing a firsthand account of the expertise and intuition that lead a doctor to make the right diagnosis. Never in human history have doctors had the knowledge, the tools, and the skills that they have today to diagnose illness and disease. And yet mistakes are made, diagnoses missed, symptoms or tests misunderstood. In this high-tech world of modern medicine, Sanders shows us that knowledge, while essential, is not sufficient to unravel the complexities of illness. She presents an unflinching look inside the detective story that marks nearly every illness—the diagnosis—revealing the combination of uncertainty and intrigue that doctors face when confronting patients who are sick or dying. Through dramatic stories of patients with baffling symptoms, Sanders portrays the absolute necessity and surprising difficulties of getting the patient’s story, the challenges of the physical exam, the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors. In Every Patient Tells a Story, Dr. Sanders chronicles the real-life drama of doctors solving these difficult medical mysteries that not only illustrate the art and science of diagnosis, but often save the patients’ lives.
The United States Social Security Administration (SSA) administers two disability programs: Social Security Disability Insurance (SSDI), for disabled individuals, and their dependent family members, who have worked and contributed to the Social Security trust funds, and Supplemental Security Income (SSSI), which is a means-tested program based on income and financial assets for adults aged 65 years or older and disabled adults and children. Both programs require that claimants have a disability and meet specific medical criteria in order to qualify for benefits. SSA establishes the presence of a medically-determined impairment in individuals with mental disorders other than intellectual disability through the use of standard diagnostic criteria, which include symptoms and signs. These impairments are established largely on reports of signs and symptoms of impairment and functional limitation. Psychological Testing in the Service of Disability Determination considers the use of psychological tests in evaluating disability claims submitted to the SSA. This report critically reviews selected psychological tests, including symptom validity tests, that could contribute to SSA disability determinations. The report discusses the possible uses of such tests and their contribution to disability determinations. Psychological Testing in the Service of Disability Determination discusses testing norms, qualifications for administration of tests, administration of tests, and reporting results. The recommendations of this report will help SSA improve the consistency and accuracy of disability determination in certain cases.
Making Sense of Psychiatric Diagnosis aims to cut through the misinformation, stigma, and assumptions that surround mental illness and give a clear picture of what mental illness really is. The book pairs diagnostic criteria and descriptions for a variety of mental illnesses in the DSM-5 with nineteen first-hand narrative accounts of what it’s like to live with those conditions. The book is also infused with the author’s own experience as a mental health nurse and person living with depression. With the fusion of diagnostic information, clinical experience, and lived experience, this book offers a unique, well-rounded perspective on the reality of mental illness.
