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2 results

  • Chapter 12 - Mental Health Classifications in Primary Care

  • Edited by Peter Tyrer, Emeritus, Imperial College London
  • Book:
    Making Sense of the ICD-11
    Published online:
    13 October 2023
    Print publication:
    26 October 2023, pp 137-144

  • Summary

    Primary care practitioners are expected to diagnose and manage common mental health problems. An effective mental health classification for primary care needs to enable differentiation of normality from disease, clarify interactions between mind and body and offer guidance on treatment or referral. Four current options are considered. SNOMED CT is a structured clinical vocabulary embedded in GP electronic record systems: despite widespread use it lacks clarity on disease status and diagnostic precision. DSM-5 is ambiguous on the borders of disease and normality, and takes a cognitive approach towards somatic diagnoses. The 3rd edition of the International Classification for Primary Care (ICPC-3) emerges from the experience of primary care consultations and includes both patient and physician perspectives. ICD-11 for primary care (PHC) is a work in progress: some elements, such as eating disorders, simplify ICD-11 categorizations; others, such as anxious depression and bodily stress syndrome, differ from ICD-11. While field trials offer rationales for these differences, uncertainties remain about their diagnostic status and about their impact on the ability of primary care and specialist mental health services to integrate. To enable more effective nosology and integration of care, greater convergence is recommended between ICPC-3 and ICD-11 PHC.

  • Role of DSM5 Anxious Distress Specifier Interview in symptoms severity and medication adherence in 1st episode mania

  • S. El Sayed, S. Gomaa, Z. Gomaa
  • Journal:
    European Psychiatry / Volume 65 / Issue S1 / June 2022
    Published online by Cambridge University Press:
    01 September 2022, pp. S400-S401
    • Article
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      • Open access
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  • Introduction

    -Anxious Distress Specifier is one of the newly added specifier in diagnosis and managment of bipolar disorder.This unique item may paly a role in not only the symptoms severity but also the degree of adherence to the psychotropics. -DSM5 Anxious distress specifier is not well studied in the 1st manic episode of bipolar disorder.

    Objectives

    1-To study the role of DSM5 Anxious Distress Specifier in the symptoms severity of 1st diagnosed manic episode 2-To investigate its role in medication adherence in thses patients

    Methods

    1-DSM 5 Anxious distress specifier interview which includes 5 items : a- Keyed up or tense b-Restlessness c-Impaired concentration. d-Sense of foreboding e-Loss of control 2-The Young Mania Rating Scale (YMRS) is one of the most frequently utilized rating scales to assess manic symptoms. The scale has 11 items and is based on the patient’s subjective report of his or her clinical condition 3-Drug Attitude Inventory:consists of a questionnaire that is completed by the patient, pertaining to various aspects of the patient’s perceptions and experiences of treatment.

    Results

    1-There is a positive correlation between the mean score of Young mania Rating scale in 1st episode manic patients and the mean score of DSM5 Anxious Distress specifier Interview 2-The presence of high score of DSM5 Anxious Distress Specifier Interview is positively correlated to the mean score of Drug Attitude Inventory during the follow up visits after controlling the 1st episode mania

    Conclusions

    The presence of high levels of Anxious Distress in the 1st episde mania affected the symptoms severity and medication adherence

    Disclosure

    No significant relationships.