Margaret L. Bloom – Mastering Differential Diagnosis with the DSM-5: A Symptom-Based Approach

Outline

Quick Review of Using the DSM-5 and ICD-10

• Diagnosis of mental disorders in the U.S.A.
  • Use of two models DSM-5 and ICD-10
  • Use of Specifiers
  • DSM-5 and ICD Coding and Recording
• Web-based DSM-5 Resources
  • Digital Updates
  • DSM-5 Cross-Cutting Symptom Measures and Screening Tools

Four Step Diagnostic Method

• Case 1: Michelle
• Goals of the Clinical Interview
• Steps to a DSM-5 Diagnosis
• Step 1: Gathering Client Information and Behavior Sample
  • Interview Phases I, II, and III
  • Using Client Observation Sheet in Step 1
  • Using assessment tools to supplement data
  • Sources of Error to avoid in the clinical interview
• Step 2: Identifying Key DSM-5 Symptom Clusters
• Step 3: Differential Diagnosis List
  • Considering medical and substance causes of symptoms
  • Assessments for Alcohol, Drug and Tobacco use
  • Differential Diagnosis Guides in DSM-5 Manual
• Step 4: Initial DSM-5 Diagnosis
  • Comorbidity considerations

Differential Diagnosis of Specific DSM-5 Mental Disorders
Clients with Symptoms of Depression

• Key symptoms of Depression and Dysphoria
• Substance-Related and Medical conditions with Depressive Symptoms
• Mental Disorders with Symptoms of Depression
• Diagnosis Challenge: Case 2: Marilyn Wilson
• Differentiating Disorders with Symptoms of Depression
• Frequent Comorbid Disorders

Clients with Fear and Anxiety

• Key Symptom Patterns of Anxiety
• Substance-Related and Medical conditions with Anxiety Symptoms
• Mental Disorders with Symptoms of Anxiety
• Differentiating by Patterns of Anxiety symptoms
• Diagnosis Challenge: Case 3: Hunter
• Specific Differential Diagnoses
  • Generalized Anxiety Disorder
  • Panic Disorder
  • Frequent Comorbid Disorders

Clients with Abnormal or Impaired Cognition

• Diagnostic Challenge: Case 4: Christa
• Sorting Patterns of Psychosis
• Substance-Related and Medical conditions with Psychosis symptoms
• DSM-5 mental disorders with psychosis symptoms
• Sorting Patterns of Cognitive Deficit: Case 5: Bob Gray
• Substance-Related and Medical conditions that produce cognitive deficits
• Differential Diagnosis when Cognitive Deficits as a Key Symptom​
  • Neurodevelopmental Disorders
  • Neurocognitive Disorders

Clients with Repetitive Thoughts and Behaviors

• Diagnostic Challenge: Case 6: Devin
• Mental Disorders with Symptoms of Repetitive Thoughts and Behaviors
• Substance-Related and Medical conditions associated with Repetitive Thoughts and Behaviors
• Frequent Comorbid Disorders

Clients with Disruptive Behaviors

• Disruptive Behavior Symptoms
• Diagnostic Challenge: Case 7: Natalia is a Problem
• Substance-Related and Medical conditions associated with Disruptive Behaviors
• Differential Diagnosis by Patterns of Disruptive Behavior
  • Defiant, Angry and Vindictive
  • Impulsive and/or Antisocial
• Comorbidity in DSM-5 Disruptive, Impulse Control, and Conduct Disorders