Behavioral Health Exam 1 Study Guide PDF

Behavioral Health Exam 1 Study Guide (what is in red is what the previous class made red, not me) Introduction Mental disorders defined by DSM 5 o Clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in...

Behavioral Health Exam 1 Study Guide (what is in red is what the previous class made red, not me) Introduction Mental disorders defined by DSM 5 o 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 o Associated with significant distress or disability in social, occupation, or other important activities Leading cause of psychiatric disability in the world (Class Q) o Depression is the leading cause of disability worldwide, and is a major contributor to the global burden of disease Majority of mental illness begins by what age (Class Q) o 24 1 in 5 US adults experience mental illness (Highlighted Stat) ½ of chronic mental illness by age 14, ¾ by age 24 (Highlighted Stat) 19% of common mental illnesses are anxiety disorders (Highlighted Stat) 32% of adults who report mental illness are mixed/multiracial (Highlighted Stat) LGBTQ diagnosis of psychiatric illness compared to the general population o LGBTQ individuals are 2 or more times more likely as straight individuals to have a mental health condition (Class Q) o LGBTQ youth are 2 - 3 times more likely to attempt suicide than heterosexual youth (We don’t have this) o 11% of transgender individuals reported being denied care by mental health clinics (we don’t have this) o 44% of lesbian, gay, and bisexual adults report mental illness (Highlighted Stat) o Lesbian, Gay, bisexual group has highest prevalence of mental illness (Class Q) o 42% of LGBTQ youth seriously considered attempting suicide, including >50% of transgender and nonbinary youth (Highlighted Stat) Potential problems with using DSM 5 o Pathologizes normal, expected behavior ▪ Disruptive mood disorder (temper tantrum vs. mental disorder) ▪ Normal grief vs. major depressive disorder ▪ Minor neurocognitive disorder vs. mild cognitive impairment ▪ Binge eating vs. enjoying food ▪ GAD vs. worries of everyday life o Encouraging Medication use w/ pressure from pharmaceutical companies ▪ Misuse of stimulants in ADD o Under-diagnosing ▪ New definition of autism lead to funding loss d/t less people being dx o Over-diagnosing ▪ Possible inflation of PTSD in court o The DSM era has not deceased large-scale reduction in the morbidity associated w/ major mental disorders (cardiovascular disease, colon cancer, chronic respiratory disease)  7. Chronic substance abusers lumped with one time drug user 8. Behavioral addiction dx overused Specifiers in the DSM 5 o Syntonic vs. Dystonic ▪ Ego syntonic vs dystonic definition Syntonic: heavily defensive, rationalized behaviors and no motivation to change, angry about being told what to do, resign to his/her fate, sees benefits in current behaviors, lacks insight into the condition-typical for children, resistant to therapy/treatment and often has to be motivated to do so o Pt doesn’t think there is a problem Dystonic: experience significant distress, disability or impairment in functioning. Has no capacity to cope with the condition at the current time. Is motivated for treatment/therapy to improve the situation and condition o Pt knows there is a problem Good/fair insight = Dystonic Poor insight = ambivalence Absent insight = syntonic ▪ A mental health pt who is ego dystonic is more likely to: Be motivated for treatment/therapy (Class Q) o Correlated Disorders and Suicide Risk: each diagnosis will comment of correlation among disorders o Respect for age, gender, and culture: each diagnosis will incorporate developmental symptom manifestation, gender specific disorders, cultural sensitivity in regard to certain behaviors ▪ Cultural Formulation Review (CFI): way to interact w/ people culturally Exploring the pts way of being in the world (religion, culture, preferences) o Severity Index Across Time & Circumstances: time and circumstances essential specifiers, will assure that individual does qualify for mental disorder from definition. Severity ranges are mild, moderate, severe, in partial remission, in full remission, *prior history ▪ Coding Specifiers: F31.9 = Unspecified (He put this in red?) Behavioral Health Intro ➔ Mental Disorder- clinically significant disturbance in an individual's cognition, emotion regulation or behavior that reflects dysfunction in psychological, biological or developmental processes underlying mental functioning. A/w significant distress or disability in social, occupational or other activities. ➔ DSM 5 Diagnoses Caveats ◆ Not caused by drug unless it’s substance use disorder dx ◆ Not caused by medical condition or better explained by other condition ◆ All psych disorders are caused by combination of genetic, physical, environmental & psychosocial influences ➔ Mental Illness- an imbalance, lack of peace/well being, mostly unknown cause ➔ NOT a mental disorder ◆ Culturally approved/expected response to stressor ◆ Socially deviant behavior & conflicts primarily b/t individual & society unless deviance results from dysfunction ➔ Half of care received for common psych disorders provided by PCPs, Internal/Emergency medicine or general practice ➔ Depression is leading cause of disability worldwide ➔ Majority of chronic illnesses begins @ 24 y/o ➔ 1 in 5 adults experience mental illness ➔ Anxiety is the most prevalent mental illness in the US (19%) ➔ LGBTQIA are 2x more likely to have a mental condition ➔ 32% multiracial adults & 44% LGBTQIA adults have a mental illness ➔ 50% or less people don’t get treated for their mental illness ➔ 42% LGBTQ youth considered attempting including >50% of transgender & nonbinary youth ➔ DSM 5 provides: common language understood by healthcare providers, Assist in clinical documentation, information to 3rd party payers, relief vs burden of diagnosis ➔ Ego-Dystonic: significant distress/disability/impaired function ◆ Little to no capacity to cope w/ condition ◆ Motivated for tx/therapy to improve situation ◆ Good/Fair insight- ‘I need help’ ➔ Syntonic Patients ◆ Defensive ◆ No motivation to change ◆ Rationalizes behavior ◆ Angry about being told what to do ◆ Resigned to his/her fate ◆ Resistant to therapy ◆ Lacks insight into the condition (usually children) ➔ Poor insight- Ambivalence ➔ Subtypes & Specifiers for DSM 5 Diagnoses: ◆ Syntonic vs dystonic ◆ Associated features & Suicide risk ◆ Respect for age, gender, culture Age: Some diagnoses can’t be done