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Miscellaneous psychiatric disorders

Miscellaneous psychiatric disorders

Published in: Health & Medicine

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  • 1. Other Conditions That May Be The Focus of Clinical Attention
  • 2. Mental disorder affecting medical condition Axis I disorder such as major depressive disorder delaying recovery from myocardial infarction. Psychological symptoms affecting medical conditions Depressive symptoms delaying recovery from surgery; anxiety exacerbating asthma. Personality traits or coping style affecting medical condition Pathological denial of the need for surgery in a patient with cancer; hostile, pressured behavior contributing to cardiovascular disease. Maladaptive health behaviors affecting medical condition lack of exercise, unsafe sex, overeating, etc. Stress-related physiological response affecting medical condition Ulcer, hypertension, arrhythmia, or tension headaches Other unspecified psychological factors affecting med. Condition Interpersonal, cultural, or religious factors Psychological Factors Affecting Medical Condition
  • 3. Medication-Induced Movement Disorders
    • Neuroleptic-Induced Parkinsonism
    • Parkinsonian tremor, muscular rigidity, or akinesia developing within a few weeks of starting or raising the sdose of a neuroleptic medication, or after reducing a medication to treat EPS.
    • Neuroleptic-Induced Acute Dystonia
      • Characterized by abnormal positioning of the head and neck in relation to the body.
      • Spasms of the jaw muscles
      • impaired swallowing, speaking, or breathing
      • slurred speech due to enlarged tongue
      • tongue protrusion or tongue dysfunction
      • eyes deviated up, down, or sideward
      • abnormal positioning of the distal limbs or trunk
  • 4.
    • Neuroleptic Malignant Syndrome
    • Development of severe muscle rigidity and elevated temperature
    • with two or more of the following:
      • diaphoresis (artificially induced sweating)
      • dysphagia (difficulty swallowing)
      • tremor
      • incontinence
      • changes in consciousness ranging from confusion to coma
      • mutism
      • tachycardia (rapid heartbeat)
      • elevated or labile blood pressure
      • leukocytosis (indication of infection from blood work)
      • lab evidence of muscle injury (elevated CPK)
      • CPK = creatine phosphokinase
    Medication-Induced Movement Disorders
  • 5. Medication-Induced Movement Disorders
    • Neuroleptic-Induced Acute Akathisia
      • fidgety movements or swinging of the legs
      • rocking from foot to foot while standing
      • pacing to relieve restlessness
      • inability to sit or stand for at least several minutes
    • Neuroleptic-Induced Tardive Dyskinesia
    • Involuntary movements of the tongue, jaw, trunk, or extremities.
      • choreiform movements (rapid, jerky, nonrepetitive)
      • athetoid movements (slow, sinuous, continual)
      • rhythmic movements (stereotypies)
  • 6. V - Codes (Relational Problems) May be comorbid condition with another classified disorder. Insurance carriers will not pay for most of these. Relational Problem Related to a Mental Disorder - impaired interaction with family members Parent-Child Relational Problem - impaired communication, overprotection, inadequate discipline Partner Relational Problem - poor interaction between spouses or partners Sibling Relational Problem - causes significant impairment in individual/family functioning Relational Problem NOS - not classified above, (e.g., difficulties with co-workers)
  • 7. V - Codes (Abuse or Neglect) Physical Abuse of Child Sexual Abuse of Child Neglect of Child Physical Abuse of Adult Sexual Abuse of Adult
  • 8. V - Codes (Additional Conditions) Noncompliance With treatment Malingering Adult Antisocial Behavior Child or Adolescent Antisocial Behavior Borderline Intellectual Functioning (coded on Axis II) Age-Related Cognitive Decline Bereavement
  • 9. V - Codes (Additional Conditions) Academic Problem Occupational Problem Identity Problem (not a V-code) 313.82 Religious or Spiritual Problem Acculturation Problem Phase of Life Problem V71.09 No Diagnosis or Condition on Axis I or II 799.9 Diagnosis Deferred on Axis I or II
  • 10. The End