Diagnostic Formulation - Eppp Skills

1. What is the DSM-5-TR term for a diagnosis assigned when full criteria are not met and the reason is not specified?

   "Unspecified" disorder. Applies when symptoms cause distress or impairment but insufficient information prevents specifying the reason for not meeting criteria.

2. Which DSM-5-TR category should be used when symptoms are intentionally produced for external incentives?

   Malingering (V/Z code; condition that may be a focus of attention). Classifies intentional feigning of symptoms motivated by external gains, such as avoiding responsibilities.

3. Which DSM-5-TR principle requires that symptoms cause clinically significant distress or impairment?

   Clinical significance criterion (distress or impairment). Ensures that only symptoms leading to significant suffering or functional disruption qualify for a disorder diagnosis.

4. Which DSM-5-TR disorder involves intentional symptom falsification without obvious external incentives?

   Factitious Disorder. Involves deceptive fabrication of symptoms to assume the sick role, lacking evident external rewards.

5. What is the DSM-5-TR definition of a mental disorder (core elements, in one phrase)?

   Clinically significant disturbance causing distress/impairment; not expected response. Captures the essence of a mental disorder as a syndrome reflecting dysfunction that is not merely a culturally expected reaction.

6. Identify the DSM-5-TR diagnosis: intrusive memories/avoidance plus mood/cognition and arousal changes after trauma.

   Posttraumatic Stress Disorder (PTSD). Encompasses re-experiencing, avoidance, negative alterations in cognition/mood, and hyperarousal following trauma exposure.

7. Identify the DSM-5-TR diagnosis: fear of scrutiny with avoidance, persistent for at least 6 months.

   Social Anxiety Disorder. Marked by intense fear of social situations leading to avoidance and significant interference in daily functioning.

8. What is the most current primary taxonomy used for clinical mental disorder diagnosis in the United States?

   DSM-5-TR. Serves as the latest edition of the American Psychiatric Association's manual for classifying mental disorders in the US.

9. What DSM-5-TR diagnosis is appropriate when a person has delusions for at least 1 month without schizophrenia criteria?

   Delusional Disorder. Applies to isolated delusions without the broader symptom profile or functional impairment required for schizophrenia.

10. Identify the DSM-5-TR diagnosis: 2+ years of depressed mood most days plus 2+ additional symptoms.

    Persistent Depressive Disorder (Dysthymia). Involves chronic low-grade depression with at least two additional symptoms persisting for two or more years.

11. What is the DSM-5-TR term for symptoms resembling a disorder but attributable to another medical condition?

    Disorder due to another medical condition. Attributes psychiatric symptoms to the physiological effects of a general medical condition rather than a primary disorder.

12. What is the DSM-5-TR term for symptoms resembling a disorder but attributable to a substance or medication?

    Substance/Medication-Induced disorder. Distinguishes symptoms directly caused by substance use or medication effects from primary mental disorders.

13. Which DSM-5-TR diagnosis requires at least 1 manic episode at any point in the lifetime?

    Bipolar I Disorder. Established by the presence of at least one full manic episode, regardless of depressive episodes.

14. Which DSM-5-TR diagnosis requires hypomanic episode(s) and major depressive episode(s), with no manic episode history?

    Bipolar II Disorder. Requires history of hypomania and major depression but excludes any manic episodes to differentiate from Bipolar I.

15. Identify the DSM-5-TR diagnosis: excessive anxiety and worry more days than not for at least 6 months.

    Generalized Anxiety Disorder (GAD). Involves uncontrollable worry accompanied by physical symptoms, persisting for six months or more.

16. Which DSM-5-TR diagnosis coding system is used for billing and administrative purposes in the United States?

    ICD codes (ICD-10-CM currently used for billing in the United States). Aligns DSM diagnoses with the standardized coding required for insurance reimbursement and health records in the US.

17. What is the DSM-5-TR term for a diagnosis assigned when full criteria are not met and the reason is specified?

    "Other Specified" disorder. Provides flexibility to diagnose presentations close to a disorder category while specifying why full criteria are unmet.

18. Identify the DSM-5-TR diagnosis: recurrent unexpected panic attacks plus 1+ month worry or maladaptive change.

    Panic Disorder. Features unexpected panic attacks followed by persistent concern or behavioral changes to avoid future attacks.

19. Identify the DSM-5-TR diagnosis: at least 1 week of elevated/irritable mood plus increased energy and impairment.

    Manic Episode (Bipolar I context). Defined by a distinct period of abnormally elevated mood and energy causing significant impairment, key to Bipolar I.

20. Which DSM-5-TR documentation element records psychosocial stressors and environmental problems affecting treatment?

    ICD Z codes (formerly DSM-IV Axis IV psychosocial problems). Capture non-diagnostic factors like relational or economic stressors that influence diagnosis and treatment.

21. Identify the DSM-5-TR diagnosis: at least 4 days of elevated/irritable mood plus increased energy, no marked impairment.

    Hypomanic Episode (Bipolar II context). Characterized by a shorter duration of elevated mood and energy without severe impairment, distinguishing it from mania.

22. Identify the DSM-5-TR diagnosis: obsessions and/or compulsions that are time-consuming or cause distress/impairment.

    Obsessive-Compulsive Disorder (OCD). Defined by recurrent intrusive thoughts and repetitive behaviors that significantly disrupt daily life.

23. What DSM-5-TR tool is used to document symptom severity and functional impact across domains?

    DSM-5-TR dimensional severity specifiers/measures. Allow for quantitative assessment of symptom intensity and disability to enhance diagnostic precision and treatment planning.

24. What is the primary international taxonomy used for mental and behavioral disorder diagnosis worldwide?

    ICD-11. Developed by the World Health Organization as the global standard for classifying diseases, including mental and behavioral disorders.

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