Posted by simcha on December 6, 2004, at 23:21:46
In reply to Re: Benefits versus risks of diagnosis in psychiatry, posted by SLS on December 6, 2004, at 15:18:30
Scott,
If you have a DSM IVTR look in the back. You will find ICD-10 codes. It's only a start. It describes treatable symptomology rather than labelling people with disorders.
It's more specific than labelling someone as MDD with Recurrant Features. It can allow psychiatrists, psychologists, social workers, and therapists more freedom to treat symptoms without having to place clients in a diagnostic box.
For Major Depressive Disorder for instance, a clinician can list; depressed mood (time), lack of appetite, erectile dysfunction or less interested in sex, hyper-insomnia or hypo-insomnia, etc. You would have a cluster of symptoms that are more specific. With Major Depressive Disorder not every depression looks the same. The DSM IV does not allow clinicians to differentiate the depression as much as the ICD.
We see evidence in different types of mania, hypomania, depression, hallucinations, etc. on this board. We also see that people with the same diagnosis do not do as well as other people do on specific medications. The ICD might be a way to help psychiatrists tailor medical treatment to more specific symptomology. Also for pscychotherapists we can tailor our treatment plans more specifically too. This is going to really frustrate the American Medical Insurance Machine because they will have to cover conditions they don't cover.
The ugly secret is that sometimes you HAVE to come up with a DSM diagnosis so that clients can use insurance, medicaid, or medicare to pay for their treatment. This forces clinicians to lump people into DSM categories who generally fit the category but might not present with all the symptoms. Also it can keep people from treatment who have only some of the symptoms of a DSM category yet their life is impaire to an extent that they aren't functioning. Insurance, medicaid, and medicare will not allow treatment without a DSM classification. In the future they will be forced to help these people with very real symptoms that impair their real functioning.
So, the DSM IVTR is expensive. If you do not have one and have no reason to fork over $50 then you can go to the public library and look at the end of it. There you will find ICD-10 codes.
Simcha
poster:simcha
thread:422741
URL: http://www.dr-bob.org/babble/20041206/msgs/425475.html