The vast majority of mental health clinicians and researchers rely on diagnostic systems based on operational criteria. However, in their everyday practice, many clinicians also pay attention to their own feelings or intuitions about the patient. For an even greater number of clinicians, this process may occur inadvertently. Scholars from various fields are increasingly stressing the importance of complementing the emphasis on operational criteria with thoughtful attention to the subjective and intersubjective elements involved in a thorough psychopathological evaluation. This book aims at capturing the essence, implications and full potential of the clinician’s subjective experience in the diagnosis and treatment of mental disorders. It gathers contributions from several different disciplines, such as phenomenology, neuroscience, the cognitive sciences, and psychoanalysis. It also presents the development, validation, and clinical application of a psychometric instrument that reliably investigates the clinician’s feelings, thoughts, and perceptions related to the clinical encounter.

Many published books that comment on the medical model have been written by doctors, who assume that readers have the same knowledge of medicine, or by those who have attempted to discredit and attack the medical practice. Both types of book have tended to present diagnostic categories in medicine as universally scientifically valid examples of clear-cut diseases easily distinguished from each other and from health; with a fixed prognosis; and with a well-understood aetiology leading to disease-reversing treatments. These are contrasted with psychiatric diagnoses and treatments, which are described as unclear and inadequate in comparison. The Medical Model in Mental Health: An Explanation and Evaluation explores the overlap between the usefulness of diagnostic constructs (which enable prognosis and treatment decisions) and the therapeutic effectiveness of psychiatry compared with general medicine. The book explains the medical model and how it applies in mental health, assuming little knowledge or experience of medicine, and defends psychiatry as a medical practice.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

This book explores the purpose of clinical psychological and psychiatric diagnosis, and provides a persuasive case for moving away from the traditional practice of psychiatric classification. It discusses the validity and reliability of classification-based approaches to clinical diagnosis, and frames them in their broader historical and societal context. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is used across the world in research and a range of mental health settings; here, Stijn Vanheule argues that the diagnostic reliability of the DSM is overrated, built on a limited biomedical approach to mental disorders that neglects context, and ultimately breeds stigma. The book subsequently makes a passionate plea for a more detailed approach to the study of mental suffering by means of case formulation. Starting from literature on qualitative research the author makes clear how to guarantee the quality of clinical case formulations.

The publication of the Cultural Formulation Outline in the DSM-IV represented a significant event in the history of standard diagnostic systems. It was the first systematic attempt at placing cultural and contextual factors as an integral component of the diagnostic process. The year was 1994 and its coming was ripe since the multicultural explosion due to migration, refugees, and globalization on the ethnic composition of the U.S. population made it compelling to strive for culturally attuned psychiatric care. Understanding the limitations of a dry symptomatological approach in helping clinicians grasp the intricacies of the experience, presentation, and course of mental illness, the NIMH Group on Culture and Diagnosis proposed to appraise, in close collaboration with the patient, the cultural framework of the patient's identity, illness experience, contextual factors, and clinician-patient relationship, and to narrate this along the lines of five major domains. By articulating the patient's experience and the standard symptomatological description of a case, the clinician may be better able to arrive at a more useful understanding of the case for clinical care purposes. Furthermore, attending to the context of the illness and the person of the patient may additionally enhance understanding of the case and enrich the database from which effective treatment can be planned. This reader is a rich collection of chapters relevant to the DSM-IV Cultural Formulation that covers the Cultural Formulation's historical and conceptual background, development, and characteristics. In addition, the reader discusses the prospects of the Cultural Formulation and provides clinical case illustrations of its utility in diagnosis and treatment of mental disorders. Book jacket.

This book presents an innovative approach to clinical assessment in psychiatry based on a number of psychopathological dimensions with a presumed underlying pathophysiology, that are related to fundamental phenomenological aspects and lie on a continuum from normality to pathology. It is described how the evaluation of these dimensions with a specific, validated rapid assessment instrument could easily integrate and enrich the classical diagnostic DSM-5 or ICD-10 assessment. The supplemental use of this dimensional approach can better capture the complexity underlying current categories of mental illness. The findings from a large patient sample suggest how this assessment could give a first glance at how variable and multifaceted the psychopathological components within a single diagnostic category can be, and thereby optimise diagnosis and treatment choices. Being short and easy to complete, this dimensional assessment can be done in a busy clinical setting, during an ordinary psychiatric visit, and in an acute clinical context, with limited effort by a minimally trained clinician. Therefore, it provides interesting and useful information without additional costs, and allows research work to be performed even in difficult settings.

Many texts review the scientific knowledge, diagnostic procedures, clinical syndromes, and therapeutic methods of importance to modern psychiatry. Barry Nurcombe and Rollin Gallagher offer something further. The Clinical Process in Psychiatry is about how to think in clinical settings. The authors take as their organizing theme the supple, efficient, systematic problem-solving of the experienced practitioner: from the eliciting of diagnostic clues and the intuition of patterns, through the generation of hypotheses and the gathering of evidence, to the formulation of comprehensive diagnoses and the design of goal-directed management plans. Throughout, they present theotetical material in a manner which is readily accessible to both students and clinicians during their daily encounters with patients.

DSM-5® Handbook of the Cultural Formulation Interview provides the background, context, and detailed guidance necessary to train clinicians in the use of the Cultural Formulation Interview (CFI), which was created as part of the 2007-2013 DSM revision process. The purpose of the CFI -- and this unique handbook -- is to make it easier for providers to account for the influence of culture in their clinical work to enhance patient-clinician communication and improve outcomes. Cultural psychiatry as a field has evolved enormously from the days when it was principally concerned with epidemiological and clinical studies of disease prevalence; it now examines a multitude of issues, primary among them the differing patient, family, and practitioner models of illness and treatment experiences within and across cultures. The editors, all of whom have been intimately involved in the evolution of the field, have designed the book and accompanying videos for maximum instructional and clinical utility. The Handbook boasts many strengths and useful features, including: A detailed description of each of the three CFI components: a core 16-item questionnaire, which can be applied in any clinical setting with any patient by any mental health clinician; an informant version of the core CFI used to obtain information from caregivers; and 12 supplementary modules that expand on these basic assessments. This material facilitates implementation of the CFI by clinicians. Over a dozen clinical vignettes are included to illustrate use of the three components, and the Handbook also includes multiple videos that demonstrate the application of portions of the core CFI, and several supplementary modules. Strategies for incorporating the CFI into clinical training are identified and discussed, furthering the objective of developing culturally-sensitive and astute practitioners. The theoretical bases of the CFI are explored, raising questions for discussion and identifying areas for further research. The CFI is a valuable tool for all patients, not just those judged to be culturally different. The CFI has been called the single most practically useful contribution of cultural psychiatry and medical anthropology to clinical psychiatry, primary care, and medicine in general. DSM-5® Handbook on the Cultural Formulation Interview is the only book on the market that equips readers with the skills and insight to incorporate the CFI into practice, making it a critically important addition to the clinical literature.

Grounded in author Allen Frances's extensive clinical experience, this comprehensive yet concise guide helps the busy clinician find the right psychiatric diagnosis and avoid the many pitfalls that lead to errors. Covering every disorder routinely encountered in clinical practice, Frances provides the ICD-9-CM and ICD-10-CM (where feasible) codes required for billing, a useful screening question, a colorful descriptive prototype, lucid diagnostic tips, and a discussion of other disorders that must be ruled out. The book closes with an index of the most common presenting symptoms, listing possible diagnoses that must be considered for each. Frances was instrumental in the development of past editions of the DSM and provides helpful cautions on questionable aspects of DSM-5. The revised edition features ICD-10-CM codes where feasible throughout the chapters, plus a Crosswalk to ICD-10-CM Codes in the Appendix. The Appendix, links to further coding resources, and periodic updates can also be accessed online (www.guilford.com/frances_updates).

This handy DSM-5(R) Classification provides a ready reference to the DSM-5 classification of disorders, as well as the DSM-5 listings of ICD-9-CM and ICD-10-CM codes for all DSM-5 diagnoses. To be used in tandem with DSM-5(R) or the Desk Reference to the Diagnostic Criteria From DSM-5(R), the DSM-5(R) Classification makes accessing the proper diagnostic codes quick and convenient. With the advent of ICD-10-CM implementation in the United States on October 1, 2015, this resource provides quick access to the following: - The DSM-5(R) classification of disorders, presented in the same sequence as in DSM-5(R), with both ICD-9-CM and ICD-10-CM codes. All subtypes and specifiers for each DSM-5(R) disorder are included.- An alphabetical listing of all DSM-5 diagnoses with their associated ICD-9-CM and ICD-10-CM codes.- Separate numerical listings according to the ICD-9-CM codes and the ICD-10-CM codes for each DSM-5(R) diagnosis.- For all listings, any codable subtypes and specifiers are included with their corresponding ICD-9-CM or ICD-10-CM codes, if applicable. The easy-to-use format will prove indispensable to a diverse audience--for example, clinicians in a variety of fields, including psychiatry, primary care medicine, and psychology; coders working in medical centers and clinics; insurance companies processing benefit claims; individuals conducting utilization or quality assurance reviews of specific cases; and community mental health organizations at the state or county level.