Psychiatric Assessment Measures Useful In Primary Care From DSM-5

Posted on July 22, 2016 by Tom Wade MD

Primary care physicians’ evaluation of psychiatric problems should be as complete as any evaluation for any other medical problem.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5th ed., 2013 has resources that are useful for all primary care clinicians (physicians, nurse practitioners, and physician assistants).

What follows are a list of and links to all the different assessment measures available from the website www.psychiatry.org Online Assessment Measures*:

*Please review the notes on the above link which discuss how to use the measures below. And each of the links below will download to your computer

Level 1 Cross-Cutting Symptom Measures

Level 2 Cross-Cutting Symptom Measures

Disorder-Specific Severity Measures

Disability Measures

Personality Inventories

Early Development and Home Background

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What follows is a brief discussion from DSM-5 of some of the assessment measures:

Definition of a Mental Disorder (p 20):

A mental disorder is a syndrome characterized by clinically significant disturbances in individuals cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability and social, occupational, or other important activities. Acceptable or culturally approved response to a common stressors or loss such as the death of a loved one is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results, dysfunction in the individual as described above.

Criterion for Clinical Significance (p 21)

There have been substantial efforts by the DSM-5 task force and the World Health Organization (WHO) to separate the concepts of mental disorder [from the] concept of disability (impairment in social, occupational, or other important areas of functioning). In the WHO system, the international classification of diseases (ICD) covers all diseases and disorders, while the international classification of functioning, disability and health (ICF) provides a separate classification of global disability. The WHO disability assessment schedule (WHODAS) is based on the ICF and has proven useful as a standardized measure of disability for mental disorders.

Assessment Measures  (p 733 + 734):

Cross-cutting symptom measures modeled on general medicines and review of systems can serve as an approach for reviewing critical psychopathological domains. The general medical review of systems is crucial to detecting subtle changes in different organisms that can facilitate diagnosis and treatment. A similar review of various mental functions can aid in a more comprehensive mental status assessment by drawing attention to symptoms that may not fit neatly into the diagnostic criteria suggested by the individuals presenting symptoms, but that may nevertheless be important to the individual’s care. The crosscutting measures have two levels: level I questions are a brief survey of 13 symptom domains for adult patients” domains for child and adolescent patients. Level II questions provide more in-depth assessment of certain domains. These measures were developed to be administered both at the initial interview and overtime to track the patient’s symptom status and response to treatment

Severity measures but disorders specific, corresponded closely to the criteria that constitute the disorder definition. They be administered to individuals who have received a diagnosis for the clinically significant syndrome that fall short of meeting full criteria for a diagnosis. 70 assessments are so completed by an individual, it does require the clinician to complete. As with the cost-cutting symptom measures, these measures were developed to be administered both at initial interview and over time to track the severity of an individual’s disorder and response to treatment.

The World Health Organization Disability Assessment Schedule, Version 2.0 (WHODAS 2.0) was developed to assess a patient’s ability to perform activities in six areas: understanding and communicating; getting around; self-care; getting along with people; life activities (e.g., household, work/school); and participation in society. The scale itself administered and was developed to be used in patients with any medical disorder it corresponds to concepts contained in the WHO international classification of functioning, disability, and health. This assessment can also be used over time to track changes in a patient’s disabilities.

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