DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS FOURTH EDITION, TEXT REVISION

The Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision is a taxonomy published by the APA (American Psychiatric Association). The DSM-IVTR describes all mental disorders, outlining specific diagnostic criteria for each based on clinical experience and research. All mental health clinicians who diagnosed psychiatric disorders use the DSM-IV-TR. The DSM-IV-TR has three purposes: y To provide a standardized nomenclature and language for all mental health professionals y To present defining characteristics or symptoms that differentiate specific diagnoses y To assist in identifying the underlying causes of disorders

Axis I- is for identifying all major psychiatric disorders except mental retardation and personality disorders Patient Diagnosis: Disorganized Schizophrenia

Patients Manifestation  Hallucinations  Grossly disorganized  Delusions

 Flat Affect  Anhedonia Axis II- is for reporting mental retardation and personality disorders well as prominent maladaptive personality features and defense mechanisms  No personality and mood disorder are present during the assessment but in the chart in says Patient X has the manifestation of Mental Retardation severe.

Axis III- for reporting current medical conditions that is potentially relevant to understanding or managing the persons mental disorder as well as medical conditions that might contribute to understanding the person  General medical condition is excluded because the disturbance is not due to the psychological effects of general medical conditions

Axis IV- Reporting psychosocial and environment problems that may affect the diagnosis, treatment, and prognosis.

PRIMARY SUPPORT GROUP Only the health care team of Davao Mental Hospital was the primary support group of Patient X since his family is still to be trace. SOCIAL ENVIRONMENT Patient X has no home. His only considered home is the male ward. The area is not conducive to patient X because its not properly ventilated for patients with mental illness.

Axis V- Presents a Global Assessment of Functioning which rates the persons overall psychological functioning on a scale of 0 to 100

GAF Scale ranges from 0-100 A score of 100 is the highest possible score which means superior functioning. A score of 0 is the lowest possible score which means inadequate information.

First Interaction: Date: May 10 2011 Time Assessed: 8:15 to 10:15am Patient Manifestations:  Disturbed thought process  Flight of ideas  Hallucination ( Visual)  Impaired perception as evidence by Visual hallucination and delusions  Disorientation time, place and date  Self care deficit  Showing no facial expression (Flat affect)  Looseness of association  Altered communication pattern  Impaired social interaction  Incoherent, whispered speech

 Euphoric mood  Interrupted sleep  Delusion ( loose of association) GAF SCORE: 20-11 Some danger of hurting self or others (e.g. suicide attempts without clear expectations of death, frequently violent, manic excitement) OR occasionally fails to maintain minimal personal hygiene (e.g. smears feces) OR gross impairment in communication (e.g. largely incoherent or mute)

Second Interaction: Date: May 11, 2011 Time Assessed: 8:15- 10:15 Patient Manifestations:  Flight of ideas  Visual hallucinations  Disordered thoughts  Feelings of despair  Disorientation to time, date and place  Self care deficit  Happy mood  Poor eye to eye contact  Keeps on smiling  Delusions GAF SCORE: 30-21 behaviors is considerably influence by illusions or hallucination, impairment in communication or judgment (e.g. sometimes

incoherent, acts grossly inappropriately, suicidal preoccupation) or inability to function in almost all areas (e.g. stays in bed all day, no job, home, friends

Third Interaction: Date: May 12, 2011 Time Assessed: 8:15- 10:15 am Patient Manifestations:  Happy mood  Flight of ideas  Restless  Disturbed thought process  Feelings of hopelessness  Hallucination  Looseness of association  Disoriented to time and date  Limited attention span  Talkative  Keeps on smiling  Respond coherently but not spontaneously GAF SCORE: 30-21 Behaviors is considerably influence by illusions or hallucination, impairment in communication or judgment (e.g. sometimes incoherent, acts grossly inappropriately, suicidal preoccupation) or inability to function in almost all areas (e.g. stays in bed all day, no job, home, friends.

Fourth Interaction: Date: May 13, 2011 Time Assessed: 8:15- 10:15 am Patient Manifestations:  Looseness of association  Flight of ideas  Disoriented to time and date GAF SCORE: 40-31 Some impairment in reality testing or communication (e.g. speech is at times, illogical obscure, or irrelevant) OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g. depressed man avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home and is failing at school).

Fifth interaction Date: May 14, 2011 Time Assessed: 8:15- 10:15 am Patient Manifestations:  Looseness of association  Flight of ideas  Behaved appropriately with eye to eye contact  Happy mood  Restless

 Responsive GAF SCORE: 70-61 Some mild symptoms (e.g. depressed mood and mild insomnia) or some difficulty in social, occupational, or functioning, but generally functioning pretty well, has some meaningful interpersonal relationship

Sixth CIU Visit: Date: May 15, 2011 Time Assessed: 8:15- 10:15 am Patient Manifestations:  Restless  Risk for injury  Happy mood

GAF SCORE: 70-61 Some mild symptoms (e.g. depressed mood and mild insomnia) or some difficulty in social, occupational, or functisoning, but generally functioning pretty well, has some meaningful interpersonal relationship.

Seventh Interaction Date: May 16, 2011 Time Assessed: 8:15- 10:15 am Patient Manifestations:  Well-groomed

 Responsive  Calm  Appropriate affect  Laughing moments was minimized  Hallucination (visual) GAF SCORE: 70-61 Some mild symptoms (e.g. depressed mood and mild insomnia) or some difficulty in social, occupational, or functioning, but generally functioning pretty well, has some meaningful interpersonal relationship.

Eight Interaction Date: May 17, 2011 Time assessed: 8:15- 10:oo am Patient Manifestations:  Calm  Responsive  unConscious  Well Groomed  Always smilinh  Able to take a bath  Able to participate in the activity GAF Score: 81-90 Absent or minimal symptoms ( e.g., mild anxiety before an exam

), good functioning in all areas, interested and involved in a wide range of activities,

socially effective, generally satisfied with life, no more than everyday problems or concerns ( e.g., an occasional argument with family members ) Analysis: The patient has only the Axis I, II and V, Axis I in which he has a major psychotic illness Axis IV because mostly her onset of illness is also due to lack of social and environmental influences and family support group, Axis V in which her global assessment functioning has the scale of which it increases upon every visit, therefore patient is recovering slowly from the illness, the GAF scoring is followed and is based on the patients showed symptoms of the illness. The lowest GAF scoring was during the first home visit which was 20-11 and the highest GAF scoring is 81-90 which means that the patient is recovering and if medication regimen is continued and family support is enough the patient would have a small probability to experience relapse.