Mental Disorders Due to a General Medical Condition (GMC)

HOMEWORK Mental Disorders Due to a General Medical Condition (GMC) Other Conditions That May Be a Focus of Clinical Attention 2010 21 possible points 1. Mack Tauber: Diagnose on Axis I (only). Axis I V71.01 Adult Antisocial Behavior 3/3 Axis II 301.9 799.9 V71.09 Personality Disorder NOS OR Diagnosis Deferred on Axis II OR No Diagnosis The lack of clear-cut childhood antisocial behavior or Conduct Disorder eliminates Antisocial Personality. Although no specific Personality Disorder appears likely, the pervasive, maladaptive quality of Mack’s behavior and lifestyle, and his marked social impairment, suggest an “NOS” Axis II diagnosis. One should be cautious about equating a Personality Disorder diagnosis with “mental illness” in chronically antisocial people, especially when it may be used to excuse them from responsibility for their behavior. A Deferred (799.9) or No Diagnosis (V71.09) Axis II code could also be defended. There is insufficient information for a clear Axis I diagnosis of a Substance-Related Disorder, but it is probable and further information is being sought. 2. Will Jacks: Diagnose on Axis I and Axis II Axis I 310.1 Personality Change Due to Head Trauma, Apathetic Type 4/4 Axis II V71.09 No Diagnosis 3/3 Axis III Suspected Contusion, Cerebral; Multiple Fractures Will Jacks was involved in a serious automobile accident and suffered extensive body and head trauma. As a result of the head trauma, his personality has changed; he was transformed from an industrious man to one who is indifferent and seems to lack spontaneity. There is no evidence of cognitive dysfunction (i.e., Delirium, Dementia, or Amnestic disorder), Substance Abuse, Major Depression, Anxiety Disorder, or a pre-injury Personality Disorder. 3. Jim Davis: Diagnose on Axis I and II Axis I V15.81 Noncompliance With Treatment 2/2 316 Maladaptive Health Behaviors Affecting Diabetes 4/4 (plus 1 point for correct order of diagnoses) 1/1 (plus 1 point for specifying the Psychological Factor; i.e., “Maladaptive Health Behaviors ) 1/1 Axis II V71.09 No Diagnosis on Axis II 3/3 Axis III Diabetes Mellitus, Type I/Insulin Dependent, per Physician Report Both the psychological factor and the noncompliance with treatment for diabetes are clinically significant and merit psychological treatment focus. There is no indication that the problem meets criteria for an Axis I mental disorder (e.g., a Mood or Adjustment Disorder). No Identity Problem or Phase of Life Problem is described, although one might consider such diagnoses in light of Jim’s possible view of himself as infirmed and/or perhaps destined to be disabled.