mental health tx planning

• Axis I-III
• records the mental
• physical diagnosis

• Axis IV-V
• note environmental probllelms
• assess function over the previous years

• personality disorders
• mental retardation

disorders that needs immediate attention

• -major depressive episode
• -exacerbation of schizophrenia
• -flare-up of panic disorder
• -psychological factors affecting medical conditions
• -medication-induced movement disorders (tardive dyskinesia)
• -problems in relationships
• -problems related to abuse or neglect
• -difficulties adjusting to a new culture
• -problems in school & work

Personality disorders/mental retardation

characteristic styles of adaptation that constitutes a maladaptive personality

• not a disease entity as in axis I
• personality disorder that may be shaping the current response to the Axis I problem

• any developemental disorders
• -mental retardation
• -learning disability
• which may be predisposing the person to the Axis I problem

• -paranoid-personality
• -histrionic-behavior
• -dependent personality

EX:  someone with severe mental retardation or a paranoid personality disorder may be more likiely to be "bowled over" by a major life stressor, and succomb to a major depressive episode.

Physical illness is stressful and may evoke psychological reactions

any medical or neurological problems that may be relevant to the individual's current or past psychiaric problems.

EX:  someone with severe asthma may experience respiratory symptoms that are easily confused with a panic attack, or indeed, which may precipitate a panic attack.

• major psychosocial stressors the individual has faced recently
• -recent divorce
• -death of spouse
• -job loss

environmental or psychological event or condition that affect the diagnosis or management of the patient

• economic problems
• housing
• problelms w/ primary support group
• occupational problems
• educational problems
• problems related to the social environment
• legal system/crime
• access to health care system

• Global Assessment of Functioning
• GAF

• reflects the patient's current overall:
• occupational
• psychological
• social functioning

100-pt scale

• 100-90pts indicates good functioning
• 10 associated w/ persistant damage to self or others