Search for other papers by Marcia Scott in
Current site
Google Scholar
PubMed
Abstract
Chapter 14 of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) discusses diagnosis, mental impairment, impairment severity assessment, special impairment categories, report format, and psychiatric impairment evaluation. The chapter differs from others in the AMA Guides insofar as it does not provide percentages for estimates of mental impairment because such usage suggests a certainty that does not exist. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, is a widely accepted classification system for mental disorders, but it omits context. Few clinically standardized tests can identify functional or structural effects, and neuropsychological testing is not the standard for documenting subtle impairment. How individuals manage their illness and cope with life demands are better measures of impairment than diagnostic labels or numbers and kinds of symptoms. Further, assessment requires an evaluation of the context in which the illness unfolds, including premorbid function and previous response to treatment; details about the individual's life course; review of developmental and functional deficits; character style and comorbidities such as anxiety and substance abuse; severity of precipitants, current stage of the episode, and current effectiveness of treatment; and external supports that can moderate impairment. A table lists areas of functional impairment, symptoms to consider, and patient history relevant to symptoms.
-
1.
Hays RD, Wells KB, Sherbourne CD, Rogers W, Spritzer D. Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry. January 1995;52:11–19.
-
2.
Okapaku SO, Sibulkin AE, Schenzler C. Disability determinations for adults with mental disorders: Social Security Administration vs. independent judgments Am J Public Health. November 1994;84:1791–1795.
-
3.
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association; 1994.
-
4.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Primary Care Version. Washington, DC: American Psychiatric Association; 1995.
-
5.
Olfson M, Broadhead WE, Weissman MM, Leon AC, Farber L, Hoven C, Katho R. Subthreshold psychiatric symptoms in a primary care group practice. Arch Gen Psychiatry. October 1996;53:880–886.
-
6.
Kendler KS, Gardner CO Jr. Boundaries of major depression. Am J Psychiatry. February 1998;155:172–177.
-
7.
Judd LL, Paulus MP, Wells KB, Rappaport MH. Socioeconomic burden of subsyndromal depressive symptoms and major depression in a sample of the general population. Am J Psychiatry. November 1996;153:1411–1417.
-
8.
Friedman RA. Social impairment in dysthymia. Psychiatric Annals. November 1993;23:632–637.
-
9.
Marin RS. Apathy—who cares? An introduction to apathy and related disorders of motivation. Psychiatric Annals. January 1997;27:18–23.
-
10.
Costell EJ, Angold A, Burns BJ, Erkanli A, Stangl DK, Twee DL. The Great Smoky Mountains study of youth. Arch Gen Psychiatry. December 1996;53:1137–1143.
-
11.
Gordon RE, Gordon KK. Assessing the elements of biopsychosocial functioning. Hospital and Community Psychiatry. May 1991;42:508–512.
-
12.
Brown SA, Inaba RK, Gillin JC, Schuckit MA, Stewart MA, Irwin MR. Alcoholism and affective disorder: clinical course of depressive symptoms. Am J Psychiatry. January 1995;152:45–51.
-
13.
Schuckit MA, Hesselbrock V. Alcohol dependence and anxiety disorders: what is the relationship? Am J Psychiatry. December 1994;151:1723–1734.
-
14.
Kendler KS, Kessler RC, Walters EE, MacLean C, Neal MC, Heath AC, Eaves LJ. Stressful life events, genetic liability, and onset of an episode of major depression in women. Am J Psychiatry. June 1995;152:833–842.
-
15.
Coryell W, Sheftner W, Keller M, Endicott J, Maser J, Klerman GL. The enduring psychosocial consequences of mania and depression. Am J Psychiatry. May 1993;150:720–726.
| All Time | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 850 | 802 | 31 |
| Full Text Views | 40 | 1 | 0 |
| PDF Downloads | 0 | 0 | 0 |
