ICD 10 in Psychiatry

A Learning Guide

Jaspreet Phull

• Publisher: CRC Press
• Year: 2021
• ISBN:
  9781000466959
• Edition: 1
• Topic: Medizin
• Subtopic: Medizinische Theorie, Praxis & Referenz

Core to psychiatry is the practice of assessment, diagnosis and management. All three elements are subject to identifying the correct diagnosis and all three influence the clinical management of individuals with a mental disorder. This easy-to-comprehend, list-based book presents mnemonics to aid immediate recall of the International Classification of Diseases and Related Health Problems (ICD 10) for prompt diagnosis in psychiatry. Used in conjunction with other ICD 10 guides, this remarkable resource is ideal for memorising the myriad complexities of the ICD 10 for anyone with an interest in learning about diagnostic coding in psychiatry including medical students, psychiatry trainees and mental health professionals. During my time revising for my psychiatry postgraduate examinations, I found learning of ICD 10 for diagnosis particularly testing, especially given the depth and complexity of the criteria. I found aide memoires in the form of mnemonics particularly helpful to support my learning of the subject, allowing for much more efficient recall. From the Preface

Chapter 1

Organic mental disorders (F00–F09)

General criteria for dementia (G1–G4)

G1 Memory decline– especially for new information (mild/moderate/ severe)

Thinking and judgement deterioration (mild/moderate/severe) – objective evidence is required

G2 Absence of clouding of consciousness

G3 Emotional control decline: Lability, Irritability, Apathy and Behavioural changes (BAIL)

G4 G1 present for at least Six months – for confidence

Memory deficit for new information

Absence of clouding of consciousness

Thinking and judgement deficit

Emotional control decline (BAIL)

Six months duration (at least)

MATES

‘Lots of social support (in the form of “good mates”) is required in dementia’

F00 Dementia in Alzheimer’s disease

1. 1. General (G1–G4) criteria for dementia are met
2. 2. No evidence for any other causes for the dementia (e.g. HIV, reversible causes of dementia, etc.)

The diagnosis is ultimately confirmed by postmortem evidence

F00.0 Dementia in Alzheimer’s disease with early onset

1. 1. Criteria for F00 met, and age of onset should be below 65 years
2. 2. One of the following met:

1. i. Rapid onset and progression
2. ii. In addition to memory impairment, must be aphasia, agraphia, alexia, acalculia or apraxia (5As – signs of cortical dysfunction)

Dementia general criteria (F00) met

Rapid onset and progression Age – younger (<65 years)

Multiple disorders of cortical function + memory affected

A 5As – aphasia, agraphia, alexia, acalculia or apraxia

DRAMA

F00.1 Dementia in Alzheimer’s disease with late onset

Late onset, i.e. >65 years

1. 1. Criteria for F00 met
2. 2. One of the following:

1. i. Slow onset and progression (usually identified after 3 years or more)
2. ii. Predominance of a memory impairment, over intellectual impairment

Slow onset and progression

Age – late onset (>65 years old)

Memory impairment

SAM

F00.2 Dementia in Alzheimer’s disease, atypical or mixed type

Atypical dementias

Mixed vascular and Alzheimer’s dementia are included in this category

F00.9 Dementia in Alzheimer’s disease, unspecified

F01 Vascular dementia

This is usually a later-onset dementia (i.e. >65 years old), which is infarct induced. It is as a result of brain tissue infarction due to vascular disease

G1 General criteria for dementia G1–G4 met

G2 Unevenly distributed deficits in higher cognitive function deficits, with some functions affected and others relatively spared

G3 Clinical evidence of focal brain damage (shown by at least one of the following):

1. 1. unilaterally increased tendon reflexes R
2. 2. an extensor plantar response E
3. 3. pseudobulbar palsy P
4. 4. unilateral spastic weakness of the limbs S (REPS)

G4 There is evidence from the history, examination or tests of significant cerebrovascular disease

Clinical evidence (REPS)

of focal brain damage

Unevenly distributed deficits in higher cognitive function General criteria for dementia met

History and examination suggestive of cerebrovascular disease

CoUGH

F01.0 Vascular dementia of acute onset

1. A. Criteria for F01 met (CoUGH)
2. B. Dementia develops rapidly, i.e. usually within one month (but not longer than three months) after a succession of strokes or after a single infarct

F01.1 Multi-infarct dementia

Usually a cortical dementia:

1. A. Criteria for F01 met (CoUGH)
2. B. Onset is gradual within 3–6 months following a number of minor ischaemic episodes

Thought to be as a result of an accumulation of infarcts in the brain matter. There may be some possible improvement between ischaemic episodes

F01.2 Subcortical vascular dementia

1. A. Criteria for F01 met (CoUGH)
2. B. Hypertension history
3. C. Clinical examination and investigations show vascular disease in the deep white matter of the cerebral hemispheres, with preservation of the cerebral cortex

Hypertension history

Investigation displays evidence of vascular disease in the deep white matte...