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Making the diagnosis in clinical practice 

Making the diagnosis in clinical practice
Chapter:
Making the diagnosis in clinical practice
Author(s):

Patricia Casey

DOI:
10.1093/med/9780198786214.003.0006
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date: 26 June 2019

Neither ICD-10 nor DSM-5 has clinical criteria for making the diagnosis of AD. The only requirement is a stressor, either psychosocial or traumatic. The onset of symptoms within 1 month (ICD) and 3 months (DSM) is not evidence based. The symptoms may be depressive, anxious, behavioural, or a mixture of these. A useful clinical indicator that the event was the trigger is that the intensity of the symptoms increases when it is being recalled or recounted and diminishes when the person is removed from it. A number of differentials should also be considered. ICD-11 proposes specific criteria for ICD-11 that include preoccupation with the stressor and difficulty adapting, as evidenced by impaired concentration, sleep disturbance, and so on, causing impairment in functioning. It is unclear whether those diagnosed with AD using the new criteria will be the same clinically as those currently so diagnosed.

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