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1. Case Summary
2. Clinical Impression (Diagnosis)
Write the clinical impression in the DSM-5 format:
XXX.xx (Yyy.yy) Primary Diagnoses (list in order of salience).
(DSM-5 Code is first, as in XXX.xx, and ICD-10 codes next, in parentheses.)
Use the V and Z codes, or simply appropriate descriptors to psychosocial and contextual factors of importance to the diagnostic case. These replace the DSM-IV-TR Axis IV & V used to address these concerns.
Explain any recommendations for interventions, treatment, and/or disposition.
Address the specific questions that were asked in the instructions for this assignment.
Here is a sample assignment question and an appropriate brief response:
Question: Describe what further information you would need to accurately diagnose this case.
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