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sathish16

Steroid induced mania

12 posts in this topic

what is the ICD code for Steroid induced mania?

sudden onset with steroid use, remission after stopping steroid without any pyschotropics.

DSM !V has, ICD doesnt, what is the most appropriate one?

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May be F19.- Mental and behavioural Disorders caused by other psychoactive substances?

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F19 mental and beh disorders due to multiple drug use AND other psychoactive substance use

What about F06?

Does brain damage need to morphological, can be functional damage be regarded as part of brain damage?

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What about F06?

Does brain damage need to morphological, can be functional damage be regarded as part of brain damage?

I think u r right. I would place it under F 06.8 'Other specified mental disorders due to brain damage and dysfunction and to physical disease'

This is a question for dorian- what say u dorian- do u agree?

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Sands.. I dont use ICD... strict follower of DSM

According to DSM, it is substance induced psychotic disorder

In DSM, the brain damage would be Psychotic disorder/Mood disorder due to a GMC

BUT...

ICD F 06  (from the blue book) says

This category includes miscellaneous conditions causally related to brain dysfunction due to primary cerebral disease, to systemic disease affecting the brain secondarily, to [highlight]endocrine disorders such as Cushing's syndrome or other somatic illnesses, and to some exogenous toxic substances (but excluding alcohol and drugs classified under F10-F19) or hormones.[/highlight]

It goes on further to say...

The following are among the conditions known to increase the relative risk for the syndromes classified here: toxic effects of nonpsychotropic drugs (propranolol, levodopa, methyldopa, [highlight]steroids[/highlight],

antihypertensives, antimalarials).

So I guess Sands is right... it should be [highlight]coded in F 06 [/highlight]rather than substance induced... (F 10 - F19)

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Sands.. I dont use ICD... strict follower of DSM

I thought u need to know ICD 10 in and out for MD exams in India, don't they use ICD10 more than DSM 4? Well, of course, they can ask u anything over there, just to show that they know one thing more than u do! ;)

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Oh.. they do ask... I knew the major criteria for most illnesses... but forgot them soon after the exams...

I always thot DSM is more practical and most research even in the UK and europe uses DSM... so makes sense to use DSM even if it is to practise evidence based medicine

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/me bows down to superior knowledge and wisdom...

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Oh.. they do ask... I knew the major criteria for most illnesses... but forgot them soon after the exams...

I always thot DSM is more practical and most research even in the UK and europe uses DSM... so makes sense to use DSM even if it is to practise evidence based medicine

except the diagnosis required by the NHS for it's satistics is an ICD-10 diagnosis so if you are working in the NHS and use a dsm diagnosis then someone in the clinical coding dept will be adding an icd10 diagnosis to things (based on your dsm diagnosis or whatever they feel like...).  you say that most research in uk and europe uses DSM - have you got any data to back that up?  it may well be true - i'd be interested to know.

I looked at all the rcts of early intervention recently.  they are all european and all use ICD10.  having said that research project i was involved in as an spr used dsm, but that was cos the target journal was the AJP.

can you explain how dsm is more practical than icd10?

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1. you say that most research in uk and europe uses DSM - have you got any data to back that up?  it may well be true - i'd be interested to know.

Ans: My opinion was based on the research I read... I had not actually taken a headcount... The first thing that came to my mind was Cutlass, funded by our own NHS used DSM IV...

But I thot, just that you said,  I will just go through the last BJPs... for eg: the September BJP (only because October BJP contains mostly non UK studies)... Out of 9 UK/European research articles that used a diagnostic criteria, 6 of them used DSM, 2 used ICD and 1 used DISC (NIMH).

And you yourself has said that the research project you were involved in, used DSM (assuming you did the research in UK... although it seems a bit odd that the reason you used DSM was because the target journal was AJP... which is probably for collabrative/funding/academic reasons)...

'having said that research project i was involved in as an spr used dsm, but that was cos the target journal was the AJP.'

2. can you explain how dsm is more practical than icd10?

Ans: From a clinical point of view, DSM is easier to use (atleast for me, because I have used it always, and that seems practical for me).. for eg:

DSM 4 - Schizophrenia (is much more easier to remember than ICD), same with Brief psychotic disorder (Acute and transient Psy Dis in ICD)...

But equally, someone else might find ICDs to be more practical...

Eventhough our NICE guidelines says its is for ICD, a significant number of research used in their metaanalysis have used DSM...

But that said, a lot of ICD and DSM criteria overlap anyway... so it doesnt matter...

and as for the coding, I do it at a spinal level, I have never used ICD as a checklist, I diagnose major depression or paranoid schizophrenia using DSM, and give an ICD code for it (painstakingly looking at the blue book for the code).. (although in practice, I have never done this many times; it must have been done by someone in the records)

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Thanks Dorian.

Got to familarise myself with DSMIV. It always sounded better to me. Did not get around to read it due to negative symptoms.

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