SOWO 758
Spring 2016
THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL
SCHOOL OF SOCIAL WORK
COURSE NUMBER:
COURSE TITLE:
SEMESTER & YEAR:
TIME:
LOCATION:
INSTRUCTOR:
SOWO 758 : Section 001
Differential Diagnosis of Mental Health Disorders
Spring 2016 (Jan-March)
Mondays 2-4:50pm
Tate-Turner-Kuralt Building,
Marilyn Ghezzi, MSW, LCSW
School of Social Work
Tate-Turner-Kuralt Building, Campus Box 3550
Phone: (919) 962-6490
E-mail : mghezzi@email.unc.edu
OFFICE HOURS:
OFFICE LOCATION:
563-C
COURSE DESCRIPTION: This course focuses on the process of conducting a differential diagnosis of mental
health disorders using the current Diagnostic and Statistical Manual of Mental Disorders.
COURSE OBJECTIVES: At the conclusion of this course:
1. Students will be able to use the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition to
identify major mental health conditions.
2. Students will be able to distinguish between different disorders to complete a differential diagnosis, including
issues of comorbidity, and write a diagnostic statement for a client.
3. Students will understand the impact of race, ethnicity, gender, age, culture, sexual orientation, and
socioeconomic status on mental health diagnosis, particularly on symptom presentation, assessment, and
access to care.
4. Students will be able to articulate the psychological and behavioral indicators and course of a range of mental
health conditions that can affect functioning and development.
5. Students will be sensitive to the potential use of personal data in mental health assessments for persons who
may be in vulnerable and oppressed situations.
6. Students will demonstrate an understanding of ethical issues in assessment and diagnosis of mental health
conditions.
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EXPANDED DESCRIPTION: This course is designed for students who are interested in psychiatric assessment and
diagnosis. It builds on the foundation HBSE course and the advanced practice/HBSE course by furthering
students’ knowledge of psychiatric disorders and how to complete a differential diagnosis using the DSM.
Students will read, view, and discuss cases throughout the semester and gain confidence in using the DSM to
complete a formal psychiatric diagnosis.
REQUIRED TEXTS/READINGS:
Morrison, J. (2014). DSM-5 made easy: The clinician’s guide to diagnosis. Guilford Press. IBSN: 978-1-4625-7
RECOMMENDED TEXTS/READINGS:
• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth
edition. Washington, D.C.: American Psychiatric Press.
As a UNC student, you can access a free online version of DSM 5 at the following website:
http://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596
•
Sadock, B.J., & Sadock, V.A. (2008). Kaplan and Sadock’s concise textbook of clinical psychiatry.
Lippincott Williams & Wilkins, Philadelphia, PA.
CLASS PARTICIPATION AND TEACHING METHODS:
Class participation counts for 15% of your final grade. Everyone will receive a standard score of 100 for
participation, in recognition of a norm of attendance, contributions to small group activities and informed
participation in class discussion. Informed participation means that you clearly demonstrate that you have
completed assigned readings and can offer analysis, synthesis and evaluation of written material. In order to
fully participate in and benefit from each class session, students must complete required readings and come to
class prepared to discuss them. Excellent participation also means that your comments are thoughtful, focused
and respectful. Points will be deducted from the base score if you miss class, are late, leave early, disappear for
long periods on break or are unprepared. Please turn off cell phones during class.
This class will use a variety of teaching and learning methods to cover the content. These different methods
include: small group activities; lecture; videos; and class discussions. The development of a supportive learning
environment is fostered by respectfully listening to the ideas of others, being able to understand and appreciate a
point of view which is different from your own, clearly articulating your point of view, and linking experience
to readings and assignments. If you will not be able to attend a class, it is your responsibility to obtain handouts,
information about class content, and information about announcements, etc., from your classmates.
GRADING SYSTEM
In accordance with the Graduate school, letter grades are assigned to the following numeric ranges:
H = 94 and above
P = 80 to 93
L = 70 to 79
F = 69 and below
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POLICY ON PAPER SUBMISSION, INCOMPLETES AND LATE ASSIGNMENTS
A course grade of “Incomplete” will be given only in extreme extenuating circumstances and in accordance
with SSW and University policy.
All papers and assignments are to be submitted electronically to the Drop Box on our Sakai site and are due at
the beginning of class on the dates noted on this syllabus. Ten percent will be deducted from your grade for
each day that a paper is late. If you have a situation arise that may prohibit you from completing the assignment
on time, any request for an extension on the papers must be done in advance of the due date (at least 24 hours)
for the paper. Approved delays will not affect the grade.
Your cover sheet for the paper should contain your name, PID# and honor code pledge. Do not put your name
in the body of the paper that you submit to Sakai, instead use your PID# as a running head on each page.
POLICY ON ACADEMIC DISHONESTY
The Student Honor Code is always in effect in this course. Please refer to the APA Style Guide, The SSW
Manual, and the SSW Writing Guide for information on attribution of quotes, plagiarism and appropriate use of
assistance in preparing assignments. All written assignments should contain a signed pledge from you stating
that, "I have not given or received unauthorized aid in preparing this written work". In keeping with the UNC
Honor Code, if reason exists to believe that academic dishonesty has occurred, a referral will be made to the
Office of the Student Attorney General for investigation and further action as required.
POLICY ON ACCOMMODATIONS FOR STUDENTS WITH DISABILITIES
The University of North Carolina – Chapel Hill facilitates the implementation of reasonable accommodations,
including resources and services, for students with disabilities (including mental health), chronic medical
conditions, a temporary disability or pregnancy complications resulting in difficulties with accessing learning
opportunities.
All accommodations are coordinated through the Accessibility Resources and Service Office. In the first
instance please visit their website http://accessibility.unc.edu, call 919-962-8300 or email
accessibility@unc.edu. Please contact ARS as early in the semester as possible.
USE OF LAPTOPS OR OTHER ELECTRONIC DEVICES
Please turn off all cell phones or other devices that would disrupt the learning environment of the classroom. I
encourage you to bring your laptop to every class. We will use laptops to access the DSM-5 online and to
access the powerpoint and save paper. I ask that you try to bring your laptop to every time. Laptops should
be closed during class discussion and other activities that do not require the use of a laptop.
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APA AND WRITTEN ASSIGNMENTS
The School of Social Work faculty has adopted APA style as the preferred format for papers and publications.
The best reference is the Publication Manual of the American Psychological Association, Sixth Edition (2009)
that is available at most bookstores. The following web site provides additional information:
http://juno.concordia.ca/help/howto/apa.php
Students are strongly encouraged to review the materials on the School of Social Work’s website
http://ssw.unc.edu/students/writing . This page includes numerous helpful writing resources such as tutorials on
understanding plagiarism, quick reference guide to APA, writing tips and ESL materials. Students are also
strongly encouraged to review the section on plagiarism carefully. All instances of academic dishonesty will
result in disciplinary measures pre-established by the School of Social Work and the University.
ASSIGNMENTS
Assignments
Mid-Term Examination: Multiple Choice Exam to be given in Class 5
Final Examination: Take home case summary
Class Attendance and Participation
Due Date
February 15
March 5
ongoing
Points
40
45
15
FURTHER INFORMATION ABOUT ASSIGNMENTS
MID- TERM EXAM: The mid-term exam will be a closed book exam that will be given at the beginning of Class
5. I will provide a study guide for your mid-term exam. The study guide will include details about which parts
of the powerpoints and readings will be on the exam and which diagnostic criteria to memorize. You will never
need to memorize prevalence rates, epidemiological data or diagnostic codes.
FINAL EXAM: The final exam will be an open book take-home exam. You will be given two cases which
you will answer questions about in an essay format. You will diagnose the two cases and justify your
diagnoses. For one of the cases, you will write out a mental status exam. Although the exam will be open book
you are not allowed to consult with any other person about the exam.
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COURSE CALENDAR
Class 1 :
Syllabus Review, Introductions, Introduction to DSM-5 and Differential Diagnosis;
DSM-5 Classification; Neurodevelopmental Disorders
Class 2:
Bipolar and Related Disorders; Depressive Disorders
Class 3:
Anxiety Disorders; Obsessive-Compulsive and Related Disorders; Trauma- and
Stressor-Related Disorders
Class 4:
Substance-Related and Addictive Disorders
Class 5:
Schizophrenia Spectrum and Other Psychotic Disorders; Mid-Term Exam given in
class
Class 6:
Personality Disorders (Borderline/Antisocial); Feeding and Eating Disorders
(Anorexia/Bulimia/Binge Eating Disorder)
Class 7:
Disruptive, Impulse-Control, and Conduct Disorders (ODD/Conduct Disorder) ;
Neurocognitive Disorders (Dementia)
DETAILED CLASS SCHEDULE
WEEK 1 – JANUARY 11
Topic: Syllabus Review, Introductions, Introduction to DSM-5 and Differential Diagnosis; DSM-5
Classification; Neurodevelopmental Disorders (ADHD; Autism Spectrum;
Intellectual disability)
Readings:
61 pages total
Morrison text: Chapter 1 - pp. 17-38 which covers Intellectual disability, Autism and ADHD
Goodman, R., & Scott, S. (2012). Child Psychiatry (3rd Ed.). (pp. 3-21) Somerset, NJ: John Wiley & Sons.
Retrieved from http://www.ebrary.com
This is a very useful summary of how to conduct a diagnostic assessment with a child and how to make
sense of the various presenting symptoms.
McQuaide, S. (1999). A social worker’s use of the diagnostic and statistical manual. Families in Society, 80(4),
410-416. (This article was also assigned in your SOWO 505 class, so just review this article. It nicely
summarizes social work’s key ethical concerns about the use of the DSM)
Poland, J. & Caplan, P. (2004). The deep structure of bias in psychiatric diagnosis. In P. Caplan & L. Cosgrove
(Eds.), Bias in psychiatric diagnosis (pp. 9-23). NY: Jason Aronson.
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Rapin, I. (2001). An 8-year-old boy with Autism. Journal of the American Medical Association, 285, 17491757.
Feldman, H.M. & Reiff, M.I. (2014). Attention deficit-hyperactivity disorder in children and adolescents. New
England Journal of Medicine, 370, 838-846.
Optional Reading:
DSM-5: Neurodevelopmental Disorders, pp. 31-86.
Volkow, N.D. & Swanson, J.M. (2013). Adult attention-deficit hyperactivity disorder. New England Journal of
Medicine, 369, 1935-1944.
Baker, J.P. (2013). Autism at 70—redrawing the boundaries. New England Journal of Medicine, 369,10891091.
JANUARY 18- NO CLASS- MARTIN LUTHER KING HOLIDAY
WEEK 2 – JANUARY 25
Topic:
Bipolar and Related Disorders; Depressive Disorders
Readings:
75 pages total
Morrison text: Chapter 3
Sachs, G.S. (2001). A 25-year-old woman with bipolar disorder. Journal of the American Medical Association,
285, 454-462.
Frye, M.A. (2011). Bipolar disorder—A focus on depression. New England Journal of Medicine, 364, 51-59.
Salzman, C. (2006). A 60-year-old woman who has felt sad for much of her life. Journal of the American
Medical Association, 295, 318-323.
Optional Readings:
DSM 5: Mood Disorders, pp. 123-189
Viguera, A.C., et al. (2008). Case 24-2008: A 35-year-old woman with postpartum confusion, agitation, and
delusions. New England Journal of Medicine, 359, 509-515.
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Schroeder, S.A. (2009). A 51-year-old woman with bipolar disorder who wants to quit smoking. Journal of the
American Medical Association, 301, 522-531.
Kroenke, K. (2002). A 75-year-old man with depression. Journal of the American Medical Association, 287,
1568-1576.
Kennedy, N. Boydell, J. Van Os, J. & Murray, R.M. (2004). Ethnic differences in the presentation of bipolar
disorder: Results from an epidemiological study. Journal of Affective Disorders, 83, 161-168.
WEEK 3 – FEBRUARY 1
Topic:
Anxiety Disorders; Obsessive-Compulsive and Related Disorders; Trauma- and StressorRelated Disorders
Readings:
82 pages total
Morrison text: Chapters 4, 5 and 6
Hinton, D. E., & Lewis-Fernández, R. (2011). The cross-cultural validity of posttraumatic stress disorder:
Implications for DSM-5. Depression and Anxiety, 28(9), 783-801. doi:10.1002/da.20753
Optional Readings:
DSM 5: Anxiety Disorders, OCD and related and Trauma and Stressor and Related, pp. 189-291.
Marouf, F., Giallourakis, C., Baer, L., Hanau, M. & Holbert, B. (2013). Case 33-2013: A 40-year-old woman
with abdominal pain, weight loss and anxiety about cancer. New England Journal of Medicine, 369, 16391647.
Katon, W.J. (2006). Panic disorder. New England Journal of Medicine, 354, 2360-2367.
Jenike, M.A. (2004). Obsessive-compulsive disorder. New England Journal of Medicine, 350, 259-265.
Caren, G. S., & David Mataix-Cols. (2014). Hoarding disorder. The New England Journal of Medicine, 370,
2023-2030.
Stamm, B.H. & Friedman, M.J. (2000). Cultural diversity in the appraisal and expression of trauma. In A.Y.
Shalev, R. Yehuda, & A.C. McFarlane (Eds.), International handbook of human response to trauma (pp.
69-85). Dordrecht, Netherlands: Kluwer Academic Publishers.
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WEEK 4 – FEBRUARY 8
Topic: Substance-Related and Addictive Disorders
Readings:
100 pages total (the Morrison chapter is very long because he reviews each substance and
gives case examples—you can skip the case examples to cut down on your reading)
Morrison text: Chapter 15
Schuckit, M.A. (2009). Alcohol-use disorders. The Lancet, 373, 492-501.
Hodgins, D.C., Stea, J.N., & Grant, J.E. (2011). Gambling disorders. The Lancet, 378, 1874-1884.
Optional Readings:
DSM 5: Substance-Related Disorders, pp. 481-590
O’Brien, C.P. (2008). A 50-year-old woman addiction to heroin: A review of the treatment of heroin addiction.
Journal of the American Medical Association, 300, 314-321.
Knight, J.R. (2004). A 35-year-old physician with opioid dependence. Journal of the American Medical
Association, 292, 1351-1357.
WEEK 5 – FEBRUARY 15
MID-TERM EXAM- to be given in class at beginning of class
Topic:
Schizophrenia Spectrum and Other Psychotic Disorders;
Readings:
61 pages total
Morrison text: Chapter 2
Goff, D.C. (2002). A 23-year-old man with schizophrenia. Journal of the American Medical Association, 287,
3249-3257.
Optional Readings:
DSM 5: Schizophrenia and Other Psychotic Disorders, pp. 87-122
Onishi, H., et al. (2003). Brief psychotic disorder associated with bereavement in a patient with terminal-stage
uterine cervical cancer: A case report and review of the literature. Support Care Cancer, 11, 491-493.
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Jordan, H.W., et al. (2006). Erotomania revisited: Thirty-four years later. Journal of the National Medical
Association, 98, 787-793.
van Meijel, B., van der Gaag, M., Sylvain, R., & Grypdonch, M. (2004). Recognition of early warning signs in
patients with schizophrenia: A review of the literature. International Journal of Mental Health Nursing, 13,
107-116.
Mosqueda, L., & Dong, X. (2011). Elder abuse and self-neglect: “I don’t care anything about going to the
doctor, to be honest….”
Ritchie, C.S., Roth, D.L., & Allman, R.M. (2011). Living with an aging parent: “It was a beautiful invitation.”
Journal of the American Medical Association, 306, 746-753.
WEEK 6 – FEBRUARY 22
Topic:
Personality Disorders (Borderline/Antisocial); Feeding and Eating Disorders
(Anorexia/Bulimia/Binge Eating Disorder)
Readings:
95 pages total
Morrison text: Chapters 9 and 17
Oldham, J.M. (2002). A 44-year-old woman with borderline personality disorder. Journal of the American
Medical Association, 287, 1029-1037.
Mehler, P.S. (2003). Bulimia nervosa. New England Journal of Medicine, 349, 875-881.
Yager, J., & Anderson, A.E. (2005). Anorexia nervosa. New England Journal of Medicine, 353, 1481-1488.
Optional Readings:
DSM 5: Personality Disorders, pp. 645-684
DSM 5: Eating and Feeding Disorders, pp. 329-354
Calliess, I.T., Sieberer, M., Machleidt, & Ziegenbein, M. (2008). Personality disorders in a cross-cultural
perspective: Impact of culture and migration on diagnosis and etiological aspects. Current Psychiatry
Reviews, 4(1), 39-47.
Paris, J. (2003). Personality disorders over time: Precursors, course and outcome. Journal of Personality
Disorders, 17(6), 479-488.
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WEEK 7 – FEBRUARY 29
Topic: Disruptive, Impulse-Control, and Conduct Disorders (ODD/Conduct Disorder); Neurocognitive
Disorders (Dementia)
Readings: 110 pages total
Morrison text: Chapters 14 and 16
Blair, J., Leibenluft, E. & Pine, D. (2014). Conduct disorder and callous-unemotional traits in youth. New
England Journal of Medicine, 371, 2207-2216.
Kimonis, E.R. & Frick, P.J. (2010). Oppositional defiant disorder and conduct disorder grown-up. Journal of
Developmental & Behavioral Pediatrics, 31(3), 244-254.
Mitchell, S.L. (2007). A 93-year-old man with advanced dementia and eating problems. Journal of the
American Medical Association, 298, 2527-2536.
Optional Readings:
DSM-5: Disruptive, Impulse-Control and Conduct Disorders, pp. 461-480
DSM-5: Neurocognitive Disorders, pp. 591-644
Breitbart, W., & Alici, Y. (2008). Agitation and delirium at the end of life: “We couldn’t manage him.” Journal
of the American Medical Association, 300, 2898-2911.
Hamilton, S.S. & Armando, J. (2008). Oppositional defiant disorder. American Family Physician, 78(7), 861866.
Ellison, J.M. (2008). A 60-year-old woman with mild memory impairment: Review of mild cognitive
impairment. Journal of the American Medical Association, 300, 1566- 1574.
FINAL EXAM DUE NO LATER THAN SATURDAY, MARCH 5 AT MIDNIGHT
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