Introduction
This chapter covers conditions and problems that may attract clinical attention or otherwise affect diagnosis, course, prognosis, or treatment. The conditions are not diagnoses or mental disorders. They are issues that may affect patient care and help explain the need for a test, procedure, or treatment. These may also be included in medical records as useful information. Including them in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) acknowledges that a broad range of additional issues can impact patient care. Documenting them systematically is useful to clinicians and beneficial to patients.
These conditions have International Statistical Classification of Diseases and Related Health Problems codes ICD-9-CM (V codes) and ICD-10-CM (Z codes) and include: relational problems; child abuse (physical and sexual) and neglect; partner abuse or violence (psychological, physical, and sexual); educational and occupational problems; housing and economic problems; other problems related to the social environment; problems related to crime or interaction with the legal system; other health service encounters for counselling and medical advice; problems related to other psychosocial, personal, and environmental circumstances; other circumstances of personal history; problems related to access to medical treatment; non-adherence to medical treatment; overweight or obesity; and malingering,
This chapter specifically examines various problems related to relationships, child and adult maltreatment and neglect, housing and economic difficulties, and other psychosocial, personal, and environmental circumstances.
Many of the issues to be discussed occur in addition to other presentations/diagnoses. As such, they are likely to be addressed in the context of other presentations. Therefore, treatment should typically follow guidelines for main presentation/diagnosis. In addition to the conditions addressed here, refer to the DSM-5 for information on various other problems that may be the focus of clinical attention.
Australia
Relational problems
Recent statistics on incidence and prevalence indicate the number of divorces decreased in 2013 by 2279 (4.6%) and the crude divorce rate decreased from 2.2 divorces per 1000 population in 2012 to 2.1 in 2013 (Australian Bureau of Statistics [ABS], 2014). About 31.6% of children aged 5–9 years who had a natural parent living elsewhere had daily/weekly frequency of face-to-face contact between parent and child, compared to 24% of less than once a year or never (ABS, 2011).