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Tambourine-Man
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27 Sep 2011, 6:00 pm

Supposedly I have autistic disorder and mood disorder - not otherwise specified.

I looked up md-NOS on Wickipedia and found two sentences.

Does anyone know why this label exists and how it can be of benefit to anyone?


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Apple_in_my_Eye
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27 Sep 2011, 7:05 pm

I think it's a matter of there being more things that can go wrong with people than can be named and given a diagnosis code in the DSM. You'll probably have to talk to the person who made the dx to find out what they meant.



godoftruemercy
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01 Oct 2011, 12:43 pm

Like Apple_in_my_Eye said, not all mood disorders fit DSM guidelines. A DSM diagnosis is mainly a way to get insurance companies to pay for treatment anyway, so I wouldn't worry too much. Ask your psychiatrist for an extensive rundown of why you're NOS anyway. It could be an important factor in which kind of treatment you receive.



nikaTheJellyfish
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01 Oct 2011, 6:36 pm

Basically this is the catch all category for mood issues that do not fit under another mood disorder. I would definitely ask why you got the NOS diagnosis. Also I know that at times for me sensory overload can look like a mood disorder NOS because to a psych professional my mood issues may look random, but to me sensory issues are anything other than random. If you are getting stressed or angry due to over stimulation or frustrations with communication make sure your psych person knows this.



NeantHumain
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02 Oct 2011, 1:05 am

The DSM-IV-TR diagnostic nosology has a node-leaf structure. These are underpinned by ICD-9-CM codes used for insurance purposes. The ICD-9-CM uses x.8/9 for not otherwise specified (NOS) diagnoses in a given category. For example, DSM-IV-TR "Asperger's Disorder" has ICD-9-CM code 299.80, which technically gives it the code of Pervasive Developmental Disorder, Not Otherwise Specified. The UN World Health Organization published the ICD-9 back in 1977, and the U.S. medical-insurance industry has been trying to lurch along with its Clinicial Modification until just recently (Medicare is finally forcing the industry to update to the ICD-10-CM, and the ICD-10 was only published in 1991 with a specific code for Asperger's Syndrome).

Code:
+ Axis I
  + Mood Disorders
    + Depressive Disorders
      - Dysthymic Disorder
      + Major Depressive Disorder
        - Single Episode
        - Recurrent
      - Depressive Disorder, Not Otherwise Specified (minor depression, brief depressive episodes, etc.)
    + Bipolar Disorders
      - Cyclothymic Disorder
      - Bipolar I Disorder
      - Bipolar II Disorder
      - Bipolar Disorder, Not Otherwise Specified
    - Mood Disdorder Due to a General Medical Condition
    - Substance-Induced Mood Disorder
    - Mood Disorder, Not Otherwise Specified

Things will change considerably in the DSM 5, and the ICD-10 separates manic episodes without the presence of depressive episodes from bipolar affective disorders.



mcsquared
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03 Oct 2011, 10:55 pm

Tambourine-Man wrote:
Supposedly I have autistic disorder and mood disorder - not otherwise specified.
Does anyone know why this label exists and how it can be of benefit to anyone?


It seems like the psychiatrist is either too lazy or too obsessed with having some label to use as placeholder because they can't figure out.
Maybe for insurance, maybe as an excuse to put you on meds, maybe because they want to give it some thought before giving you a more serious label.
But sometimes they don't know about autism to realize when something can be explained by that and not some separate disorder so make sure they know ASD well before they try to add something to that.



kopetski
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10 Oct 2011, 8:06 am

i don't like this last one. Sorry, I studied to become a psychologist, I knew DSM-criteria by heart, so don't go telling me this.

DSM 4 is the book/bible with criteria for all mental disorders. If you have Major depression, you should fall under these criteria : http://www.mental-health-today.com/dep/dsm.htm
If you fit all criteria, except one, for example, then you have Major Depression but .. not entirely, so they will have to diagnose you as Mood Disorder NOS. That's how things work, also with Autism/aspergers. If you don't fit ALL criteria for a specific diagnose, they have to add NOS to it.
Other explanation is possible too. You can dig up those criteria yourself and try to see where you fit in.



NeantHumain
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10 Oct 2011, 9:25 am

kopetski wrote:
i don't like this last one. Sorry, I studied to become a psychologist, I knew DSM-criteria by heart, so don't go telling me this.

DSM 4 is the book/bible with criteria for all mental disorders. If you have Major depression, you should fall under these criteria : http://www.mental-health-today.com/dep/dsm.htm
If you fit all criteria, except one, for example, then you have Major Depression but .. not entirely, so they will have to diagnose you as Mood Disorder NOS. That's how things work, also with Autism/aspergers. If you don't fit ALL criteria for a specific diagnose, they have to add NOS to it.
Other explanation is possible too. You can dig up those criteria yourself and try to see where you fit in.

Well, no, the diagnostic books (DSM-IV-TR and ICD-10) specify a threshold of criteria that must be met to qualify for diagnosis, so a patient does not necessarily need to meet every criterion. If the patient's clinical presentation does not meet threshold criteria for major-depressive disorder but still causes marked impairment, they would qualify for depressive disorder – not otherwise specified rather than mood disorder – not otherwise specified. Mood disorder – NOS is for when the disorder is clearly one of mood but does not fit into any depressive or bipolar pattern.



jackbus01
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12 Oct 2011, 7:56 am

That is the same for me. I technically got the md-nos diagnosis. I have had severe reoccurring episodic depressions but it is unclear whether I had any hypomanic epsisodes or if those were attributed to any antidepresant use. Maybe this is best described as bipolar type 2.
The important question is does that label make sense and is the treatment that you are receiving make sense. The combination of autism and mood disorder is probably going to look different than just mood disorder by itself. My experience as a patient (or consumer or whatever) is that a good doctor will treat symptoms and try to work with you on what meds work and what doesn't.



LunaUlysses
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28 Oct 2011, 5:29 am

Aspergers-tendencies and bipolar2 maybe?