General clinically significant psychiatric condition

Panic Disorder - General clinically significant psychiatric condition Factor

In the SOPs for panic disorder, the RMA has defined "a clinically significant psychiatric condition" to mean  a condition from specified list 1 for clinical onset, and a condition from specified list 2, for clinical worsening

"specified list 1" means one of the Axis I or Axis II disorders of mental health listed below:

(a)        a mood disorder;

(b)       a substance dependence or substance abuse disorder;

(c)        acute stress disorder;

(d)       anxiety disorder;

(e)        obsessive-compulsive disorder;

(f)        phobic anxiety;

(g)       posttraumatic stress disorder;

(h)       substance-induced anxiety disorder;

(i)        eating disorder;

(j)        schizophrenia;

(k)       avoidant personality disorder; - Onset only

(l)        borderline personality disorder; - Onset only

(m)      dependent personality disorder; - Onset only

(n)       histrionic personality disorder; or- Onset only

(o)       obsessive-compulsive personality disorder, - Onset only

that attract a diagnosis under DSM-IV-TR and are severe enough to warrant ongoing management. The ongoing management may involve regular visits (for example, at least monthly), to a psychiatrist, clinical psychologist or general practitioner;

"specified list 2" means one of the Axis I disorders of mental health listed below:

(a)        a mood disorder;

(b)       a substance dependence or substance abuse disorder;

(c)        acute stress disorder;

(d)       anxiety disorder;

(e)        obsessive-compulsive disorder;

(f)        phobic anxiety;

(g)       posttraumatic stress disorder;

(h)       substance-induced anxiety disorder;

(i)        eating disorder; or

(j)        schizophrenia,

that attract a diagnosis under DSM-IV-TR and are severe enough to warrant ongoing management. The ongoing management may involve regular visits (for example, at least monthly), to a psychiatrist, clinical psychologist or general practitioner;

Generally it would be expected that if a psychiatric disorder warranted treatment then treatment would be sought.  However, where treatment was not sought, a person's psychiatric disorder might still meet the RMA definition if there was persuasive and professional evidence, based on a comprehensive clinical history, that ongoing management had been warranted.

Note:  As the specified lists for clinical onset and clinical worsening differ the factor has been split into two factors; general and specific.  The five conditions (identified in list 1 above) have been separated out under the factor specific clinically significant psychiatric condition for the onset of panic disorder as they only apply in the clinical onset path.  All the other conditions apply to both the clinical onset and clinical worsening path.  Therefore if you are investigating a psychiatric condition for the clinical onset path only, you may also need to consider the 'specific' factor to address these additional conditions.

LAST REVIEWED FOR CCPS 21 MAY 2010.

PRELIMINARY QUESTIONS [41388]

1709     the veteran has had a psychiatric condition at some time.

41398  a clinically significant psychiatric condition means a psychiatric condition as defined in the Statements of Principles for panic disorder.

26043 the identified illness or injury, a psychiatric condition, has been clinically significant at some time.

26320  the veteran has established the causal connection between the psychiatric disorder and VEA service for the condition under consideration.

22877 the identified illness or injury, a psychiatric condition, was clinically significant at the time of the clinical onset of the condition under consideration.

26322   the veteran has established the causal connection between the psychiatric disorder and VEA service for the clinical onset of the condition under consideration.

26327  the veteran has established the causal connection between the psychiatric disorder and operational service for the clinical onset of the condition under consideration.

or

26328  the veteran has established the causal connection between the psychiatric disorder and eligible service for the clinical onset of the condition under consideration.

or

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

35214 the identified illness or injury, a psychiatric condition, was clinically significant at the time of the clinical worsening of the condition under consideration.

26326   the veteran has established the causal connection between the psychiatric disorder and VEA service for the clinical worsening of the condition under consideration.

26329  the veteran has established the causal connection between the psychiatric disorder and operational service for the clinical worsening of the condition under consideration.

or

26330  the veteran has established the causal connection between the psychiatric disorder and eligible service for the clinical worsening of the condition under consideration.

CLINICAL ONSET AND OPERATIONAL SERVICE [26327]

26044  the identified illness or injury, a clinically significant psychiatric condition, is causally related to operational service.

CLINICAL ONSET AND ELIGIBLE SERVICE [26328]

26045  the identified illness or injury, a clinically significant psychiatric condition, is causally related to eligible service.

CLINICAL WORSENING AND OPERATIONAL SERVICE [26329]

26044  the identified illness or injury, a clinically significant psychiatric condition, is causally related to operational service.

6029     the clinical onset of the veteran's condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a clinically significant psychiatric condition, is causally related.

CLINICAL WORSENING AND ELIGIBLE SERVICE [26330]

26045  the identified illness or injury, a clinically significant psychiatric condition, is causally related to eligible service.

6030     the clinical onset of the veteran's condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, a clinically significant psychiatric condition, is causally related.