TABLE 4. Likert-scale scores of round 2 criteria. Diagnostic criteria Disagree or strongly disagree Agree or strongly agree Action after analysing the comments Structured psycho-diagnostic testing, including personality testing when relevant, should be performed, unless the psychiatrist provides clear reasons why it is not necessary. 32% 55% Accepted When establishing irremediable psychiatric suffering a narrative account must be given, that includes etiology and pathogenesis, in addition to the classification according to the DSM-5. 2% 91% Accepted There are limits to the number of new diagnostic procedures a patient must undertake before it can be said that the psychiatric suffering is irremediable. For example: a patient or psychiatrist may refrain from further diagnostic procedures on reasonable grounds, such as a long history of illness and treatment. 6% 81% Accepted Treatment criteria Disagree or strongly disagree Agree or strongly agree Action after analysing the comments Because it is often difficult to establish a reliable prognosis, the judgment about non-remediable psychiatric suffering must be based on the failure of treatment in the past. 11% 66% Accepted Because all reasonable treatments must be tried, the psychiatric suffering must be present for several years before irremediable psychiatric suffering can be established. 15% 81% Accepted If indicated, psychosurgery (such as DBS) must be discussed and offered to the patient before irremediable psychiatric suffering can be established. 28% 62% Accepted If indicated, at least one acceptance-oriented psychotherapy must have been attempted without leading to a significant reduction in suffering before irremediable psychiatric suffering can be established. 13% 66% Accepted If there are indications that entering into a repeated psychotherapeutic trajectory is meaningful, this must be offered before irremediable psychiatric suffering can be established. For example: because conditions were sub-optimal in previous therapy. 4% 70% Accepted There are limits to the number of treatments a patient must undergo before it can be referred to as irremediable psychiatric suffering. For example, patient or psychiatrist may refrain from further treatment on reasonable grounds, such as a long history of illness and treatment and / or the prospect of serious side effects. 11% 81% Accepted DSM-5 = Diagnostic statistical manual fifth edition | DBS = deep brain stimulation 108 | PART III - CHAPTER 6 6
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