Hi! I'll be glad to be of help with this issue.
I can imagine how frustrating this situation must be for you. Psychiatric terms and descriptions can seem like they are very precise. And yet how the diagnoses were arrived at can be very mysterious. This is because there are no blood tests or MRIs or similar types of batteries of tests that are done either as outpatients or in the hospital psychiatric departments. Rather, psychiatric diagnoses are a matter of matching symptoms with diagnostic criteria.
And this is actually the key to my answer to you that you need to consider and think about. There were no batteries of tests conducted to arrive at the diagnosis you describe. Let's start with Somatization Disorder (SD). The diagnostic criteria (referred to as the DSM criteria, because the DSM is the reference work from the Am. Psychiatric Assn. that lists the symptoms that we use to diagnose all mental health disorders) for SD are not that long, but they require evaluating the patient's history in detail. Here is a copy of the DSM criteria for Somatization Disorder on a web page I found for you:
Psychosis, NOS (Not Otherwise Specified) is a DSM diagnosis for a psychotic episode that the doctors did not see as related to a medical condition, drug use, or ongoing schizophrenia or other thought disorder. That would be diagnosed by an interview with the patient and evaluation of the patient's responses and behavior during the interview(s) along with reports of the patient's behavior outside of the interview. The psychiatrist might or might not use a formal Mental Status Exam. The DSM doesn't require this for that diagnosis. Here, though, is a page I found on the web that gave a good overview of what the Mental Status Exam is like. You can see it's also a framework for interviewing a patient but a little more formal:
Now, your final question really gets us to the subjective part of the psychiatric diagnosis process. The Axis 5 GAF Scale, which you are referring to when you say a score of 35, is the psychiatrist's judgment about the patient's overall functioning. Here is a copy from the DSM of what the page in the manual on the Scale looks like:
So, you can see that a score of 35 means that the patient has some significant impairment both in functioning and functionality. The ability to work is impaired, there might be some psychosis, and there might be other problems as well.
Okay, I wish you the very best!
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