APPROACH TO PSYCHIATRIC DISORDERS

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APPROACH TO PSYCHIATRIC DISORDERS

• BACKGROUND
• INTERVIEW
• MENTAL STATUS EXAMINATION
• INVESTIGATIONS

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OBJECTIVES OF THE ASSESSMENT

• CLINICAL DIAGNOSIS
• PERSONALITY DIAGNOSIS
• ASSESSMENT OF FUNCTIONAL STATUS
• ASSESSMENT OF RESOURCES
• ASSESSMENT OF FITNESS FOR VARIOUS CONDITIONS

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EVALUATION OF PSYCHIATRIC ILLNESS

• PSYCHIATRIC HISTORY
• MEDICAL HISTORY
• FAMILY HISTORY
• PERSONAL HISTORY
• MENTAL STATUS EXAMINATION

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HOMOEOPATHIC ASECT OF CASE TAKING

• CROSS SECTION STUDY OF PATIENT
• LONGITUDINAL STUDY OF PATIENT
• DIAGNOSIS OF DISEASE
• DIAGNOSIS OF PATIENT
• DIAGNOSIS OF REMEDY

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INTERVIEW TECHNIQUE

• DOCTOR- PATIENT RELATIONSHIP
• PHASES OF INTERVIEW
• SPECIFIC TECHNIQUE
• TYPES OF INTERVIEW

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INTERVIEW PROPER
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MENTAL STATE EXAMINATION

• APPEARANCE
• SPEECH
• EMOTIONAL EXPRESSIONS
• THINKING PERCEPTION
• SENSORIUM

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APPEARANCE BEHAVIOR

• Person sitting Quietly in waiting room

NO
MOUTH CORNERS TURN DOWN
YES
MANIC
PSYCHOTIC ILLNESS SENILE ILLNESS PARKINSON PSYCHOT
ROPIC DRUGS
DEPRESSION
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DISORDERED CONDITION
YES
NO
PSYCHOTIC ILLNESS
NEUROTIC DEPRESSION
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GAIT - BEHAVIOR - ATTITUDE
Hurried
Overt Behavior Psychomotor activity
Ambivalence Attention Overt friendly Seduction Apa
thetic Hostile
ANXIETY
Gestures Tics Mannerism Rigidity Restlessness Extr
a pyramidal symptoms
HYSTERIA
SCHIZO
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RESTLESSNESS
With purpose of letting out something
With Anger
With Inappropriate Happy mood
With slowness
With Purposeless movement
ANXIETY
AGITATION
MANIA
CNS ILLNESS PSYCHOTIC
SENILTY M.R PSYCH.DRUGS SUBSTANCE WITHDRAWAL
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SPEECH
Rapid Hesitant Pressurized
Aphasia
Dramatic
Functional disturbances
Slow Monotonous
ORGANIC STATES
Stammering
confused
ANXIETY PSYCHOTIC
ANXIETY AC. SCHIZ
Mutism
SCHIZO
Dist.Childhood Hysteria Depression Schizophrenia C
oarse brain diseases
M.R DEPRESSION PSYCHOTIC
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THINKING
Retarded
Form
Content of Thought
Accelerated
SCHIZOPHRENIA
Flight of Ideas
DEPRESSION SENILITY ORGANIC STATE M.R.
Delusions
MANIA ORGANIC STATE SCHIZO
Persecutory
Jealous
Grandiose
SCHIZOPHRENIA
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PERCEPTION
SENSORY DISTORTION
SENSORY DECEPTION
?? ??
ILLUSION
HALLUCINATION
PHYSIOLOGICAL HYPOCHONDRICAL RETINAL
DISEASES DELIRIUM
Misinterpretation of stimuli
Perception without object
CAN OCCUR IN NORMAL
Auditory
Visual
Olfactory
Tactile
SCHIZOPHRENIA
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MEMORY
Amnesia
Dysamnesia
Organic
Psychogenic
Disorder Of Recall
Distortion of Recognition
AC./SUB AC. COARSE BRAIN DISEASES
CONFUSION PSYCHOSIS PARONIOD May occur in normal
ANXIETY HYSTERIA DISSOCIATIVE DISORDER
PSYCHOPATH HYSTERICAL SCHIZO
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EMOTIONS
Abnormal emotional predisposition
Abnormal Expression Of Emotion
Morbid Disorder of Expression of Emotions
Morbid Disorder of Emotions
Abnormal Emotional Reaction
Irritability Dysthymic Cyclothymic Hyperthymic
ANXIETY DEPRESSION
M D P
M D P
SCHIZOPHRENIA
DISSOCIATION DEPERSONLIZATION
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SPECIAL TECHNIQUES AND SKILLS OPEN ENDED VERSUS
CLOSE ENDED QUESTIONS REFLECTION FACILITATION SILE
NCE CONFRONTATION SUMMATION EXPLANATION POSITIVE
REINFORCEMENT REASSURANCE ADVICE STEPS OF
COMMUNICATION AND UTILIZATION OF SKILLS AT
VARIOUS JUNCTURE
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INVESTIGATIONS

• Rarely biochemical, endorcine or neurologically
  based investigations are ordered
• IQ assessment
• Neuropsychological assessment
• Personality assessment