Methods of diagnosis Flashcards
What are the three important aspects of psychiatric assessment?
- History
- Mental State Examination
- Risk Assessment
What should be included in the history assessment?
- History of presenting complaint
- Medical history
- Medication history
- Forensic History (any criminal issues)
- Drug and alcohol
- Family history
- Past psych history
Why is the past medical history important in a psych assessment?
-To see if any medication or medical condition could be inducing psychosis
What is covered in psychiatric assessment?
- Appearance
- Behaviour
- Speech
- Mood
- Cognition
Why is risk assessment important?
- To see if patient is risk to themselves or others
- To determine what setting a patient should be treated in
Why is diagnosis important?
- Clarification of treatment options
- Understanding the problem/difficulty
- Enable health promotion and disease prevention
- Enables further research
- Entitles access to health and social care services
What are the potential social benefits?
- Social care package
- Freedom pass
- Free prescription
- Housing aid
- Help with CV/job-seeking
What is the negative aspect of “labelling”?
- Stigma associated with psychiatric diagnosis (schizophrenia)
- Diagnoses can change so might not seem consistent
- Longer you know patient, more likely to get accurate diagnosis
- Presentation of symptoms may change
What is the positive aspect of “labelling”?
- Provide relief to patients
- “Finally know what’s wrong with me?”
What is formulation?
-A summary and interpretation of the presenting problem (based on assessment)
What are the three Ps?
- Predisposing
- Precipitating
- Perpetuating
What is meant by predisposing factors?
-Factors that make an individual more vulnerable to a mental health issue
What is meant by precipitating factors?
-The factors that currently act as the trigger for their symptoms
What is meant by perpetuating factors?
-The factors that cause the problem to continue
What are examples of biological predisposing factors?
- Genetic
- Chronic illness
What are examples of psychological predisposing factors?
- Domestic violence
- Bereavement
What are examples of social predisposing factors?
-Low income
What are examples of biological precipitating factors?
-Accident
What are examples of psychological precipitating factors?
-Bereavement
What are examples of social precipitating factors?
- War
- Bullying
What are examples of biological perpetuating factors?
-Substance use
What are examples of psychological perpetuating factors?
-Complex family dynamic
What are examples of social perpetuating factors?
- Low simulation
- Limited access to meaningful activities
What is the meaning of diagnosis?
-The identification of a disease or other problems by means of its symptoms, signs and investigation results
What is a diagnostic criteria?
-An algorithm or a classification/ list of features required to demonstrate a specific diagnosis
What is neuroses?
-Usually the patient retains insight and orientation; they experience deep distress and may commit suicide
What are examples of neuroses?
-Depression, Anxiety, Mania, Obsessions and Compulsions
What is the psychoses?
-The patient is disorientated, deluded, and lacking in insight
What are examples of psychoses?
-Schizophrenia
What are dementias?
-Progressive deterioration with loss of recent memory and deterioration of a normal personality
What is the current hierarchy of diagnostic psychiatry?
1) Organic disorders
2) Psychotic disorders
3) Mood disorders
4) Anxiety disorders
5) Personality disorders
What are examples of organic disorders?
- Disorders related to drug and alcohol misuse
- Delerium
- Dementia
What are examples of mood disorders?
- Depression
- Bipolar affective disorder
What are examples of aniexty disorders?
- Panic
- Anxiety
- PTSD
What are examples of personality disorders?
- Dependent personality disorder
- Bipolar personality disorder
What are the two current diagnostic systems?
- ICD 10/11
- DSM IV/V
What happens after formulation?
- First: Consider which group of conditions it will fall in to (using diagnostic hierarchy)
- Second: Consider which specific condition meets the DSM/ICD criteria
What is a differential diagnosis?
-A shortlist of diagnoses that could account for a symptom/set of symptoms, signs, and investigation results
