Mental patients psychiatric examinations

The identity of witches was established by three principal methods confession, examination for witch s marks with or without pricking, and ordeal by water. We shall examine them separately and compare each to contemporary psychiatric methods of identifying mental patients. 

Accurate diagnosis of patients with inhalant use disorders may require a variety of methods, including psychiatric history and mental status examination, physical examination and laboratory testing, neuropsychological testing, and neurophysiological testing. 

Evaluation of the anxious patient requires a complete physical and mental status examination appropriate laboratory tests and a medical, psychiatric, and drug history. 

Table 17.1. In this context, mental retardation deserves special comment. Although most persons with mental retardation are not violent, there is an increased risk of inappropriate aggression among individuals with psychiatric diagnoses in general, including mental retardation. Most research on associations between violence and mental illness has focused on adults. To assess the relationship between aggressive behaviors and psychiatric disorders, it is useful to look at the prevalence of psychiatric disorders in those who have committed violent acts, and to examine the prevalence of violence in psychiatric patients in different settings.

Chapter 1 examined three risperidone studies that confirm the braindisabling principles of psychiatric treatment by demonstrating that the drug causes a metabolic suppression in the frontal and temporal lobes (deactivation) that occurs in both normal persons and patients diagnosed with schizophrenia, and that this disabling effect correlates with a reduction in the expression of symptoms, such as hallucinations and delusions, that require a fully functioning brain. As previously noted, if measured, the effect would also correlate with an overall reduction in spontaneous mental activity and verbal expressions, which are common clinical phenomena in patients who experience psychomotor retardation in response to neuroleptics. 

Additional information besides the DSM-IV-TR diagnosis is required before a comprehensive treatment plan can be developed. The American Psychiatric Association Practice Guidelines for Psychiatric Evaluation of Adults offers a more comprehensive approach to patient assessment. It includes a full discussion of the domains needed for a thorough clinical evaluation, including chief complaint history of present illness past psychiatric history general medical history social, family, and occupational history physical and mental status examinations and diagnostic tests. It further describes issues of privacy, evaluations in the elderly, and techniques for working with multidisciplinary teams. ... 

The mental status examination (MSE) involves an evaluation of a patient s psychiatric condition. The psychiatrist elicits information about the patient s symptoms and observes the patient s appearance and demeanor to identify any signs of pathology. The examiner also gathers biographical and social data, as well as details about the reasons for the contact and the patient s description of problems and complaints. Social and conversational skills are also important indicators of the patient s level of functioning. Furthermore, the mental status examination is designed to assess the patient s reality testing, alertness, memory, and orientation to person, place, and time. 

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