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Psycology » Psychiatry and psychotherapy » Methods of study of mentally ill » Somatic, neurological examination and laboratory

  1. Questioning. History
  2. The method of psychological examination
  3. Neuropsychological testing
  4. Neuroimaging examination and pharmacological methods
  5. Somatic, neurological examination and laboratory
  6. Special laboratory techniques

Study of somatic condition in psychiatry is mandatory method, since the psyche and somatic are in close unity and often have a correlation. In addition, many mentally ill because of the nature of the condition do not give yourself and your physical status due attention, do not comply with the rules of hygiene, they are more likely, than in the general population exhibit tuberculosis, other infectious diseases.

Important to consider that somatic symptoms may be a manifestation of a particular mental disorder. For example, depression is accompanied by hypertension, tachycardia, constipation, weight loss. It is important to bear in mind that the structural features of the body may indicate the specific type of psycho-physiological constitution (pyknic type, asthenic, hypersthenic, athletic) or the presence of dysplasia.

Somatic examination involves study of the state of the skin, mucous membranes, cardiovascular and pulmonary systems, the gastrointestinal tract. External examination allows to establish the presence of scars, scars and traces of self-cutting, intravenous injection, which occurs in patients with addiction. In the process of monitoring of patients in the hospital are monitored systematically indicators pulse, blood pressure, if necessary specialized support consultant physician (suspected pneumonia, acute infectious diseases, etc.). For somatic debilitated patients under constant surveillance with temperature measurement, description physiological functions.

Neurological Examination Necessary to study the characteristics of the nervous system and excluding evidence of organic CNS. Consultation with a neurologist is indicated for a suspected brain tumor, the diagnosis of various vascular brain lesions, atrophic brain processes, the effects of various neuroinfections (encephalitis, meningitis, neurosyphilis). Peripheral nerve serves as confirmation of the presence of alcohol intoxication (polyneuritis) or beriberi. Incoordination, tremor, nystagmus - objective symptoms of traumatic brain injury, various types of toxicity (mercury, lead), multiple sclerosis, amyotrophic lateral sclerosis, abstinence from drug addicts. An important feature of organic brain damage are seizures.

Observation neurologist is indicated in patients taking large doses of neuroleptics, as they show signs of muscle stiffness, tremor, a symptom of "gear", hyperkinesis, torsion spasm.

In some cases, for example in the form of catatonic schizophrenia, movement disorders are not associated with organic brain damage. A variety of movement disorders observed in hysteria (here except seizures, paralysis observed various forms of sensory disturbances or hyperesthesia gipostezii).

For suspected organic pathology ophthalmologic examination performed to examine the status fundus vessels structure, definition of the fields of view, signs of increased intraocular pressure. Evidence of vascular brain lesions are sclerotic changes vascular spasm, crimped pattern of arterioles, venules expansion.

On examination, the patient's psychiatrist draws attention to the reaction of his pupils to light. It allows you to diagnose diseases such as paralysis and syphilis of the brain (no response of pupils to light, while maintaining the reaction at the accommodation and convergence, or Argyll Robertson symptom). Change the width of the pupil observed in drug intoxication (miosis - when opium intoxication, mydriasis - with cocaine). Mydriasis observed in patients endogenous depression, as well as various acute psychosis accompanied by fear.


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