Diagnostic Tests for Psychosis
Psychosis Tests: Book Excerpts
Home Diagnostic Testing
These home medical tests may be relevant to Psychosis:
- Child Behavior: Home Testing
- Mental Health (Adults): Home Testing
- Mental Health: Home Testing:
- Brain & Neurological Disorders: Related Home Testing:
Psychosis Diagnosis: Book Excerpts
Diagnostic Tests for Psychosis: Online Medical Books
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HALLUCINATIONS:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
A blood alcohol level and urine drug screen are essential at the outset. Most physicians will want to refer the patient to a psychiatrist if these studies are negative. However, the interested physician may proceed further with a wake-and-sleep EEG to identify psychomotor epilepsy, or a CT scan and MRI to identify brain tumors and other causes of organic brain syndrome. Remember, the MRI costs twice as much as a CT scan. A spinal tap will be helpful in diagnosing central nervous system lues. A sleep study will help diagnose narcolepsy. Psychometric testing will help identify schizophrenia and other psychiatric disorders.
» READ BOOK EXCERPT ONLINE »
Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Violent behavior:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
During your evaluation, determine if the patient has a history of violent behavior. Is he intoxicated or suffering symptoms of alcohol or drug withdrawal? Does he have a history of family violence, including corporal punishment and child or spouse abuse? (See Understanding family violence.)
Watch for clues indicating that the patient is losing control and may become violent. Has he exhibited abrupt behavioral changes? Is he unable to sit still? Increased activity may indicate an attempt to discharge aggression. Does he suddenly cease activity (suggesting the calm before the storm)? Does he make verbal threats or angry gestures? Is he jumpy, extremely tense, or laughing? Such intensifying of emotion may herald loss of control.
If your patient’s violent behavior is a new development, he may have an organic disorder. Obtain a medical history, and perform a physical examination. Watch for a sudden change in his level of consciousness. Disorientation, failure to recall recent events, and display of tics, jerks, tremors, and asterixis all suggest an organic disorder.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Psychotic behavior:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
Because the patient’s behavior can
make it difficult — or potentially dangerous — to obtain pertinent information, conduct the interview in a calm, safe, and well-lit room. Provide enough personal space to avoid threatening or agitating the patient. Ask him to describe his problem and circumstances that may have precipitated it. Obtain a drug history, noting especially the use of an antipsychotic, and explore his use of alcohol and other drugs, such as cocaine, indicating duration of use and amount. Ask about recent illnesses or accidents.
As the patient talks, watch for cognitive, linguistic, or perceptual abnormalities such as delusions. Do thoughts and actions seem to match? Look for unusual gestures, posture, gait, tone of voice, and mannerisms. Does the patient appear to be responding to stimuli? For example, is he looking around the room?
Interview the patient’s family. Which family members does he seem closest to? How does the family describe the patient’s relationships, communication patterns, and role? Has a family member ever been hospitalized for psychiatric or emotional illness? Ask about the patient’s compliance with his drug regimen.
Finally, evaluate the patient’s environment, educational and employment history, and socioeconomic status. Are community services available? How does the patient spend his leisure time? Does he have friends? Has he ever had a close emotional relationship?
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Violent behavior:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
During your evaluation, determine if the patient has a history of violent behavior. Is he intoxicated or suffering symptoms of alcohol or drug withdrawal? Does he have a history of family violence, including corporal punishment and child or spouse abuse? (See Understanding family violence, page 800.)
Watch for clues indicating that the patient is losing control and may become violent. Has he exhibited abrupt behavioral changes? Is he unable to sit still? Increased activity may indicate an attempt to discharge aggression. Does he suddenly cease activity (suggesting the calm before the storm)? Does he make verbal threats or angry gestures? Is he jumpy, extremely tense, or laughing? Such intensifying of emotion may herald loss of control.
If your patient’s violent behavior is a new development, he may have an organic disorder. Obtain a medical history, and perform a physical examination. Watch for a sudden change in his level of consciousness. Disorientation, failure to recall recent events, and a display of tics, jerks, tremors, and asterixis all suggest an organic disorder.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Psychotic behavior:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
Because the patient’s behavior can make it difficult—or potentially dangerous—to obtain pertinent information, conduct the interview in a calm, safe, and well-lit room. Provide enough personal space to avoid threatening or agitating the patient. Ask him to describe his problem and any circumstances that may have precipitated it. Obtain a drug history, noting especially use of an antipsychotic, and explore his use of alcohol and other drugs such as cocaine, indicating duration of use and amount. Ask about any recent illnesses or accidents.
As the patient talks, watch for cognitive, linguistic, or perceptual abnormalities such as delusions. Do thoughts and actions seem to match? Look for unusual gestures, posture, gait, tone of voice, and mannerisms. Does the patient appear to be responding to stimuli? For example, is he looking around the room?
Interview the patient’s family. Which family members does he seem closest to? How does the family describe the patient’s relationships, communication patterns, and role? Has any family member ever been hospitalized for psychiatric or emotional illness? Ask about the patient’s compliance with his drug regimen.
Finally, evaluate the patient’s environment, educational and employment history, and socioeconomic status. Are community services available? How does the patient spend his leisure time? Does he have friends? Has he ever had a close emotional relationship?
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Delirium/Hallucinations:
Diagnostic Approach
(Field Guide to Bedside Diagnosis)
Delirium is characterized by gross disorientation in the presence of alertness and vigilance, disorders of perception with vivid illusions, and psychomotor and autonomic hyperactivity. It usually develops over a short time and is associated
with fluctuating mental status, decreased attention, disorganized thinking as indicated by rambling, irrelevant, or incoherent speech, and a decreased level of consciousness. The most sensitive findings are variability in level of arousal, impaired short-term memory (e.g., digit span), and disorientation to time. Relatives or friends are helpful sources of information about the tempo and degree of impairment.
Fever, tachycardia, or hypertension should prompt a careful evaluation for a medical cause. Infection is a common cause in the elderly, especially pneumonia or urinary tract infection. Visual hallucinations are organic in origin, due to factors such as drugs, rather than due to schizophrenia.
Confusion Assessment1) Change in mental state (from baseline) that is acute and fluctuates. 2) Difficulty focusing attention or trouble keeping track of what is said. 3) Disorganized thinking (rambling or irrelevant conversation, unpredictable switching between subjects, illogical flow of ideas). 4) Altered level of consciousness (lethargy, stupor, or hyperalert). A positive test requires 1 and 2 positive, and either 3 or 4.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Psychotic behavior:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Assess the patient’s appearance, behavior, mood, thought, coping mechanisms, and potential for self-destructive behavior. As the patient talks, watch for cognitive, linguistic, or perceptual abnormalities such as delusions. Do thoughts and actions seem to match? Look for unusual gestures, posture, gait, tone of voice, and mannerisms. Does the patient appear to be responding to stimuli? For example, is he looking around the room?
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Violent behavior:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
During your evaluation, determine whether the patient has a history of violent behavior. Is he intoxicated or suffering symptoms of alcohol or drug intoxication or withdrawal? Does he have a history of family violence, including corporal punishment and child or spouse abuse? (See Understanding family violence.)
Watch for clues indicating that the patient is losing control and may become violent. Has he exhibited abrupt behavioral changes? Is he unable to sit still? Increased activity may indicate an attempt to discharge aggression. Does he suddenly cease activity (suggesting the calm before the storm)? Does he make verbal threats or angry gestures? Is he jumpy, extremely tense, or laughing? Such intensifying of emotion may herald loss of control.
If your patient's violent behavior is a new development, he may have an organic disorder. Obtain a medical history and perform a physical examination. Watch for a sudden change in his level of consciousness. Disorientation, failure to recall recent events, and display of tics, jerks, tremors, and asterixis all suggest an organic disorder.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Psychotic behavior:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
Because the patient's behavior can make it difficult—or potentially dangerous—to obtain pertinent information, conduct the interview in a calm, safe, and well-lit room. Provide enough personal space to avoid threatening or agitating the patient. Ask him to describe his problem and circumstances that may have precipitated it. Obtain a drug history, noting especially the use of an antipsychotic, and explore his use of alcohol and other drugs, such as cocaine, indicating duration of use and amount and when it was last taken. Ask about recent illnesses or accidents.
As the patient talks, watch for cognitive, linguistic, or perceptual abnormalities such as delusions. Do thoughts and actions seem to match? Look for unusual gestures, posture, gait, tone of voice, and mannerisms. Does the patient appear to be responding to stimuli? For example, is he looking around the room?
Interview the patient's family. Which family members does he seem closest to? How does the family describe the patient's relationships, communication patterns, and role? Has a family member ever been hospitalized for psychiatric or emotional illness? Ask about the patient's compliance with his drug regimen.
Finally, evaluate the patient's environment, educational and employment history, and socioeconomic status. Are community services available? How does the patient spend his leisure time? Does he have friends? Has he ever had a close emotional relationship?
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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