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PDF Editor FAQ

How do psychiatrists diagnose personality disorders?

Both psychiatrists and clinical psychologists can diagnose personality disorders.The Psychological Assessment ProcessPsychiatrists, like psychologists assess the patient over three one-hour face to face sessions in an attempt to make a diagnosis.However, due to the complexity of personality disorders, both the above-mentioned clinicians may request to see the patient over a longer period of time.Experienced mental health clinicians often use a combination of their clinical judgement and assessment results. Clinical psychologists in particular, may administer personality tests to obtain detailed information that will either regulate or support their diagnostic hypothesis.Psychiatrists may conduct medical tests and refer the patient to allied health clinicians for further testing.The use of streamlined psychological assessment formsOver the years, mental health services have streamlined the psychiatric assessment process. Psychiatric assessment forms have been developed that consists of 10 or so pages of questions. The clinician must complete and sign the assess forms and file them in the patients medical records.The assessment forms prompt the clinician to ask questions related to cognitive and emotional functioning. Recent graduates find the assessment forms more useful than experienced clinicians.The mental health clinicians must also closely observe the patient during the assessment sessions. In particular, they have been trained to observe the patients body language, gait, eye contact, grooming and so on.The majority of mental health clinics develop their own psychiatric assessment forms. However, the majority of psychiatric assessment forms are very similar (an attempt to adhere to best practice guidelines).Specifically, a psychiatrist or clinical psychologist would collect the following information during a psychiatric assessment:presenting problems,demographic information,the patients medical and mental health history,the prevalence of mental illness in the client’s family (develop a Genogram),information regarding the client’s childhood,the number and duration of friendships the patient has had,the number of intimate relationships the client has had, in particular long-term relationships,clients current living conditions,a more detailed examination of current symptoms,a risk assessment, andother relevant areas.Please click on the link below to view a psychiatric assessment form developed by the Behavioural Healthcare Group:http://www.bhicares.org/wp-content/uploads/2016/12/NEW-Mental-Health-Assessment-Form.pdfIn additional to basically going through the assessment form, the psychiatrist or clinical psychologist must formulate a diagnostic hypothesis based on the information they collect from the assessment, previous assessments of the patient (from their file), and their clinical judgement.The clinician then weighs up all the information they have collected from the patient against the criteria for a specific DSM diagnosis (in this case, a personality disorder).Different Possible DSM Diagnoses For People With Personality Disorder’sIf after completing their assessment, a psychiatrist is not absolutely sure that the client meets DSM criteria for a specific personality disorder, they can offer a provisional or preliminary diagnosis that can be changed in future. However, they must assess the client again (several times) before making a formal diagnosis and note why they made such a decision.Alternatively, a client may be given a differential diagnosis if they appear to meet the criteria for two or more disorders. Differential diagnoses are made when patients present with a complex condition.The DSM classification system also allows a clinician to make a Not-Otherwise-Specified diagnosis if the patient doesn't appear to meet the criteria for any specific disorder. For example, Personality Disorder-Not Otherwise Specified.Clinical Psychology: Psychometric, Personality & Projective TestingIf a psychiatrist is not sure of a patients' diagnosis, they should refer the patient to a Clinical Psychologist for psychometric, personality and projective testing and an opinion.A clinical psychologist would generally use psychometric testing to test their hypothesis about a client’s diagnosis and personality structure. Many psychiatrists do not refer their patients to a clinical psychologist unless the client presents with a diagnostic dilemma.Most Western countries have laws that limit psychometric & personality testing to psychologists. The laws were passed because these tests require competent clinics such as psychologists to be administered correctly.Psychologists undergo extensive training that focuses on the administration, scoring and interpretation of these tests. Moreover, it is important that an experienced clinician sit with the client and explain the rest results.In fact, the Church of Scientology forced the Australian government to pass specific legislation pertaining to the administration of such psychological tests several decades ago. The Church of Scientology developed their own personality and IQ tests (unreliable and invalid) and encouraged people to sit their tests as a way of engaging potential followers.Psychometric tests include IQ tests such as the Wechsler Intelligence Scales (children, adults).Personality tests include the Psychological Inventory, Eysenck Personality Questionnaire, MMPI, Myers Briggs Personality test.Projective tests include the House Tree Person drawing test, Thematic Apperception Test, the Rorschach and others.These tests provide detailed information about the person. The psychologist examines the test results, the psychiatric assessment results and use their clinical judgement to formulate a diagnosis and treatment regime. The above-mentioned tests add another layer to the psychological assessment and hopefully increase the probability that the diagnosis is accurate.DSM Multi-Axial Diagnostic SystemI believe that psychiatrists and psychologists really should use the DSM Multi-Axial diagnostic system. The previous versions of the DSM used this system. However, the DSM 5 (current version) has done away with the system.They provided multiple reasons for the change, however, I do not believe that they made a good decision. I believe that the Multi-Axial diagnostic system provided a more in-depth understanding of a persons functioning.The Multi-Axial diagnostic system was designed to assist the mental health clinician to make a more detailed assessment of the patients function and life in general. For example, instead of making a Major Depressive or Personality disorder diagnosis, the clinician was able to make five Types of Axes By Disorder.The following information briefly outlines the five types of Axes:Axis 1: Major Depressive Disorder (acute clinical disorders);Axis 2: Personality Disorder/Intellectual Disability;Axis 3: Medical/Physical Conditions;Axis 4: Environmental/ Psychosocial Factors;Axis 5: Global Assessment of Functioning.I believe that it is important for experienced psychiatrists, clinical psychologists and other mental health clinicians to work with people that may have a personality disorder. I also believe that many inexperienced or unsuitable clinicians should not be working with people that have personality disorders (they only make matters worse).Kamal

Can alcohol trigger a schizophrenic state? I am asking because of the really strange and unpleasant feelings/states of mind I had during and after I drank. Also, I have a family history of mental illness.

The truth is that the truth is that yes alcohol or substances can bring about psychosis weather it is a form of schizophrenia or another type of psychosis it's hard to determine from your description without having a really good psychosocial assessment but with that said this is a pretty good article I wanted to look at to explore for yourself.Alcohol-Related Psychosis

How do you know when you're suffering from depression without going to see a doctor or a therapist?

You can experience depressive symptoms at times. That may or may not qualify as a depression dx. There is a lot of criteria to meet to have a dx form of depression that would be provided by a qualified Mental Health Specialist using a good psychosocial assessment as well as time spent teaming up with a mental health treatment team to determine if there is a mental health issue and dx. Depression can beA feeling or emotion developed related to life events and life stress or trauma.A symptom or set of symptoms that may be related to something else.A dx within a spectrum of possible diagnosis related to depression.

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