topics / مواضيع

  Risk assessment Risk assessment is a crucial part of every psychiatric assessment. Consider: • Who is at risk? • What is the nature of the risk? • What is the likelihood of the risk? The person usually at risk, if anyone, is the patient themselves. The risk posed to others by people with mental disorder must Putting it all together: clinical vignettes • 325 16 Psychiatric rating scales The use of psychiatric rating scales as clinical tools in psychiatric assessment is increasing. Most were developed in research studies to make a confident diagnosis or to measure change in severity of illness. Some require special training; all must be used sensibly. In general, scales are too inflexible and limited in scope to replace a well-conducted standard psychiatric interview but they can be useful adjuncts for screening, measuring response to treatment or focusing on particular areas. In routine practice, scales are most widely used to assess cognitive function when an organic brain d

 The main difference between them is that delusions either lack a cultural basis for the belief or have been derived from abnormal psychological processes. Overvalued ideas These are usually beliefs of great personal significance. They fall short of being full delusions but are abnormal because of their effects on a person’s behaviour or wellbeing. For example, in anorexia nervosa, people may still believe they are fat when they are seriously underweight – and then respond to their belief rather than their weight, by further starving themselves. Delusional beliefs These beliefs also matter greatly to the person, resulting in powerful emotions and important behavioural consequences; they are always of clinical significance. They are classified by their content, such as: • paranoid • religious • grandiose • hypochondriacal • of guilt • of love • of jealousy • of infestation • of thought interference (broadcasting, insertion and withdrawal) • of control. Biza